The Role of Social Contagion in Initiating Non-Suicidal Self-Injury in Schizophrenia: A Case Report

Non-suicidal self-injury (NSSI) is a highly prevalent maladaptive behavior with studies indicating that it can affect between 40-80% of individuals with schizophrenia spectrum disorder. NSSI can arise during any point during the course of schizophrenia spectrum disorder and has the potential to suddenly manifest as major-self mutilation (MSM), a particularly severe and catastrophic form of NSSI. Although the motivation for NSSI/MSM varies by patient, the literature indicates that there are factors associated with these behaviors such as first-episode psychosis, command hallucinations, and past self-harming episodes. In this case report, the authors discuss a rare case of a 25-year-old male with schizophrenia who presented with ligature of multiple digits on both hands. The authors examine this rare presentation and how it is suspected to be linked to a similar case in nearby Los Angeles county through social contagion. Through this case, the authors aim to highlight the prevalence of NSSI, the potential for NSSI to transform to MSM, and the need for ongoing screening for these behaviors in those with psychotic disorder diagnoses.