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Self-inflicted patient burns: suicide versus mutilation
G M Tuohig1, J R Saffle, J J Sullivan
1Department of Surgery, University of Utah Health Sciences Center, Salt Lake City 84132, USA.
The Journal of Burn Care & Rehabilitation
|July 1, 1995
Summary
Self-inflicted burns without suicidal intent, or self-mutilation, differ significantly from attempted suicide burns. Self-mutilation involves smaller burn sizes and controllable methods, contrasting with the severe injuries from attempted suicide by burning.
Area of Science:
- Burn Care
- Psychiatry
- Trauma Surgery
Background:
- Self-inflicted burns are often associated with suicide attempts.
- Limited data exists on self-mutilation by burning without suicidal intent.
- Distinguishing between self-mutilation and suicide attempts is crucial for appropriate treatment.
Purpose of the Study:
- To describe differences between self-mutilation and attempted suicide (AS) in patients with self-inflicted burns.
- To identify distinct characteristics, methods, and psychiatric profiles of these two groups.
- To inform burn care professionals about the syndrome of self-mutilation by burning.
Main Methods:
- Retrospective review of 31 patients admitted with self-inflicted burns between 1980 and 1991.
- Comparison of burn size, methods used, psychiatric diagnoses, and treatment outcomes between self-mutilation and AS groups.
- Analysis of demographic and clinical data, including previous self-inflicted burns and length of hospital stay.
Main Results:
- Self-mutilation group (16 patients) had significantly smaller mean burn size (1.6% TBSA) compared to AS group (15 patients, 35.4% TBSA; p < 0.0001).
- Self-mutilators used controllable methods (scalding, chemicals, contact) while AS patients often used flammable liquids.
- Self-mutilators had higher rates of personality disorders (56%), whereas AS patients more frequently had depression (47%). Nine (56%) self-mutilators had prior self-inflicted burns.
- AS group had longer hospital stays, more surgeries, and higher charges.
Conclusions:
- Self-mutilation by burning is a distinct syndrome requiring specialized psychiatric care alongside burn treatment.
- Burn care professionals must recognize the differences in presentation and underlying psychopathology between self-mutilation and suicide attempts.
- Early identification and appropriate psychiatric intervention are essential for managing patients with self-inflicted burns.