The surgeon and self-harm: At the cutting edge

Kinahan, James; MacHale, Siobhan

doi:10.1016/j.surge.2014.03.002

Cited by 6 publications

(11 citation statements)

References 10 publications

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“…Self-harm is a serious self-destructive behavior that implies psychological suffering, can have long-term and profound effects on a person’s quality of life, and challenges the health care system [ 1 , 2 ]. It is also demanding on close friends and family.…”

Section: Introductionmentioning

confidence: 99%

Deliberate self-harm behavior among young violent offenders

et al. 2017

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Deliberate self-harm behavior (DSH) can have profound effects on a person’s quality of life, and challenges the health care system. Even though DSH has been associated with aggressive interpersonal behaviors, the knowledge on DSH in persons exhibiting such behaviors is scarce. This study aims to (1) specify the prevalence and character of DSH, (2) identify clinical, neurocognitive, psychosocial, and criminological characteristics associated with DSH, and (3) determine predictors of DSH among young violent offenders. Data were collected from a nationally representative cohort of 270 male violent offenders, 18–25 years old, imprisoned in Sweden. Participants were interviewed and investigated neuropsychologically, and their files were reviewed for psychosocial background, criminal history, mental disorders, lifetime aggressive antisocial behaviors, and DSH. A total of 62 offenders (23%) had engaged in DSH at some point during their lifetime, many on repeated occasions, yet without suicidal intent. DSH was significantly associated with attention deficit hyperactivity disorder, mood disorders, anxiety disorders, various substance use disorders, being bullied at school, and repeated exposure to violence at home during childhood. Mood disorders, anxiety disorders, and being bullied at school remained significant predictors of DSH in a total regression model. Violent offenders direct aggressive behaviors not only toward other people, but also toward themselves. Thus, DSH must be assessed and prevented in correctional institutions as early as possible, and more knowledge is needed of the function of DSH among offenders.

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Section: Introductionmentioning

confidence: 99%

Deliberate self-harm behavior among young violent offenders

et al. 2017

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“…2,4 Although self-harm can occur within the whole population, it is more prevalent among those who are socially deprived and/or have a history of major childhood trauma (emotional, physical or sexual abuse). 5,6 The most common method of self-injury is by cutting oneself; others range from minor lesions such as burning, self-poisoning and alcohol abuse, to serious permanent damage including eye enucleation, genital mutilation and amputation of the tongue or ear. 2,4,7 Although suicide is not the intention of self-harm, the relationship between self-harm and suicide is often complex; as self-harming behaviour may be potentially life-threatening.…”

Section: Introductionmentioning

confidence: 99%

“…2,4,7 Although suicide is not the intention of self-harm, the relationship between self-harm and suicide is often complex; as self-harming behaviour may be potentially life-threatening. Furthermore, there is also an increased risk of suicide in individuals who self-harm 5,8,9,10 , especially in males with previous psychiatric history and/or self-harm. 11 According to data collected by Owens et al, 1.8% of people who harm themselves commit suicide within a year following an incident 9 and those who repeat self-harm are twice as likely to die by suicide compared with those who selfharm only once 10 .…”

Section: Introductionmentioning

confidence: 99%

“…5 Self-harm imposes a significant cost to society; besides increased health care costs as a result of multiple presentations to health professionals, there can be an effect on workplace attendance, the costs of long-term disability and premature mortality. 5,10 The last few years have seen a rise in the number of self-harm cases reported in the relevant literature 12 , although only a handful have been described within the maxillofacial specialty. Figures published in 2014 suggested a 70% increase in 10-14 year olds attending to the accident and emergency department (A & E) for self-harm related reasons over the preceding 2 years.…”

Section: Introductionmentioning

confidence: 99%

“…13 It is therefore essential that clinicians learn to recognize cases which could potentially involve severe outcomes. 5 Lewis and colleagues estimated that additional interventions following self-harm reduces the rate of subsequent suicide by 25%. 9 We present two cases of adolescents who attended A & E on multiple occasions due to repeated episodes of self-harming behaviour; mainly the insertion of FBs and self-inflicted cuts to the face, neck and scalp.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of Self-Harm Injuries in the Maxillofacial Region: A Report of 2 Cases and Review of the Literature

Malaga

Aguilera

Eaton

et al. 2016

Journal of Oral and Maxillofacial Surgery

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Clinicians face numerous challenges when managing psychiatric patients who self-inflict injuries within the maxillofacial region. In addition to a complex clinical examination, there are both surgical and psychiatric factors to consider, such as the risk of damaging vital structures, the exacerbation of the patient's psychiatric status, and the long-term psychosocial and esthetic sequelae. We present 2 cases of adolescents who repeatedly self-inflicted wounds and/or inserted foreign bodies (FBs) into the face, scalp, and neck. The different treatment modalities were based on full evaluation of the patient's clinical, medical, and diagnostic test findings coupled with a psychiatric assessment. The decision for conservative management or surgical intervention was made according to the presence and location of the FBs, degree of hemorrhage, signs and symptoms of infection, and unpleasant scars that could lead to long-term psychological impairment. In most cases, the FBs were removed and the wounds were toileted and closed under local or general anesthesia. We advocate a holistic approach via a multidisciplinary team, which is deemed essential to provide the highest quality of care for patients to reduce the risk of further relapses. Lastly, a satisfactory esthetic outcome is always paramount to achieve long-term psychological and physical welfare.

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