Cutting and Self-Harm

Chelsea Hayes Thompson, MD and Megan M. Sick, MD Reviewed 06/2019

BASICS

Synonyms: nonsuicidal self-injury (NSSI); deliberate self-harm; self-injurious behavior; self-mutilation; self-wounding; parasuicide; cutting

Use a nonjudgmental tone and “respectful curiosity” when interviewing patients who disclose history of self-injury.
Explain confidentiality and applicable limitations.
Address immediate...

Often necessary to treat underlying/comorbid psychiatric disorders before directly addressing NSSI
Most patients benefit from a multidisciplinary approach to treatment with co...

Close follow-up after initial disclosure, ideally within 1 to 2 weeks
Establish care with a mental health professional that can offer an appropriate therapy modali...

Cipriano A, Cella S, Cotrufo P. Nonsuicidal self-injury: a systematic review. Front Psychol. 2017;8:1946. [View Abstract on OvidMedline]

Fox KR, Franklin JC, Ribeiro JD, et al. Meta-...

Matney J, Westers NJ, Horton SE, et al. Frequency and methods of nonsuicidal self-injury in relation to acquired capability for suicide among adolescents. Arch Suicide Res. 20...

X78.1xxA Intentional self-harm by knife, initial encounter

E956 Suicide and self-inflicted injury by cutting and piercing instrument

NSSI should be viewed as a maladaptive but effective coping mechanism for intra- or interpersonal distress rather than a suicidal gesture/behavior.
Although not a suicidal gesture, NSSI...

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