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Cutting and Self-Harm

Chelsea Hayes Thompson, MD and Spencer A Dean, B.S. Exercise Science, D.O. Reviewed 06/2022
 


BASICS

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

DESCRIPTION

  • NSSI is broadly defined as deliberate s...

DIAGNOSIS

HISTORY

  • Use a nonjudgmental tone and “respectful curiosity” when interviewing patients who disclose history of self-injury.

  • Explain confidentiality and applicable limitations.

  • Address immediate...

TREATMENT

GENERAL MEASURES

  • Often necessary to treat underlying/comorbid psychiatric disorders before directly addressing NSSI.

  • Most patients benefit from a multidisciplinary approach to treatment with c...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • 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 modal...

REFERENCES

1
Cipriano  A, Cella  S, Cotrufo  P. Nonsuicidal self-injury: a systematic review. Front Psychol.  2017;8:1946. [View Abstract on OvidMedline] ...

ADDITIONAL READING

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

  • ...

CODES

ICD10

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

SNOMED

  • 248073004 Cutting self

  • 248061004 Self-harm

  • 248062006 Self-injurious behavior

CLINICAL PEARLS

  • NSSI should be viewed as a maladaptive coping mechanism for intra- or interpersonal distress rather than a suicidal gesture/behavior.

  • Although not a suicidal gesture, NSSI may be a stro...

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