Epidemiology and course

The prevalence of narrowly defined repetitive self-mutilation is unknown. Available studies, however, suggest that repetitive self-mutilation is more common in women than men, usually begins early in life (e.g. late childhood, adolescence, and early adulthood), and may persist for 10 to 15 years. Associated psychopathology and comorbidity

Repetitive self-mutilation often co-occurs with other Axis I and II psychiatric disorders, especially mood, substance use, eating, psychotic, and borderline personality disorders. For example, in a 1983 review of 56 cases from the literature of patients with the 'deliberate self-harm syndrome', 45 per cent of patients were depressed, 41 per cent were psychotic, and 36 per cent were substance abusers.(28) In another evaluation of 54 psychiatric inpatients with 'self-injurious behaviour', eating disorders were the most common associated ICD-10 Axis I diagnosis, present in 54 per cent of patients, followed by substance use (33 per cent), affective disorders (20 per cent), and schizophrenic disorders (18 per cent). (29> Borderline and histrionic were the most frequent personality disorders, present in 52 and 23 per cent of the group, respectively. However, 22 per cent of patients did not fulfil criteria for any personality disorder.

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