Repetitive selfmutilation Clinical description

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Repetitive self-mutilation, also called deliberate self-harm or self-injurious behaviour, is the repeated, direct destruction of body tissue without suicidal intent. (2,29 and 30> Examples include skin cutting, skin burning, self-hitting, severe skin scratching, and even bone breaking. A wide range of body parts are mutilated, such as arms, legs, abdomen, head, chest, and genitals.

Although recommendations that repetitive self-mutilation be included as a formal impulse control disorder not elsewhere classified in DSM-IV were rejected because of concerns that it was usually a symptom of borderline personality disorder, numerous clinical studies suggest that this syndrome does in fact meet the DSM-IV and ICD-10 concepts of impulse control disorders, and as such, may exist in the absence of borderline personality disorder. (2 29 and 30) Specifically, repetitive self-mutilation is characterized by intrusive, recurrent, and irresistible impulses to harm oneself without suicidal intent that are associated with increasing tension, anxiety, anger, or other dysphoric states, along with relief of the uncomfortable affect with or shortly after the act of self-harm. In addition, the act of self-harm is often not associated with pain and performed privately.

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