Hyman S L, Fisher W, Mercugliano M, Cataldo M F
Kennedy Institute for Handicapped Children, Baltimore, Maryland.
Pediatrics. 1990 Mar;85(3 Pt 2):437-41.
Self-injurious behavior is a serious problem that is not uncommon among individuals with mental retardation. Medical and developmental characteristics of 97 children, adolescents, and young adults (age range 11 months to 21 years, 11 months) assessed and treated for self-injurious behavior in a specialized, interdisciplinary inpatient unit between 1980 and 1988 were reviewed. This population differed from those reported in previous studies in that it was of school age and predominantly community based. Severe or profound mental retardation was present in 82.5% of our patients. The causative diagnoses associated with self-injurious behavior were similar to those of severe mental retardation alone. Associated disabilities represented at greater than expected frequencies included pervasive developmental disorders, visual impairment, and a history of infantile spasms. Most patients (81.4%) engaged in more than one type of self-injurious behavior. The most common topographies were head banging, biting, head hitting, body hitting, and scratching. Physical injury was documented in 77% of cases; the injuries most frequently reported were excoriations, scars/callus formation, hematomas, and local infection. As community placement of handicapped individuals continues to increase, pediatricians will be called upon to monitor patients who engage in self-injurious behavior.
自伤行为是一个严重的问题，在智力障碍者中并不罕见。回顾了1980年至1988年间在一个专门的跨学科住院单元接受评估和治疗的97名儿童、青少年和青年（年龄范围为11个月至21岁11个月）的自伤行为的医学和发育特征。该人群与以往研究报道的人群不同，因为它是学龄期的，且主要以社区为基础。我们82.5%的患者存在重度或极重度智力障碍。与自伤行为相关的病因诊断与单纯重度智力障碍的病因诊断相似。出现频率高于预期的相关残疾包括广泛性发育障碍、视力障碍和婴儿痉挛病史。大多数患者（81.4%）存在不止一种自伤行为类型。最常见的形式是撞头、咬、打头部、打身体和抓挠。77%的病例有身体损伤记录；最常报告的损伤是擦伤、疤痕/胼胝形成、血肿和局部感染。随着残障人士社区安置的持续增加，儿科医生将被要求监测有自伤行为的患者。
