Patel V, de Moore G
Department of Psychiatry, Westmead Hospital, NSW, Australia.
J Clin Psychiatry. 1994 Mar;55(3):98-103.
Stabbing is an uncommon method of self-harm that has not been previously described in the psychiatric literature. The aim of this study was to describe the clinical features and management of patients presenting with self-inflicted stab injuries.
Case notes of all patients presenting with deliberate self-inflicted injuries during a 2-year period to a teaching general hospital were screened to identify the sample of interest. Clinical data were then collected by means of a detailed case-note study.
Ten patients who deliberately stabbed themselves were identified. The patients fell into two distinct clinical groups: the first consisted mostly of young men with antisocial personalities who were intoxicated at the time of the self-stabbing and who reported ambivalent suicidal intent; the second consisted of psychotic patients, most of whom were actively ill at the time of the self-stabbing, and who reported clear suicidal intent. Patients in the first group were noncompliant with treatment and difficult to engage; those in the second group needed psychiatric hospitalization and often responded to antipsychotic medication.
Persons who stab themselves tend to fall into two clinical groups that have different diagnoses and management. Distinctions between violent suicidal behavior and self-mutilation are blurred because suicidal intent can be difficult to assess.
刺伤是一种不常见的自我伤害方式，此前尚未在精神病学文献中被描述。本研究的目的是描述自我刺伤患者的临床特征及治疗方法。
对一家教学综合医院在两年期间所有出现故意自我伤害的患者病历进行筛查，以确定感兴趣的样本。然后通过详细的病历研究收集临床数据。
确定了10名故意刺伤自己的患者。这些患者分为两个不同的临床组：第一组主要由具有反社会人格的年轻男性组成，他们在自我刺伤时处于醉酒状态，且自述有矛盾的自杀意图；第二组由精神病患者组成，他们中的大多数在自我刺伤时病情活跃，且自述有明确的自杀意图。第一组患者不配合治疗且难以参与治疗；第二组患者需要精神科住院治疗，且常常对抗精神病药物有反应。
刺伤自己的人往往分为两个临床组，其诊断和治疗方法不同。由于自杀意图可能难以评估，暴力自杀行为和自残之间的区别很模糊。
