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| Medical Education Section |
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Diagnosis:
"Deliberate Self Harm Syndrome," (Cutters)
“Cutters”
This patient suffers from what is known as "Deliberate Self Harm Syndrome," also called "complex post-traumatic stress disorder" (PTSD), "Repetitive Self-Harm Syndrome" or "multiple personality/dissociative identity disorders" (MPD/DID). Many of these people simply call themselves "Cutters," and some simply call what they do SI, or self-injury, and use SI as a verb, as in "I SI once a month".
The majority of cutters are women, between the ages of 13 and 30, but there are cutters of every age and gender. Many cutters have been sexually and/or physically abused during childhood. It is estimated that slightly less than 1 in 1000 people in the U.S. suffer from this condition.
Interestingly, the majority “cutters” are not suicidal. The act of cutting, oddly, gives a sense of both control and calm. Many will go to great lengths to wear clothing to hide the scars. The scars are a loud cry that something is very wrong and that they need help. Obviously, this is a very complex psychiatric condition that requires the help of skilled professionals.
As the WebMD article/link below mentions, if you see a patient with “cutter’s scars”, you should carefully but directly ask them about it, tell them that you are concerned and worried about them and want them to get help, and then gently guide them to skilled professionals who treat the condition.
Articles/links
http://en.wikipedia.org/wiki/Self-harm
http://women.webmd.com/features/when-pain-is-all-you-have
To view other "Crutchield Dermatology Clinical Cases of the Month" in our archives please click here
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