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Self-mutilation: a systematic review

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Abstract

Self-mutilation lesions can represent a clinical diagnosis challenge for healthcare professionals, as patients do not admit to self-mutilation. This leads to failed diagnoses due to the similarity of this condition to other diseases. Searches on the subject were carried out at the PubMed, Periódicos Capes, Scopus, Science Direct and WoS databases, according to the following inclusion criteria: articles in English, Portuguese or Spanish, published from 2018 to June 2023, encompassing case reports, case series and literature reviews. Men are slight more affected by self-mutilation injuries, also presenting the most serious lesions. Self-mutilation injuries are reported globally, mostly in the Asian and American continents. Clinical presentations are varied, but morphology is, in most cases, associated to the form/instrument used for self-mutilation. Greater evidence of diagnosed mental disorders in women and underreporting of these cases in men due to low demands for specialized treatment are noted. A higher prevalence of self-mutilation lesions was verified for men, affecting a wide age range, with the highest number of cases in the USA. The most affected body areas are arms and external genitalia, mostly due to knife use. An association between self-mutilation injuries and mental disorders is clear, with most cases being previously undiagnosed.

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Authors and Affiliations

  1. Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil

    Matheus Medeiros Nunes, Sérgio Adriane Bezerra de Moura & Pedro Paulo de Andrade Santos

  2. Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil

    Caio Rodrigues Maia, Antônio de Lisboa Lopes Costa & Pedro Paulo de Andrade Santos

  3. Postgraduate Program in Public Health, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil

    Paulo Roberto de Andrade Santos

  4. Centro de Biociências, Departamento de Morfologia, Universidade Federal do Rio Grande do Norte (UFRN), Campus Universitário, Lagoa Nova, CEP 59072-970, Natal, RN, Brasil

    Pedro Paulo de Andrade Santos

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P.P.A.S, M.M.N and C.R.M. performed the literature review, C.R.M, A.L.L.C, S.A.B.M and M.M.N. analysed the data, C.R.M and M.M.N. prepared the figures, and P.P.A.S and M.M.N. wrote the main manuscript text. P.P.A.S supervised the project, and A.L.L.C. and S.A.B.M reviewed the manuscript text. P.P.A.S, S.A.B.M and A.L.L.C supervised the project, offered senior supervision, and P.P.A.S reviewed the main manuscript text.

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Medeiros Nunes, M., Maia, C.R., de Andrade Santos, P.R. et al. Self-mutilation: a systematic review. Forensic Sci Med Pathol (2024). https://doi.org/10.1007/s12024-024-00809-4

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