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Patterns of wrist cutting: A retrospective analysis of 115 suicide attempts

  • Cho, Jakwang (Department of Plastic and Reconstructive Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Choi, Youngwoong (Department of Plastic and Reconstructive Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine)
  • Received : 2020.01.17
  • Accepted : 2020.05.05
  • Published : 2020.05.15

Abstract

Background Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

Keywords

References

  1. Matsumoto T, Yamaguchi A, Chiba Y, et al. Patterns of self-cutting: a preliminary study on differences in clinical implications between wrist- and arm-cutting using a Japanese juvenile detention center sample. Psychiatry Clin Neurosci 2004;58:377-82. https://doi.org/10.1111/j.1440-1819.2004.01271.x
  2. Rosenthal RJ, Rinzler C, Wallsh R, et al. Wrist-cutting syndrome: the meaning of a gesture. Am J Psychiatry 1972;128: 1363-8. https://doi.org/10.1176/ajp.128.11.1363
  3. Simpson MA. The phenomenology of self-mutilation in a general hospital setting. Can Psychiatr Assoc J 1975;20:429-34. https://doi.org/10.1177/070674377502000601
  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.
  5. Lee CH, Cha SM, Shin HD. Injury patterns and the role of tendons in protecting neurovascular structures in wrist injuries. Injury 2016;47:1264-9. https://doi.org/10.1016/j.injury.2016.01.044
  6. Kisch T, Matzkeit N, Waldmann A, et al. The reason matters: deep wrist injury patterns differ with intentionality (accident versus suicide attempt). Plast Reconstr Surg Glob Open 2019;7:e2139. https://doi.org/10.1097/GOX.0000000000002139
  7. Statistics Korea. Population Census [Internet]. Daejeon: Statistics Korea [cited 2018 Oct 30]. Available from: http://kostat.go.kr/portal/korea/index.action.
  8. Chuinard RG, Friermood TG, Lipscomb PR. The 'suicide' wrist: epidemiologic study of the injury. Orthopedics 1979; 2:499-503. https://doi.org/10.3928/0147-7447-19790901-07
  9. Ersen B, Kahveci R, Saki MC, et al. Analysis of 41 suicide attempts by wrist cutting: a retrospective analysis. Eur J Trauma Emerg Surg 2017;43:129-35. https://doi.org/10.1007/s00068-015-0599-4
  10. Razvodovsky YE. Suicide and alcohol psychoses in Belarus 1970-2005. Crisis 2007;28:61-6. https://doi.org/10.1027/0227-5910.28.2.61
  11. Hawton K, Bergen H, Cooper J, et al. Suicide following self-harm: findings from the multicentre study of self-harm in England, 2000-2012. J Affect Disord 2015;175:147-51. https://doi.org/10.1016/j.jad.2014.12.062
  12. Suyemoto KL. The functions of self-mutilation. Clin Psychol Rev 1998;18:531-54. https://doi.org/10.1016/S0272-7358(97)00105-0