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Intracranial Self-Stabbing

Large, Matthew BSc(Med), MBBS, FRANZCP*†; Babidge, Nicholas MBBS, FRANZCP; Nielssen, Olav MBBS, MCrim, FRANZCP†§

The American Journal of Forensic Medicine and Pathology: March 2012 - Volume 33 - Issue 1 - p 13–18
doi: 10.1097/PAF.0b013e3181dd5b47
Original Articles

Background Little is known about the psychiatric state of patients who stab themselves in the brain (intracranial self-stabbing), including whether the behavior is usually an attempt to commit suicide and whether it is performed in association with symptoms of psychotic illness.

Method A search for cases of intracranial self-stabbing in New South Wales, Australia (NSW), and a systematic search for published case reports of intracranial self-stabbing.

Results We located 5 cases in NSW in the last 10 years and 47 published case reports of intracranial self-stabbing since 1960. Intracranial self-stabbing was associated with a diagnosis of a psychotic illness in 27 of 49 (55%) cases in which a diagnosis was available. Intracranial self-stabbing was not always performed with the intention of committing suicide and does not usually have a fatal outcome.

Conclusions Intracranial self-stabbing appears to be an under-recognized form of self-harm that is associated with, but not limited to, psychotic illness.

From the *Mental Health Service, Prince of Wales Hospital, Randwick, NSW, Australia; †School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; ‡Mental Health Service, Sutherland Hospital, Caringbah, Australia; and §Mental Health Service, St Vincent’s Hospital, Darlinghurst, Australia.

Manuscript received October 8, 2009; accepted November 16, 2009.

The authors report no conflicts of interest.

Reprints: Matthew Large, BSc(Med), MBBS, FRANZCP, The Euroa Centre, Mental Health Services, The Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.