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Self-Inflicted Burns: A Systematic Review of the Literature

Hahn, Anne P. PhD*; Jochai, Diana PhD; Caufield-Noll, Christine P. MLIS, AHIP; Hunt, Carly A. MA; Allen, Lauren E. MA§; Rios, R. PhD; Cordts, Grace A. MD, MPH

doi: 10.1097/BCR.0b013e31828b0a46
Review Article

Suicide attempts by self-immolation are relatively rare in North America, but the physical, psychological, and social effects on the patients, families, and staff are significant. An understanding of the characteristics of the self-inflicted burn population is imperative to better inform acute, postacute, and long-term care. The goal of the present systematic review is to summarize existing literature findings on self-inflicted burns in the United States. Seven databases were searched for articles published between 1970 and 2011 in the English language, which investigated self-burning. Thirty-two articles met selection criteria for inclusion. Review of the literature revealed that published studies on self-inflicted burns are scarce, inconclusive, and weak in design. Most studies contained limited contextual information and limited data on the long-term outcomes of survivors of self-inflicted burn injuries. Despite lack of consistency in data-collection methods and contradictory findings across studies, this review provides insight into both the characteristics of self-immolators and the context in which self-immolation events occur. A picture emerged of a group of individuals who act impulsively in the context of psychiatric and or alcohol/drug disorder, and individuals who may be reacting to stressful life events and loss. Although sparse, the existing data examining long-term outcomes in the self-inflicted burn population indicate that survivors can be successfully rehabilitated, provided that early and intense psychiatric and social interventions are in place. Future investigations are needed to further inform the development of best practices for every phase of treatment and recovery of self-inflicted burn survivors.

From the *Adult Burn Unit, Johns Hopkins Burn Center; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine; Harrison Medical Library, Johns Hopkins Bayview Medical Center; §Department of Health Policy and Management, Johns Hopkins School of Public Health; Division of General Internal Medicine, Johns Hopkins School of Medicine; and Veterans Administration Maryland Health Care System, Baltimore, Maryland.

Address correspondence to A. Hahn, PhD, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, Maryland 21224.

© 2014 The American Burn Association