Harakiri: a clinical study of deliberate self-stabbing

J Clin Psychiatry. 1994 Mar;55(3):98-103.


Background: Stabbing is an uncommon method of self-harm that has not been previously described in the psychiatric literature. The aim of this study was to describe the clinical features and management of patients presenting with self-inflicted stab injuries.

Method: Case notes of all patients presenting with deliberate self-inflicted injuries during a 2-year period to a teaching general hospital were screened to identify the sample of interest. Clinical data were then collected by means of a detailed case-note study.

Results: Ten patients who deliberately stabbed themselves were identified. The patients fell into two distinct clinical groups: the first consisted mostly of young men with antisocial personalities who were intoxicated at the time of the self-stabbing and who reported ambivalent suicidal intent; the second consisted of psychotic patients, most of whom were actively ill at the time of the self-stabbing, and who reported clear suicidal intent. Patients in the first group were noncompliant with treatment and difficult to engage; those in the second group needed psychiatric hospitalization and often responded to antipsychotic medication.

Conclusion: Persons who stab themselves tend to fall into two clinical groups that have different diagnoses and management. Distinctions between violent suicidal behavior and self-mutilation are blurred because suicidal intent can be difficult to assess.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Antisocial Personality Disorder / diagnosis
  • Antisocial Personality Disorder / epidemiology
  • Antisocial Personality Disorder / psychology
  • Australia / epidemiology
  • Comorbidity
  • Emergency Service, Hospital
  • Female
  • Hospitals, General
  • Humans
  • Male
  • Middle Aged
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology
  • Self-Injurious Behavior / diagnosis*
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / psychology
  • Sex Factors
  • Suicide, Attempted / statistics & numerical data
  • Wounds, Stab / diagnosis*
  • Wounds, Stab / epidemiology
  • Wounds, Stab / psychology