Self inflicted upper limb injuries in a tertiary care rural Plastic Surgery unit - A psychiatric evaluation

Joice Geo; Cyril Joseph; Chintu Sabu George; Roy Abraham Kallivayalil

doi:10.30834/KJP.33.2.2020.192

Authors

Joice Geo Associate Professor in Psychiatry, Pushpagiri Medical College, Thiruvalla, Kerala
Cyril Joseph Associate Professor and HOD in Plastic and Reconstructive Surgery, Pushpagiri Medical College, Thiruvalla
Chintu Sabu George ssistant Professor in Plastic Surgery, Pushpagiri Medical College, Thiruvalla, Kerala
Roy Abraham Kallivayalil Professor and HOD in Psychiatry, Pushpagiri Medical College, Thiruvalla, Kerala

DOI:

https://doi.org/10.30834/KJP.33.2.2020.192

Keywords:

self inflicted injuries, plastic surgery, psychiatric co-morbidity

Abstract

Background: Deliberate self-harm patients (DSH) with upper limb injuries are commonly admitted in the plastic surgery units. Psychiatric comorbidities are risk factors for these patients with self-inflicted injuries. A multidisciplinary team approach is needed.

Methods: Patients who presented with self-inflicted upper limb injuries in the plastic surgery department were referred for psychiatric liaison services. Socio-demographic data, mode of injury, plastic surgical procedures, and psychiatry diagnosis were noted.

Results and discussion: Out of 48 patients, 20 (41.6%) belong to the 21-30 age group, 30 (62.5%) were males. 43 (89.6%) patients needed major plastic surgery procedures. The major psychiatric comorbidities were depressive disorder (27.1%), adjustment disorder (16.6%), alcohol dependence syndrome (14.6%), and bipolar mood disorder (12.5%). High psychiatric morbidity among self-inflicted hand injuries suggests the need for a multidisciplinary approach and long term follow-up.

Conclusion: Psychiatric liaison services are important in the treatment of self-inflicted upper limb injuries.

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