Exploring various factors of major self-mutilation in psychosis: A case series from North India

Self-injurious behavior can be seen in various physical and psychiatric illnesses. Violence toward self is higher as compared toward others in psychotic illness. This relationship is complex and is associated with various clinical factors such as nature and severity of delusion and hallucinations, frequency of hallucinations, certain positive symptoms, duration of untreated psychosis, social isolation, substance use, age and gender of the patient, poor compliance to treatment and lack of follow up, and sociocultural factors such as lack of insight regarding mental illness in attendants of patients, the stigma associated with mental illness and treatment, the belief of supernatural causation of psychotic symptoms, and having more faith on indigenous alternative/complementary method of treatment. Here, we present case series of people who were suffering from some form of psychosis and presented to us with a severe self-inflicted injury. We emphasize on the potential benefit of early identification and redressal of the abovementioned clinical and sociocultural factors associated with higher MSM in patients with psychotic illness and prompt intervention and treatment in such types of cases for a better outcome.