Intentional Self-inflicted Burn Injuries: Review of the Literature

Background: Intentional self-inflicted burn injuries are a rare occurrence in the United States, but they represent a considerable portion of all burn injuries in the developing world. Compared to nonintentional burns, patients with intentional self-inflicted burns have increased rates of higher total body surface area involvement and associated complications, including overall mortality. Methods: We present 2 representative cases and review the available literature on the topic of self-inflicted burns. We review epidemiologic, social, and cultural factors of importance, and also provide an overview of most common psychiatric pathologies encountered in patients with self-inflicted burns. Results: The patient demographics and motivation for intentional self-inflicted burn injuries differ considerably across the world. Although self-immolation is commonly associated with women experiencing domestic stress in the developing world, most cases of self-immolation in higher-income countries are males. Psychiatric pathologies, including primary mood and thought disorders and substance use, play a significant component in latter cases, while most patients in the developing world lack any pre morbid psychiatric diagnosis, or carry diagnosis of adjustment disorder. Conclusions: Nonlethal self-burns present a distinct subset of intentional self-burn injuries, often occurring in the context of significant personality pathology, or with potential secondary gain.