Self-embedding of objects in body a puzzling teen disorder

Some teens are wounding themselves and embedding objects such as paper clips and glass to cope with disturbed thoughts and feelings, say U.S. doctors who are looking for ways to remove the objects safely.

Self-embedding moves beyond self-injury, such as cutting the skin, burning, bruising or pulling hair, breaking bones or swallowing toxic substances.

The prevalence is unknown because many cases go unreported, but recent studies reported that 13 to 24 per cent of high school students in the U.S. and Canada have deliberately injured themselves at least once, according to research presented at the Radiological Society of North America's annual meeting in Chicago on Wednesday.

"We identified a group of 10 patients over a three-year period of time that have this pattern of self-inflicted injury," said Dr. William Shiels, chief of radiology at Nationwide Children's Hospital in Columbus, Ohio, who presented his findings on developing a minimally invasive surgical technique to remove the objects at the meeting.

"It's cutting gone to the next level."

Before 2005, Shiels said, he had never seen a case. Shiels and his colleagues studied 19 episodes of self-embedding injury in nine young women and one male, all aged 15 to 18.

Teens inserted the objects into their arms, hands, feet, ankles and necks, the researchers said.

In agitated state

Most had significant psychiatric problems, including depression. The teens reported they were in an agitated state and that the embedding brought a degree of comfort, Shiels said.

Researchers have speculated that self-injury may release natural opiates in the brain.

Pediatric radiologists used ultrasound and fluoroscopic imaging to guide their removal of 52 embedded objects — including needles, staples, paper clips, wood, plastic, crayon and stone — that could not normally be detected in X-rays.

The technique offers surgeons and emergency physicians a safe and effective way to remove objects that could break apart using traditional surgical techniques, said co-author Adam Young.

The act of cutting itself may not be a suicide attempt, but self-injurers were nine times more likely to have attempted suicide than those with no history of self-injury, said Wendy Lader, a psychologist and co-founder of S.A.F.E. Alternatives, a treatment program for self-injury disorders in Naperville, Ill.

"They are trying desperately to find ways to cope with life's problems, and suicide is definitely an option," Lader said.