Self-mutilations are defined as an intentional behaviour that involves direct aggression to the person's body, without aware suicide intention. The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) included self-mutilation as part of the diagnostic criteria for the other specified disruptive, impulse-control, and conduct disorder or borderline personality disorder. Later, the DSM-5 suggests that this behavior constitutes a separate diagnostic entity. Despite the growing concern regarding the increased incidence of self-mutilation among adolescents, there is still no consensus on the pathogenesis of this behavior. Recent studies have suggested that, in some cases, non-suicidal self-injurious behavior may be understood as an addictive behavior. Based on this hypothesis, several researchers have conducted genetic, neurobiological and clinical studies, to verify the existence of common pathways between these two nosological entities.

The aim of this study is to conduct a literature review of studies that propose an additive model for self-injurious behavior, discussing its implications in the diagnostic and therapeutic interventions.

Articles indexed in the Pubmed database were analyzed as well as book and studies published in scientific journals.

A better understanding of the pathogenesis of self-mutilation is crucial to our diagnostic and therapeutic interventions. Unfortunately, studies done on this topic in the past were inconclusive. Further clarification, through new studies, is needed in order for us to help adolescents with this behavior in a more effective way.

The authors have not supplied their declaration of competing interest.