Q. I `m researching self-injury (repetitive, superficial self-injury as a coping mechanism), and have come to understand that many self injurers have in the past been misdiagnosed as borderline because of their self injury. It has been suggested that Self Injury be included in DSM axis 1, perhaps in its own category -not as a symptom, but as a disease. I'm wondering what is currently being discussed around this subject, and if there has been any progress ?

A. There are other illnesses associated with self injury, but when we see it in an adult with depression or anxiety, it is BPD 99% of the time. Even if it is not, the treatment is pretty much the same.

I am not aware of any rumblings in the psychiatric community to include self-injury as a distinct Axis I diagnosis.