青少年治疗抵抗性双相障碍患者自伤行为演变

Background Bipolar disorder is frequently associated with non-suicidal self-injury (NSSI), the manifestations of which vary across the illness course. Ear piercing may represent a covert alternative form of self-injury with an NSSI-like function that is commonly overlooked in clinical practice; consequently, reports documenting this phenomenon remain scarce. Case summary This report describes an 18-year-old female with treatment-resistant bipolar disorder whose self-injurious behavior evolved from wrist cutting to periungual skin picking and, ultimately, to 11 self-inflicted ear piercings with