This article examines self-mutilation both as a symptom of mental disorders & as a distinct syndrome with an autonomous course. Data from the literature & extensive clinical experience was reviewed. A typology of self-mutilation is presented in 3 categories: major, stereotypic, & superficial or moderate. The authors propose that a syndrome of repetetive superficial or moderate self-mutilation should be regarded as axis I disorder. In most cases it coexists with character pathology. (80 Refs.)