Between 1990 and 2000, the overall rate of hospitalization for children and adolescents who intentionally injured themselves declined only slightly. However, the average length of these hospital stays decreased significantly, and diagnoses shifted toward more severe conditions, e.g., bipolar disorder. Olfson et al. (p. 1328) derived these findings from over 10,000 hospitalizations for self-inflicted injuries of patients ages 5–20 years. Although the rate did not change overall, hospitalizations increased for children ages 5 to 9 years, for ingestion of acetaminophen and antidepressants, and for injuries from cutting and from hanging or suffocating. Cutting may be more closely related to self-mutilation than to suicidal behavior, however, and without it the rate of hospitalizations for self-inflicted injuries shows an actual decline, from 47.2 per 100,000 population in 1990 to 39.4 per 100,000 in 2000.