Abstract
Self-neglect is a recognised, but poorly emphasised, complication of spinal cord injury, with a prevalence in this study of 9% of a consecutive sample of 400 patients. Self-neglect may be the presenting symptom of problems related to adjustment to disability, a major depressive disorder (DSM III criteria), or a clear and rational wish to die (existential self-neglect). Management is discussed, emphasising the importance of respecting spinal injured patients' autonomy.