1/35. female genital self-mutilation, dysorexia and the hysterical personality: the Caenis Syndrome.A detailed case report of female genital self-mutilation associated with dysorexia and the hysterical personality is presented. This lends support to recent literature that has suggested the possibility that these clinical features may comprise a discrete syndrome. The usefulness of considering this triad as a syndrome is illustrated by its facilitating the recall of two previous patients who in retrospect appear to fulfil these criteria. It is suggested that the name Caenis syndrome be given to this triad of behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/35. Oral self-mutilation in a patient with rhombencephalosynapsys.Rhombencephalosynapsis (RS) is a rare cerebellar malformation. Its essential features are the absence of the incisura cerebelli posterior, fusion of the cerebellar hemispheres, the absence of the velum medullare anterius and nuclei fastigii, and fusion of the dentate nuclei, which are shifted towards the mid-line. Clinically, affected patients present with signs of cerebellar and motor disturbances. The present report describes a new patient affected by RS. The subject first presented at the age of 22 years because of a psychiatric symptomatology which was characterized by obsessive oral self-mutilation associated with an intellectual disability. Objective evaluation documented dysmorphic features, while neurological examination showed only a slight truncal ataxia. The subject's IQ was 74 on the Wechsler Scale (verbal IQ = 79, performance IQ = 74). Psychiatric evaluation with DSM-IV criteria documented an obsessive-compulsive personality disorder associated with emotional instability and oral self-mutilation. The typical picture of rhombencephalosynapsis was evident on magnetic resonance imaging. Both chromosomal analysis and routine biochemical investigations were normal. The relationship between oral self-injurious behaviour and cerebellar malformations is discussed with particular regard to the behavioural aspects of cerebellar congenital pathology in affective disorders and in autism.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
3/35. Psychological treatment of self-injury.Behavioural treatment techniques were used for eliminating self-injurious behaviours of two mentally retarded patients. During treatment, each self-injurious response resulted in punishment followed by a timeout period and then differential reinforcement of other behaviours incompatible with self-injury. This procedure was effective in rapidly eliminating self-injury.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
4/35. Self-enucleation in drug-related psychosis.OBJECTIVE: To report on a patient who committed self-enucleation with his own fingers. methods: Case report of a 28-year-old man who self-enucleated his right eye. After ophthalmological treatment, he was referred to the psychiatric department for further evaluation and treatment. RESULTS: Reconstruction of the orbit was performed, and neither ophthalmological nor neurological complications were noted. The psychiatric history revealed continuous drug abuse (cannabis and amphetamines). The diagnosis of a drug-induced psychosis was established. CONCLUSIONS: Self-enucleation or 'oedipism' is a rare entity which requires, besides an operative reconstruction of the orbit, neurological monitoring to prevent possible intracranial complications. Long-term psychiatric therapy should be attempted to prevent further self-injurious behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/35. Psychological management of two cases of self injury on the paediatric intensive care unit.Self injury has not been previously reported in an intensive care setting. Two cases are presented of ventilator dependent children with high spinal cord lesions who exhibited an unusual form of self mutilation, namely lip biting. The key to extinguishing this behaviour was to address the children's psychological needs.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
6/35. Self-mutilation behaviour in lesch-nyhan syndrome.lesch-nyhan syndrome (LNS), first described in 1964 by Lesch and Nyhan, is a rare X-linked genetic disorder involving (near) absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase (HPRT). It occurs in 1:100,000 to 380,000 live births (1, 2). The deficiency of HPRT activity leads to an excessive uric acid production resulting in neurological, renal and musculoskeletal manifestations. death usually occurs in the second or third decade from infection or renal failure. Clinical presentation is characterized by mental retardation, choreoathetosis, spasticity, hyperuricemia and cerebral palsy. A characteristic feature of LNS is the appearance of intractable self-injurious behaviour (SIB), usually in the form of severe lip and finger biting, gouging of eyes, face scratching and head banging requiring extreme management techniques such as the application of restraints and or extraction of teeth at an early age. In this case report a unique approach of SIB in LNS is presented.- - - - - - - - - - ranking = 5keywords = behaviour (Clic here for more details about this article) |
7/35. An unusual monosymptomatic hypochondriacal delusion presenting as self-insertion of a foreign body into the urethra.The case of a middle-aged man who inserted a knitting needle into his urethra is described. This behaviour was associated with a monosymptomatic hypochondriacal delusion. The causes of such behaviour are discussed, together with the nosological status of monosymptomatic hypochondriacal psychosis.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
8/35. massage for very severe self-injurious behaviour in a girl with Cornelia de lange syndrome.The authors report the use of massage in a case of severe self-injurious behaviour in a girl with Cornelia de lange syndrome, after failing to elicit a response to conventional management for 10 years. Improvement was dramatic and the possible mechanisms are discussed.- - - - - - - - - - ranking = 5keywords = behaviour (Clic here for more details about this article) |
9/35. Comparative effects of gentle teaching and visual screening on self-injurious behaviour.Gentle teaching and visual screening procedures have been used to control severe behaviour problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening and a task-training condition in the reduction of high levels of self-injury of an adult with profound mental retardation. Following baseline, a task-training condition using standard behavioural techniques was implemented to establish the effects of training the subject on age-appropriate tasks. Results showed a modest reduction in self-injury. This was followed by an alternating treatments phase in which visual screening, gentle teaching and no-treatment control conditions were compared. Both procedures were superior to the control condition in reducing self-injury, with visual screening being more effective than gentle teaching. When visual screening was implemented across two and then all three daily conditions, self-injury was further reduced to near-zero levels. Bonding occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents.- - - - - - - - - - ranking = 6keywords = behaviour (Clic here for more details about this article) |
10/35. Genital self-amputation and the Klingsor syndrome.Two psychotic individuals, who performed acts of genital self-amputation, are presented. One of the patients had self-mutilated with the intention of suicide and had also in the past amputated his hand. Psychotic patients with delusions (often religious), sexual conflict associated with guilt, past suicide attempts or other self-destructive behaviour and depression, severe childhood deprivation, and major premorbid personality disorder, are the group at risk for genital self-amputation. It has been proposed that the eponym, the "Klingsor" syndrome, be applied only to acts of genital self-mutation, involving religious delusions. The author suggests that this syndrome should be expanded to include all cases of genital self-mutation resulting from a psychotic illness.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
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