1/68. 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 = person (Clic here for more details about this article) |
2/68. 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 = 0.2keywords = person (Clic here for more details about this article) |
3/68. Psychiatric and surgical management of male genital self-mutilation.Cases of genital self-mutilation are usually seen in the general hospital setting and can be difficult to manage especially in those patients who have psychiatric illness. A joint effort between the psychiatric and the surgical services will be required right from the beginning of hospital admission to diagnosis and later, to follow-up. Psychiatric consultation strategies at the different phases of intervention will be needed to cater for the special needs of the surgical team, patient and family. We describe three cases of genital self- mutilators and the general management of these patients.- - - - - - - - - - ranking = 0.0051002675573977keywords = illness (Clic here for more details about this article) |
4/68. life-threatening pica: liver abscess from perforating foreign body.A case is presented of a patient with a psychiatric illness and pica who developed a pyogenic liver abscess due to perforation of the duodenum by a pen. This report emphasizes the importance of ultrasound and computed tomography in making a rapid diagnosis. The relative superiority of ultrasound was revealed because an anaesthetic was not required for scanning, and in addition to the liver abscess, the precise location of the perforating foreign body was demonstrated.- - - - - - - - - - ranking = 0.0051002675573977keywords = illness (Clic here for more details about this article) |
5/68. munchausen syndrome.munchausen syndrome is a rare condition in which the patient repeatedly seeks medical care for factitious illnesses. With this self-inflicted disease, the patients characteristically travel from one hospital to another, feigning acute, usually spectacular illnesses. The patients willingly submit themselves to extensive as well as invasive diagnostic and therapeutic procedures. munchausen syndrome is a psychiatric disorder that requires psychiatric treatment. reconstructive surgical procedures may be required to correct the acquired deformities. The difficulty in munchausen syndrome lies essentially in early recognition of the psychiatric syndrome. Two exceptional cases are reported, and diagnosis and treatment are presented in the light of the current literature.- - - - - - - - - - ranking = 0.010200535114795keywords = illness (Clic here for more details about this article) |
6/68. Self-inflicted injury: a follow-up study of 43 patients.Forty-three patients, 38 women and 5 men, with self-inflicted skin lesions were studied. Thirty-three were followed up for up to 22 years. In most cases dermatitis artefacta was only one incident in a long history of psychogenic illness. Of the 43 patients, 13 (30%), 12 women and one man, continued to produce lesions or were disabled with other psychiatric disorders more than 12 years after the onset of symptoms. prognosis was difficult but recovery seemed to occur when the patient's life circumstances changed rather than as a result of treatment.- - - - - - - - - - ranking = 0.0051002675573977keywords = illness (Clic here for more details about this article) |
7/68. Acne excoriata--look for allergy!Acne excoriata (AE) is a frequent variant of self-inflicted skin conditions, which occurs predominantly in females. The condition seems to be almost always found in persons with psychological problems. Therapeutic approaches are often unsatisfying since this special group of patients typically does not recover with dermatological treatment. We report a 37-year-old female patient who had suffered for 5 years from AE. Exact history taking revealed that her manipulations were correlated with episodes of contact with bird products like feathers and eggs. The diagnosis of a bird egg syndrome could be proved by skin prick tests (ALK Abello, denmark) as well as laboratory results (CAP FEIA, Pharmacia, sweden), and consequent avoidance of handling bird products was the only but effective therapeutic measurement. In patients with suspected artefactual diseases, we strongly recommend to listen to the patients' complaints in order to make the correct diagnosis and not to overlook a potential stimulus.- - - - - - - - - - ranking = 0.2keywords = person (Clic here for more details about this article) |
8/68. Situational determinants of inpatient self-harm.Auto-aggressive individuals have a higher likelihood of engaging in interpersonal violence, and vice versa. It is unclear, however, whether ward circumstances are involved in determining whether aggression-prone patients will engage in auto-aggressive or outwardly directed aggressive behavior. The current study focuses on the situational antecedents of self-harming behavior and outwardly directed aggression of psychiatric inpatients. Inwardly and outwardly aggressive behavior were monitored on a locked 20-bed psychiatric admissions ward for 3.5 years with the Staff observation aggression Scale-Revised (SOAS-R). A map of the ward was attached to each SOAS-R form, enabling staff members to specify locations of aggressive incidents. time of onset, location, and provoking factors of auto-aggressive incidents were compared to those connected to aggression against others or objects. Of a total of 774 aggressive incidents, 154 (20%) concerned auto-aggressive behavior. Auto-aggression was significantly more prevalent during the evening (i.e., 50% compared to 32%), and reached its highest level between 8 and 9 P.M. (17% compared to 7%). The majority of self-harming acts (66%) were performed on patients' bedrooms. Outwardly directed aggression was particularly common in the day-rooms (24%), the staff office (19%), the hallways of the ward (14%), and the dining rooms (10%). Provoking factors of auto-aggressive behavior are less often of an interactional nature compared to outwardly directed aggression. The results suggest that a lack of stimulation and interaction with others increases the risk of self-injurious behavior. Practical and testable measures to prevent self-harm are proposed.- - - - - - - - - - ranking = 0.2keywords = person (Clic here for more details about this article) |
9/68. Silicone oil-induced corneal hydrops?A 27-year-old man with a personality disorder, who did not have keratoconus previously, recently presented with a clinical picture resembling acute corneal hydrops OS three years after silicone oil injection for a complicated retinal detachment. Although self-induced trauma could not be excluded completely, this case might represent a newly described late corneal complication of intracameral silicone oil.- - - - - - - - - - ranking = 0.2keywords = person (Clic here for more details about this article) |
10/68. Self-inflicted mutilation of the dentition in a schizophrenic patient.A case is presented in which a patient performed mechanical self-mutilation of her dentition during an episode of psychotic illness. The management of this case is described and discussed.- - - - - - - - - - ranking = 0.0051002675573977keywords = illness (Clic here for more details about this article) |
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