Genital Self-mutilation in Schizophrenia-A Case Series

Abstract

Background: Major self-mutilation of various parts of the body with or without suicidal intent is seen in mental illness. It needs attention due to risk of significant disability. Available literature finds majority of cases to be psychotic. These are associated with motives and various risk factors.

Case Series: In our study we describe lacerations over penis inflicted by two elderly gentlemen, both diagnoses with schizophrenia, with different motives. The aim was to try and explore the distinct reasons for such self-mutilation and whether these have any differences across socio-demographic variables, such as gender and duration of illness.

Discussion and Conclusions: Various psychodynamic factors have been ascribed to genital self-mutilation. The ability to conduct GSM without anaesthetics also points to deficiencies in pain expression in attempters. A multidisciplinary approach with antipsychotics, surgery and addressing non-compliance needs to be adopted in treatment of genital self-mutilation. Further studies are required to find out social and risk factors pertaining to genital self-mutilation.