Autoenucleation in the context of psychosis.

Aust N Z J Psychiatry

Alfred Health, Melbourne, VIC, Australia Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.

Published: September 2015

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http://dx.doi.org/10.1177/0004867415595289DOI Listing

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Self-enucleation of the right eye by a 38-year-old woman diagnosed with schizoaffective disorder: a case report.

BMC Psychiatry

November 2020

Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstrasse 23, 52074, Aachen, Germany.

Background: Autoenucleation is a rare form of self-mutilation typically associated with psychiatric disorders such as schizophrenia, substance-induced psychosis and bipolar disorder. The act is usually unilateral, although bilateral attempts are also well documented in the literature.

Case Presentation: It is a case study involving a female patient (NN) diagnosed with schizoaffective disorder who self-enucleated her right eye following sexual intercourse with a fellow patient, and was forcefully prevented by staff from enucleating the second eye.

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Background: Although the first medically-reported case of auto-enucleation was described in the mid-19th century, ocular self-gouging has long been depicted in historical legend and mythology. Cases of enucleation have since been identified across various cultures. Though relatively uncommon, this major form of self-mutilation now afflicts approximately 500 individuals per year, and may present more commonly among certain clinical populations.

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Cases of autoenucleation may provide a good example of the pathoplastic effects of culture. To further characterize this phenomenon, the author reviewed the medical literature and conducted a retrospective search of the local psychiatric hospital records. Medline search did not show a single case of autoenucleation in the non-European Christian culture.

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