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Major Self-mutilation in the First Episode of Psychosis

Content Provider	PubMed Central
Author	Large, Matthew Babidge, Nick Andrews, Doug Storey, Philip Nielssen, Olav
Copyright Year	2009
Abstract	Major self-mutilation (MSM) is a rare but catastrophic complication of severe mental illness. Most people who inflict MSM have a psychotic disorder, usually a schizophrenia spectrum psychosis. It is not known when in the course of psychotic illness, MSM is most likely to occur. In this study, the proportion of patients in first episode of psychosis (FEP) was assessed using the results of a systematic review of published case reports. Histories of patients who had removed an eye or a testicle, severed their penis, or amputated a portion of a limb and were diagnosed with a schizophrenia spectrum psychosis were included. A psychotic illness was documented in 143 of 189 cases (75.6%) of MSM, of whom 119 of 143 (83.2%) were diagnosed with a schizophrenia spectrum psychosis. The treatment status of a schizophrenia spectrum psychosis could be ascertained in 101 of the case reports, of which 54 were in the FEP (53.5%, 95% confidence interval = 43.7%–63.2%). Patients who inflict MSM in FEP exhibited similar symptoms to those who inflict MSM later in their illness. Acute psychosis, in particular first-episode schizophrenia, appears to be the major cause of MSM. Although MSM is extremely uncommon, earlier treatment of psychotic illness may reduce the incidence of MSM.
Related Links	http://dx.doi.org/10.1093/schbul/sbn040
Ending Page	1021
Page Count	10
Starting Page	1012
File Format	PDF
ISSN	05867614
e-ISSN	17451701
Journal	Schizophrenia Bulletin
Issue Number	5
Volume Number	35
Language	English
Publisher	Oxford University Press
Publisher Date	2009-09-01
Access Restriction	Open
Rights Holder	Oxford University Press
Subject Keyword	Psychiatry and Mental health Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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