Citation

Chechko N, Stormanns E, Podoll K, Stickel S, Neuner I. BMC Psychiatry 2020; 20(1): e563.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12888-020-02974-6

PMID

33238922

Abstract

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. We report recurrent episodes of her illness culminating in this severe act of self-mutilation. The motivational reasons behind this form of self-harm along with differential diagnosis and potential treatment options are discussed in the context of the available literature.

CONCLUSION: Autoenucleation is commonly associated with religious and sexual delusions, and patients are thought to be at a greater risk of further self-harm. Timely antipsychotic treatment is likely to reduce the risk of such extreme forms of self-harm, although they can occur despite robust therapeutic intervention and treatment attempts. While self-inflicted eye injuries are rare, their prevention in what is typically a difficult patient group is fraught with challenges.

Language: en

Keywords

Delusion of sin; Schizoaffective disorder; Self-enucleation; Self-mutilation