Management of Self-Mutilation

Abstract

The management of diverse types of self-mutilation is discussed with a particular emphasis on the selective use of open confrontation of the dissimulating patient with the self-inflicted nature of the lesions. Integration of psychotherapy with psychotropic drug treatment in self-mutilating patients is a necessity.

Factitious Disorders in the Field of Surgery

“…In a comprehensive study of the patients referred to their department for psychiatric/psychosomatic evaluation, Suther land and Rodin [6] reported 4 surgical pa tients among 10 (0.8%) suffering from facti tious disorders. Over a period of 22 years, Moffaert [7] found a total of 9% of the pa tients treated at Genter Hospital for factitious disorders who required surgical care. Women clearly have the edge over men with respect to surgical care.…”

Management and Prevention of Oral Self-Injuries in Lesch–Nyhan Syndrome

“…Thanks to the delay of renal failure, which is the common cause of death in early childhood, a significant increase in life expectancy has been observed [10][11][12]. Benzodiazepines, neuroleptics, antidepressants, chloralhydrates, and anticonvulsive drugs have also been proposed to control SIB [13,14]. Recent therapeutic trials also include gabapentin, which is free from side effects [15], botulinum toxin A (BTX-A), which acts on the central and peripheral nervous system [16], dopamine replacement therapy, and deep brain stimulation in the globus pallidus (GPi) [17,18].…”