Cases reported "Self Mutilation"

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1/17. False rape: a case report.

    A 16-year-old girl was admitted to the emergency department for sexual assault. The forensic examination revealed genital lesions of an age that were incompatible with her statements. She also presented extragenital lesions that resembled self-inflicted lesions. The reports of false rape allegations in the literature have all dealt with the motivations of the false victims. This case report is a reminder that an allegation of rape can be considered only on the basis of proof and not on speculation.
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2/17. munchausen syndrome.

    munchausen syndrome is a rare condition in which the patient repeatedly seeks medical care for factitious illnesses. With this self-inflicted disease, the patients characteristically travel from one hospital to another, feigning acute, usually spectacular illnesses. The patients willingly submit themselves to extensive as well as invasive diagnostic and therapeutic procedures. munchausen syndrome is a psychiatric disorder that requires psychiatric treatment. reconstructive surgical procedures may be required to correct the acquired deformities. The difficulty in munchausen syndrome lies essentially in early recognition of the psychiatric syndrome. Two exceptional cases are reported, and diagnosis and treatment are presented in the light of the current literature.
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3/17. Acne excoriata--look for allergy!

    Acne excoriata (AE) is a frequent variant of self-inflicted skin conditions, which occurs predominantly in females. The condition seems to be almost always found in persons with psychological problems. Therapeutic approaches are often unsatisfying since this special group of patients typically does not recover with dermatological treatment. We report a 37-year-old female patient who had suffered for 5 years from AE. Exact history taking revealed that her manipulations were correlated with episodes of contact with bird products like feathers and eggs. The diagnosis of a bird egg syndrome could be proved by skin prick tests (ALK Abello, denmark) as well as laboratory results (CAP FEIA, Pharmacia, sweden), and consequent avoidance of handling bird products was the only but effective therapeutic measurement. In patients with suspected artefactual diseases, we strongly recommend to listen to the patients' complaints in order to make the correct diagnosis and not to overlook a potential stimulus.
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4/17. Improvement in severe self-mutilation following limbic leucotomy: a series of 5 consecutive cases.

    BACKGROUND: The efficacy of neurosurgical intervention for self-mutilation behavior associated with severe, intractable psychiatric disorders remains undetermined. We report the effects of limbic leucotomy in 5 consecutive patients with severe self-mutilation behaviors. METHOD: After unsolicited referrals from their psychiatrists and careful consideration by the massachusetts General Hospital Cingulotomy Assessment Committee (MGH-CAC), 5 patients were treated with limbic leucotomy. Their primary DSM-IV psychiatric diagnoses were either obsessive-compulsive disorder or schizoaffective disorder. Comorbid severe, treatment-refractory self-mutilation was an additional target symptom. Outcome was measured by an independent observer using the Clinical Global Improvement. Current Global Psychiatric-Social Status Rating, and DSM-IV Global Assessment of Functioning scales in addition to telephone interviews with patients, families, their psychiatrists, and treatment teams. The mean postoperative follow-up period was 31.5 months. RESULTS: All measures indicated sustained improvement in 4 of 5 patients. In particular, there was a substantial decrease in self-mutilation behaviors. postoperative complications were transient in nature. and postoperative compared with preoperative neuropsychological assessments revealed no clinically significant deficits. CONCLUSION: In carefully selected patients as described in this report, limbic leucotomy may be an appropriate therapeutic consideration for self-mutilation associated with severe, intractable psychiatric disorders.
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5/17. The use of honey in wound management.

    honey has been used as a wound treatment for more than 2,000 years. Greater scientific understanding of how it works, particularly as an antibacterial agent, has led practitioners to reconsider the therapeutic value of honey. Once honey is commercially available as a regulated product in the UK, practitioners will have access to an effective, alternative wound treatment. Specific, sterilised honeys intended for wound care will provide a safe natural product to manage colonised or infected wounds that would otherwise remain unresponsive to treatment.
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6/17. affect integration in psychoanalysis: a clinical approach to self-destructive behavior.

    Self-destructive behavior can be an attempt to reverse self-fragmentation or breakdown secondary to feeling overwhelmed by unbearable affect. Therapeutic attention to blocks in the development of affect integration may help individuals process painful feeling states more efficiently, thus dealing with tension states more constructively. The author describes two cases that illustrate therapeutic removal of such blocks, followed by cessation of the self-destructive behavior and resumption of the normal developmental process.
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7/17. Cognitive-behavioral approaches to treating borderline and self-mutilating patients.

    The cases of three self-injurious patients suffering with borderline personality disorder are briefly presented. From this clinical base, the consultant describes a cognitive-behavioral psychotherapeutic model and how it might be applied to the treatment of these and similar patients. A dialectical behavioral approach is used to describe three major dichotomies and their application. The consultant also illustrates how cognitive-behavioral therapy may be integrated with more dynamic-analytic approaches, and proposes a strategy and methodology that establish and reinforce the treatment alliance in developing a treatment plan.
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8/17. Self-cutting after rape.

    The authors present three cases of women who began to cut themselves superficially after they had been raped. To the authors' knowledge, no such findings have been reported in the current literature on short- and long-term effects of rape.
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9/17. Chronic constrictive pericarditis caused by self-mutilation with sewing needles. A case report and review of published reports.

    A 34 year old woman with a history of self-mutilation developed severe constrictive pericarditis with sterile, calcified intrapericardial abscess cavities as a result of inserting sewing needles into her chest seven years previously. After pericardiectomy she made a good recovery.
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10/17. Treatment package to reduce SIB in a Lesch-Nyhan patient.

    Self-destructive behaviour in LNS children results in a tremendous burden to parents, teachers, staff members, and other responsible for their care. As constant vigilance is not always feasible, developing alternate methods of managing SIB becomes imperative. This report presents our efforts to improve the care of an LNS child and to ease the burden on staff members and parents by obtaining special devices (e.g. the custom-made mouthguard and the gloves) to prevent him from injuring himself. Others (e.g. Letts & Hobson, 1975) have likewise reported success in fabricating custom-designed chairs and devices in an effort to manage SIB in LNS children. Their devices were, however, more elaborate and much more expensive than the ones used in this report. The cost of obtaining a mouthguard similar to the one used with K. is estimated at between $20-$30 (US), while the gloves cost only $14.00. The major advantages of using such devices are that they safely allow employment of the extinction procedure along with allowing the child to participate more fully in activities of daily living. It is recognized that K. was in some ways an atypical Lesch-Nyhan child in that he possessed low normal receptive intelligence and scored fairly high (relative to most LNS children) on a test of verbal intelligence. His cognitive and verbal abilities made him a unique case in that he responded favourably to therapeutic instructions regarding relaxation and self-control tactics. The therapists were able to rely on K.'s verbalizations and feelings about his biting in structuring the treatment approach.(ABSTRACT TRUNCATED AT 250 WORDS)
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