Nursing care study: compulsive self-mutilation.
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According to DSM-IV affective instability in borderline personality disorder is due to marked reactions to environmental events. The aim of this study was to investigate affective responsiveness of abnormal personalities with self-harming impulsive behaviors by means of an affect-stimulation design. The first experiment was based on the presentation of a short story that allowed affective responses to various stimuli to be assessed in regard to quality, intensity, and alterations over time. The second one presented a typical frustration design, which provoked specific feelings of anger and disappointment. Impulsive personalities showed an affective hyperreactivity that was characterized by a decreased threshold for affective responses, as well as by intensive, rapidly changing affects. Furthermore, affect experiences turned out to be qualitatively diffuse and undifferentiated. Results support that affective instability of patients with borderline personality disorder should be differentiated from the autonomous deviations of mood typical of affective disorders. Their affective hyperreactivity is a crucial part of impulsive personality functioning.
We describe the characteristic symptoms and the progress of self-inflicted injuries to the limbs on the basis of 4 out of 15 cases. Glove-like edemas (which can lead to the misdiagnosis Sudeck's disease) are the most frequent. Chronic tapping and scratching of soft tissues induces local swelling which suggests a sarcoma. Contractures are especially difficult to diagnose. Development resulting from self-manipulation should always be considered when the disease manifestations persist for an incredibly long time (even after an adequate trauma), when the cause cannot be explained by mechanical or neurological findings and when the symptoms do not match the imitated disease in all details. Mostly the patient own to the self-inflicted injury, when he clearly feels to be sized up.
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This is an epidemiological study on Self-Inflicted Suicide and Lesions (E950 to E959) that we do not know if they are accidentally or intentionally inflicted (E980 to E989) among adolescents attended in a Psychiatric Ward at an Emergency Service in Ribeirão Preto, S.P., Brazil, from 1988 to 1991. The diagnoses were grouped according to CID-9. Data were obtained from the Hospital Statistics Service. The feminine sex predominated in the 4 years and in both diagnoses. It was observed that the occurrence of E950 to E959 increased during the period, while the occurrence of E980 to E989 decreased among the adolescents.
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Amphetamine usage has been associated with addiction, psychosis and self-injurious behavior. We report on two patients who severely and repeatedly mutilated their own genitalia while intoxicated on amphetamines and consider possible diagnostic etiologies.
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