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Dopamine agonist-induced stereotypic grooming and self-mutilation following striatal dopamine depletion.

Rats with bilateral 6-OHDA-induced striatal lesions exhibit altered apomorphine-induced behavior compared to the typical response seen in intact rats. This response is characterized by stereotypic grooming behavior which is transformed to compulsive and intense biting at higher doses. Other agonists, pergolide, bromocriptine, N-n-propylnorapomorphine and L-dopa/carbidopa, caused the same response. Direct intrastriatal infusion of apomorphine after 6-OHDA-induced lesions of the striata also produced this response, while similar SKF 38393 infusion caused more licking than biting, directed at the abdomen instead of the forepaws. The dopamine receptor antagonists haloperidol, SCH 23390 and sulpiride effectively blocked apomorphine-induced behaviors in dopamine-depleted animals. This altered behavior was not observed in rats with dopamine depletion in nucleus accumbens (NAS), nor did additional NAS lesions in rats with existing striatal lesions affect the behavior. Further, high doses of apomorphine (up to 60 mg/kg) failed to induce stereotypic grooming in unlesioned rats. We therefore propose that altered apomorphine-induced behavior is a unique consequence of striatal dopamine depletion and not just an intense form of normal stereotypic activity.

Animals↗

Borderline personality disorder. Suicidality and self-mutilation.

Epidemiological and neurobiological perspectives about suicidality in borderline patients are described, highlighting how self-destructive and seemingly suicidal acts are their "behavioral specialty." Principles for management, including the need for a primary clinician to oversee safety, and the pros and cons of both "contracting for safety" and hospitalization are presented. Clinical material is used to illustrate an approach that involves minimal initiative to rescue by therapists, a readiness to comply with patients' wishes for protection (the principle of false submission), and very active interpretation. This approach is contrasted with those advocated by Linehan and Kernberg.

Borderline Personality Disorder↗

Genital self-mutilation by radio-frequency in a male-to-female transsexual.

We report the case of a male-to-female transgender individual who inflicted radio-frequency injuries to her testicles in an attempt to damage them. Important consideration should be given by medical practitioners when they are faced with an individual who believes he or she is transgender. A sympathetic approach should be taken and a referral made to a clinician or service experienced in dealing with transgender patients.

Adult↗

[Rectal self-mutilation, rectal bleeding and Prader-Willi syndrome].

UNLABELLED: Prader-Willi syndrome is a genetic disorder characterized by infantile hypotonia, obesity, hypogonadism and mental retardation. Individuals with Prader-Willi syndrome manifest a severe skin picking behavior, including rectal picking. CASE REPORT: We report the case of a girl (12 years old) with this syndrome in whom rectal picking resulted in rectal bleeding and solitary rectal ulcer. CONCLUSION: Caregivers of children with Prader-Willi syndrome should be aware of a potential rectal picking behavior, which results in significant bleeding. Early recognition of such a behavior helps to avoid misdiagnosis.

Child↗