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At least 739 records · Page 41Linked to original sources
PubMed2007

Parent-teacher disagreement regarding psychopathology in children: a risk factor for adverse outcome?

OBJECTIVE: To investigate if parent-teacher discrepancies in reports of behavioral/emotional problems in children predict poor outcome. METHOD: A total of 1154 4- to 12-year-old children from the general population were followed up. At the first assessment, parent and teacher ratings were obtained with the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF). Fourteen years later, DSM-IV diagnoses were assessed, and ratings of self-reported and parent-rated behavioral and emotional problems were obtained. RESULTS: CBCL and TRF scores predicted most of the outcomes, but in general, discrepancies between CBCL and TRF scores did not. There were some exceptions. For instance, higher parental vs. teacher ratings of aggressive behaviors increased the risk of suicide attempts/self-mutilation. CONCLUSION: Risk factors for self-mutilating behaviors may be supplemented with parent-reported aggressive behaviors that are not observed by the teachers. In general, whereas CBCL and TRF scale scores were useful predictors of outcome, parent-teacher discrepancies were not.

Adolescent↗
PubMed1999

Congenital insensitivity to pain with anhidrosis: a case report.

Congenital insensitivity to pain with anhidrosis (CIPA) is a very rare genetic disorder of the peripheral nervous system characterized by recurrent episodes of unexplained fever, generalized anhidrosis, insensitivity to pain and temperature, and accompanied by self-mutilating behavior and mental retardation. We report on a 16 month-old boy with CIPA who exhibited these characteristic clinical features. A sural nerve biopsy revealed markedly reduced numbers of unmyelinated and small myelinated fibers, consistent with the characteristic features of CIPA.

Atrophy↗
PubMed1979

Effects of L-5-hydroxytryptophan on monoamine and amino acids turnover in the Lesch-Nyhan syndrome.

In a patient with the Lesch-Nyhan syndrome we found decreased spinal fluid 5-hydroxyindole acetic acid (5-HIAA), the major metabolite of serotonin, and decreased homovanillic acid (HVA), the major metabolite of dopamine, indicating a decrease in monoamine metabolism. Administration of 5-hydroxytryptophan and carbidopa produced an increase in spinal fluid 5-HIAA, indicating that it might be possible to correct the serotonin deficiency in this syndrome, but there were no changes in the marked mental retardation and neurological deficits. Self-mutilation appeared to be suppressed by therapy but the effectiveness of the drugs decreased with time. There were also changes in the spinal fluid concentration of amino acids that might affect brain protein synthesis. These changes were corrected during administration of 5-hydroxytryptophan and carbidopa.

5-Hydroxytryptophan↗
PubMed2006

Congenital insensitivity-to-pain with anhidrosis (CIPA): a case report with 4-year follow-up.

Congenital Insensitivity-to-pain with anhidrosis (CIPA) is a rare disorder in which pain perception is absent from birth, despite the fact that all other sensory modalities remain intact or minimally impaired and tendon reflexes are present. The challenge in dentistry is to manage the self-mutilation behavior avoiding serious damages especially to oral structures, hands and fingers. A Brazilian case of CIPA is presented and discussed with clinical documentation of the oral-related problems over a 4-year follow-up. A conservative treatment (mouthguard-like appliance) was proposed with the objective to avoid full mouth extraction.

Consanguinity↗
PubMed1982

A comparison of hospitalized and nonhospitalized borderline patients.

The author compared 14 hospitalized borderline patients with 24 nonhospitalized patients given the same diagnosis. Twenty-nine clinical features of borderline patients were examined using the semistructured Diagnostic Interview for Borderlines. Although a few specific differences emerged in such areas as drug abuse, self-mutilation, and psychotherapy experience, both hospitalized and nonhospitalized patients manifested characteristic borderline traits of disturbed impulse-action patterns, psychotic experiences, poor regulation of affect, and disturbed interpersonal relationships. These findings are consistent with those of other studies and suggest that hospitalized and nonhospitalized borderline patients represent the same diagnostic entity.

Adolescent↗
PubMed1981

The management of chronic behavior disorders in mentally retarded adults with lithium carbonate.

The authors review the medical literature and present two case histories regarding the efficacy of lithium carbonate in the treatment of chronic behavior disorders in mentally retarded adults. They conclude that the available data lend tentative support for the use of lithium to manage behavior disorders in retarded individuals which are characterized by lifelong hyperactivity, aggressiveness, and/or self-mutilation. They recommend that, when lithium is used for this indication, a blood level of approximately 1.0 mEq/1 is necessary, and that all patients be given a drug-free trial once a therapeutic effect has been achieved in order to assess the continued need for treatment. Etiological issues, a possible mechanism of action involving lithium's effect on CNS serotonergic activity, and areas for future research are discussed.

Adult↗
PubMed1992

The Lesch-Nyhan syndrome--an under-recognised condition in South Africa? A case report.

The Lesch-Nyhan syndrome is a rare inborn error of purine metabolism caused by a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT), which results in mental retardation with characteristic self-mutilation, spasticity, extrapyramidal signs and hyperuricaemia. The clinical and biochemical findings in an 18-month-old boy, who presented with renal calculi and was shown to have less than 1% of normal HGPRT activity, are reported. The obvious neurological abnormalities had previously been thought to be due to hypoxic-ischaemic encephalopathy. The expected incidence of this disease is much higher than the known number of cases diagnosed.

Athetosis↗
PubMed1978

Gilles de la Tourette syndrome: further studies and thoughts.

A possible association between the Gilles de la Tourette and Lesch-Nyhan syndromes has recently been postulated. Fourteen patients with Tourette syndrome demonstrated no similarity to Lesch-Nyhan based upon patterns of inheritance, behavioral changes, or alterations of purine metabolism. Despite a strong male predominance, a sex-linked pattern of inheritance could not be confirmed. Self-mutilating behavior was found in 4 male patients but was readily differentiated from that characteristic of the Lesch-Nyhan syndrome. Quantitation of hypoxanthine-guanine phosphoribosyltransferase and isoelectric focusing of its isoenzymes produced results that were indistinguishable from those in controls. We speculate that, pathophysiologically, Tourette syndrome represents an imbalance between the central neurotransmitters dopamine and serotonin rather than an alteration in purine metabolism.

Child↗
PubMed1999

Effects of estrogen on autotomy in normal and ovariectomized rats.

Gonadal hormones may modulate analgesia responses induced by acute stress in humans and rats. To evaluate the effects of gonadal hormones in modifying neuropathic pain, we measured autotomy changes following sciatic nerve resection in ovariectomized rats and in the presence of estrogen replacement. Two groups of female rats were subjected to ovariectomy and sham surgery. Each group was then divided into two subgroups receiving subcutaneously sesame oil with or without estradiol benzoate (5 microg/day/rat). All rats then underwent sciatic nerve resection in one hindlimb. Degree of self-mutilation was measured daily for 8 weeks. Estradiol treatment resulted in significantly lower autotomy scores in ovariectomized rats (3.6 +/- 0.6 vs. 5.5 +/- 0.3, p < 0.01) and in sham-operated rats (3.4 +/- 0.7 vs. 5.1 +/- 0.4, p < 0.05). The results of this study indicate that estrogen can modify the autotomy behavior, an indicator of neuropathic pain, in rats after nerve injury.

Animals↗
PubMed1981

The deafferentation syndrome in genetically blind rats: a model of the painful phantom limb.

The hypothesis was tested which states that the somatic deafferentation syndrome is a visually prompted response to sensorimotor loss. The dorsal roots, C5-T2, were bilaterally cut in a strain of rats known to be genetically blind. These complete dorsal rhizotomies left the forelimbs totally anesthetic, analgesic and paretic. Contact and visual placing reactions were absent, and responses to pinprick or pinch were absent. Self-mutilation limited to the distal digits appeared on the first or second postoperative days and then progressed proximally. The forelimbs were symmetrically affected, and no other body parts were mutilated. The spatial precision of this syndrome, in the absence of visual as well as peripheral somatosensory information from the affected limb, indicates that controlled guidance of the behavior arises from an existing central representation of the limb and its relationship with the total body; a phantom limb. Consideration of other reports regarding the deafferentation syndrome leads to the view that it is motivated by disturbing abnormal sensations (pain) of central neural origin.

Afferent Pathways↗
PubMed2006

[Dermatitis artefacta: retrospective study in 31 patients].

BACKGROUND: The outcome for patients with dermatitis artefacta is not well known. The primary objective of this single-centre retrospective study was to describe the initial clinical aspects and the prognosis of the disease. The secondary objective was to describe the somatic and psychological management and long-term treatment of these patients. PATIENTS AND METHODS: Records of patients with dermatitis artefacta followed in the dermatology department over the 15 last years were reviewed independently by 2 dermatologists. Diagnostic criteria consisted of evocative clinical pictures and the exclusion of other forms of dermatosis. Data collection included: file analysis, photographs, review questionnaires sent to general practitioner or completed during a phone call to patients (follow-up data). RESULTS: Thirty-one patient files were selected: 23 women and 8 men, mean age 31 years (SD = 14.8). Clinical aspects included: erythema (50%), ulceration (37%), crust (23%) and blisters (17%). The main sites were the face (67%) and arms (43%). Topical treatment was prescribed in all cases and systemic treatment was prescribed in 23% of cases. Psychological support was offered to 65% of the patients and was accepted by 50%. A follow-up study was performed for 17 patients and showed serious complications in 4 cases consisting of psychosis (n=2) and/or severe self-mutilation (n=3) occurring over several years following diagnosis (5 years for one patient and 12 years for 2 patients). DISCUSSION: The results confirm the usual and characteristics of dermatitis artefacta such as predominance in young female patients, with lesions affecting visible areas (face, upper legs). In contrastwith published studies, no cases of attempted suicide were observed in our series, although severe dermatitis artefacta was evidenced in only a minority of patients.

Adult↗
PubMed1991

Prevalence and correlates of cutting behavior: risk for HIV transmission.

The prevalence of cutting behavior among a population of 76 psychiatrically hospitalized adolescents was found to be 61.2%. The frequency ranged from a single occasion to over 50 instances, with a mean of 9.9 occasions. Increased self-mutilation was not found to be associated with gender, age, ethnicity, or primary psychiatric diagnosis. A significant association was identified between adolescents who report forced sex and those who report cutting behavior. Approximately 26.7% of those reporting this behavior also report sharing cutting implements with other adolescents. This article raises concern about this behavior as it relates to the transmission of human immunodeficiency virus and makes recommendations for clinicians treating this population.

Adolescent↗
PubMed1986

Factitious disorder and coexisting depression: a report of successful psychiatric consultation and case management.

The authors present a case illustrating factitious illness with a coexisting depressive disorder. The factitial presentation involved self-mutilation that served to procure and prolong patient status, while obscuring the recognition of a major depressive episode. The importance of accurate assessment and prompt recognition of factitious illness is discussed, with emphasis upon the identification of contributing psychodynamics, underlying psychopathology and ongoing psychosocial stressors. Psychiatric consultation efforts were successful, but in the context of considerable morbidity. Psychotherapeutic gains occurred only after vigorous antidepressant drug therapy and substantial psychotherapeutic efforts that empathically addressed the patient's masochism and dependency.

Adult↗
PubMed2000

Hereditary sensory and autonomic neuropathy: review and a case report with dental implications.

Hereditary sensory and autonomic neuropathy (HSAN) is a rare syndrome which is seen in early childhood. Five different types are described. Absence of pain and self-mutilation are characteristic findings of this syndrome. Teeth in the oral cavity can cause damage to the oral tissues and tongue. When it is diagnosed, there should be co-operation between dentist and neurologist. Using an oral shield prevents the biting and, thus, traumatization of the tissues can be prevented. A case report which is diagnosed as HSAN type 4 is presented and information submitted about its treatment.

Child↗
PubMed1994

A survey of the phenomenology and pharmacotherapy of compulsive and impulsive-aggressive symptoms in Prader-Willi syndrome.

Prader-Willi Syndrome (PWS) is a congenital disorder characterized by hyperphagia as well as by other behavioral disturbances such as self-mutilation and temper outbursts. Some of these symptoms have been reported to respond to psychotropic medications. A systematic survey was conducted to gather information on the phenomenology and pharmacotherapy of compulsive and impulsive-aggressive symptoms in PWS. Both compulsive and impulsive-aggressive symptoms are frequent in this population. Pharmacotherapeutic intervention may have a role in the management of these symptoms. Rigorous diagnostic and treatment studies should be undertaken in this population.

Adolescent↗
PubMed1976

Behavior in the Lesch--Nyhan syndrome.

The Lesch--Nyhan syndrome is a heritable disorder of the metabolism of uric acid in which behavioral manifestations are prominent and among the most provocative. The mutated or variant gene that determines this disorder is carried on the X chromosome. The disease is expressed exclusively in males. The molecular expression of the abnormal gene is in the completely defective activity of the enzyme hypoxanthine guanine phosphoribosyl transferase. As a result these patients overproduce uric acid and may develop early in life many of the clinical findings we associate with gout. They have in addition a variety of neurological abnormalities including mental retardation, spastic cerebral palsy, and involuntary, choreoathetoid movements. Involved patients have unusual, compulsive, aggressive behavior. Its most prominent but by no means exclusive feature is self-mutilation. The central feature in the management of this behavior is physical restraint. A number of practical procedures have been learned which facilitate the care and feeding of these patients. Promising new findings suggest that behavioral modification using extinction techniques and pharmacologic methods utilizing agents designed to increase the effective cerebral content of serotonin may each have a place in the management of behavior in this syndrome.

5-Hydroxytryptophan↗
PubMed1980

[Accidents on circular bench saws (author's transl)].

For an expert opinion in a lawsuit regarding the suspicion of self-mutilation the physical data of an accident on a circular saw bench have been investigated. The result was as follows: The time required for severing a human forearm of 6 cm diameter is 40 to 80 ms depending on the feeding power. The impulse of 13 to 15 Ns necessary for severing an arm in only 1/10 to 2/10 of the impulse a slipping person exerts when striking the disk. The standard time data for such accidents indicated in the scientific literature are much too high.

Amputation, Traumatic↗
PubMed1994

The effect of testosterone on psychopathology and sexual function in a paranoid schizophrenic self-castrate.

It has been suggested that the administration of androgens to paranoid schizophrenics who castrate themselves because of religious delusions and sexual guilt might exacerbate the psychosis and increase the risk of further self-mutilation. We administered testosterone enanthate to such a case intermittently during his 12 week hospital stay and studied simultaneously, psychopathology (Brief Psychiatric Rating Scale and clinical assessment), hormone levels and sexual behaviours. Sexual behaviours increased in line with increased serum testosterone levels; psychopathology declined. Following his discharge, he was managed on a regime of phenothiazines and monthly testosterone injections. After one year, he was enjoying normal heterosexual activities (without guilt) although his extreme religiosity had not declined.

Adult↗