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[Psychoanalysis of self injury].

Psychoanalytic aspects of diseases with self-inflicted mutilation (factitious diseases and Munchhausen syndrome) have been investigated increasingly within the last years in the setting of long term ambulatory and hospital treatments. The author describes in this report how these disease states may also be interpreted as equivalents of remembrance and can be understood as inadequate attempts for self assistance. He outlines possibilities for psychotherapy arising in view of this background.

Adult↗

Self-enucleation and psychosis.

Four cases of self-enucleation are reported. Self-induced ocular mutilation is uncommon. Self-enucleation is rare and is specifically associated with paranoid delusions, either as a result of a drug-related toxic psychosis or in the functional psychoses, especially schizophrenia. An association with solvent abuse is reported. Such patients use self enucleation as a form of parasuicide and may mutilate themselves in other ways. In the management of such patients close co-operation between ophthalmologist and psychiatrist is important, as further self injury, including suicide is common.

Adolescent↗