Gössler Ralf, Vesely Christine, Friedrich Max H
Universitätsklinik für Neuropsychiatrie des Kindes und Jugendalters, Wien, Germany.
Psychiatr Prax. 2002 May;29(4):214-7. doi: 10.1055/s-2002-30677.
Self-mutilation of the genitals in man is a rare phenomenon mainly occurring in young males. The importance of conflicts about the male role, difficulties with the male identification in childhood and feeling of guilt for sexual offences are discussed in the literature. The influence of developmental crisis on this symbolic form of automutilation will be discussed in our case report.
We present a case of a young schizophrenic man whose illness started in adolescence. He committed genital automutilation already in early adolescence, as a young male he autocastrated himself.
We demonstrate the connection of specific problems of development in adolescence and psychopathology. Autocastration will be discussed as a "psychotic" solution of the adolescent conflict of dependence.
Developmental conflicts may be important pathoplastic factors who may lead to severe psychopathology and misbehavior. Additionally to a psychopharmacological treatment a specific adolescent- and conflictoriented psychotherapy for solving the developmental conflicts in young schizophrenic patients should be established.
男性生殖器自残是一种罕见现象,主要发生在年轻男性中。文献中讨论了男性角色冲突、童年期男性认同困难以及性犯罪内疚感的重要性。在我们的病例报告中将探讨发育危机对这种象征性自残形式的影响。
我们报告一例始于青春期的年轻精神分裂症男性病例。他在青春期早期就出现了生殖器自残行为,成年后自行阉割。
我们展示了青春期特定发育问题与精神病理学之间的联系。自行阉割将被视为青少年依赖冲突的一种“精神病性”解决方案进行讨论。
发育冲突可能是重要的病理塑形因素,可导致严重的精神病理学和不当行为。除了药物治疗外,还应建立针对年轻精神分裂症患者解决发育冲突的特定的青少年及冲突导向心理治疗。