Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstrasse 23, 52074, Aachen, Germany.
Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany.
BMC Psychiatry. 2020 Nov 25;20(1):563. doi: 10.1186/s12888-020-02974-6.
Autoenucleation is a rare form of self-mutilation typically associated with psychiatric disorders such as schizophrenia, substance-induced psychosis and bipolar disorder. The act is usually unilateral, although bilateral attempts are also well documented in the literature.
It is a case study involving a female patient (NN) diagnosed with schizoaffective disorder who self-enucleated her right eye following sexual intercourse with a fellow patient, and was forcefully prevented by staff from enucleating the second eye. We report recurrent episodes of her illness culminating in this severe act of self-mutilation. The motivational reasons behind this form of self-harm along with differential diagnosis and potential treatment options are discussed in the context of the available literature.
Autoenucleation is commonly associated with religious and sexual delusions, and patients are thought to be at a greater risk of further self-harm. Timely antipsychotic treatment is likely to reduce the risk of such extreme forms of self-harm, although they can occur despite robust therapeutic intervention and treatment attempts. While self-inflicted eye injuries are rare, their prevention in what is typically a difficult patient group is fraught with challenges.
自动眼球摘除是一种罕见的自残形式，通常与精神疾病有关，如精神分裂症、物质引起的精神病和双相情感障碍。这种行为通常是单侧的，但文献中也有双侧尝试的记录。
这是一个涉及一名女性患者（NN）的病例研究，她被诊断为分裂情感障碍，在与一名同病房的患者发生性关系后自行摘除了右眼，并被工作人员强行阻止了第二只眼睛的摘除。我们报告了她病情反复发作，最终导致这种严重的自残行为。我们结合现有文献，讨论了这种自残形式背后的动机原因、鉴别诊断和潜在的治疗选择。
自动眼球摘除通常与宗教和性妄想有关，患者更有可能进一步自残。及时的抗精神病治疗可能会降低这种极端自残形式的风险，尽管即使进行了强有力的治疗干预和治疗尝试，这种情况仍可能发生。虽然自我造成的眼部损伤很少见，但在通常是困难的患者群体中预防这些损伤存在诸多挑战。
