Hamlin Stephanie, Sharma Dana L, Kablinger Anita S
Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
Department of Psychiatry and Behavioral Science, Carilion Clinic, Roanoke, VA, USA.
Case Rep Psychiatry. 2023 Mar 13;2023:4334552. doi: 10.1155/2023/4334552. eCollection 2023.
Schizoaffective disorder is categorized by major mood episodes and symptoms of schizophrenia that include disorganized speech, delusions, paranoia, and hallucinations. It is associated with risk factors, including a history of abuse and cannabis use, and patients are typically diagnosed in adolescence and young adulthood. In this case report, we describe the unusual case of a 39-year-old male patient with undiagnosed schizoaffective disorder who self-eviscerated his intestines during an episode of psychosis. He received an emergent exploratory laparotomy with a partial colectomy. After medical stabilization and reorientation, the patient recalled a 10-year history of paranoia associated with significant cannabis use, despite otherwise functioning appropriately in society. During a two-week hospital course, his paranoia and hallucinations were remitted on olanzapine and valproic acid. In addition to discussing his presentation and recollection of the incident, we also discuss similar cases of self-mutilation in nonsuicidal patients and the relationship between cannabis use and schizophrenia spectrum disorders.
分裂情感性障碍的特征是存在重度心境发作以及精神分裂症的症状，这些症状包括言语紊乱、妄想、偏执观念和幻觉。它与多种风险因素相关，包括有受虐史和使用大麻，患者通常在青少年期和青年期被诊断出来。在本病例报告中，我们描述了一名39岁男性患者的罕见病例，该患者患有未被诊断出的分裂情感性障碍，在一次精神病发作期间自行掏出了自己的肠子。他接受了急诊剖腹探查术并进行了部分结肠切除术。在病情稳定和恢复定向力后，患者回忆起有10年的偏执观念病史，且大量使用大麻，尽管他在社会上其他方面功能正常。在为期两周的住院过程中，他的偏执观念和幻觉在使用奥氮平和丙戊酸后得到缓解。除了讨论他的临床表现和对该事件的回忆外，我们还讨论了非自杀性患者自残的类似病例以及大麻使用与精神分裂症谱系障碍之间的关系。
