A case of unrelenting pursuit of castration.

OBJECTIVE

Explore the limitations of the classification of body dysmorphic disorder.

CLINICAL PICTURE

A chinese male relentlessly pursued castration to relieve painful erections which were never substantiated. The testes and corporaspongiosum had been removed. No psychotic symptom was prominent.

TREATMENT

Cognitive therapy and psychotropics were tried.

OUTCOME

The remaining corpora cavernosa was removed subsequently.

CONCLUSION

The distorted somatic perception and secondary cognitive amplification (painful erections) could represent a variant of body dysmorphic disorder involving internal body image; diagnostic classifications should accommodate such a category.