Autoenucleation--a culture-specific phenomenon: a case series and review.

Cases of autoenucleation may provide a good example of the pathoplastic effects of culture. To further characterize this phenomenon, the author reviewed the medical literature and conducted a retrospective search of the local psychiatric hospital records. Medline search did not show a single case of autoenucleation in the non-European Christian culture. Descriptive accounts of the identified seven patients show they were all psychotic at the time of the act, and five had a history of prior drug abuse. Most were religiously preoccupied before the act and displayed prominent affective symptoms, and they all interpreted the Biblical text literally. The association of sight and the concept of sin is discussed in a wider cultural context, and it is proposed that autoenucleation may be unique to the Christian West.