Studies have shown that there are psychiatric patients who tend to aggressively mutilate themselves; they burn or in most cases attempt to burn themselves, attempt to severely damage their genital organs (especially amputate their penis), castrate themselves, attract their own eyes, amputate their own hands, or commit suicide. This report introduces two psychiatric men, aged 40 and 47, who had undergone surgical operations in Urology Department of Imam-Khomeini Hospital, Tabriz, Iran, because of Self-amputating their penis and, on discharge from Urology Ward, were referred to Razi Psychiatric Center for psychiatric consultation. Our assessment revealed that one of these patients was affected with psychotic-type major depressive disorder and the other with borderline personality disorder. Such cases of Self-mutilating behavior emphasize the significance of recognizing the alarming signs of Self-mutilation.

Self-mutilation is defined as intentional damaging of the body without intent to die. This behavior is observed among groups of psychiatric patients particularly schizophrenics. In these patients, Self-mutilative behavior may have unusual manifestations related to delusion and hallucination. In this article, an unusual form of Self-mutilation of a paranoid schizophrenic patient is reported. The subject stuck multiple needles into various parts of his body including head, face, neck, chest wall and genitalia. He also injected aubergine juice into his right popliteal fossa and ingested two medical thermometers. The relationship between Self-mutilative behavior and delusions and hallucinations is discussed.

The dysesthesia and paresthesia that occurs in laboratory rats after spinal cord injury (SCI) results in autophagia. This Self-destructive behavior interferes with functional assessments in designed studies and jeopardizes the health of the injured rat. In this study, we evaluated role of saturated picric acid in the prevention of autophagia and Self-mutilation. All rats were anesthetized with an intraperitoneal injection of a mixture of ketamine (100 mg/kg) and xylazine (10 mg/kg) for the SCI procedures. In the first 39 rats, no solution applied to the hind limbs, but in the next 26 cases, we smeared the saturated picric acid on the tail, lower extremities, pelvic, and abdomen of the rats immediately after SCI. In the rats without picric acid, 23 rats died following autophagia, but in the 26 rats with picric acid, there was no autophagia (P < 0.001). Picric acid side effects in skin and gastrointestinal signs such as irritation, redness and diarrhea were not seen in any rat. Saturated picric acid is a topical solution that if used appropriately and carefully, might be safe and effectively prevents autophagia and Self-mutilation. When the solution is applied to the lower abdomen and limbs, we presume that its bitterness effectively prevents the rat from licking and biting the limb.

Objectives Lesch-Nyhan syndrome is a rare inherited disorder associated with Self-harming behaviors, delayed mental and motor development, and disturbances such as dysarthria, choreoathetosis, and spasticity. Severe inflicted behaviors in Lesch-Nyhan syndrome often include chewing and biting of the lips or fingers, which often require management. Techniques to deal with these behaviors include using appliances that restrict the behavior or ultimately extracting the teeth. Case This case report presents a 6-year-old child with Lesch-Nyhan syndrome and Self-mutilation. He had chronic wounds in his buccal mucosa due to severe biting. Two acrylic devices with anterior and posterior bite plates were designed for the maxillary and mandibular teeth. At the follow-up visits, the wounds had been healed, but due to shedding of the primary teeth, and poor patient cooperation, the appliance design was slightly changed. The design of the device used for the patient inspires similar devices for patients with Self-mutilation behaviors. Conclusion Early diagnosis and management of patients suffering from Self-injurious behaviors may improve oral healthrelated quality of life of these patients. Acrylic appliances seem to be effective to minimize injury and to enhance fast healing of oral lesions.

Background: Self-injury is defined as the intentional injuring of one’s own body without apparent suicidal intent. Self-harm is encountered frequently in psychiatric hospitals. Deliberate Self-harm may be found in patients with a variety of diagnoses, including substance abuse, major depression, schizophrenia and especially borderline personality disorder.Objectives: This study aimed to investigate the prevalence of Self-injury and possible relating factors in patients with psychiatric diseases.Patients and Methods: In this cross-sectional study, 42 patients with Self-injury referred to Lavasani hospital in Tehran, Iran, were selected by random sampling during 2013 - 2014. The prevalence of Self-injury, site and tools of Self-injury and also possible contributing factors were evaluated. T-test and Fisher’s exact test were used to analyze data.Results: Mean distribution of Self-injury in patients was 12.5%. Sharp object was the tool of injury in 90.5% of the patients, 4.8% by fire, 2.4% by stone and 2.4% by other attempted to Self-injury. In 76.2% of the patients extremities were the site of injury. In 19%, 2.4% and 2.4% head and neck, trunk and abdomen were the sites of injury, respectively. There was a significant association between type of disorder and tool and body site of Self-injury (P<0.001).Conclusions: It can be concluded that schizophrenia and drug-induced psychotic disorder were the most common types of disorders that are at risk of Self-injury.

Objective: The aim of this cross sectional study was to assess the factor analysis of Functional Assessment of Self-mutilation (FASM) among Iranian adolescents with non-suicidal Self-injury. Method: In this study, 646 high school students, with the mean age of 16. 55 ± 0. 7, were selected using a multistage cluster sampling method; they completed FASM and the demographic form. Data were analyzed using the descriptive statistics, chi-square (χ 2), independent sample t test, MANOVA, and confirmatory factor analyses (CFA). Results: Of the participants, 178 reported at least 1 episode of NSSI during the previous year. The mean age of the participants when they first harmed themselves was 14. 64 (± 1. 71). Most of them reported to engage in NSSI impulsively (39. 32%) and experienced little (31. 5%) or moderate physical pain (31. 5%) There were no significant differences between males and females in severity of NSSI, frequency of NSSI, thinking about NSSI prior to engaging in the act, and age of onset. The results of the confirmatory factor analysis supported the 4-factor model of NSSI functions suggested by Nock and Prinstine [Χ 2/df = 1. 84; RMSEA = 0. 07; GFI = 0. 82; AGFI = 0. 77]. The most frequent function for engaging in NSSI was Automatic Negative Reinforcement. Conclusion: Findings of this study supported the structural validity of the FASM; thus, this tool can be useful in treatment and research contexts as a measure of NSSI functions. Moreover, this study found that adolescents engage in non-suicidal Self-injury because of 4 distinct reinforcement processes. The study findings have important implications for the assessment and treatment of NSSI.

Cotard syndrome is a rare condition, which its main symptom is nihilistic delusion. Self-mutilation of the nose is also a rare condition, which has not been seen in schizophrenic patients with Cotard syndrome. A single case is presented here.A 32-year-old woman who was diagnosed as having schizophrenia and believed that she was dead, cut the tip of her nose. She had no guilt feeling and described her act as a cosmetic surgery.We try to explain how various symptoms that seem to be very far from each other could exist side by side. Misinterpretation of her face is suggested to be the starting point in her complex symptoms.