Self-enucleation of the right eye by a 38-year-old woman diagnosed with schizoaffective disorder: a case report
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CASE REPORT
Open Access
Self-enucleation of the right eye by a 38year-old woman diagnosed with schizoaffective disorder: a case report Natalia Chechko1,2,3*†, Eva Stormanns1†, Klaus Podoll1ˆ, Susanne Stickel1,2 and Irene Neuner1,4
Abstract Background: 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. Case presentation: 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. Conclusion: 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. Keywords: Self-enucleation, Schizoaffective disorder, Delusion of sin, Self-mutilation
* Correspondence: [email protected] This case report is dedicated to the memory of the Late Klaus Podoll, whose commitment to improving our understanding of psychiatric disorders was exemplary. ˆKlaus Podoll is deceased. † Natalia Chechko and Eva Stormanns are joint first authors. 1 Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstrasse 23, 52074 Aachen, Germany 2 Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
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