Penile Self-Amputation in a Patient with Schizophrenia, while on Clozapine Augmentation with Modafinil: A Case Report

Authors

  • NRK Anish Psychiatrist, Government Mental Health Centre, Trivandrum
  • Anil Prabhakaran Head, Dept. of Psychiatry, Medical College, Thiruvananthapuram
  • Vidhukumar Karunakaran Head, Dept. of Psychiatry, Medical College, Ernakulam

DOI:

https://doi.org/10.30834/KJP.30.2.2017.125

Keywords:

Penile self amputation, self-mutilation in schizophrenia, modafinil

Abstract

Genital self mutilation is extremely rare and is seen in psychotic illnesses with associated risk factors like commanding hallucinations, religious delusions, past suicide attempts, depression, personality disorder, substance abuse or gender identity problems. We report a case of total penile self amputation in a 23 year old male without any of these risk factors. He was diagnosed with schizophrenia and was well maintained on clozapine 150 mg with with (an sos) prescription of modafinil 100mg in the morning. In human clinical trials, modafinil has no evidence for self mutilatory behaviour.

References

Helen S, Richard EP, Michael F jnr, David MQ, Genital self mutilation, International Journal of Urology (2006) 13, 1358–1360

Isaac Schweitzer, Genital self amputation and the Klingsor syndrome, Australian and New Zealand Journal of Psychiatry,1990, 24(4), 566 – 569

Hall DC, Lawson BZ, Wilson LG, command hallucination and self amputation of penis and hand during a first psychotic break, J Clin Psychiatry, 1981 Aug;42(8):322-4

Rana A, Johnson D. Sequential self-castration and amputation of the penis. Br. J. Urol. 1993; 71: 750.

Vafaei B, Two case reports of self mutilation or van gogh syndrome, Acta Medica Iranica,2003; 41:199-201

Ames D. Autocastration and biblical delusions in schizophrenia, British Journal of Psychiatry 1987; 150:347

Aboseif S, Gomez R, McAninch JW, Genital self mutilation, J Urol 1993; 150: 1143-6

Paul HK , Henning TB, Joel EDimsdale, Self-mutilation and severe self-injurious behavior associated with

amphetamine psychosis, General Hospital Psychiatry, 1996, 18(2), 117-120

Israel JA, Lee K, Amphetamine usage and genital self mutilation, Addiction, 2002, 97(9), 1215-8

Thomas NW, Ram CK, Amputee Fetishism and Genital Mutilation: Case Report and Literature Review, Journal of Sex & Marital Therapy, 26:339–344, 2000

Downloads

Published

2018-03-04

How to Cite

Anish, N., A. Prabhakaran, and V. Karunakaran. “Penile Self-Amputation in a Patient With Schizophrenia, While on Clozapine Augmentation With Modafinil: A Case Report”. Kerala Journal of Psychiatry, vol. 30, no. 2, Mar. 2018, pp. 88-89, doi:10.30834/KJP.30.2.2017.125.