كليدواژه :
سايكوز , آلت تناسلي , گزارشهاي موردي , قطع اندام
چكيده فارسي :
زمينه و هدف: قطع عضو، يكي از انواع شديد آسيب به خود است كه به قصد صدمه به بدن، انجام مي‌گيرد. چشم، دستگاه ژنيتال و دست، اعضاي مهمي هستند كه مورد هدف قرار مي‌گيرند. تاكنون، قطع آلت تناسلي توسط خود، در جهان كمتر گزارش شده است و شايع‌ترين علت آن اختلالات سايكولوژيك و در راس آن‌ها سايكوزها هستند.
معرفي بيمار: مرد ساله مجرد، مبتلا به اختلال دوقطبي، كه از دوران نوجواني تحت درمان قرار داشت. وي سابقه سوء‌مصرف مواد و همين‌طور روابط جنسي متعدد را داشت. از دو ماه پيش، توهمات شنوايي بيمار مبني بر قطع آلت تناسلي شروع شده بود كه در نهايت در روز حادثه، منجر به اين اقدام شد.
نتيجه‌گيري: به‌نظر مي‌رسد مجموعه عواملي مانند ابتلاي بيمار به سايكوز به‌دنبال اختلال دوقطبي، سوء‌مصرف مواد، عقب‌ماندگي ذهني، داشتن روابط جنسي متعدد و همين‌طور رابطه قوي عاطفي با مادر مي‌تواند به‌عنوان محرك براي اقدام به قطع آلت تناسلي باشد.
چكيده لاتين :
Background: Self-mutilation is one of the most extreme types of self-harm, which is done deliberately to hurt the body, regardless of suicidal intent. In self-mutilation, the most important targets are the eyes, genital tract, and hands. So far, genital self-mutilation (GSM) has been less frequently reported around the world. According to our study, this is the first case of GSM reported in Iran. The most common cause of GSM is psychological disorder, especially psychosis.
Case Presentation: The patient was an unmarried 32-year-old man, who was hospitalized in Rasul-Akram Hospital in December 2018 for severe bleeding caused by GSM. He was diagnosed with type I bipolar disorder, which was treated from the late adolescence. Also, a history of drug abuse (amphetamine, opium, cannabis, alcohol) and multiple sexual relationships with different partners was reported. He abused tramadol tablets daily nowadays. His IQ was normal. He had lots of abrasions, scars and lacerations due to suicidal attempts in the past years. Two months before GSM, his auditory hallucinations about genital self-mutilation had started. He committed GSM after having sexual intercourse and was transferred to our hospital by an ambulance with severe hemorrhage, scrotum damage, and presentation of both testes, for which he received appropriate treatments.
Conclusion: It seems that a set of factors, such as patient's history of psychosis following bipolar disorder, substance abuse, mental retardation, multiple sexual relationships, and strong emotional relationship with the mother can contribute to self-injury that may lead to genital self-mutilation. It should be noted that genital self-mutilation cases are less likely to be reported in Iran, considering the cultural and religious background. Therefore, the pathology of this devastating phenomenon should be more thoroughly examined.
