title: Male genital self-mutilation as a psychotic solution.
abstract: BACKGROUND
  Male genital self-mutilation (GSM) is a rare, but serious phenomenon. Some of the risk factors for this act are: presence of religious delusions, command hallucinations, low self-esteem and feelings of guilt associated with sexual offences. Other risk factors include failures in the male role, problems in the early developmental period, such as experiencing difficulties in male identification and persistence of incestuous desires, depression and having a history of GSM. The eponym Klingsor Syndrome, which involves the presence of religious delusions, is proposed for GSM.
  Four male GSM cases are presented: Case 1 and Case 2 were diagnosed with schizophrenia, Case 3 with schizophrenia and depressive disorder, not otherwise specified, and Case 4 with bipolar depression with psychotic features.
  
  
  CONCLUSIONS
  All definite and probable motives and cultural aspects for their GSM are discussed. Atonement is proposed as a new concept in formulating religiously themed psychotic male GSM.
authors.affiliation: Ataturk University, School of Medicine, Department of Psychiatry, Erzurum, Turkey. erolozan@gmail.com
authors.forename: Erol
authors.initials: E
authors.lastname: Ozan
authors.forename: Erdem
authors.initials: E
authors.lastname: Deveci
authors.forename: Meltem
authors.initials: M
authors.lastname: Oral
authors.forename: Esra
authors.initials: E
authors.lastname: Yazici
authors.forename: Ismet
authors.initials: I
authors.lastname: Kirpinar
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003466:Cultural Characteristics; D003702:Delusions / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D005837:Genitalia, Male / Q000293:injuries*; D006212:Hallucinations / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012071:Religion and Sex; D012307:Risk Factors; D012563:Schizophrenia, Paranoid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D012652:Self Mutilation / Q000209:etiology / Q000523:psychology
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents