title: Gender and Racial Disparities in Cases of Autoenucleation.
abstract: OBJECTIVE
  This review demonstrates the gender and racial disparities among patients who have committed ocular autoenucleation.
  
  
  METHODS
  Peer-reviewed articles were identified and reviewed on the basis of a literature search in PubMed/MEDLINE and Ovid/EMBASE databases from all available literature to date.
  
  
  RESULTS
  We identified 60 cases of autoenucleation published in contemporary literature with nine attempted cases. The ratio of men to women who have committed autoenucleation is 8:1. Only 28 cases of autoenucleation included confirmed reports of racial makeup. 17 out of 28 cases were White, eight out of 28 cases were Hispanic or Asian, and only three cases were Black. White patients account for 61% of the cases, while Black patients make up 11% and other races constitute 28%. The common underlying psychiatric motivations among autoenucleation patients include biblical interpretations, religious delusions, and paranoia of the eye. The most common associated psychiatric disorders among patients with autoenucleation include schizophrenia, major depressive disorder, and bipolar disorder.
  
  
  CONCLUSIONS
  Autoenucleation largely occurs amongst male patients with active psychiatric disorders. Our findings challenge previously published reviews where the incidence of autoenucleation is reported as equal for the two sexes. A higher incidence among the White population is also suggested. This is the first time gender and racial disparity have been demonstrated with respect to autoenucleation.
authors.affiliation: a Vanderbilt Eye Institute, Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Zhang
authors.affiliation: b Vanderbilt University School of Medicine , Nashville , TN , USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: c Vanderbilt University College of Arts and Sciences , Nashville , TN , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mercier
authors.affiliation: a Vanderbilt Eye Institute, Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hollar
authors.affiliation: a Vanderbilt Eye Institute, Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Jeanie D
authors.initials: JD
authors.lastname: Ling
authors.affiliation: a Vanderbilt Eye Institute, Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Gregory
authors.affiliation: a Vanderbilt Eye Institute, Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Behin
authors.initials: B
authors.lastname: Barahimi
mesh_terms: D015353:Eye Enucleation / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D044469:Racial Groups; D012652:Self Mutilation / Q000453:epidemiology* / Q000523:psychology; D017678:Sex Distribution
keywords: Autoenucleation; disparity; psychosis; race