title: A Case of Genital Self-Mutilation in a Female-Symptom Choice and Meaning.
abstract: Self-mutilation is understood as any willful gesture or alteration of the body tissue without a suicidal intent. The most common self-mutilating gestures are, to a great extent, those that are superficial or moderate, such as cuts, burns, or bites. The most severe, as is the case of genital self-mutilation (GSM), are extremely rare and, in most cases, observed in patients suffering from psychosis. Furthermore, they are mostly reported from a surgical standpoint. Here, we report the case of a 20-year-old female patient who resorted to the emergency department after having amputated her clitoris with surgical scissors. This dramatic gesture, coupled with the patient's narrative, prompted for differential diagnosis between a psychotic syndrome and a severe personality disorder. We propose that, despite the magnitude of the self-harm, it is possible to conceptualize this GSM within a disturbed personality with significant sexuality issues and, therefore, this case report aims to broaden the limits that have been associated with the self-mutilating gestures in borderline personality disorder.
authors.affiliation: a Department of Psychiatry and Mental Health , Baixo-Vouga Hospital Centre , Aveiro , Portugal.
authors.forename: Ema
authors.initials: E
authors.lastname: Conde
authors.affiliation: a Department of Psychiatry and Mental Health , Baixo-Vouga Hospital Centre , Aveiro , Portugal.
authors.forename: Telma
authors.initials: T
authors.lastname: Santos
authors.affiliation: a Department of Psychiatry and Mental Health , Baixo-Vouga Hospital Centre , Aveiro , Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Leite
authors.affiliation: a Department of Psychiatry and Mental Health , Baixo-Vouga Hospital Centre , Aveiro , Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Vicente
authors.affiliation: a Department of Psychiatry and Mental Health , Baixo-Vouga Hospital Centre , Aveiro , Portugal.
authors.forename: António Mesquita
authors.initials: AM
authors.lastname: Figueiredo
mesh_terms: D005260:Female; D005836:Genitalia, Female / Q000293:injuries* / Q000473:pathology; D006801:Humans; D010554:Personality Disorders / Q000523:psychology; D012652:Self Mutilation / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000523:psychology*; D013520:Urologic Surgical Procedures; D055815:Young Adult