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Genital self-mutilation is an uncommon, but severe form of self-injury. The causes of self-mutilation of genitalia are multiple that is, from command hallucination in psychotic disorder, drug intoxication, mental retardation, gender dysphasia to personality disorders. Self-mutilation of genitalia as a method of suicide is very rare in depression. Here we report a case of 28 year old male, who presented to emergency department with self-mutilation of genitalia as an attempt of suicide. Thus the clinician should always be watchful while dealing with self-mutilation in psychiatric patients, as sometimes self-mutilation of genitalia in psychiatric patients can present as suicide.Self-mutilation is defined as repetitive, deliberate self-destruction of a part of his or her own body that is not life-threatening. Self-mutilation is categorized as a form of self-injury according to some researchers.
Self-injury has been defined as a type of self-harm that involves inflicting injury or pain on one’s own body. Various forms of self-injurious behavior include cutting with sharp objects, pulling out finger and toe nails, pin pricks, skin picking, head banging and other injurious behavior. Minor self-mutilation is fairly common in general population and does not cause any infirmity, as it is usually part of cultural practice. Major Self-Mutilation (MSM) is a very rare complication of severe mental illness and causes significant disability.Ocular, genital, and limb mutilation are the three main forms of major self-mutilation. The estimated incidence of self-mutilation in adolescents and young adults is 1,800 per 100,000. However incidence among inpatient adolescents is 40%.The incidence of severe forms of major self-mutilation is very rare (1 in 4,000,000 per annum). Further, 4% of hospitalized psychiatric patients have history of attempt of self-mutilation. 55%-85% of self-mutilators have attempted suicide, at least one in their life.
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