Man with rare schizophrenia ripped off his own genitals

An extremely rare case of severe schizophrenia, reported in Pune three months ago, which involved genital selfmutilation, has brought about a research paper with the patient as a case study. This was said to be the first case of such extreme severity, where the patient ripped off his own genitals, including testicles and penis, and also had a history of eating faeces. After treatment and reconstruction surgery for his genitals, he suffered from severe depression and was later treated for that as well. The case was reported at Sassoon General Hospital.

Elaborating on the case, consultant psychiatrist Dr Anuj Khandelwal, who treated the patient and co-wrote the paper, said “Suraj (name changed), a 22-year-old, was brought to the casualty wing a few months ago and was extremely violent. He had jumped off a bridge, severely injured his limbs and was later admitted for surgery. However, due to his behaviour and classic symptoms of psychosis, his case was referred to us. On thoroughly perusing his history, we found it to be a case of schizophrenia.”

On being diagnosed, Suraj’s actions grew more volatile. “He ripped off his own genitals, severing the organs badly. He also ate faeces, including his own. When he was admitted, no such details were noted initially. But, the next day he was observed more closely and he confessed to some of his actions himself. On asking why he did such things, he said a voice told him to do so and that it was related to self-realisaton,” Khandelwal said.

“Earlier, his symptoms included, shouting, screaming, talking to people who weren’t visible, giving irrelevant answers, etc. After the episode of self-harm, he was immediately referred for surgical intervention and underwent a reconstruction. However, after recovering 45 days later, he realised the episodes and self-mutilation he had suffered and plunged into severe depression and shock for which he was treated. During this time, he revealed that he had travelled to Pune in search of a motivational guru and was studying engineering. He also said that he is not originally from Pune. He has been asked to undergo a compulsory follow-up session,” Khandelwal added.

Emphasising the rarity of the case, Dr Avinash Desouza, from Mumbai, consultant psychiatrist and research associate at Lokmanya Tilak Medical College, who also had a hand in writing the research paper, said, “Usually, in schizophrenia, patients try to commit suicide and end up harming themselves. Burning or cutting themselves is seen, but genital self-mutilation is hardly reported. In Mumbai, only three or four cases have been seen so far in many years. Such severity calls for immediate intervention and early diagnosis.”

Dr Krishna Kadam, senior psychiatrist at Maharashtra Institute of Mental Health and Sassoon hospital, said, “The patient was brought to us and I have never seen such a severe case of schizophrenia in my career of 20 years. Such episodes occur in extremely severe case but so far none has been reported apart from this one.”

Dr B Donglikar, medical superintendent at Yerwada Regional Mental Hospital, said, “Such cases are extremely unique and we haven’t seen any at the hospital. Patients in such cases get exceedingly violent. Early intervention and diagnosis are very important so that harm is avoided.”

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