Meeting abstract

https://doi.org/10.24869/spsih.2026.218

Genital Self-Injury: Clinical and Etiological Features, With a Case Report

Hana Plesničar ; General Hospital Varaždin, Ivana Meštrovića 1, 42000 Varaždin, Croatia *
Petar Bilić ; University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10090 Zagreb, Croatia
Javor Vouk- Kamenski ; General Hospital Varaždin, Ivana Meštrovića 1, 42000 Varaždin, Croatia
Suzana Vlatković ; University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10090 Zagreb, Croatia
Andrea Tomić ; University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10090 Zagreb, Croatia
Mladen Haupert ; University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10090 Zagreb, Croatia
Ana Papić ; University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10090 Zagreb, Croatia
Antoana Bagarić ; University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10090 Zagreb, Croatia
Emanuel Lacković ; General Hospital Varaždin, Ivana Meštrovića 1, 42000 Varaždin, Croatia

* Corresponding author.

Abstract

Genital self-injury is a rare and complex form of
self-destructive behavior that involves the intentional
damage of one’s own external genital
organs to varying degrees (superficial self-injury,
autocastration/autoorchiectomy, autopenelectomy).
Given the specificity and rarity of such cases,
they are often isolated, and there are no precise
data on the incidence and prevalence of genital
self-injury. However, with respect to sex, the vast
majority of published cases involve individuals
of male biological sex. Within risk groups, the
highest frequency is found in psychotic disorders
(this group also has the greatest risk of recurrent
genital self-injury), followed by substance use
disorders, personality disorders, and gender dysphoria.
In contrast to other forms of self-injury,
genital self-injury is characterized by its acute ness, often the absence of a prior pattern of other
self-injurious behaviors, a high degree of bodily
harm, and its association with an altered state
of consciousness/reality. We present the case of
a patient (F23.2) who, during an acute psychotic
episode with sexual–moral themes (previously
treated for psychotic decompensations), carried
out a partial autopenelectomy. Based on diagnostic
workup and extensive history taking, it was
concluded that this was a patient with late-onset,
recurrent, and short-lasting psychotic decompensations
on the background of a neurotic–narcissistic
personality structure characterized by feelings
of inferiority, fragile identity, sexual guilt
and shame, along with simultaneous hypersexualization
of identity and idealization of self-image
aimed at affirming his own worth. The patient’s
history of alcoholism, predominantly serving a
self-medication function, together with atrophic
brain changes described on CT, represent potential
precipitating factors which, in the context
of reduced impulse control and impaired affect
regulation, may have increased vulnerability to
psychotic breakdowns. The patient was treated
with a combination of psychopharmacotherapy
and psychosupport, and given the characteristics
and complexity of the psychopathology, psychotherapeutic
treatment was also indicated.

Keywords

genital self-injury; autocastration; psychosis

Hrčak ID:

352347

URI

https://hrcak.srce.hr/352347

Publication date:

15.6.2026.

Article data in other languages: croatian

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