Citation

Crawford A, Wand AP, Smith MA. Australas. Psychiatry 2015; 24(2): 173-175.

Affiliation

Staff Specialist Psychiatrist, Consultation-Liaison Psychiatry and Conjoint Lecturer, South Eastern Sydney Local Health District, NSW, and; Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia.

Copyright

(Copyright © 2015, Royal Australian and New Zealand College of Psychiatrists, Publisher SAGE Publishing)

DOI

10.1177/1039856215604479

PMID

26400454

Abstract

OBJECTIVES: To detail a diagnostic dilemma of intentional hand amputation in a man with a history of substance misuse and associated psychosis, depression and traumatic brain injury and to highlight issues in joint psychiatric and surgical management of such a complex patient in a general hospital setting.

CONCLUSIONS: Deliberate limb self-amputation is a rare event with the majority of reported cases occurring during an episode of psychosis. This case illustrates the diagnostic utility of the literature supporting that a person who has self-inflicted amputation of a limb should be treated as psychotic until proven otherwise. The presence of a traumatic brain injury, with associated cognitive and psychosocial sequelae, affected diagnosis and management. Early and ongoing involvement of consultation-liaison psychiatry collaborating with a multidisciplinary general hospital team may improve mental and physical health outcomes for such patients.

Language: en