Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T04:10:51.444Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-injurious behaviour and the Gilles de la Tourette syndrome: a clinical study and review of the literature

Published online by Cambridge University Press:  09 July 2009

Mary M. Robertson ,
M. R. Trimble  and
A. J. Lees
Mary M. Robertson*
Affiliation:
Department of Psychiatry, University College and Middlesex Hospital Schools of Medicine, National Hospitals for Nervous Diseases, Queen Square, London
M. R. Trimble
Affiliation:
Department of Psychiatry, University College and Middlesex Hospital Schools of Medicine, National Hospitals for Nervous Diseases, Queen Square, London
A. J. Lees
Affiliation:
Department of Psychiatry, University College and Middlesex Hospital Schools of Medicine, National Hospitals for Nervous Diseases, Queen Square, London
*
1Address for correspondence: Dr M. M. Robertson, Academic Department of Psychiatry, University College and Middlesex Hospital Schools of Medicine, Middlesex Hospital, London WIN 8AA.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Thirty (33%) of 90 patients with the Gilles de la Tourette syndrome exhibited selfinjurious behaviour. Fourteen were head bangers, of whom two had cavum septum pellucidum. Clinical correlates of self-injury were the severity of Gilles de la Tourette syndrome symptoms and psychopathology, with special reference to obsessionality and hostility. We discuss an additional patient who died from a subdural haematoma as a result of head banging, and three who had permanent vision impairment from self inflicted eye injuries.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 3 , August 1989 , pp. 611 - 625
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edn.). American Psychiatric Association: Washington DC.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn. – revised). American Psychiatric Association: Washington DC.Google Scholar
Arons, B. S. (1981). Self-Mutilation: clinical examples and reflections. American Journal of Psychotherapy 35, 550–557.CrossRefGoogle ScholarPubMed
Ascher, E. (1948) Psychodynamic consideration in Gilles de la Tourette's disease (maladie des tics): with a report of five cases and discussion of the literature. American Journal of Psychiatry 105, 267–276.CrossRefGoogle Scholar
Bach-Y-Rita, G. (1974). Habitual violence and self-mutilation. American Journal of Psychiatry 131, 1018–1020.CrossRefGoogle ScholarPubMed
Barron, J. & Sandman, C. A. (1983). Relationship of sedativehypnotic response to self-injurious behaviour and stereotype by mentally retarded clients. American Journal of Mental Deficiency 88, 177–186.Google ScholarPubMed
Bayer, C. A. (1972). Self-monitoring and mild aversion treatment of trichotillomania. Journal of Behavioural Therapy and Experimental Psychiatry 3, 139–141.CrossRefGoogle Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Bennun, I. (1983). Depression and hostility in self-mutilation. Suicide and Life-Threatening Behaviour 13, 71–84.CrossRefGoogle Scholar
Bird, T. D., Cederbaum, S., Valpey, R. W. & Stahl, W. L. (1978). Familial degeneration of the basal ganglia with acanthocytosis: a clinical, neuropathological, and neurochemical study Annals of Neurology 3, 253–258.CrossRefGoogle ScholarPubMed
Backer, K. H. & Wong, N. (1963). Four cases of autocastration. Archives of General Psychiatry 8, 169–176.CrossRefGoogle Scholar
Bonitz, G. (1969). Sur klinische-diagnostischen Bedeutung des erweiterten und kommunizierenden cavum septi pellucidi. Nervenarzt 40, 121–128.Google Scholar
Bruun, R. D. (1984). Gilles de la Tourette's syndrome: an overview of clinical experience. Journal of the American Academy of Child Psychiatry 23, 126–133.CrossRefGoogle ScholarPubMed
Bruyn, G. W. (1977). Agenesis septi pellucidi, cavum septi pellucidi, cavum vergae and cavum veli interpositi. In Handbook of Clinical Neurology, Vol. xxx (ed. Vinken, P. J. and Bruyn, G. W.), pp. 299–336. Elsevier/North Holland: Amsterdam.Google Scholar
Bryson, Y., Sakati, N., Nyhan, W. L. & Fish, C. H. (1971). Selfmutilative behaviour in the Cornelia de Lange syndrome. American Journal of Mental Deficiency 76, 319–324.Google ScholarPubMed
Caine, E. D. (1985). Gilles de la Tourette's syndrome: a review of clinical and research studies and consideration of future directions for investigation. Archives of Neurology 42, 393–397.CrossRefGoogle ScholarPubMed
Caine, T. M., Foulds, G. A. & Hope, K. (1967) Manual of the Hostility and Direction of Hostility Questionnaire. University of London Press: London.Google Scholar
Caine, E. D., McBride, M. C., Chiverton, P., Bamford, K. A., Rediess, S. & Shiao, J. (1988). Tourette syndrome in Monroe County school children. Neurology 38, 472–475.CrossRefGoogle ScholarPubMed
Carson, D. I. & Lewis, J. M. (1971). Ocular auto-enucleation while under the influence of drugs: a case report. Adolescence 6, 397–403.Google Scholar
Casas-Bruge, M., Almenar, C., Grau, I. M., Jane, J., Herrerea-Marschitz, M. & Ungerstedt, V. (1985). Dopaminergic receptor supersensitivity in self-mutilatory behaviour of Lesch-Nyhan disease. Lancet i, 991.CrossRefGoogle Scholar
Christian, T. (1984). Self-damage in patients with Klinefeller's syndrome. Bulletin of Royal College of Psychiatrists 9, 218.Google Scholar
Christie, R., Bay, C., Kaufman, I. A., Bakay, B., Borden, M. & Nyhan, W. L. (1982). Lesch –Nyhan disease: clinical experience with nineteen patients. Developmental Medicine and Child Neurology 24, 293–306.CrossRefGoogle ScholarPubMed
Coid, J. M., Allolio, B. & Rees, L. H. (1983). Raised plasma metenkephalin in patients who habitually mutilate themselves. Lancet ii, 545–546.CrossRefGoogle Scholar
Conte, H. R., Plutchik, R., Karsau, T. B. & Jerrett, I. L. (1980). A self-report borderline scale: discriminative validity and preliminary norms. Journal of Nervous and Mental Diseases 168, 428–435.CrossRefGoogle ScholarPubMed
Corbett, J. (1975). Aversion for the treatment of self-injurious behaviour. Journal of Mental Deficiency Research 19, 79–95.Google ScholarPubMed
Corbett, J. A. & Campbell, H. J. (1980). Causes of severe selfinjurious behaviour. In Mental Retardation New Horizons, Vol.II Biomedical Aspects (ed. Mittler, P. and De Jong, J. M.), pp. 285–292. University Park Press: Baltimore.Google Scholar
Cordle, C. H. & Long, C. G. (1980). The use of operant self-control procedures in the treatment of compulsive hair-pulling. Journal of Behavioural Therapy and Experimental Psychiatry 11, 127–130.CrossRefGoogle Scholar
Corsellis, J. A. N., Burton, C. J. & Freeman-Browne, D. (1973). The aftermath of boxing. Psychological Medicine 3, 270–303.CrossRefGoogle ScholarPubMed
Critchley, E. M. R., Clark, D. B. & Wilker, A. (1968). Acanthocylosis and neurological disorder without betalipoproteinemia. Archives of Neurology 18, 134–140.CrossRefGoogle ScholarPubMed
Crowder, J. E., Gross, C. A., Heiser, J. F. & Crowder, A. M. (1979). Self-mutilation of the eye. Journal of Clinical Psychiatry 40, 420–423.Google ScholarPubMed
Crown, S. & Crisp, A. H. (1966). A short clinical diagnostic selfrating scale for psychoneurotic patients: the Middlesex Hospital Questionnaire (MHQ). British Journal of Psychiatry 122, 917–923.CrossRefGoogle Scholar
Dewhurst, K., Oliver, J. E. & McKnight, A. L. (1970). Sociopsychiatric consequences of Huntington's disease. British Journal of Psychiatry 116, 255–258.CrossRefGoogle ScholarPubMed
Dunlap, J. R. (1960). A case of Gilles de la Tourette's disease (maladie des tics): a study of the intrafamily dynamics. Journal of Nervous and Mental Diseases 130, 340–344.CrossRefGoogle ScholarPubMed
Eisenberg, L., Ascher, E. & Kanner, L. (1959). A clinical study of Gilles de la Tourette's disease (maladie des tics) in children. American Journal of Psychiatry 115, 715–723.CrossRefGoogle ScholarPubMed
Eldridge, R., Sweet, R., Lake, C. R. & Shapiro, A. K. (1977). Gilles de la Tourette's syndrome: clinical, genetic, psychologic, and biochemical aspects in 21 selected families. Neurology 27, 115–124.CrossRefGoogle ScholarPubMed
Eriksson, B. & Persson, T. (1969). Gilles de la Tourette's syndrome, two cases with an organic brain injury. British Journal of Psychiatry 115, 315–353.CrossRefGoogle ScholarPubMed
Esman, A. H. (1954). A case of self-castration. Journal of Nervous and Mental Disease 120, 79–82.CrossRefGoogle ScholarPubMed
Eysenck, J. J. & Eysenck, S. B. G. (1964). Manual of the Eysenck Personality Inventory. University of London Press: London.Google Scholar
Fabisch, W. (1980). Psychiatric aspects of dermatitis artefacta. British Journal of Dermatology 102, 29–34.CrossRefGoogle ScholarPubMed
Fadel, K. M. (1985). Self-mutilation. Psychiatry in Practice 4, 19–26.Google Scholar
Fairbairn, A. & Hassanyeh, (1981). Self mutilation. The Practitioner 225, 1498–1499.Google ScholarPubMed
Gardner, A. R. & Gardner, A. J. (1975). Self mutilation, obsessionality and narcissism. British Journal of Psychiatry 127, 127–132.CrossRefGoogle ScholarPubMed
Gilbert, S., Spellacy, E. & Whatts, R. W. E. (1979). Problems in the behavioural treatment of self-injury in the Lesch–Nyhan syndrome. Developmental Medicine and Child Neurology 21, 795–800.CrossRefGoogle ScholarPubMed
Gilles, , de la Tourette, G. (1885) Étude sur une affection nerveuse caracterisée par de l'incoordination motrice accompagnée d'écholalie et de copralalie. Archives of Neurology 9, 19–42, 158–200.Google Scholar
Gillman, M. A. & Sandyk, R. (1986). Tourette syndrome and the opioid system. Psychiatry Research 15, 161–162.CrossRefGoogle Scholar
Golden, G. S. & Greenhill, L. (1981). Tourette syndrome in mentally retarded children (review). Mental Retardation 19, 17–19.Google Scholar
Gorea, E. & Lombard, M. C. (1984). The possible participation of a dopaminergic system in mutilating behaviour in rats with forelimb deafferentation. Neuroscience Letters 48, 75–80.CrossRefGoogle ScholarPubMed
Graff, H. & Mallin, R. (1967). The syndrome of the wrist cutter. American Journal of Psychiatry 124, 36–42.CrossRefGoogle ScholarPubMed
Green, A. H. (1967). Self-mutilation in schizophrenic children. Archives of General Psychiatry 17, 234–244.CrossRefGoogle ScholarPubMed
Greilsheimer, H. & Groves, J. E. (1979). Male genital self-mutilation. Archives of General Psychiatry 36, 441–446.CrossRefGoogle ScholarPubMed
Griffin, N., Webb, M. G. T. & Parker, R. R. (1982). A case of selfinflicted eye injuries. Journal of Nervous and Mental Disease 170, 53–56.CrossRefGoogle ScholarPubMed
Haber, S. N., Kowall, N. W., Vonsattel, J. P., Bird, E. D. & Richardson, E. P. (1986). Gilles de la Tourette's syndrome: a postmortem neuro-pathological and immunohistochemical study. Journal of the Neurological Sciences, 75, 225–241.CrossRefGoogle Scholar
Hall, D. C., Lawson, B. Z. & Wilson, L. G. (1981). Command hallucinations and self-amputation of the penis and hand during a first psychotic break. Journal of Clinical Psychiatry 42, 322–324.Google ScholarPubMed
Hassanyeh, F. (1988). Self-mutilation in psychiatric inpatients. British Journal of Clinical and Social Psychiatry 3, 27–29.Google Scholar
Holm, V. A. (1981). The diagnosis of the Prader-Willi syndrome. In The Prader Willi Syndrome, (ed. Holm, V. A.Sulzbacher, S. J.Steffes, M. J. and Pipes, P. L.), pp. 27–44. University Park Press: Baltimore.Google ScholarPubMed
Isherwood, I., Mawdsley, C. & Ferguson, F. R. (1966). Pneumoencephalographic changes in boxers. Acta Radiology 5, 654–661.Google ScholarPubMed
Jenkins, R. L. & Ashby, H. B. (1983). Gilles de la Tourette syndrome in identical twins. Archives of Neurology 40, 249–251.CrossRefGoogle ScholarPubMed
Johnson, J. (1969). Organic psychosyndromes due to boxing. British Journal of Psychiatry 115, 45–53.CrossRefGoogle ScholarPubMed
Johnson, H G., Ekman, P. & Friesen, W. (1976). A behavioural phenotype in the de Lange syndrome. Pediatric Research 10, 843–850.CrossRefGoogle ScholarPubMed
Jones, I. H. & Barraclough, B. M. (1978). Auto-mutilation in animals and its relevance to self-injury in man. Acta Psychiatrica Scandinavica 58, 40–47.CrossRefGoogle ScholarPubMed
Kendell, R. E. & Discipio, W. J. (1968). Eysenck Personality Scores of patients with depressive illness. British Journal of Psychiatry 114, 767–770.CrossRefGoogle Scholar
Kinnell, H. G. (1984). ‘Addiction’ to a strait jacket: a case report of treatment of self-injurious behaviour in an autistic child. Journal of Mental Deficiency Research 28, 77–79.Google Scholar
Kito, S., Itoga, E., Hiroshige, Y., Matsumoto, N. & Miwa, S. (1980). A pedigree of amyotrophic chorea with acanthocytosis. Archives of Neurology 37, 514–517.CrossRefGoogle ScholarPubMed
Kushner, A. W. (1967). Two cases of auto-castration due to religious delusions. British Journal of Medical Psychology 40, 293–298.CrossRefGoogle ScholarPubMed
Lees, A. J., Robertson, M., Trimble, M. R. & Murray, N. M. F. (1984). A clinical study of Gilles de la Tourette syndrome in the United Kingdom. Journal of Neurology, Neurosurgery and Psychiatry 47, 1–8.CrossRefGoogle ScholarPubMed
Lesch, M. & Nyhan, W. L. (1964). A familial disorder of uric acid metabolism and central nervous system function. American Journal of Medicine 36, 561–570.CrossRefGoogle ScholarPubMed
Lieh Mak, F., Ghung, S. Y., Lee, P. & Chen, S. (1982). Tourette syndrome in the Chinese: a follow-up of 15 cases. In Gilles de la Tourette Syndrome Advances in Neurology, Vol. xxxv (ed. Friedhoff, A. J. & Chase, T. N.), pp 281–283. Raven Press: New York.Google Scholar
Lloyd, K. G., Hornykiewics, O., Davidson, L., Shannak, K., Farley, I. L., Goldstein, M., Shibuya, M., Kelley, W. N. & Fox, I. H. (1981). Biochemical evidence of dysfunction of brain neurotransmitters in the Lesch-Nyhan syndrome New England Journal of Medicine 305, 1106–1111.CrossRefGoogle ScholarPubMed
Lowy, F. H. & Kolivakis, T. L. (1971) Autocastration by a male transsexual. Canadian Psychiatric Association Journal 16, 399–405.CrossRefGoogle ScholarPubMed
Lubin, A. J. (1961). Vincent van Gogh's ear. Psychoanalytic Quarterly 30, 351–384.CrossRefGoogle Scholar
Lukianowicz, N. (1967). Body image disturbances in psychiatric disorders. British Journal of Psychiatry 113, 31–47.CrossRefGoogle ScholarPubMed
Lyon, L. S., (1983). A behavioural treatment of compulsive lipbiting Journal of Behavioural, Therapeutic and Experimental Psychiatry 14, 275–276.CrossRefGoogle ScholarPubMed
McKerracher, D. W., Loughnane, T. & Watson, R. A. (1968). Selfmutilation in female psychopaths. British Journal of Psychiatry 114, 829–832.CrossRefGoogle ScholarPubMed
Maclean, G. & Robertson, B. M. (1976). Self-enucleation and psychosis. Archives of General Psychiatry 33, 242–249.CrossRefGoogle ScholarPubMed
McNair, O. M & Lorr, M. (1964). Analysis of mood in neurotics. Journal of Abnormal and Social Psychology 69, 620–627.CrossRefGoogle ScholarPubMed
Martin, M. A. & Rundle, A. T. (1980). Physiological and psychiatric investigations into a group of mentally handicapped subjects with self-injurious behaviour. Journal of Mental Deficiency Research 24, 77–85.Google Scholar
Mizuno, T. & Yugari, Y. (1975). Prophylactic effect of L-5- hydroxytryptophan on self-mutilation in the Lesch–Nyhan syndrome. Neuropaediatric 6, 13–23.CrossRefGoogle Scholar
Moldofsky, H., Tullis, C. & Lamon, R. (1974). Multiple tics syndrome (Gilles de la Tourette's syndrome). Journal of Nervous and Mental Diseases 15, 282–292.CrossRefGoogle Scholar
Morgan, H. G., Burns-Cox, C. J., Pocock, H. & Pottle, S. (1975). Deliberate self-harm: clinical and socio-economic characteristics of 368 patients. British Journal of Psychiatry 127, 564–574.CrossRefGoogle ScholarPubMed
Morphew, J. A. & Sim, M. (1969). Gilles de la Tourette's syndrome: a clinical and psychopathological study. British Journal of Medical Psychology 42, 293–301.CrossRefGoogle ScholarPubMed
Murphy, G. H. (1985). Self-injurious behaviour in the mentally handicapped: an up-date. Newsletter of the Association of Child Psychology and Psychiatry 7, 2–11.Google Scholar
Murray, T. J. (1979). Dr Samuel Johnson–s movement disorders. British Medical Journal 1, 1610–1614.CrossRefGoogle Scholar
Nee, L. E., Caine, E. D., Polinsky, R. J., Eldridge, R. & Ebert, M. H. (1980). Gilles de la Tourette syndrome: clinical and family study of 50 cases. Annals of Neurology 7, 41–49.CrossRefGoogle ScholarPubMed
Nyhan, W. L. (1968). Introdution –clinical and genetic features. Federation Proceedings 27, 1027–1033.Google Scholar
Nyhan, W. L. (1972). Clinical features of the Lesch–Nyhan syndrome. Archives of International Medicine 130, 186–192.CrossRefGoogle ScholarPubMed
Obendorf, C. P. (1916). Simple tic mechanism. Journal of American Medical Association 16, 99–100.CrossRefGoogle Scholar
Odejide, A. O., Williams, A. O., Ohaeri, J. U. & Ikuesan, B. A. (1986). The epidemiology of deliberate self-harm. The Ibadan Experience. British Journal of Psychiatry 149, 734–737.CrossRefGoogle ScholarPubMed
Pao, P. N. (1969). The syndrome of delicate self-cutting. British Journal of Medical Psychology 42, 195–206.CrossRefGoogle ScholarPubMed
Pfeiffer, C. C., Iliey, , Nichols, R. E. & Surgerman, A. A. (1969). The serum urate level reflects degree of stress. Journal of Clinical Pharmacology 9, 384–392.Google ScholarPubMed
Philip, A. E. (1971). Psychometric changes associated with response to drug treatment. British Journal of Social and Clinical Psychology 10, 138–143.CrossRefGoogle ScholarPubMed
Phillips, R. H. & Alkan, M. (1961). Recurrent self-mutilation. Psychiatric Quarterly 35, 424–431.CrossRefGoogle ScholarPubMed
Priest, R. G., Addala, A. D. & Wallis, G. G. (1984). Self-damage in patients with Klinefelter's syndrome. Bulletin of the Royal College of Psychiatrists 8, 140.Google Scholar
Rada, R. T. & James, W. (1982). Urethral Insertion of foreign bodies. A report of contagious self-mutilation in a maximumsecurity hospital. Archives of General Psychiatry 39, 423–429.CrossRefGoogle Scholar
Rajathurai, A., Chasan, B. I. & Jeans, J. E (1983). Self mutilation as a feature of Addison's disease. British Medical Journal 287, 1027CrossRefGoogle ScholarPubMed
Ramsey, N. (1985). Self-damage in patients with Klinefelter's syndrome. Bulletin of the Royal College of Psychiatrists 9, 39.CrossRefGoogle Scholar
Reid, A. H., Ballinger, B. R. & Heather, B. B. (1978). Behavioural syndromes identified by cluster analysis in a sample of 100 severely and profoundly retarded adults. Psychological Medicine 8, 399–412.CrossRefGoogle Scholar
Richardson, H. S. & Zaleski, W. A. (1983). Naloxone and selfmutilation. Biological Psychiatry 18, 99–101.Google ScholarPubMed
Rinzler, C. & Shapiro, D. A. (1968). Wrist-cutting and suicide. Journal Mount Sinai Hospital NY. 25, 485–488.Google Scholar
Robertson, M. M., Trimble, M. R. & Lees, A. J. (1988). The psychopathology of the Gilles de la Tourette syndrome. A phenomenological analysis. British Journal of Psychiatry 152, 383–390CrossRefGoogle ScholarPubMed
Rogers, T. & Pullen, I. (1987). Self-inflicted eye injuries. British Journal of Psychiatry 151, 691–693.CrossRefGoogle ScholarPubMed
Rosen, D. H. & Hoffman, A. M. (1972). Focal suicide: selfenucleation by two young psychotic individuals. American Journal of Psychiatry 128, 1009–1011.CrossRefGoogle ScholarPubMed
Rosenthal, R. J., Rinzler, C., Walsh, R. & Klausner, E. (1972). Wrist-cutting syndrome: the meaning of a gesture. American Journal of Psychiatry 128, 47–42.CrossRefGoogle ScholarPubMed
Rutter, M. & Lockyer, I. (1967). A five to fifteen year follow-up study of infantile psychosis. Description of sample. British Journal of Psychiatry 113, 1169–1182.CrossRefGoogle ScholarPubMed
Sakai, T., Mawatari, S., Twashita, H., Goto, I. & Kuroiwa, Y. (1981). Choreoacanthocytosis. Clues to clinical diagnosis. Archives of Neurology 38, 335–338.CrossRefGoogle ScholarPubMed
Sanchez, V. (1979). Behavioural treatment of chronic hair pulling in a two-year-old. Journal of Behavioural Therapy and Experimental Psychiatry 10, 241–245.CrossRefGoogle Scholar
Sandyk, R. (1985). The effects of naloxone in Tourette's syndrome. Annals of Neurology 18, 367–368.CrossRefGoogle ScholarPubMed
Schaffer, C. B., Carroll, J. & Abramowitz, S. I. (1982). Self-mutilation and the borderline personality. Journal of Nervous and Mental Diseases 170, 468–473.CrossRefGoogle ScholarPubMed
Schneider, S. F., Harrison, S. I. & Siegel, B. L. (1965). Self-castration by a man with cyclic changes in sexuality. Psychosomatic Medicine, 27 53–70.CrossRefGoogle Scholar
Scully, C. (1981). The orofacial manifestations of the Lesch-Nyhan syndrome. International Journal of Oral Surgery (Copenhagen) 10, 380–383.CrossRefGoogle ScholarPubMed
Seegmiller, J. E. (1968). In discussion, Hoefnagel, D. (1968). Seminars on Lesch–Nyhan Syndrome, summary. Federation Proceedings 27, 1046.Google Scholar
Shapiro, A. K., Shapiro, E., Bruun, R. D. & Sweet, R. D. (1978). Gilles de la Tourelte Syndrome. Raven Press: New York.Google Scholar
Shaw, C. M. & Alvord, E. C. (1969). Cava septi pellucidi et vergae: their normal and pathological states. Brain 92, 213–224.CrossRefGoogle Scholar
Shear, C. S., Nyhan, W. L., Kirman, B. H. & Stern, J. (1971). Selfmutilative behaviour as a feature of the de Lange syndrome. Journal of Pediatrics 78, 506–509.CrossRefGoogle ScholarPubMed
Shore, D. (1979). Self-mutilation and schizophrenia. Comprehensive psychiatry, self-mutilation and Klinefelter's syndrome. Bulletin of the Royal College of Psychiatrists 9, 384–387.Google Scholar
Simpson, M. A., (1985). Self mutilation and Klinefelter's syndrome. Bulletin of the Royal College of Psychiatrists 9, 83.CrossRefGoogle Scholar
Singh, N. N. & Pulman, R. M. (1979). Self-injury in the De Lange syndrome. Journal of Mental Deficiency Research 23, 79–81.Google ScholarPubMed
Singh, N. N. & Winston, A. S. W. (1984). Behavioural monitoring of pharmacological interventions for self-injury. Applied Research in Mental Retardation 5, 161–170.CrossRefGoogle ScholarPubMed
Slawson, P. F. & Davidson, P. W. (1964). Hysterical self-mutilation of the tongue. Archives of General Psychiatry 11, 581–588.CrossRefGoogle ScholarPubMed
Snowdon, J (1980). A comparison of written and postbox forms of the Leyton Obsessional Inventory. Psychological Medicine 10, 165–170.CrossRefGoogle ScholarPubMed
Soebo, J. (1941). Automutilation bulborum. A rare case of sel-fmutilation in an epileptic. Acta Ophthalmology 265, 451–453.Google Scholar
Sonnlag, I., Nadjmi, M., Lajosi, F. & Fuchs, G. (1971). Anlage-bedingte Gehirnanomalien der Mittellinie. Nervenarzt 42, 531–539.Google Scholar
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. E. (1970). Manual for the Slate Trait Anxiety Inventory (‘Self-Evaluation Question-naire’. )Consulting Psychologists Press: Palo Alto.Google Scholar
Spillane, J. D. (1962). Five boxers. British Medical Journal, ii, 1205–1210.CrossRefGoogle Scholar
Stannard, K., Leonard, T.. Holder, G. & Shilling, J. (1984). Oedipism reviewed: as case of bilateral ocular self-mutilation. British Journal of Oplhalmology 68, 276–280.Google ScholarPubMed
Stefl, M. E. (1984). Mental health needs associated with Tourette syndrome. American Journal of Public Health 74, 1310–1313.CrossRefGoogle ScholarPubMed
Stevens, J. R. & Blachly, P. H. (1969). Successful treatment of the maladie des tics. American Journal of Diseases of Childhood 112, 541–545.CrossRefGoogle Scholar
Sweeny, S. & Zamecnik, K. (1981). Predictors of self-mutilation in patients with schizophrenia. American Journal of Psychiatry. 138, 108–1089.Google ScholarPubMed
Swenson, O. (1944). Nature and occurrence of the cavum septi pellucidi. Archives of Pathology 37, 119–123.Google Scholar
Tapper, C. M., Bland, R. C. M. & Danyluk, L. (1979). Self-inflicted eye injuries and self-inflicted blindness. Journal of Nervous and Mental Disease 167, 311–314.CrossRefGoogle ScholarPubMed
Tenzer, J. A. & Orozco, H. (1970). Traumatic glossectomy. Oral Surgery 30, 182–184.CrossRefGoogle ScholarPubMed
Thomas, C. J. & Turner, P. (1984). Self-damage in patients with Klienfeller's syndrome. Bulletin of Royal College of Psychiatrists 9, 218.Google Scholar
Thompson, J. N. & Abraham, T. K. (1983). Male genital self mutilation after paternal death. British Medical Journal 287, 727–728.CrossRefGoogle ScholarPubMed
Thompson, P. J. (1981) The effects of anticonvulsant drugs on the cognitive functioning of normal volunteers and patients with epilepsy. Ph.D. Thesis, University of London.Google Scholar
Van Woert, M. H., Jutkowitz, R., Rosenbaum, D. & Bowers, M. B. (1976). Gilles de la Tourette's syndrome biochemical approaches. In The Basal Ganglia (ed. Yahr, M. D.), pp. 459–465. Raven Press: New York.Google Scholar
Van Woert, M. H., Yip, L. C. L. & Ballis, M. E. (1977). Purine phosphoribosyltransferases in Gilles de la Tourette syndrome. New England Journal of Medicine 297, 210–212.CrossRefGoogle Scholar
Vassella, F., Emrich, H. M., Krause-Ruppert, R., Aufdermaur, F. & Tonz, O. (1968). Congenital sensory neuropathy with anhidrosis. Archives of Diseases of Childhood 43, 124–130.CrossRefGoogle ScholarPubMed
Virkkunen, M. (1976). Self mutilation in antisocial personality disorder. Acta Psychiatrica Scandinavica 54, 347–352.CrossRefGoogle ScholarPubMed
Waugh, A. C. (1986). Autocastration and biblical delusions in schizophrenia. British Journal of Psychiatry 149, 656–658.CrossRefGoogle ScholarPubMed
Woody, R. C. & Eisenhauer, G. (1986). Tooth extraction as a form of self-mutilation in Tourette's disorder. Southern Medical Journal 79, 1466.CrossRefGoogle ScholarPubMed
Yesavage, J. A. (1983). Direct and indirect hostility and selfdestructive behaviour by hospitalized depressives. Acta Psychiatrica Scandinavica 68, 345–350.CrossRefGoogle ScholarPubMed
Zealley, A. K. (1983). Mental handicap. In Companion to Psychiatric Studies (ed. Kendell, R. E. and Zeally, A. Z.), pp. 374–395. Churchill Livingstone Edinburgh.Google Scholar