Liaison psychiatry: Its impact in an intrahospital treatment for a psychotic patient

Abstract

Different manners of non-suicidal self-injuries are common ways to deliberately hurt oneself in order to aliviate suffering. It can be seen in various psychiatric affections. The ingestion of bizarre objects in psychotic patients is part of aggressive behaviour as a reaction to massive anxiety. We hereby present the case of a schizophrenic patient who presented to the Emergency Department for a second episode of ingestion of numerous metallic objects (screws, coins, knives, spoon, handles, …). Physical examination showed no abdominal guarding. CT scan revealed the presence of multiple metallic objects, which seemed impossible to go through the pylorus. Surgical transgastric extraction was performed. Outcome was uneventful. Patient was discharged and followed-up in a private structure. Three months later, the patient was readmitted for the same reason. Flexible endoscopy allowed this time complete extraction of the ingested objects. He recovered rapidly and was allowed to discharge from the surgical ward. The psychiatrist took decision with family to transfer him into a psychiatric hospital for the first time. His treatment was: chlorpromazine, Proton pump inhibitor, pain killers. Patient was treated by means of medication, psychotherapy, daily activities and family, preparation him for a day hospital.

Conclusion

We discuss here the beneficial multifocal treatment of a 42-year-old man suffering from schizophrenia. The life threatening ingestion of sharp and other metallic objects three times in a year was treated surgically with success. The psychiatric affection including invalidating acoustic-verbal delusions and severe negative signs were treated in pcychiatric hospital. The definite results will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.