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A case of unrelenting pursuit of castration
C M Leung1, T S Lee, M W Chan Ho
1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong.
Objective:
Explore the limitations of the classification of body dysmorphic disorder.
Clinical Picture:
A chinese male relentlessly pursued castration to relieve painful erections which were never substantiated. The testes and corporaspongiosum had been removed. No psychotic symptom was prominent.
Treatment:
Cognitive therapy and psychotropics were tried.
Outcome:
The remaining corpora cavernosa was removed subsequently.
Conclusion:
The distorted somatic perception and secondary cognitive amplification (painful erections) could represent a variant of body dysmorphic disorder involving internal body image; diagnostic classifications should accommodate such a category.