Treatment of pathomymia in a clinic in Moscow

Pathomimia - causes, signs, treatment, symptoms

Pathomimia is the actions of individuals of a self-destructive nature aimed at causing injury to their own body. More often, such actions are a consequence of the presence of defects in mental functioning.

This deviation is expressed in self-harm of the skin, that is, the main symptom is auto-aggression (mutilation by an individual to himself). The term literally means “depiction of suffering and pain.”

Simply put, the subject inflicts bodily injuries on himself that mimic the skin lesions that occur in a variety of dermatological ailments. The injuries usually appear as bites, cuts, wounds, or burns.

Self-harm is most often observed in areas of the body that are easily accessible for self-harm, for example, on the skin of the chest, face, arms or legs.

Pathomimia in psychiatry and dermatology

Psychiatrists identify this disorder with Munchausen syndrome - the imitation of symptoms of a physical or mental illness by self-harm.

Dermatologists interpret the concept of pathomymia more broadly. It refers to a group of self-destructive manifestations inflicted on the patient himself, intentionally or unknowingly - under the influence of a mental disorder. This group includes:

• mechanical dermatoses;

• damage to the skin in delusional disorders;

• dermatomanias/phobias: neurotic escoriations; onychophagia, or nail biting; onychotillomania, or damage to the nail plates; trichotillomania, or hair pulling; Cheilophagia, or biting the cheeks or their mucous membranes.

What can cause pathomimia?

Artificial dermatosis can be caused by a wide range of painful conditions:

• personal – psychopathy of the schizoid, paranoid, hysterical circle;

• psychogenic – post-traumatic stress disorders;

• dissociative disorders;

• depression;

• organic diseases of the central nervous system;

• behavioral and mental disorders associated with the use of psychoactive substances;

• schizophrenia.

Signs of auto-aggression, expressed in unconscious skin self-harm, may indicate not only the presence of mental disorders.

Infantile, sensitive individuals who have difficulty coping with failures and have increased anxiety and aggressiveness are susceptible to pathomymia.

Psychoanalysts consider auto-aggression one of the ways to protect against emotional overstrain, a unique form of repressing uncertainty, anxiety, and fears.

Reasons for the development of the disease

In some cases, specific working conditions or the presence of diseases of the endocrine system can provoke pathology.

It is extremely rare that the cause of pathomimia is a genetic predisposition to the disease.

Some doctors consider pathomimia as an option for self-defense, which arises from the psyche as a result of exposure to external negative factors. It is believed that when a person is unable to direct his aggression to an external object (stimulant), he engages in self-flagellation.

The following factors can trigger the development of pathomymia:

According to research, the first self-harm occurs as a result of a strong psycho-emotional event.

Subsequent desires to inflict self-mutilation arise even with minor psychological experiences. In most cases, the patient chooses one of the options for self-flagellation - cuts, bites, scratching, etc.

After performing the action, the sick person experiences some relief, satisfaction and calm.

Depending on the damage caused, pathomimia is classified into several types:

Dermatomania - a person experiences a constant desire to damage the mucous membranes and epidermis.
Onychophagia - the patient regularly bites his nails.
Dermatolasia - a person experiences an uncontrollable desire to damage the skin around the nail plate.
Cheilophagia is a pathology characterized by an uncontrollable desire to damage the lips.
Trichotillomania is a constant urge to pull out hair.
Excoriation is an uncontrollable desire to scratch the skin, which can lead to the appearance of abrasions, scars and wounds on the skin.

Diagnosis of pathomymia

Identifying this disorder is not an easy task. There are cases where it took specialists more than one year to recognize the disease.

The following are considered diagnostic confirmations of pathomymia:

• bizarre outlines of rashes of various sizes or polygonal nature of scratches;

• disfiguring self-harm of a grotesque nature in the schizophrenic process;

• unchanged dermis around wounds;

• frequent occurrence of new injuries of the same type

• localization of lesions in places most accessible to the patient: on the forearms, thighs, face, upper back;

• itching or pain in the injured areas;

• with a pronounced nature of auto-aggression, patients persistently deny the fact of involvement in it;

• during a psychiatric examination, psychopathic personality traits are often revealed, prone to aggravation, hysteria, and obsessive thoughts;

• with delusional disorders, in particular manic-depressive psychosis, patients experience tactile hallucinations, it seems to them that some insects are crawling on them, so they constantly disinfect their body and underwear;

• patients can show the doctor containers with particles of skin or its appendages that they have scraped off, requesting analysis of this material;

• detection of self-harm instruments in the patient, after removal of which the pathological symptoms quickly disappear.

Source: https://gudi1991.ru/kompleksy/patomimiya-lechenie.html

What is pathomimia?

The site for psychotherapeutic help psymedcare.ru calls pathomymia the individual’s direction against himself when he begins to injure himself, thus trying to cause harm. A person inflicts injuries on himself that resemble burns, wounds, bites, etc. Accordingly, they are located in areas that are accessible to a person for causing harm to himself.

The main feature of pathomimia is auto-aggression - self-mutilation. When a person sees evil in himself, blames himself for something, hates his body or simply himself, then he begins to cause harm. You can harm yourself in various ways, one of which is pathomimia.

It is based on a lack of self-love. Why does a person dislike himself? Unfortunately, a large number of people have this quality. These people may not only have low self-esteem, but also high self-esteem.

Representatives with high self-esteem prefer to hide their own self-dislike by emphasizing other qualities and demonstrating their achievements. But this is just a mask that hides a person’s true attitude towards himself.

So, where does self-dislike come from? It often forms in early childhood, when unreasonable parents constantly criticize and punish their child for any offense.

Some parents even go so far as to start comparing their children with others, talking about how unlucky they are to have bad kids. And there are parents who constantly evaluate the actions, words and even appearance of their children.

“You look like a homeless person,” the mother looks at her baby, whom she has just dressed.

Such unpleasant situations and assessments form in the little man the understanding that he is not good, worthy, or attractive. And, growing up, all this only gets worse, since in adulthood a person faces criticism from strangers almost every day.

Self-dislike can also arise in older age, when a person tries to please everyone or value someone’s opinion. If he constantly hears negative criticism addressed to him from a respected and loved person, then over time he will believe in other people's words, ceasing to love himself.

Self-dislike is non-acceptance of oneself. You don't accept that you're not a fashion model, aren't rich, are constantly sick, are whiny, or are too modest. You don't accept yourself as you are now. And this happened because you were taught this by your parents, who were unhappy with you, or because you agree with the assessments of other people who say bad things about you.

It should be understood that self-love always begins only with oneself. To love, you need to learn to accept everything that is in you. All your shortcomings should be accepted in the same way as your advantages. You may, of course, want to change something about yourself that will be a helpful solution.

However, if you notice something negative in yourself, but at the same time you have no desire to change it, then learn to accept everything in yourself as it is. Maybe over time you will understand the value of your shortcoming and turn it into good. And, perhaps, you will get tired of being somehow “not like that”, which is why you will begin your changes. But this should not affect whether you love yourself or not.

Start loving yourself in any form, even when you are imperfect and have not achieved everything you want.

Causes of pathomymia

Patomimia can be caused by numerous reasons, which are based on self-dislike. Patomimia can be a consequence of an individual’s incorrect upbringing, when a person gets used to harming himself. It may be the result of a strong feeling of guilt or conscience.

Scientists reveal three main components of the formation of pathomymia:

Frustration is when an individual restrains his aggression, while fencing himself off from his inner desires.
A psychotraumatic situation in which a person finds a way out of his aggression, which has already accumulated.
Internal need to resolve conflict.

Auto-aggression develops gradually in a person. This is a consequence of the need to throw out one’s aggression, while lacking resolution mechanisms. In other words, a person finds himself in situations in which he accumulates negative experiences, but does not have the opportunity to throw them out, since his environment prohibits him from doing so.

Many people find themselves in similar situations. We all live in a society that prohibits us from behaving in a certain way. You can be polite and sociable, but you must not harm those who have offended you.

This leads to the need to find a method for releasing negative energy. One of its options, for which a person will not be punished, is self-education.

A person can mutilate himself as much as he wants, he will not be punished for it, at most, they will regret it and begin to treat him.

Punishment for displaying aggression and the absence of other ways to release negative emotions leads to the fact that a person begins to harm himself.

Undoubtedly, a person with pathomymia is not always mentally healthy. Often the disorder occurs against the background of other mental disorders: mental retardation, schizophrenia, neurasthenia, psychosis, autism.

In other words, pathomimia becomes a symptom of many other diseases.

Symptoms of pathomimia

The main symptom of pathomimia is self-inflicted dermatological injuries. Experts may note various skin lesions in a person who suffers from this disorder. Thus, the signs of pathomymia are:

The constant appearance of new skin lesions that are pointless to treat.
Unreasonable appearance of dermatological lesions.
Same type of damage.
The presence of itching and pain in areas of skin damage.
Correctly located wounds on the skin. In other words, specialists may note the unnatural appearance of wounds, although the patient may claim that he did not inflict them on himself.
The location of the injuries is available to the person himself.
A sharp negative reaction of a person to the provision of medical assistance in eliminating damage.

Patomimia is marked by various lesions on human skin. They can be of various kinds: in the form of burns, cuts, bites, hair pulling, etc. A person, naturally, does not admit that he inflicted these injuries on himself. But his words can be refuted by facts such as:

The constant appearance of injuries of the same type in their meaning. Either they occur in the same place all the time, or a person injures himself in different places, but in the same way.
Constant occurrence of injuries. Before a person has time to recover from previous injuries, the same wounds, burns, and cuts appear on his body. There is not a single day when a person is completely free from his own exposure.

Patients may differ in their behavior. There are individuals who are not ashamed of their behavior. They may even show off pieces of their body that they have torn off in one way or another. For example, pulling out hair on your head can lead to patches of baldness. At the same time, the person keeps his torn hair and even shows it to specialists.

More adequate patients will hide their inclinations from the surrounding society, so at first relatives will not notice any changes in the individual, and at an appointment with a psychotherapist the patient will assure that he is not doing anything to himself.

A characteristic feature of patients may be a manic desire to examine themselves. First they examine their body, then they inflict the mutilation, then they examine themselves again and examine the mutilation, observing its occurrence and changes.

There are several types of pathomimia:

Conscious destruction as a result of delusional ideas.
Conscious destruction for the sake of profit.
Destruction due to an obsessive state, a person is accustomed to scratching or scratching himself.
Destructions of a conscious or unconscious nature that arise as a result of psychological difficulties that are difficult for the individual to bear.
Munchausen syndrome is when injury is inflicted on another individual to satisfy one's emotional needs.

Treatment of pathomymia

Before treating pathomymia, it is first identified. This is quite difficult to do, since just the presence of injuries on a person’s body does not indicate the presence of a disease. It must be proven that these injuries are permanent and inflicted by the person himself. If pathomimia is confirmed, then physiotherapy and medications are prescribed.

Physiotherapy includes:

Paraffin therapy.
Ultrasound irradiation.
Laser therapy.
Ultraviolet therapy.
Electrophoresis.

Various ointments, sprays, gels and lotions are also prescribed, which should help the skin heal quickly and eliminate infection.

Psychotherapy is carried out, which is aimed at eliminating a person’s desire to damage his body. Various techniques are used here, which are selected individually.

The main thing is to give the patient a conscious understanding that he is harming himself, and also to choose a behavior that will help him in the most difficult moments not to engage in self-aggression, but to throw out his feelings in more peaceful ways.

Psychotherapy can be very lengthy, since the patient will not make contact or understand why he is being treated. First you need to find out the causes of pathomimia, and then eliminate them. Often these reasons are psychological in nature. It is necessary to eliminate psychological problems, which will help in eliminating the harmful disorder.

Bottom line

Pathomimia is a form of auto-aggression when a person inflicts self-mutilation, manifested in wounds, burns, cuts and other damage to the skin. Since the skin becomes a protective layer of the entire body, if a person gets an infection, other diseases may develop.

Pathomimia is not a normal health condition. All people hurt themselves a little. But when it comes to serious wounds and open skin mutilations, then the problem needs to be treated. The help of a psychotherapist becomes necessary because he will carry out treatment together with doctors and psychiatrists.

Source: https://psymedcare.ru/patomimiya

Symptoms of pathomimia

Today, an urgent problem in psychodermatology is pathomimia, as the psychopathology of auto-aggression in dermatology.

The main symptoms of pathomymia:

the constant appearance of new wounds, as a result of which dermatological treatment is unsuccessful;
causeless occurrence of skin lesions;
linearly correct location of wounds;
location of injuries in easily accessible areas of the body;
uniformity of lesions;
pain or itching in places where skin lesions appear;
a sharply negative response to the medical worker’s assumption about the psychogenic cause of the injuries.

In general, the described pathological self-destruction of the skin, in accordance with the international classification of diseases, belongs to the class of intentionally causing symptoms of a skin disease and simulating psychophysiological abnormalities.

The clinical picture of this pathology is very diverse: from ordinary burns to deep necrotic lesions and ulcerative formations, from multi-bubble rashes or subcutaneous hemorrhages resembling hemorrhagic vasculitis, to severe pathologies that mimic all kinds of ailments, including rare dermatoses.

Most often, rashes are located on the facial area, limbs and other easily accessible and visible areas of the skin. In this case, there is no damage, mainly in places where it is difficult for the patient to reach with his hand, for example on the back.

In addition, sharply defined boundaries of wounds with unchanged dermis around or specific outlines of lesions and pronounced polymorphism of rashes (most often false) are indicative.

Self-destruction of the skin is divided into: neurotic excoriation, hair pulling (trichotillomania), uncontrollable desire to bite nails (onychophagia), mechanical damage to the nail plates (onychotillomania), biting the lips and mucous membrane of the cheeks (cheilophagia).

The basis of neurotic excoriations are the effects of “obsession,” which often indicate a stable neurotic state or psychosis. Individuals suffering from pathomimia can spend a long time working on their own appearance, opening blisters with their nails, squeezing out often non-existent acne with a needle. On the face and extensor skin of the extremities, such patients have small abrasions with reddened edges and deep injuries with bloody crusts, minor pink scars that form after the crusts fall off.

Trichotillomania is the term for pulling out hair on the head or other hairy areas of one's own body. Redness, atrophy, or scarring is rarely seen in trichotillomania. Only with very severe itching may superficial abrasions appear.

Systematized dermatozoal delirium is characterized by patients demonstrating to specialists the most “affected” areas of the skin. Such patients place pre-prepared jars with skin particles, scales, crusts, tufts of hair and nail plates on the table in front of the doctors and demand examination of these tissues and materials.

These patients can spend hours examining themselves with a magnifying glass, scrape and wash their own bodies constantly, and destroy the “living creatures” supposedly living on their skin with their nails or with knives and acids. They boil underwear and bed linen for a long time, disinfect it, and throw out suspicious used clothing.

Patients are afraid of infecting their close circle and friends, as a result of which they may commit suicide attempts.

Patomimia

Self-harm is most often observed in areas of the body that are easily accessible for self-harm, for example, on the skin of the chest, face, arms or legs.

How does pathomimia manifest itself? diagnosis and treatment methods

Self-harmful behavior is understood as a series of actions of an auto-aggressive nature aimed at causing damage to one’s body. One type of such self-destructive influences is pathomimia.

The term literally translates as “depiction of pain and suffering,” in other words, a person causes damage to himself, simulating skin lesions in dermatological diseases.

Self-mutilation usually takes the form of wounds, cuts, bites, and burns on areas of the body accessible to injury, such as the face, chest, arms, and legs.

Artificially causing damage to one’s body is a disorder of desire and is studied by a separate science – psychodermatology. Self-harm is observed in various mental disorders, depressive states, alcoholism and behavioral disorders.

Pathomimia as a type of self-harming behavior

Self-harmful actions are based on auto-aggressive behavior. Self-injury to the skin caused by psychogenic factors is divided into several types:

excoriations of a neurotic nature;
dermatomania;
delirium dermatozoa;
compulsive pulling out of hair and nails;
pathomimia.

Patomimia is one of the manifestations of self-harmful behavior aimed at injuring the skin and initiating dermatological diseases.

First, physical harm inflicted on one’s body is a unique form of response to psychotraumatic factors. Later, any psychological experience can trigger the wounding process.

Self-mutilation is carried out systematically, secretly and mainly in the same traumatic way. Before committing an act of auto-aggression, a person worries and panics; later, after the physical damage occurs, a phase of satisfaction begins.

Often, patients seek medical help unaware of the true nature of the injuries, as they inflict injuries unknowingly. Causing physical damage during pathomymia can take several forms:

unconsciously (in case of mental illness and behavioral disorders);
consciously, with demonstrative coloring (in borderline states);
for the purpose of profit.

Often such self-harm is caused unconsciously, especially if self-aggression is a symptom of a mental disorder. Self-injurious behavior in the form of skin lesions and self-mutilation can be observed in the following mental disorders and conditions:

Quite often, signs of auto-aggression with skin self-harm do not always indicate the presence of a mental disorder.

These conditions affect emotional, sensitive, infantile individuals who find it difficult to tolerate failures and have a high level of anxiety and aggressiveness.

The risk of self-harmful behavior increases significantly with alcoholism and drug use.

From the perspective of in-depth analysis, auto-aggression is one of the ways to avoid emotional stress, worries, life difficulties, and conflicts. This is a unique form of substitution for anxiety, fears and personal inferiority.

Sometimes people resort to self-harm in a state of anhedonia, the so-called emotional inertia. For example, often with post-traumatic syndrome a person withdraws into himself and becomes an emotionally stingy person.

Often, auto-aggressive behavior with physical self-flagellation becomes the only way to feel, “get rid of the emptiness.”

Let's consider the main symptoms of psychogenic dermatoses:

unsuccessful dermatological treatment, constant occurrence of new wounds;
spontaneous, causeless appearance of skin lesions;
linear, correct location of wounds;
uniformity of lesions;
location of injuries in accessible areas of the body - head, neck, limbs, chest;
the patient complains of itching or pain at the sites of skin lesions;
negative emotional reaction to the assumption of a psychogenic cause of lesions.

In general, this pathological self-harm of the skin, according to the International Classification of Diseases, belongs to the category F.68.1, intentionally causing symptoms of a dermatological disease and simulating psychophysiological disorders.

Quite often, pathomimia is equated with other psychogenic skin lesions observed in mental disorders, for example, dermatomania.

In this case, self-harm is caused to accessible parts of the skin (consciously or unconsciously) and has the appearance of real-life dermatological diseases, however, such injuries are caused artificially. The forms of manifestation of such damage most often take the form of the following skin defects:

ulcers;
hematomas;
erosion from burns;
bullous rashes;
excoriation;
dermatitis;
excoriated acne.

There are cases when patients imitate skin diseases so accurately that their manifestations are very difficult to distinguish from real-life dermatological diseases, for example, seborrheic pemphigus and hemorrhagic vasculitis.

According to statistical studies, 0.8% of people suffer from self-harming behavior, most of whom are women. Adolescence is considered the peak of destructive actions aimed at self-harm.

Diagnosis and treatment

Diagnosing this desire disorder is a rather difficult task; there is a known case where it was not possible to determine pathomimia for 18 years. A reliable diagnosis can be established using the following methods:

Psychological conversation with the patient is the main approach to study the nature of skin damage. Often people do not realize the true cause of the pathology of the skin, they do not remember how they harm themselves, their consciousness seems to turn off at the time of such manipulations.

Sometimes, in order for the patient to realize his involvement in dermatosis, it is necessary to resort to psychoanalysis. There are cases when people come with complaints, not understanding why they were referred to a psychologist, instead of treating a “real-life illness.”

A psychological conversation is aimed at a tactful, step-by-step questioning of a person to establish the true causes of skin lesions.

The absence or presence of the disease can be determined using histological examination. Examination of a skin sample helps determine the true cause of dermatological lesions. Thanks to ultrasound diagnostics of the skin, the etiology of dermatological lesions can be determined.

As a treatment for pathomymia, complex therapy is indicated, including psychotherapeutic, physiotherapeutic and medicinal approaches. Physiotherapy for psychogenic dermatitis includes the following treatment methods:

electrophoresis;
paraffin therapy;
ultrasonic influence;
laser therapy;
ultraviolet treatment.

Treatment of affected areas of the skin is provided with the help of various medicinal ointments and gels that have anti-inflammatory and restorative effects. To reduce the obsessive desire to self-harm, antipsychotics, psychotropic drugs and antidepressants are used.

If self-harm is not a symptom of severe mental illness, then cognitive behavioral therapy is quite effective. The specialist faces the difficult task of finding out the causes of self-harmful behavior and explaining to the client how to eradicate the desire to exhibit self-aggression.

Dermatologists, psychiatrists, cosmetologists, and psychotherapists deal with the treatment of skin self-harm. Patients with severe obsessive and delusional states are indicated for treatment in a neuropsychiatric hospital to avoid excessive self-harm.

The prognosis for treatment of pathomimia is often favorable, however, there are certain difficulties in correcting the destruction of the skin in schizophrenia with dermatozoal delirium.

In general, the patients’ condition begins to improve after 6 months of complex therapy in a neuropsychiatric hospital.

Source: https://onevroze.ru/v-chem-proyavlyaetsya-patomimiya-diagnostika-i-metody-lecheniya.html

Causes of pathomymia

The nature of the described illness is described in sufficient detail in the work of pathomimia, psychopathology of auto-aggression in dermatological practice. The basis of any auto-aggressive actions are various mental pathologies that require differentiation in the approach to therapy. More often, pathomimia occurs as a result of psychogenic illnesses and are manifestations of psychoses, neurotic conditions, and psychopathy. Patients never seek psychiatric help on their own. A dermatologist makes a primary diagnosis of pathomimia. The development of this disease is often associated with occupational or endocrinological diseases, as well as genetic abnormalities.

In psychoanalysis, self-aggressive behavior is considered as a mechanism for protecting the psyche. Such actions are believed to be the result of a redirection of hostility originally concentrated on an external object. If the well-being of an individual depends on such an external object, then he redirects his hostility: in some situations to another object or subject (displacement), in others, aggression is directed towards himself (for example, if the object of displacement is not found or such redirection is unacceptable).

Some psychiatrists are confident that for the emergence of auto-aggression, the presence of at least three components is necessary: frustration, a traumatic situation and negative feedback.

Thus, for the appearance of auto-aggression it is necessary:

a frustrated individual with an internal conflict, restraining his own aggression and at the same time rejecting his socialized introjects;
a psychotraumatic event in which defensive patterns of behavior are embodied, caused by a previously arising intrapersonal conflict;
the need to resolve intrapersonal confrontation.

Auto-aggression is one of the means of avoiding emotional stress and conflicts. It is a unique form of substitution for anxiety, fears and one’s own inferiority. Sometimes individuals suffering from anhedonia (lack of pleasure and emotional inertia) resort to it. Often, self-harming actions become the only opportunity to feel and get rid of mental “emptiness.”

Pathomymology studies have shown that initially, physical injuries inflicted on one’s own body are a specific way of responding to traumatic events, then any psychological experiences can provoke the process of inflicting wounds. Self-harm occurs systematically and secretly. Often subjects always use the same traumatic method. An individual worries and panics before inflicting wounds on himself, but after realizing self-harm he feels satisfied. Often, patients come to doctors with complaints of physical defects, not knowing how they appeared, since they hurt themselves unconsciously.

With pathomimia, self-harm can occur: unconsciously (due to mental illnesses and behavioral defects), consciously and demonstratively (in borderline states) and for the sake of profit.

Self-harmful actions in the form of self-mutilation can manifest themselves in the following mental pathologies: post-traumatic syndrome, hysterical personality disorder, depression, obsessive-compulsive disorder, dissociative identity disorder, organic brain damage, drug addiction, alcoholism, emotional instability, mental retardation, schizophrenia, autism .

Signs of auto-aggression, expressed by self-injury to the skin, do not always indicate the presence of abnormalities in mental processes. Numerous studies of pathomymia indicate that self-harming behavior is susceptible to infantile, emotional and sensitive individuals who have difficulty withstanding failures and mistakes and have a high degree of aggressiveness and anxiety. The threat of auto-aggression in alcoholism and drug addiction increases significantly.

Patomimia: causes, symptoms, classification and treatment methods

Pathomimia is a psychotic disorder characterized by a number of actions that are aimed at causing injury to one’s own body.

The patient independently creates lesions on the skin that mimic dermatological diseases. Typically these are cuts, wounds, burns or bites.

Patients leave such marks on the face, arms, legs and other parts of the body, mainly those that are more accessible and open.

This pathology is extremely rare as an independent disease. In most cases, pathomimia develops against the background of depression, alcoholism and other mental disorders.

A patient with pathomymia can cause damage to the skin or nails consciously, unconsciously, or for the purpose of obtaining benefit (attracting attention). The most common form of the disease is the second one - the patient is unable to evaluate his actions because they are caused by mental abnormalities.

Pathomimia - why people hurt themselves

Pathomymia is a mental disorder in which an individual causes physical harm to himself. Literally translated, the term “pathomimia” means the image of suffering and pain.

Most often, patients inflict wounds on their skin: cuts, burns, scratches, bites, hemorrhages. These wounds are visible and noticeable to others, since they are in publicly accessible places: on the arms, legs, face, chest.

Pathomimia is one of the types of auto-aggression, i.e. aggression, which is directed not at other people, but at oneself.

Classification of pathomimia

Depending on which parts of the body a person’s aggression is directed to, the following types of pathomimia are distinguished:

Dermatomania – constant damage to the skin (cuts, burns);
Onychophagia and dermatolasia - the patient constantly injures the nails and the skin around the nails;
Cheilophagia – the patient constantly bites his lips and cheeks until they bleed;
Trichotillomania – the patient pulls out hair;
Dermatozoan delusion is an obsessive idea about the presence of parasites under the skin and the desire to get them.

Reasons for the development of the disease

The main reason for the development of pathomimia is the presence of mental disorders in the patient. As a rule, it occurs against the background of psychosis or psychopathy, alcoholism or severe depression. In some cases, specific working conditions or the presence of diseases of the endocrine system can provoke pathology. It is extremely rare that the cause of pathomimia is a genetic predisposition to the disease.

Some doctors consider pathomimia as an option for self-defense, which arises from the psyche as a result of exposure to external negative factors. It is believed that when a person is unable to direct his aggression to an external object (stimulant), he engages in self-flagellation.

The following factors can trigger the development of pathomymia:

Organic damage to the cerebral cortex.
Obsessive-compulsive personality disorder.
Histrionic or dissociative disorder.
Post-traumatic syndrome.
Oligophrenia.
Schizophrenia.
Autism.

According to research, the first self-harm occurs as a result of a strong psycho-emotional event. Subsequent desires to inflict self-mutilation arise even with minor psychological experiences. In most cases, the patient chooses one of the options for self-flagellation - cuts, bites, scratching, etc. After performing the action, the sick person experiences some kind of relief, satisfaction and calm.

Depending on the damage caused, pathomimia is classified into several types:

Dermatomania - a person experiences a constant desire to damage the mucous membranes and epidermis.
Onychophagia - the patient regularly bites his nails.
Dermatolasia - a person experiences an uncontrollable desire to damage the skin around the nail plate.
Cheilophagia is a pathology characterized by an uncontrollable desire to damage the lips.
Trichotillomania is a constant urge to pull out hair.
Excoriation is an uncontrollable desire to scratch the skin, which can lead to the appearance of abrasions, scars and wounds on the skin.