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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1207

Knockout: a case report of recurrent self-injurious behavior through self-inflicted punching to the face in a Filipino adult with schizophrenia

KNOCKOUT: A CASE REPORT ON RECURRENT SELF-HARM THROUGH SELF-INFLICTED FACIAL BLOWS IN A FILIPINO ADULT WITH SCHIZOPHRENIA

Atypical motor self-injurious behavior associated with psychosis, involving repeated punching of one's own face, decreased markedly with clozapine and multidisciplinary care.

The aim of this case report is to describe motor self-injurious behavior involving punching one's own face, which is rarely reported in schizophrenia, and to emphasize the importance of early recognition. The case concerns a 32-year-old Filipino man with long-standing schizophrenia and prolonged medication nonadherence; his clinical course progressed from mood symptoms to persecutory and grandiose delusions, auditory hallucinations, religious preoccupations, and impaired social functioning. Repeated, forceful blows to his own face caused severe facial swelling and recurrent emergency department visits, with self-injury escalating to near-daily episodes during the two months before admission. Neuroimaging revealed no intracranial pathology; mental status examination identified psychomotor retardation, blunted affect, persistent delusions, and impaired impulse control. Following immediate safety measures and assessment of traumatic injuries, clozapine was initiated for treatment-resistant psychosis and high-risk self-injury, and care was delivered within a multidisciplinary framework encompassing psychiatry, nursing, psychology, social work, and occupational therapy. With family involvement, behavioral monitoring, psychotherapy, and rehabilitation interventions, the frequency and severity of self-injury decreased markedly, emotional stability improved, and partial insight was achieved. The authors emphasize the need for early recognition of atypical motor self-injurious behavior, evidence-based pharmacotherapy—particularly clozapine—and coordinated multidisciplinary care, noting that detailed case reports from low-resource and Asian settings are important for culturally appropriate assessment strategies.

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