Klingsor Syndrome: Clozapine Response in a Genital Self Mutilation Case

Klingsor Syndrome has been defined as a self-mutilative behaviour to genital organs, which is rare but can be accompanied by serious complications, and is often accompanied by psychotic symptoms. In the literature, risk factors of Klingsor syndrome are found as having commanding type auditory hallucinations, religious delusions, personality disorders, history of suicidal attempt, thoughts of guilt related to sexual conflicts, depressive features, and severe childhood deprivation. In this paper, our aim is presenting the clozapine response of a patient with schizophrenia, who had recurrent suicidal attempts, and performed genital self mutilation due to commanding type hallucinations. In this patient with severe self-mutilative behavior, and a history of multiple suicidal attempts, it was observed that parasuicidal thoughts regressed, self-mutilative behavior, and thoughts did not recur during the 28-week follow-up period. Recognition of risky patients, and taking precautions for this, treatment of psychotic symptoms and performing anatomical repair in terms of surgery are important for prognosis of these type of cases.