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Dr Joachim Müllner (Psychiatrist)
Iranian doctors report the astonishing case of a 37-year-old man who ingested nearly 3 kilos of small objects, mainly metal, following a psychotic crisis. How is it possible to put one’s life in danger in this way? Dr. Joachim Müllner, a psychiatrist, sheds light on the matter.
The case is so surprising that it has been the subject of a scientific publication. A 37-year-old man swallowed nearly 3 kg of small objects of all kinds, mainly metal, following a psychotic crisis.
Taken to a hospital in the Iranian city of Ahvaz, near the border with Iraq, the man underwent various medical examinations, including an abdominal X-ray that revealed a metal mass in his stomach. The mass caused him chronic stomach pain and frequent vomiting, which prevented him from eating and drinking properly.
After a further endoscopy, the doctors realised that these were in fact objects stuck in the patient’s stomach, which he had swallowed at least three months ago.
An operation to remove more than 450 objects of all kinds
The man was operated on quickly and is said to have recovered perfectly from his procedure. Doctors, for their part, report that 452 “screws, nuts, keys, stones and other metal parts” weighing a total of 2.9 kg were removed from the man’s abdomen.
At the same time, the hospital psychiatrists established that he had suffered a psychotic crisis, which had pushed him to commit this act. The causes of this crisis were not detailed by the experts, who nevertheless report that the man is “strongly addicted to opium”. How can this be explained?
A “delusional” or “disorganized” episode
When interviewed, psychiatrist Joachim Müllner, member of the Doctissimo expert committee, tells us more about this unusual case.The article does indeed speak of a “psychotic” episode, but this term is used less and less. Today, we prefer the term “delirious” or “disorganization” episode. the doctor begins.
A crisis of this type corresponds to “an episode during which the brain exhibits disorganization in the processing of information” adds Dr. Müllner. “This leads to a disorganization of emotions, thoughts and behaviors. As a result of this information processing disorder, so-called “psychotic” episodes are most often accompanied by delusional ideas.”
According to Joachim Müllner, this is most likely what happened to this person.”She must have had delusions that produced the “necessity” to ingest these pieces of metal, most likely as a result of delusions of persecution and the idea that this behavior would protect herself.”. Another possibility: the certainty that the person would have “like the supernatural ability to be able to do these kinds of things without it harming him“.
What should we do in the face of this type of crisis?
When faced with a person experiencing a delusional episode, compulsory hospitalization is often the rule. “We hospitalize the person to protect them from their self-aggressive or hetero-aggressive behavior – against themselves or others – and therefore to protect those around them as well.” says the psychiatrist.”And he is also hospitalized to treat the illness, the delusional episode can occur in the context of different illnesses such as schizophrenic disorder or during a manic episode of a bipolar disorder”.
Finally, the treatment administered will be established according to two plans: “a treatment that will be anxiolytic and sedative if the person is agitated, and a background treatment, anti-delirious neuroleptic – or “antipsychotic” – with more or less a thymoregulator treatment, that is to say mood regulator” confides Joachim Müllner.
Finally, this type of delusional outburst has three developments:
- “In a third of cases, the episode will be isolated and will never happen again;
- In the second third, we witness several episodes, but with a return to normal, each time;
- Finally, in the last third, the evolution takes place towards a schizophrenia or bipolar disorder” concludes the doctor.