Suicidal attempt with intracranial sewing needle in a female adult with major depressive disorder, case report

Abstract

Background: Major depressive disorder is one of the most common psychiatric illnesses. It is counted as an important suicide-attempting factor. Beside common and known suicide methods such as pesticide poisoning and hanging, some unusual methods (adapted by major depressive disorder patients) are reported in the literature. One of these methods is intracranial swing needle insertion. Case presentation: Hereby, we detail a 44-year-old woman who was admitted to our hospital due to a sewing needle in her brain tissue. The first sign suggesting the existence of a metal foreign body in her brain was the rejection of magnetic resonance imaging ordered (follow-up of a previous admission). Later, a sewing needle was observed in her skull inserted in a suicidal attempt. Her denial of the attempt has aroused the medical team attention to make further study of the patient from a psychiatric point of view. The psychiatric study expressed major depressive disorder in the patient which can justify her suicide intention in the needle insertion. Conclusions: Treating such patients should be tackled in two fronts. From neurosurgical point of view, it should be decided whether to extract the foreign body or conduct a follow-up in order to determine the necessary time for operation. On the other hand, from a psychiatric point of view, rigorous consult sessions with patient and family members are required to prevent recurrence of such attempts.