Recurrent Cylindrical Battery Ingestion in Borderline Personality Disorder: Balancing Medical Risk and Behavioural Reinforcement.
- 1Psychiatry, Hospital Prof. Dr. Fernando Fonseca, Amadora, PRT.
Abstract
Intentional foreign body ingestion is a recurrent and clinically challenging form of self-harm in patients with borderline personality disorder (BPD). Although medical guidance informs the management of individual ingestion events, recurrent presentations raise additional questions about the function of the behaviour and the consequences of repeated medical intervention. We report an 18-year-old patient with BPD and previously documented factitious features who had six episodes of intentional foreign body ingestion during a two-month psychiatric admission in 2026: five involving cylindrical batteries, including re-ingestion of a previously passed battery, and one involving a metal screw. Serial psychiatric assessments identified no psychotic symptoms. The behavioural context evolved from impulsive and reactive self-harm to later episodes that the patient described as retaliatory in the context of perceived interpersonal rejection. Multidisciplinary management integrated established medical indications with longitudinal psychiatric formulation. Endoscopic retrieval was undertaken when clinically indicated, whereas distally progressing batteries were managed conservatively with close clinical and radiological monitoring. No major medical complications occurred. This case illustrates a recurring dilemma at the interface between psychiatric and medical care: medically necessary procedures should never be withheld because of concerns about behavioural reinforcement, but unnecessary intervention may become incorporated into maladaptive behavioural and interpersonal patterns when a safe conservative alternative exists. Psychiatric formulation can therefore complement medical risk assessment and support consistent, proportionate multidisciplinary care.
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BibTeX
@article{monteiro2026recurrent,
title = {{Recurrent Cylindrical Battery Ingestion in Borderline Personality Disorder: Balancing Medical Risk and Behavioural Reinforcement.}},
author = {Carolina Monteiro and José Castro and Rita Macas and Ana Sofia Barbosa},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116845},
url = {https://europepmc.org/article/MED/42927363},
note = {CC BY},
}
RIS
TY - JOUR
TI - Recurrent Cylindrical Battery Ingestion in Borderline Personality Disorder: Balancing Medical Risk and Behavioural Reinforcement.
AU - Carolina Monteiro
AU - José Castro
AU - Rita Macas
AU - Ana Sofia Barbosa
PY - 2026
DA - 2026/09/24
JO - Cureus
DO - 10.7759/cureus.116845
UR - https://europepmc.org/article/MED/42927363
AB - Intentional foreign body ingestion is a recurrent and clinically challenging form of self-harm in patients with borderline personality disorder (BPD). Although medical guidance informs the management of individual ingestion events, recurrent presentations raise additional questions about the function of the behaviour and the consequences of repeated medical intervention. We report an 18-year-old patient with BPD and previously documented factitious features who had six episodes of intentional foreign body ingestion during a two-month psychiatric admission in 2026: five involving cylindrical batteries, including re-ingestion of a previously passed battery, and one involving a metal screw. Serial psychiatric assessments identified no psychotic symptoms. The behavioural context evolved from impulsive and reactive self-harm to later episodes that the patient described as retaliatory in the context of perceived interpersonal rejection. Multidisciplinary management integrated established medical indications with longitudinal psychiatric formulation. Endoscopic retrieval was undertaken when clinically indicated, whereas distally progressing batteries were managed conservatively with close clinical and radiological monitoring. No major medical complications occurred. This case illustrates a recurring dilemma at the interface between psychiatric and medical care: medically necessary procedures should never be withheld because of concerns about behavioural reinforcement, but unnecessary intervention may become incorporated into maladaptive behavioural and interpersonal patterns when a safe conservative alternative exists. Psychiatric formulation can therefore complement medical risk assessment and support consistent, proportionate multidisciplinary care.
SN - 2168-8184
ER -