Both epistaxis and mental health disorders are common conditions encountered in medical practice and whilst there have been investigations into individual psychiatric conditions and epistaxis, to date no overview has been published of these conditions. This review aims to summarise the various aetiologies and their managements in the setting of epistaxis.
A literature review was conducted using PubMed, Medline Ovid, and the Cochrane library using the terms epistaxis, mental health, psychiatric, and self-inflicted. The resulting literature was assessed, and their references reviewed to find additional cases not located by the initial search.
A number of case reports as well as a small number of case series and an observational cohort studies were found. These were categorised as traumatic, foreign body, factitious, psychogenic purpura, hematohidrosis, attention deficit hyperactivity disorder (ADHD), and iatrogenic.
The reported aetiologies ranged from the very rare to common with management often requiring a multidisciplinary approach to achieve an appropriate outcome for the patient. More is needed to be done to further investigate how to manage patients who present with epistaxis and these aforementioned aetiologies.