ABSTRACT
This chapter provides a case of a 26-year-old carpet fitter who presents to the emergency department having become embroiled in a fight. He says that a woman's boyfriend hit out at him for no reason. However, the paramedics report that the man had apparently 'flashed at the girlfriend and may have been masturbating'. Several differential diagnoses should be considered. Organic conditions that may lead to disinhibition should be excluded. Organic causes are unlikely here given the history and normal neurological examination, although taking a fuller drug and alcohol history or obtaining a history about recent illness or behaviour from next of kin may be helpful. It is important to exclude exhibitionism as a presenting symptom in schizophrenia and affective disorder, especially mania where disinhibition is common. Exhibitionism is the exposure of one's genitals to a stranger, usually with no intention of further sexual activity with the other person. In some cases, the exhibitionist masturbates while exposing himself.
