Selbstverletzendes Verhalten bei Essstörungen - Phänomenologie, psychologische und genetische Korrelate selbstverletzenden Verhaltens bei anorektischen und bulimischen Patientinnen

Background: High rates of self-injurious behavior (SIB) are described in eating-disordered patients. Detailed descriptions of SIB, however, and psychological or genetical differences between patients with and without SIB are missing. Methods: 200 female inpatients with an eating disorder (ED) completed self-report questionnaires and structured interviews concerning eating behavior, psychiatric diagnosis on Axis I and II of DSM-IV, personality traits and sexual and physical abuse. These variables were used in a predictive model of SIB. Moreover, blood samples were analyzed regarding genetic markers of the serotonergic system. To compare patients with and without SIB patients were matched according to ED diagnosis and age. Detailed explorative data concerning amongst others type, severity, beginning and function of SIB were collected. Results: Patients with SIB differed from patients without SIB regarding ED symptomes, general psychopathology, number of comorbide diagnosis, impulsivity and aggressivity as well as sexual abuse. Best predictors of SIB are deficts in impulsregulation, comorbide affective or anxiety disorder and a history of suicide attempts. In the subgroup without SIB the homozygous genotype of MAO-A with two low active allels seems to be more frequent; however, differences did not reach statistical significance. Discussion: The presence of SIB in patients with ED is associated with severity of psychopathology, personality traits and abuse. First evidence for a connection with genetic markers of the serotonergic systems can be found, but further research is necessary.