Habitual self-mutilation in Japan.
The purpose of the present study was to clarify the relationship between bulimic behavior, dissociative phenomenon and sexual/physical abuse histories in Japanese subjects with habitual self-mutilation. Subjects consisted of 34 female outpatients who had cut their wrists or arms on more than 10 occasions. Two age-matched groups, which consisted of 31 general psychiatric outpatients and 26 non-clinical volunteers, served as controls. They were assessed with the Beck Depression Inventory-II, Bulimia Investigatory Test of Edinburgh, Adolescent Dissociative Experience Scale, and an original self-reporting questionnaire concerning various problematic behaviors and sexual/physical abuse histories. The habitual self-mutilation and the two control groups were compared. The habitual self-mutilation group had significantly higher scores on the Beck Depression Inventory-II, Bulimia Investigatory Test of Edinburgh, and Adolescent Dissociative Experience Scale than either of the two control groups (P < 0.001). Furthermore, the habitual self-mutilation group more frequently had a history of illicit psychoactive drug use (P = 0.001), shoplifting (P < 0.001), suicide attempts (P < 0.001), overdosing with medicine (P < 0.001), sexual abuse (P = 0.011), and childhood physical abuse (P = 0.001) than the general psychiatric controls. These results are consistent with those in Western studies. Habitual self-mutilation is likely to coexist with depression, bulimia, and dissociation. Such patients frequently have clinical features similar to those of 'multi-impulsive bulimia'. Evidence supports the association between habitual self-mutilation and sexual/childhood physical abuse in Japan.
Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan. toshi-lancia@nifty.com
Toshihiko
T
Matsumoto
Takaharu
T
Azekawa
Akiko
A
Yamaguchi
Takeshi
T
Asami
Eizo
E
Iseki
D000293:Adolescent; D000328:Adult; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006184:Habits; D006785:Hospitals, University; D006801:Humans; D013287:Illicit Drugs; D007564:Japan; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital; D011594:Psychometrics / Q000706:statistics & numerical data; D012307:Risk Factors; D012652:Self Mutilation / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D013800:Theft / Q000523:psychology / Q000706:statistics & numerical data
D013287:Illicit Drugs