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[Self-destructive behaviour - occurrence and typological classification in an university psychosomatic unit]
Herbert Fliege1, Ursula Burkert, Gerhard Danzer
1Charité, Standort Virchow-Klinikum, Medizinische Klinik am Schwerpunkt Psychosomatik und Psychotherapie, Augustenburger Platz 1, D-13353 Berlin, Germany.
Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie
|January 17, 2002
Summary
Self-destructive behaviors, including direct self-harm and self-induced diseases, are prevalent in psychosomatic patients, often underestimated and inadequately captured by current diagnostic criteria.
Area of Science:
- Psychiatry
- Psychosomatic Medicine
- Clinical Psychology
Background:
- Self-destructive phenomena encompass direct self-harm, self-induced diseases, and delegated self-harm.
- These behaviors are often overlooked in clinical practice and may not be fully addressed by existing diagnostic systems.
Purpose of the Study:
- To determine the occurrence and characteristics of self-destructive phenomena in patients referred to psychosomatic services.
- To compare demographic and diagnostic profiles of patients with and without self-destructive behaviors.
Main Methods:
- A typological-descriptive assessment was used for 1057 patients over 14 months.
- Data included patient referrals, outpatient records, and discharged ward patients.
- Comparison with a control group of psychosomatic patients.
Main Results:
- Self-destructive behavior was documented in 7.5% of patients, with 62% exhibiting recurrent self-harm.
- Direct self-harm (71%), self-induced disease (48%), and delegated self-harm (35%) were observed, with significant overlap.
- Self-destructive patients were more often female, younger, and had more psychosocial diagnoses (ICD-10: F) than controls.
Conclusions:
- The occurrence and significance of self-destructive and factitious disorders are likely underestimated.
- Current diagnostic criteria (ICD-10) may be insufficient to encompass the full spectrum of self-destructive behaviors.
- Psychosocial factors play a significant role in self-destructive behaviors within psychosomatic populations.