[Non-suicidal self-injury and eating disorders: clinical and dynamic patterns in adolescence, young and middle age]

To identify clinical and dynamic patterns of the combination of non-suicidal self-injury (NSSI) and eating disorders (ED and to provide a comparative description of these disorders at different ages (adolescence, young adulthood, middle age).

Based on established criteria for NSSI behavior and diagnostic criteria for ED), 268 people (254 females and 14 males) were selected. The subjects were divided into 3 subgroups: adolescent (50 people aged 14-18 years), young (194 people aged 18-24 years) and middle-aged (24 people aged 25-35 years). A semi-structured questionnaire; the diagnostic interview «Brief International Neuropsychiatric Questionnaire»; the Russian version of «Statements about self-harm»; the Questionnaire of food preferences, short version, In Russian adaptation were administered.

99.3% met the criteria for bulimia, 21.7% for anorexia, and 7.1% for compulsive overeating disorder. Gender differences in motives for self-harm consisted in the predominance of the motive of affective regulation in women (p=0.082) and bites (p=0.066) and cauterizations (p=0.06) in men. There was a trend towards earlier onset of ED compared to NSSI (13.50 years vs. 13.00 years, p=0.079) and later completion (19.00 years vs. 18.50 years, p=0.003). In adolescents, the motive for self-harm «Interpersonal boundaries» (p=0.009) was more common compared with young people, and the motives «Dissociation/generation of feelings» (p=0.003) and «Significance» (p=0.020) were more common in comparison with middle-aged respondents. Among the young subjects, the motives «Self-punishment» (p=0.029), «Dissociation/generation of feelings» (p=0.0001) and «Significance» (p=0.020) prevailed over the middle age subgroup. Age differences in methods of self-harm were found. Self-biting (p=0.013) and obstacles to wound healing (p=0.019) were observed in all age groups, but there was a tendency for their occurrence to be lower with age. Infringement of body tissues was less observed at a young age compared to adolescence, and was absent at middle age (28.0%, 13.0% and 0.0%, respectively, p=0.004). The difference in eating behavior was that in middle age the influence on this process from others was less frequently noted compared to adolescence (p=0.037) and young age (p=0.046).

Some clinical and dynamic patterns of comorbidity between self-harm and ED have been established. NSSI occurred more often against the background of already formed ED and was reduced more quickly. The established age differences in motives for self-harm reflect, in our opinion, the defensive-coping nature of NSSI in adolescents and its habitually-established nature in young and middle age, which has a pathocharacterological basis.