Serotonergic function and self-injurious behavior in personality disorder patients

Area of Science:

• Neuroscience
• Psychiatry
• Endocrinology

Background:

• Self-directed aggression, encompassing non-suicidal self-mutilation and suicidal behavior, is a hallmark of personality disorders.
• Previous research links suicidal behavior and impulsive aggression to diminished central serotonin function.

Purpose of the Study:

• To investigate the association between self-injurious behavior (self-mutilation and suicidal behavior) and central serotonin function in patients with personality disorders.
• To determine if self-mutilation, like suicidal behavior, is linked to serotonergic deficits.

Main Methods:

• Ninety-seven patients diagnosed with DSM-III personality disorders participated in the study.
• A D,L-fenfluramine challenge test was administered to assess serotonergic activity by measuring prolactin and cortisol responses.
• Patients were categorized based on their history of self-mutilation and/or suicide.

Main Results:

• Patients with a history of self-mutilation or suicide exhibited blunted prolactin and cortisol responses to D,L-fenfluramine compared to those without such histories.
• Individuals with a history of both self-mutilation and suicide showed the most pronounced blunted responses.
• These findings suggest a link between self-directed violence and central serotonin system abnormalities.

Conclusions:

• The central serotonergic abnormality observed in suicidal behavior may also be implicated in broader self-directed violence.
• These findings suggest that decreased central serotonin function is associated with self-directed violence, not exclusively with suicidal intent.