Cross-sectional and longitudinal analyses indicated that neurobehavioral disinhibition is a component of the liability to early age at onset of substance use disorder.

Individuals with bipolar disorder possess a substantial burden of general medical comorbidity, and are occurring at an earlier age than in the general VA patient population, suggesting the need for earlier detection and treatment for patients with bipolar disorder.

The association between substance use and intimate partner violence (IPV) is robust. It is less clear how the use of specific substances relates to relationship violence. This study examined IPV perpetration and victimization related to the following specific substance use disorders: alcohol, cannabis, cocaine and opioid. The poly-substance use of alcohol and cocaine, as well as alcohol and marijuana were also examined. Data were analyzed from wave two of the National Epidemiologic Study on Alcohol and Related Conditions (2004–2005). Associations between substance use disorders and IPV were tested using logistic regression models while controlling for important covariates and accounting for the complex survey design. Alcohol use disorders and cocaine use disorders were most strongly associated with IPV perpetration, while cannabis use disorders and opioid use disorders were most strongly associated with IPV victimization. A diagnosis of both an alcohol use disorder and cannabis use disorder decreased the likelihood of IPV perpetration compared to each individual substance use disorder. A diagnosis of both an alcohol use disorder and cocaine use disorder increased likelihood of reporting IPV perpetration compared to alcohol use disorders alone, but decreased likelihood of perpetration compared to a cocaine use disorder diagnosis alone. Overall, substance use disorders were consistently related to intimate partner violence after controlling for important covariates. These results provide further evidence for the important link between substance use disorders and IPV, and add to our knowledge of which specific substances may be related to relationship violence.

The relationship of self-mutilation to suicidal behavior was studied in 108 borderline inpatients (defined by the Diagnostic Interview for Borderline Patients). Patients with histories of selfmutilation were compared to those with no self-mutilation on diagnostic comorbidity, symptom patterns, prior suicidal be haviors, and attempt characteristics, including number of at tempts, seriousness of intent, and medical lethality.Self-mutilation was found in 63% of patients, suicidal attempts in 75.7%. Patients with self-mutilation were significantly younger and more symptomatic than controls, and had more serious suicidal ideation and recent suicide attempts. On the DIB they had significantly more manipulative suicide threat or effort, depersonalization and drug-free hallucinations or delu sions. They tended toward more depression and schizotypal symptoms but less anger and assaultiveness compared to nonmutilating patients. Histories of manipulative suicide attempts were characteristic of self mutilating patients; however, self mutilation was not associated with increased seriousness of in tent or lethality of suicide attempts.Self-mutilation is a common clinical phenomenon, with a reported inci dence of 3.4-7.7% among general psychiatric admissions (Ballinger, 1971;Pao, 1969). Etiology is often described as "multifactorial," with psychologi cal, behavioral, and biologic determinants, though generally related to the disorder in which the symptom arises. The most bizarre and destructive acts arise from the thought disorder of the psychotic patient, including autocastration, enucleation, and amputations. The least severe acts, de scribed as syndromes of "wrist slashing," "delicate cutting," or "parasuicide," are generally attributed to personality-disordered patients, especially those with borderline personality disorder (BPD) (Grunebaum &