Study of the clinical characteristics of patients with self-injurious behaviors comparing to patients with obsessive-compulsive disorder

Abstract

Self-injurious behaviors(SIB) may be described as a behavior compatible with obsessive compulsive disorder(OCD), as well as part of Impulse-Control Disorders(ICD).Aims:Compare obsessive compulsive symptoms(OCS) and impulsivity between two groups: OCD and SIB patients.Method:Five patients in outpatient treatment for SIB were compared to five OCD patients. The following instruments were applied:Y-BOCS, D-YBOCS, USP-SPS, FASM, SCID, BIS-11.Results:The SIBs were repetitive and occurred from 2 to 100 episodes during the last year. The behavior relief intolerable affects and the consequent pain were mild. The patients spent some time planning the acts, especially when it was not possible to do it immediately. The most common behavior found were: skin cutting(80%), self-hitting(60%), self-biting(60%), and the patients presented more than one type of SIBs. The motivation included: relieving feelings of "numbness" (80%); punishing themselves(80%); feeling something (even pain)(60%); feeling relaxed(60%); and stopping bad feelings(60%). SIB patients also presented OCS(100%) with more prevalence of sensory phenomena preceding repetitive behaviors(100%) than among OCD patients(60%), although they were not statistically significant. Despite the fact that there were no difference between the two groups in impulsivity according to BIS-11(66,20±18,10 SD for SIB and 68,40±11,10 SD for OCD, p=0,82), SIB patients had more diagnosis of others ICD(100%).Conclusion:This study raises the question: Would SIB be an OCS, that increases it severity, or a nosologic entity with its own characteristics, where OCD comobidity is frequent? The sample size is not large enough to answer these questions, although it seems that some symptoms are shared with both disorders.