Self-injurious behavior and attempted suicide in purging bulimia nervosa: Associations with psychiatric comorbidity

Angela Favaro, Paolo Santonastaso, Palmiero Monteleone, Laura Bellodi, Mauro Mauri, Alessandro Rotondo, Stefano Erzegovesi, Mario Maj

Research output: Contribution to journalArticlepeer-review


Background: Few studies, to date, have investigated the relationship between self-damaging behavior and the presence of comorbid psychiatric diagnoses in eating disorders. The aim of the present study was to investigate the axis I and II comorbidity in subjects with bulimia nervosa who report self-injurious behavior and/or suicide attempt. Methods: The subjects were 95 patients with purging type bulimia nervosa who underwent a clinical evaluation assessing the presence of self-injurious behavior and suicide attempts, comorbidity for axis I and II psychiatric disorders and temperament. Results: No axis I diagnosis was associated with any type of self-injurious behavior, whereas social phobia and bipolar disorder were linked to attempted suicide. Significant independent predictors of impulsive self-injurious behavior were the presence of childhood sexual abuse, high harm avoidance scores, and high self-transcendence scores, whereas childhood sexual abuse, the presence of a cluster B personality disorder, and a low self-directedness were predictors of suicide attempts. Compulsive self-injurious behavior was significantly associated with harm avoidance and cluster C personality disorders. Harm avoidance was also associated with skin picking. Conclusions: Personality disorders are a frequent correlate of the presence of SIB in purging bulimia nervosa. However, temperament seems to play a more important role. Further studies on larger samples are necessary to confirm our findings in bulimia nervosa and to extend them to other patient populations.

Original languageEnglish
Pages (from-to)285-289
Number of pages5
JournalJournal of Affective Disorders
Issue number1-3
Publication statusPublished - Jan 2008


  • Bulimia nervosa
  • Comorbidity
  • Eating disorders
  • Personality disorders
  • Self-injurious behaviour
  • Suicidality

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)


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