Serotonergic function and self-injurious behavior in personality disorder patients

Psychiatry Res. 1997 Mar 3;69(1):17-26. doi: 10.1016/s0165-1781(96)02784-9.


Self-directed aggression, whether in the form of non-suicidal self-mutilation or suicidal behavior, is a prominent feature of personality disorders. We hypothesized that self-injurious behavior, like suicidal behavior, represents a form of self-directed aggression, and may, like suicidal behavior and impulsive aggression, be associated with a decrease in central serotonin function in personality disorder patients. Ninety-seven patients with DSM-III personality disorder underwent D,L-fenfluramine challenge as an assessment of serotonergic activity. Patients with a history of self-mutilation or suicide had blunted prolactin and cortisol responses to D,L-fenfluramine compared to those with neither, and those with both had the most blunted responses to fenfluramine. These data raise the possibility that the central 5-HT abnormality, previously associated with suicidal behavior, may be associated with self-directed violence and not necessarily specifically with suicidal intent.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Female
  • Fenfluramine / pharmacology
  • Humans
  • Hydrocortisone / blood
  • Hydrocortisone / metabolism
  • Male
  • Personality Disorders / complications*
  • Prolactin / blood
  • Prolactin / metabolism
  • Selective Serotonin Reuptake Inhibitors / pharmacology
  • Self-Injurious Behavior / blood*
  • Self-Injurious Behavior / complications*
  • Serotonin / metabolism*
  • Suicide, Attempted


  • Serotonin Uptake Inhibitors
  • Fenfluramine
  • Serotonin
  • Prolactin
  • Hydrocortisone