Self-mutilation in substance-dependent patients and relationship with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality.

OBJECTIVE: Aim of this study was to evaluate the prevalence of self-mutilation (SM) in Turkish male substance-dependent patients, and to investigate the relationship of SM with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality.

METHODS: Participants were 136 consecutively admitted males with substance dependence (96 alcohol and 40 drug). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV (SCID-I), Turkish version. Patients were investigated with the childhood abuse and neglect questionnaire, Toronto alexithymia scale (TAS-20) and temperament and character inventory (TCI).

RESULTS: Among substance-dependent patients 34.6% was considered as a group with SM. Rates of being single and unemployed, histories of physical and sexual abuse and suicide attempts were higher in the SM group. Current age, age at first substance use and age at regular substance use were lower in the group with SM. Mean of TAS-20 and 'difficulty in identifying feelings' (DIF) and 'difficulty in describing feelings' (DDF) subscales of TAS-20 were higher in SM group. There were no significant differences between groups in terms of TCI subscales. Age, childhood physical abuse and suicide attempt history predicted SM in logistic regression.

CONCLUSIONS: Young substance users with childhood physical abuse histories could be the target population to prevent self-mutilating behavior. This study also suggests that whenever self-mutilating behavior is present, the possibility of childhood abuse, alexithymia and suicide attempts must be evaluated.