Skip to main content Accessibility help

Self-injurious behavior and mental retardation; a multidisciplinary approach

  • W.M.A. Verhoeven (a1), A. Dosen (a2), S. Tuinier (a1) and A.E.S. Sijben (a1)


Research on the phenomenon of self-injurious behaviour (SIB) has been very limited despite the relative high prevalence of this type of disorder. The relative lack of knowledge of psychopathology in this field and the methodological problems in performing research projects may have contributed to the limitations in the interest for this area. Recently, research into biological aspects of the etiopathogenesis of SIB has yielded results that might open new vistas for a rational and effective pharmacotherapeutical approach. In this concise review the psychiatric, neurological, biological, pharmacological and methodological aspects of SIB in mental retardation will be mentioned.


Corresponding author

Vincent van Gogh Instituut voor Psychiatrie, Stationsweg 46, 5803 AC Venray


Hide All
1.Winchel, RM, Stanley, M. Self-injurious behavior: a review of the behavior and biology of self-mutilation. Am J Psychiat 1991; 148:306–15.
2.Rojahn, J. Self-injurious and stereotypic behavior of noninstitutionalized mentally retarded people: prevalence and classification. Am J ment Defic 1986; 91:268–76.
3.Reis, S. Prevalence of dual diagnosis in community-based day programs in the Chicago metropolitan area. Am J ment Retard 1990; 4:578–85.
4.Duker, PCC. Zelfverwondend gedrag bij zwakzinnigen: ge-dragsanalyse en -therapie. Nijmegen: KUN, 1975: Proefschrift.
5.Oliver, C, Murphy, GH, Corbett, JA. Self-injurious behavior in people with mental handicap: a total population study. J ment Defic Res 1978; 31:147–62.
6.Campbell, M, Malone, RP. Mental retardation and psychiatric disorders. Hosp Comm Psychiat 1991; 42:374–79.
7.Gualtieri, CT. The differential diagnosis of self-injurious behavior in mentally retarded people. Psychopharmacol Bull 1989; 25:358–63.
8.Menolascino, FJ. Mental illness in the mentally retarded: diagnostic issues and treatment considerations. In: Dosen, A, Van Gennep, A en Zwanikken, GJ, red. Treatment of Mental Illness and behavioral Disorder in the Mentally Retarded. Leiden: Logon Publications, 1990; 2136.
9.Dosen, A. Psychische stoornissen bij zwakzinnige kinderen. Lisse: Swets en Zeitlinger, 1983: Proefschrift.
10.Zwanikken, GJ, Fischer, AA, Zitman, FG, red. Psychiatrie, Utrecht: Bunge, 1990.
11.Verhoeven, WMA, Tuinier, S, Sijben, AES. Biological and pharmacological aspects of selfinjurious behaviour. In: Fletcher, RJ, red. Mental Health Aspects of Mental Retardation. New York: Lexington Books, in press.
12.Kars, H, Broekema, W, Glaudemans-van Gelderen, I, Verhoeven, WMA, Van Ree, JM. Naltrexone attenuates self-injurious behavior in mentally retarded subjects. Biol Psychiat 1990; 27:741–6.
13.Sijben, AES. Omzien naar Weldoen, Programma Evaluatie in Theorie en Praktijk. Nijmegen: K.U., 1986: Proefschrift.
14.Dosen, A. Agressief en zichzelf beschadigend gedrag bij zwakzinnigen. In: Dosen, A, red. Psychische en Gedragsstoornissen bij Zwakzinnigen; een ontwikkelingsdynamische Benadering. Amsterdam: Boom Meppel 1990: 251–60.
15.Dosen, A. Diagnostic and treatment of mental illness in mentally retarded children; a developmental model. Child Psychiat hum Devel 1989; 20:7384.
16.Bueno, M. Mental deficiency. Concept, epidemiology and preventive measures. In: Seva, A, red. European Handbook of Psychiatry and Mental Health. Barcelona: Anthropos 1991: 1507–22.
17.Lesch, M, Nyhan, WL. A familial disorder of uric acid metabolism and central nervous system function. Am J Med 1964; 36:561–70.
18.Lloyd, KG, Hornykiewicz, O, Davidson, L, Shannak, K, Farley, I, Goldstein, M, Shibuya, M, Kelley, WN, Fox, IH. Biochemical evidence of dysfunction of brain neurotransmitters in the Lesch-Nyhan syndrome. N Engl J Med 1981; 305:1106–11.
19.Breese, GR, Criswell, HE, Duncan, GE, Mueller, RA. Dopamine deficiency in self-injurious behavior. Psychopharmacol Bull 1989; 25:353–7.
20.Verhoeven, WMA, Tuinier, S. Pharmacotherapy in aggressive and autoaggressive behaviour. In: Dosen, A en Day, K, red. The Treatment of Mental Illness and Behaviour Disorders in mentally retarded Children and Adults. London: Royal College of Psychiatrists, in press.
21.Tuinier, S. De Psychiater en de Wilde Man; een Veldstudie over de Relatie psychiatrisch Syndroom en Criminaliteit. Proefschrift Meppel: Drukkerij Giethoorn, 1989.
22.Greenberg, AS, Coleman, M. Depressed 5-hydoxyindole levels associated with hyperactive and aggressive behavior. Relationship to drug response. Arch gen Psychiat 1976; 33:331–6.
23.O'Neal, M, Page, N, Atkins, WN, Eichelmann, B. Tryptophan-trazadone treatment of aggressive behavior. Lancet 1986; 2:859–60.
24.Gillberg, C, Terenius, L, Lunnerholm, G. Endorphin activity in childhood psychosis. Arch gen Psychiat 1985; 42:780–3.
25.Sandman, CA, Barron, JL, Chicz-Demet, A, Demet, EM. Plasma Bendorphin levels in patients with self-injurious behavior and stereotypy. Am J ment Retard 1990; 95:8492.
26.Rasmussen, DL, Olivier, B, Raghoebar, M, Mos, J. Possible clinical applications of serenics and some implications of their preclinical profile for their clinical use in psychiatric disorders. In: Raghoebar, M, Olivier, B, Rasmussen, DL, Mos, J, red. Drug Metabolism and Drug Interactions, Eltoprazine: a serenic compound. London: Freund Publ House, 1989: 159–86.
27.Zwanikken, GJ, Sijben, AES. Psychiaters en zwakzinnigenzorg. Tijdsch Psychiat 1991; 533:530–40.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed