Cessation of Self-Mutilation in a Patient With Borderline Personality Disorder Treated With Naltrexone

Letter to the Editor

Sir: Self-mutilation and self-injurious behavior may be duein part to dysregulation of endorphin neurotransmitter systems.Self-mutilation and dissociation occur frequently inpatients with borderline personality disorder and associatedhistories of traumatic abuse and neglect, suggesting there maybe an etiologic relationship between trauma, neglect, endorphinsystem dysfunction, and self-mutilation. This hypothesis issupported by the observation that some patients with borderlinepersonality disorder have elevated pain thresholds, a phenomenonmediated in part by endorphin systems.