SELF-INJURIOUS-BEHAVIOR AND SEROTONIN IN PRADER-WILLI-SYNDROME

Low central nervous system (CNS) serotonin levels have been associated with impulsive, aggressive and self-injurious behavior(SIB). persons with Prader-Willi Syndrome (PWS) often engage in self-injury by severe compulsive skin picking and gouging and often manifest compulsive eat ing, hoarding, and explosive outbursts. Some of the compulsive behavio rs seen in patients with obsessive-compulsive disorder(OCD) bear simil arity to behaviors associated with PWS: Skin picking, trichotillomania , and onychophagia (nail biting). There is abundant evidence that sele ctive serotonin reuptake inhibitors (SSRIs) are effective in treating OCD. Three cases are described in which persons with PWS responded fav orably to SSRI treatment. Two persons showed a significant decrease in skin picking. The third case showed a significant decrease in hoardin g and explosive outbursts. Strategies are discussed for investigating the possibility of a shared neurochemical basis for the self-injurious , aggressive, and compulsive behaviors in persons with PWS. PWS may pr ovide a relatively homogenous model for the study of skin picking and explosive outbursts among other populations.