Q. My 42-year-old childhood friend was caught drinking blood. He was diagnosed with bipolar disorder when he was 17 years old. I think he takes valproic acid now and he feels better on it. My friend hid it from me and I was shocked that he did it, because I know a relative abused him in this manner when he was a child. How do psychiatrists cure blood drinking? Is it a symptom of a behavioral disorder?

A. The behavior you describe would probably fall under the rubric of "vampirism"--which is apparently quite a rare condition. In over 20 years of psychiatric practice, I have never seen or heard of such a case.

The literature on this topic is pretty sparse. Jensen & Poulsen (Nord J Psychiatry 2002;56(1):47-48) describe a case of auto-vampirism (drinking one's own blood) in a 35-year-old schizophrenic woman. The authors describe the behavior as part of a "...bizarre delusion of a purification process." Hemphill & Zabow (S Afr Med J 1983 Feb 19;63(8):278-81) report vampirism in connection with self-injurious behavior, as well as dangerousness to others.

I don't believe there have been enough reported cases to speak of the appropriate treatment for this behavior, which is almost certainly just a part of a larger disease process. Thus, treatment would most likely be directed at the patient's underlying schizophrenia, bipolar disorder, or personality disorder. (I would guess that Borderline Personality Disorder would be especially implicated in this sort of ritualistic behavior, but I don't know of any objective evidence of that).

The history of childhood abuse in your friend's case could point to some type of post-traumatic stress disorder, perhaps accompanied by Borderline or other personality disorder--but those are really just speculations. This is certainly something that should be taken seriously, and dealt with in psychotherapy.

September 2003

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