Objective: Studies in Western world patients suggest the possible existence of a subgroup of patients with bulimia nervosa (BN) who display multiple problems with impulsivity, such as suicidal attempts. We assessed impulsive behaviors among BN patients in japan to discuss them crossculturally. Method: Impulsive behaviors in 64 BN patients were assessed and multi-impulsivity (MI) was defined according to the definition proposed by Fichter, Quadflieg, and Rief (Psychological Medicine, 24, 591-604, 1994). Results: Nineteen patients (30%) met the definition of MI. BN patients with MI had more severe clinical features, such as concurrent depressive and anxious symptoms, global functioning, and higher prevalence of borderline personality disorder than BN patients without MI. Discussion: These results showed the similarities between BN patients with MI in japan and those patients in the Western world in clinical and psychopathological characteristics and a lifetime incidence of each impulsive behavior. These findings may suggest culturally free bases for linkage between BN and MI. (C) 2000 by John Wiley & Sons, Inc.