Axis I disorders and personality disorders as risk factors for suicide

Schneider, Barbara; Wetterling, Tilman; Sargk, Dieter; Schneider, Fabian T.; Schnabel, Alexander; Maurer, K.; Fritze, Jürgen

doi:10.1007/s00406-005-0593-7

Cited by 85 publications

(60 citation statements)

References 69 publications

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“…This is contrary to previous studies (Brent, Johnson, Perper et al, 1994;Foster, Gillespie, McClelland et al, 1999;Johnson, Cohen, Skodol et al, 1999;) reporting an association between CCPD and suicidal behavior. These studies did not exclude other PD co-morbidity, which could affect findings given that the cooccurrence of personality disorders from more than one cluster has been reported to be associated with elevated suicide risk (Schneider, Wetterling, Sargk et al, 2005). On the other hand, our findings differ from those of Schneider, Wetterling, Sargk et al (2005) who reported that, in a psychological autopsy study, presence of "pure" CCPD was a predictor of suicide only for men, even independently of axis I disorders.…”

Section: Discussioncontrasting

confidence: 88%

“…These studies did not exclude other PD co-morbidity, which could affect findings given that the cooccurrence of personality disorders from more than one cluster has been reported to be associated with elevated suicide risk (Schneider, Wetterling, Sargk et al, 2005). On the other hand, our findings differ from those of Schneider, Wetterling, Sargk et al (2005) who reported that, in a psychological autopsy study, presence of "pure" CCPD was a predictor of suicide only for men, even independently of axis I disorders. In our study, there were no associations between gender and suicidal ideation or behavior in depressed patients with CCPD and those without co-occurrence of other personality disorders.…”

Section: Discussioncontrasting

confidence: 88%

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Cluster C Personality Disorders in Major Depressive Episodes: The Relationship Between Hostility and Suicidal Behavior

Dervic¹,

Grunebaum²,

Burke³

et al. 2007

Archives of Suicide Research

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There is some evidence for an association between Cluster C Personality Disorders (CCPD) and suicidal behavior. We compared depressed inpatients with and without CCPD in terms of suicidal behavior and associated psychopathology. Cluster A or B personality disorder co-morbidity were exclusion criteria for both groups (cases and controls). Depressed inpatients with "pure" CCPD had higher levels of suicidal ideation but not more previous suicide attempts compared with patients without CCPD. Greater suicidal ideation in depressed patients with CCPD in our study was associated with more hostility. Future studies examining the relationship between suicidal ideation and hostility in CCPD may clarify whether treatment focused on hostility might be of use for decreasing suicidal ideation in depressed patients with CCPD (Spitzer, Williams, Gibbon et al., 1990). Keywordscluster C personality disorders; depression; hostility; suicide Whereas there is strong support for an association of other personality disorders, such as cluster B personality disorders with suicidal behavior (Corbitt, Malone, Haas et al., 1996;Isometsa, Henriksson, Heikkinen et al., 1996;Lecrubier, 2001 Sher, Oquendo, & Mann, 2001), reports about cluster C personality disorders (CCPD) (fearful/avoidant cluster) are mixed. Few studies have investigated the association between CCPD (obsessive-compulsive, avoidant, and dependent) and suicidal behavior. In a longitudinal study of a community sample, Johnson, Cohen, Skodol, et al. (1999) reported that patients with CCPD were at increased risk for suicidal behavior even after controlling for affective disorders. In psychological autopsy studies, Brent, Johnson, Perper, et al. (1994) reported a higher prevalence of probable or definite cluster C PD among adolescent suicide victims than in controls, and Foster, Gillespie, McClelland, et al. (1999) reported CCPD as a suicide risk factor even after adjustment for axis I disorders in adults. On the other hand, Isometsa, Henriksson, Heikkinen, et al. (1996) found no differences between adult suicide victims with CCPD and controls in any of the examined variables including a history of previous suicide attempt. Chioqueta and Stiles (2004) investigated the relationship between specific disorders within cluster C and suicide attempt in a study of psychiatric outpatients, and found that only dependent personality disorder, but not obsessivecompulsive and avoidant PD, was associated with suicide attempt. Of interest, this association disappeared after controlling for co-morbid depressive disorder.Yet, co-occurrence of personality disorders of more than one cluster has been reported to be associated with increased suicide risk (Schneider, Watterling, Sargk et al., 2005). In this context, in a community sample, 32% of subjects who met criteria for a personality disorder had diagnoses in 2 or more PD clusters (Johnson, Cohen, Skodo et al., 1999). In the studies of suicidal behavior in CCPD subjects cited above, co-morbidity of other PDs, which could affect the associ...

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Section: Discussioncontrasting

confidence: 88%

Section: Discussioncontrasting

confidence: 88%

Cluster C Personality Disorders in Major Depressive Episodes: The Relationship Between Hostility and Suicidal Behavior

Dervic¹,

Grunebaum²,

Burke³

et al. 2007

Archives of Suicide Research

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“…The finding of a history of mental illness as an independent risk factor for suicide in our study is consistent with some studies in China [6,32,34] and Western countries [7,[54][55][56] . In Western cultures, psychological autopsy studies revealed that 90-95 percent of suicide victims had a diagnosable psychiatric disorder at the time of the suicide [1] , but only about half of suicide victims in China had a history of psychiatric diagnosis at the time of death [4,6,32,34] .…”

Section: Issn 2372-5923supporting

confidence: 93%

Prevalence and risk factors of suicide in a rural area of Shandong province in mainland China: a case control study

Liu

Sun

et al. 2015

国际公共卫生杂志

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Objective: Suicide is a major public health problem in China, particularly in rural areas. This study aimed to examine the rate and the risk factors for suicide in a rural area of China. Methods: The mortality data of two counties in Shandong Province from January 1st, 2004 to December 31st 2005 were used. Death information was collected via face-to-face interview with informant(s). Psychological autopsy was conducted on 137 completed suicides and 137 matched controls died from other illnesses. Chisquare/Fisher exact and multiple logistic regression were used for bivariate analyses and predictor analyses, respectively. Results: The suicide rate was 20.90 per 100,000 persons per year with almost equal rates of males and females. Among those with the age over 40 years old, the suicide rate in males was significantly higher than that in females. The peak of suicide fell in the age group of 70-79 years for males and the age group of ≥ 80 years for females. The most commonly used method for suicide was pesticide ingestion (76.7%). Poor interpersonal relationship (OR=12.79), childhood adversities (OR=7.26), a history of mental illness (OR=5.95), adverse life event(s) within 1 year prior to death (OR=3.19), and unstable extravert personality traits (OR=6.12) were independent risk factors for suicide. Male gender positively interacted with majority of these risk factors, especially with a history of mental illness (OR=17.89). Advanced age positively interacted with all independent risk factors, with a history of mental illness having the largest OR of 1.51 as every 10 year of age advancement. In bivariate analyses, a history of previous suicide attempt (OR=13.06), a family history of suicide (OR=7.08), and unstable introvert personality trait (OR=1.83) were also associated with increased risk for suicide; and stable extravert personality trait (OR=0.21) was associated with decreased risk for suicide. Conclusions: In this rural population of mainland China, the risk for suicide was almost equal in both males and females with the elderly having the highest risk. The positive interactions of advanced age and male gender with independent risk factors suggest that suicide prevention strategies targeting specific groups with different risk factors are essential.

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“…A psychiatric disorder, of which the commonest is an episode of major depression, is present in association with over 90 per cent of all suicides according to psychological studies conducted in the United States and western Europe [14][15][16][17][18]. Part of the neurobiology observed in recurrent major depression, that is present between episodes as well as during episodes, is a series of abnormalities in the serotonergic system [19].…”

Section: A Stress-diathesis Model Of Suicidal Behaviourmentioning

confidence: 99%

The serotonergic system in mood disorders and suicidal behaviour

Mann

2013

Phil. Trans. R. Soc. B

191

117

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A stress-diathesis explanatory model of suicidal behaviour has proved to be of heuristic value, and both clinical and neurobiological components can be integrated into such a model. A trait deficiency in serotonin input to the anterior cingulate and ventromedial prefrontal cortex is found in association with suicide, and more recently non-fatal suicidal behaviour, and is linked to decision-making and suicide intent by imaging and related studies in vivo . The same neural circuitry and serotonin deficiency may contribute to impulsive aggressive traits that are part of the diathesis for suicidal behaviour and are associated with early onset mood disorders and greater risk for suicidal behaviour. Other brain areas manifest deficient serotonin input, that is, a trait related to recurrent major depressive disorder and bipolar disorder. Thus the serotonin system is involved in both the diathesis for suicidal behaviour in terms of decision-making, and to a major stressor, namely episodes of major depression.

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Axis I disorders and personality disorders as risk factors for suicide

Cited by 85 publications

References 69 publications

Cluster C Personality Disorders in Major Depressive Episodes: The Relationship Between Hostility and Suicidal Behavior

Cluster C Personality Disorders in Major Depressive Episodes: The Relationship Between Hostility and Suicidal Behavior

Prevalence and risk factors of suicide in a rural area of Shandong province in mainland China: a case control study

The serotonergic system in mood disorders and suicidal behaviour

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