How Do Personality Disorders Modify Suicide Risk?

Schnabel, Alexander; Wetterling, Tilman; Bartusch, Bernadette; Weber, Bernhard; Georgi, Klaus

doi:10.1521/pedi.2008.22.3.233

Cited by 51 publications

(41 citation statements)

References 11 publications

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“…2,3 A high rate of acute in-patient admission is further associated with a high incidence of suicide among people with borderline personality disorder, estimated at 10%. 4 Partial hospitalisation over a 5-day week with a mentalisationbased treatment (MBT) approach to care has been shown to decrease this burden, reducing the duration of in-patient care among patients with borderline personality disorder, 5 in addition to a reduction in rates of self-harm and suicidality. 6,7 The provision of inexpensive open-access service user network (SUN) groups has also demonstrated effectiveness in reducing emergency department attendance among patients with personality disorder.…”

Section: Declaration Of Interest Nonementioning

confidence: 99%

A two-model integrated personality disorder service: effect on bed use

2012

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Aims and methodTo assess the impact on psychiatric in-patient bed use of a new personality disorder service that uses two psychoanalytical models: mentalisation-based treatment (MBT) and the service user network (SUN). The number of psychiatric bed days used by patients attending each of the three arms of the service model (SUN, 3-day MBT, 2-day MBT) was collated using the electronic patient records system. Bed use in the 6 months and 12 months before each patient started treatment was compared with bed use in the same periods after starting treatment.ResultsOverall, statistical analysis revealed bed use to be significantly reduced by 6 months of treatment, and the reduction continued to prove significant at 12 months. Comparison between subgroups found no significant difference in bed use between patients attending the MBT programme and patients attending the SUN project at 6 months, but patients on the 3-day MBT programme exhibited a significantly greater reduction in bed use at 6 months compared with patients on the 2-day MBT programme.Clinical implicationsIntervention had a statistically significant effect overall on reducing bed use, which we suggest is linked to an improvement in patients' functioning, and is maintained at 6 months and 12 months of treatment. The lacking difference between the SUN and MBT components of the model raises questions regarding the best allocation of resources and the longer-term effects on bed use, to be answered by further study.

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Section: Declaration Of Interest Nonementioning

confidence: 99%

A two-model integrated personality disorder service: effect on bed use

2012

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“…Comorbidity of Axis I and Axis II disorders is reported in 14 % (Vijayakumar and Rajkumar 1999 ) to 58 % of all suicide victims (Cheng et al 1997 ). Personality traits modify suicide risk differently depending on the underlying Axis I disorder (Schneider et al 2008 ). Having a depression and being substance dependent are themselves suicide risk factors.…”

Section: Comorbidity With Axis I Disordersmentioning

confidence: 99%

“…Having a depression and being substance dependent are themselves suicide risk factors. But when they are comorbid with a PD, the risk of suicide goes beyond the simple sum of relative risks (Schneider et al 2008 ). This may be particularly true for PDs in clusters B and C. For instance, the comorbidity of BPD and depression increased the number and seriousness of suicide attempts in a sample of inpatients (Soloff et al 2000 ).…”

Section: Comorbidity With Axis I Disordersmentioning

confidence: 99%

“…Considering the personality of patients at risk of suicidal behavior (SB) is important since: (i) PDs are frequently comorbid with other Axis I or Axis II disorders, (ii) the presence of a PD complicates prognosis and treatment response, and (iii) personality traits should inform any assessment of suicidal risk to control for their effect on other risk factors. Inversely, the role of personality is largely mediated by other factors, including comorbid psychopathology but also lifetime interpersonal diffi culties or adverse life events (Schneider et al 2008 ).…”

Section: Introductionmentioning

confidence: 99%

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How to Deal with Personality in Suicidal Behavior?

López-Castromán

Blasco-Fontecilla

2016

Understanding Suicide

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There is a large variability in the personality of suicide attempters, but many personality traits and disorders have been consistently associated with suicidal behavior. In clinical settings, psychiatrists and psychologists must often face high-risk patients with marked personality traits, but they seldom investigate personality features to plan the subsequent treatment. This limitation is due to the diffi culty of a reliable assessment of personality, the frequent comorbidity with other mental disorders (including other Axis II disorders), and the lack of know-how to apply this information into targeted interventions. However, researchers are progressively carving the features of personality that interact with each other and with other risk factors, such as life events, to amplify the risk of a suicidal act. In this chapter we will review recent fi ndings and outline the options for intervention that are being opened.

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“…Its association with an increased risk for suicide in our bivariate analysis (Table 3) suggests personality might play a role in averse-life-event-related "impulsive" suicide. Previously, a number of studies showed that the most attributing factors of personality disorders to suicidal behaviors were impulsivity, aggression, and hostility [37,[75][76][77][78][79][80][81][82][83][84][85][86] . Since about half of suicides in China were unplanned and impulsive, the relationship between personality traits/disorder and suicides is worthy of further exploration with larger sample size studies.…”

Section: Issn 2372-5923mentioning

confidence: 99%

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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How Do Personality Disorders Modify Suicide Risk?

Cited by 51 publications

References 11 publications

A two-model integrated personality disorder service: effect on bed use

A two-model integrated personality disorder service: effect on bed use

How to Deal with Personality in Suicidal Behavior?

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

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