Suicidal Behavior in Borderline Personality Disorder: Prevalence, Risk Factors, Prediction, and Prevention

Black, Donald W.; Blum, Nancee; Pfohl, Bruce; Hale, Nancy

doi:10.1521/pedi.18.3.226.35445

Cited by 443 publications

(294 citation statements)

References 54 publications

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“…People with mental disorders die prematurely for a variety of reasons, including poor physical health [3][4][5], adverse physiological consequences of long term psychotropic medication, unhealthy lifestyle [5], as well as increased death rates as a result of suicide, accidents and homicide [6][7][8]. The risk of increased mortality has been shown to vary according to type of mental disorder, with substance use disorders conferring a particularly high risk of early death [1,9,10].…”

Section: Introductionmentioning

confidence: 99%

Life expectancy at birth and all-cause mortality among people with personality disorder

Fok

Hayes

Chang

et al. 2012

Journal of Psychosomatic Research

208

150

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Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in the Journal of Psychosomatic Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be re ected in this document. Changes may have been made to this work since it was submitted for publication. Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. ABSTRACT ObjectiveIt is well established that serious mental illness is associated with raised mortality, yet few studies have looked at the life expectancy of people with personality disorder (PD). This study aims to examine the life expectancy and relative mortality in people with PD within secondary mental health care. MethodsWe set out to examine this using a large psychiatric case register in southeast London, UK.Mortality was obtained through national mortality tracing procedures. In a cohort of patients with a primary diagnosis of PD (n=1836), standardized mortality ratios (SMRs) and life expectancies at birth were calculated, using general population mortality statistics as the comparator. ResultsLife expectancy at birth was 63.3 years for women and 59.1 years for men with PD -18.7 years and 17.7 years shorter than females and males respectively in the general population in England and Wales. The SMR was 4.2 (95% CI: 3.03 -5.64) overall; 5.0 (95% CI: 3.15 -7.45) for females and 3.5 (95% CI: 2.17 -5.47) for males. The highest SMRs were found in the younger age groups for both genders. ConclusionPeople with PD using mental health services have a substantially reduced life expectancy, highlighting the significant public health burden of the disorder.

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Section: Introductionmentioning

confidence: 99%

Life expectancy at birth and all-cause mortality among people with personality disorder

Fok

Hayes

Chang

et al. 2012

Journal of Psychosomatic Research

208

150

View full text Add to dashboard Cite

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“…13 The association between borderline personality disorder specifically and the risk of suicide has been well documented and this is the case particularly when comorbid with major depressive disorder, which is common in this age group. 2,[14][15][16][17] In older adult patients who do go on to complete suicide successfully, it has been found that the majority (77%) had a known underlying mental health condition, with personality disorders making up a very significant proportion (44%). 18 It is therefore apparent that a failure to identify these diagnoses could be catastrophic.…”

Section: Clinical Presentation Of Personality Disorders In Older Adultsmentioning

confidence: 99%

Personality disorders in older adults: diagnosis and management

Mattar¹,

Khan²

2017

Prog. Neurol. Psychiatry

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Personality disorder traits can be quite problematic in older adult patients and the effects of these traits can sometimes present as risks that the professionals working in this field must be confident in managing. It is therefore crucial that information around the presentation and management of these disorders in the older adult psychiatry patient cohort is available. Here, the authors summarise current knowledge regarding the assessment and management of personality disorders in the older adult population, based on a literature search.

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“…We expected the LPI would be moderately correlated with depression, demonstrating convergent validity; the LPI is intended to measure BPD features, which often present with misery, hopelessness, or full diagnoses of depression [28][29][30]. We also expected LPI scores to correlate moderately with suicidal ideation, as suicidal thoughts are highly prevalent among individuals with BPD features [29].…”

mentioning

confidence: 99%

“…We also expected LPI scores to correlate moderately with suicidal ideation, as suicidal thoughts are highly prevalent among individuals with BPD features [29].…”

mentioning

confidence: 99%

Reliability and Validity of the Life Problems Inventory, A Self-Report Measure of Borderline Personality Features, in a College Student Sample

Wagner¹,

Rathus²,

Miller³

2015

J Psychol Psychother

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Rathus, Wagner, and Miller recently reported on the development and psychometric evaluation of the Life problems Inventory (LPI), a self report tool to measure Linehan's conceptualition of borderline personality disorder (BPD) as a disorder primarily of the emotion regulation system, and in particular, problems with regulation of emotions, impulses, relationships, and self. Thus, the LPI maps onto the content of her skills training component of Dialectical Behavior Therapy (DBT), with scales assessing problems addressed in DBT skills modules targeting emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. The present study furthers the investigation of the LPI's psychometrics by examining internal consistency, test-retest reliability, convergent validity with depression, suicidality and mindfulness, and discriminant validity with social desirability in an adolescent/young adult, non-clinical, suburban college student sample (N = 99). The LPI was found to be internally consistent, stable over a two-week retest interval, and related in expected ways with clinical constructs. We discuss implications for further development and application of the LPI and its utility in a college population.Keywords: Borderline personality; Measurement; College students; Life problemsLinehan [1][2][3] developed Dialectical Behavior Therapy as a comprehensive treatment to address the problems of women with BPD and chronic suicide-related behavior. Its success in reducing suicidal and non-suicidal self-injurious behavior (NSSI), reducing hospitalizations, and retaining patients in therapy has made it a standard treatment modality for this population, and numerous randomized clinical trials support its effectiveness [4][5][6]. In addition to these stability and safety-related variables, DBT has also resulted in increases in quality of life measures such as depression, hopelessness, suicidal ideation, social adjustment, and anger [7]. Further, DBT appears promising for adolescents [8][9][10][11][12][13] and for patients with BPD and other co-morbid problems such as substance abuse [14] and eating disorders [15].Currently used widely in outpatient and inpatient settings [10,16], DBT integrates traditional cognitive-behavioral approaches with Eastern acceptance and meditation practices [17]. DBT views individuals with BPD as experiencing core problems of emotional dysregulation that contribute to dysfunction across domains of interpersonal functioning, behavioral regulation/impulsivity, and self/cognitive regulation [1]. Therefore, in addition to individual therapy, a central modality of DBT is skills training in Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance, and Mindfulness, to address capability deficits associated with these areas [2,3].Despite the many replications and extensions of DBT efficacy studies for patients with problems of regulation of emotions and behaviors, none of the many standardized measures of BPD directly and comprehensively assesses the four core problem a...

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Suicidal Behavior in Borderline Personality Disorder: Prevalence, Risk Factors, Prediction, and Prevention

Cited by 443 publications

References 54 publications

Life expectancy at birth and all-cause mortality among people with personality disorder

Life expectancy at birth and all-cause mortality among people with personality disorder

Personality disorders in older adults: diagnosis and management

Reliability and Validity of the Life Problems Inventory, A Self-Report Measure of Borderline Personality Features, in a College Student Sample

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