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Distribution of suicides among patients with BPD compared with the general population of the same age group in accordance with the country and year of publication of a specific study. Dashed line, general population; straight line, patients with BPD.
Source publication
Suicide is the major cause of death among patients with borderline personality disorder; however, the literature on completed suicides in such disorder is inconclusive, as suicide rates vary greatly among cohorts of patients. We searched MedLine, Excerpta Medica and PsycLit from 1980 to 2005 to identify papers dealing with suicide in borderline per...
Context in source publication
Context 1
... In this group of patients, 94 had committed suicide. Follow-up observation ranged from 3 to 27 years. Table 1 provides information about the studies that we used for our analysis (1, 2, 7, 10, 15, 19Á/21). Each study has been positioned in the table in chronological order. Table 1 also illustrates the results of our compara- tive analysis. Fig. 1 shows distribution of suicides among patients with BPD compared with the general population of the same age group in accordance with the country and year of publication of a specific study. The number of suicides was calculated as suicides)/100,000/number of patients in the study)/follow up. Mean of suicides in a population suffering ...
Citations
... Finally, CSD features also had greater importance for model training than SC-LIWC features. A great deal of literature has reported that patients with borderline personality disorder commit suicide more often than their counterparts in the general population (67). It has also been claimed that certain personality traits may be useful markers of suicide risk (68). ...
Background:
Personality psychology studies personality and its variation among individuals and is an essential branch of psychology. In recent years, machine learning research related to personality assessment has started to focus on the online environment and showed outstanding performance in personality assessment. However, the aspects of the personality of these prediction models measure remain unclear because few studies focus on the interpretability of personality prediction models. The objective of this study is to develop and validate a machine learning model with domain knowledge introduced to enhance accuracy and improve interpretability.
Methods:
Study participants were recruited via an online experiment platform. After excluding unqualified participants and downloading the Weibo posts of eligible participants, we used six psycholinguistic and mental health-related lexicons to extract textual features. Then the predictive personality model was developed using the multi-objective extra trees method based on 3,411 pairs of social media expression and personality trait scores. Subsequently, the prediction model's validity and reliability were evaluated, and each lexicon's feature importance was calculated. Finally, the interpretability of the machine learning model was discussed.
Results:
The features from Culture Value Dictionary were found to be the most important predictors. The fivefold cross-validation results regarding the prediction model for personality traits ranged between 0.44 and 0.48 (p < 0.001). The correlation coefficients of five personality traits between the two "split-half" datasets data ranged from 0.84 to 0.88 (p < 0.001). Moreover, the model performed well in terms of contractual validity.
Conclusion:
By introducing domain knowledge to the development of a machine learning model, this study not only ensures the reliability and validity of the prediction model but also improves the interpretability of the machine learning method. The study helps explain aspects of personality measured by such prediction models and finds a link between personality and mental health. Our research also has positive implications regarding the combination of machine learning approaches and domain knowledge in the field of psychiatry and its applications to mental health.
... general population [2,3]. BPD is also associated with significant personal (i.e., severe psychosocial impairment) and economic/public health (i.e., high rates of underemployment and increased disability) consequences. ...
Background
Research on the precursors of borderline personality disorder (BPD) reveals numerous child and adolescent risk factors, with impulsivity and trauma among the most salient. Yet few prospective longitudinal studies have examined pathways to BPD, particularly with inclusion of multiple risk domains.
Methods
We examined theory-informed predictors of young-adult BPD (a) diagnosis and (b) dimensional features from childhood and late adolescence via a diverse (47% non-white) sample of females with (n = 140) and without (n = 88) carefully diagnosed childhood attention-deficit hyperactivity disorder (ADHD).
Results
After adjustment for key covariates, low levels of objectively measured executive functioning in childhood predicted young adult BPD diagnostic status, as did a cumulative history of childhood adverse experiences/trauma. Additionally, both childhood hyperactivity/impulsivity and childhood adverse experiences/trauma predicted young adult BPD dimensional features. Regarding late-adolescent predictors, no significant predictors emerged regarding BPD diagnosis, but internalizing and externalizing symptoms were each significant predictors of BPD dimensional features. Exploratory moderator analyses revealed that predictions to BPD dimensional features from low executive functioning were heightened in the presence of low socioeconomic status.
Conclusions
Given our sample size, caution is needed when drawing implications. Possible future directions include focus on preventive interventions in populations with enhanced risk for BPD, particularly those focused on improving executive functioning skills and reducing risk for trauma (and its manifestations). Replication is required, as are sensitive measures of early emotional invalidation and extensions to male samples.
... Suicidal and homicidal threats made by individuals with cluster B personality features or behaviors are a common reason for hospitalization [1][2][3]. Threats to self or others in inpatient units are handled with utmost priority and urgency and may involve involuntary admission, seclusion and restraint, or medication administration to quickly manage the physical risk on units, which are often understaffed and overcrowded [4,5]. Given the relational challenges associated with behaviors often seen in cluster B personality disorders, caring for affected patients is often frustrating for medical staff, and the phenomena of splitting, acting out, and demanding behaviors can make it difficult to assume a compassionate stance [6]. ...
Caring for patients with personality disorders can be challenging due to risks associated with suicidal ideation, homicidal threats, splitting, and acting out with problematic behavior in psychiatric inpatient units. Limited resources on inpatient units further add to the stress and burden on staff. This case summarizes how trauma-informed care was implemented in an inpatient setting to produce marked improvement in a patient’s treatment outcomes as well as better staff engagement and satisfaction. This culture change in the approach to care was not an easy process, as effortful planning and resources were required for key elements such as ongoing coaching, education, and regular staff debriefings. This case report signals the need for service providers to enable health systems to examine rules and exceptions from a cultural perspective of considering equity, diversity, and inclusion (EDI)—to allow openness to rational exceptions, even if they are unconventional.
... Moreover, BPD patients have: a mean of three lifetime suicide attempts [53,54]; treatment histories marked by multiple failed attempts; frequent attendances at emergency rooms; and hospitalizations for attempting suicide and threats of suicide [55]. Finally, suicide is more common among patients with BPD than in the general population [56,57]. These findings are interesting, since they suggest that VigilanS should be able to clearly identify who is part of this high-risk population. ...
Background
Suicide is a major health problem globally. As attempted suicide is a major risk factor for suicide, specific prevention strategies have been designed for use thereafter. An example is the brief contact intervention (BCI). In this regard, France employs a composite BCI, VigilanS, which utilizes three types of contact: phone calls, postcards and a ‘who to contact in a crisis’ card. Previous studies have found that this system is effective at preventing suicide. Nevertheless, VigilanS was not effective in the same way for all the patients included. This observation raises the question of specific adaptation during follow-up for populations that were less receptive to the service. In consideration of this issue, we identified one study which found that incoming calls to the service were linked with a higher risk of suicide reattempts. However, this study did not document the profiles of the patients who made these calls. Better understanding of why this population is more at risk is important in terms of identifying factors that could be targeted to improve follow-up. This research therefore aims to bring together such data.
Methods
We performed a retrospective analysis of 579 patients referred to VigilanS by Toulouse University Hospital (France). We examined the sociodemographics, clinical characteristics, and follow-ups in place and compared the patients who made incoming calls to the service versus those who did not. Subsequently, we conducted a regression analysis using the significantly associated element of patients calling VigilanS. Then, in order to better understand this association, we analyzed the factors, including such calls, that were linked to the risk of suicide reattempts.
Results
We found that 22% of the patients in our sample called the VigilanS service. These individuals: were older, at 41.4 years versus 37.9 years for the non-callers; were more likely to have a borderline personality disorder (BPD) diagnosis (28.9% versus 19.3%); and had a history of suicide attempts (71.9% versus 54.6%). Our analysis confirmed that incoming calls to VigilanS (OR = 2.9) were associated with reattempted suicide, as were BPD (OR = 1.8) and a history of suicide attempts (OR = 1.7).
Conclusion
There was a high risk that the patients calling VigilanS would make another suicide attempt. However, this association was present regardless of the clinical profile. We postulate that this link between incoming calls and reattempted suicide may arise because this form of contact is, in fact, a way in which patients signal that a further attempt will be made.
... Detaillierte Studien/Daten zu Suiziden speziell bei Jugendlichen mit BPS fehlen. Pompili et al. (2005) weisen in ihrer Metaanalyse daraufhin, dass die erste Erkrankungsphase stärker mit vollendeten Suiziden assoziiert ist als bei chronischen BPS Patient_innen. Letzteres legt ein höheres Risiko für vollendete Suizide bei beginnender BPS im jungen Erwachsenenalter nahe. ...
Zusammenfassung: Die Borderline-Persönlichkeitsstörung (BPS) ist eine schwere psychische Erkrankung, die durch hohe Morbidität und Mortalität gekennzeichnet ist sowie mit einem niedrigen psychosozialen Funktionsniveau einhergeht. Die BPS zeigt sich oft mit Beginn der frühen Adoleszenz (ab dem 12. Lebensjahr). Neben repetitiver Selbstverletzung und Suizidalität bestehen häufig sowohl Symptome internalisierender (Depression und Angst) als auch externalisierender Störungen (Hyperaktivität und Substanzkonsum). Daher kommt einer differentialdiagnostischen Abklärung und der Diagnosestellung mit dem Ziel der Frühintervention im klinischen Alltag eine besondere Rolle zu. Die Psychotherapie stellt bei der BPS eine äußerst wirksame Behandlungsmethode dar, Belege für die Wirksamkeit von pharmakologischen Intervention fehlen. Der Schlüssel zu einer Verbesserung der Versorgung für Jugendliche mit BPS liegt in einer Generierung von Wissen zu Vorläufersymptomen sowie einer evidenzbasierten, stadienspezifischen Behandlung (frühe Behandlung bereits subklinischer BPS mit Behandlungsintensität abgestuft nach dem Schweregrad). Dieser Übersichtsartikel beleuchtet den aktuellen Stand der Forschung und gibt Empfehlungen für die therapeutische Arbeit in der klinischen Praxis.
... In retrospective studies, the rate of death by suicide is between 8% and 12% among individuals with BPD. [32] Years of suicide threats and self-injurious behaviour may precede a completed suicide and therefore predicting a suicide outcome may be difficult. All reported suicide ideations or attempts should be taken seriously in patients with BPD. ...
... Further study of different motives for suicide threats, attempts, and nonsuicidal self-harm by individuals in abusive relationships would help elucidate the role of such behaviors in the construct of coercive control. Both suicidality and IPV risk have been associated with personality disorders (e.g., Collison & Lynam, 2021;Douglas et al., 2008;Pompili et al., 2005). In borderline personality, fear of abandonment may trigger reactive IPV, whereas antisocial personality is associated with more instrumental aggression (e.g., Ennis et al., 2017;Ross & Babcock, 2009). ...
... The instability of relationships, the creation, and regulation of impulses, self-awareness, and a sense of agency, were some of the main features of the disorder (2). BPD is a severe disorder that accounts for 20 to 40% of psychiatric admissions, and it is estimated that 84% of patients show suicidal behaviors, and 8% of them die due to suicide (3,4). The exact etiology of BPD is still unclear and is likely multifactorial and heterogeneous; current explanations assume the stress-diathesis model, with an interaction between the experience of traumatic events during childhood (e.g., sexual abuse, neglect) and genetic factors (5). ...
Background:
Borderline personality disorder is a major mental illness characterized by sustained relationship instability, impulsive behavior, and intense affects. Adherence is a complex behavior, from minor refusals to abandonment of treatment, which can be affected by various factors. Therefore, the present study aimed to investigate the factors affecting pharmacological and psychotherapy adherence, patients' attitude toward medication, and assessing medication and treatment adherence in patients with borderline personality disorder referred to an outpatient referral clinic in Tehran, Iran.
Methods:
The study was a cross-sectional study. The files of patients with borderline personality disorder referred to the outpatient clinic of the Tehran Psychiatric Institute were reviewed as the first step. Data were collected using the Drug Attitude Inventory-10 (DAI-10) questionnaire and a questionnaire to determine the attitude of patients toward pharmacological and psychotherapy treatment as well as therapeutic adherence. After collecting data, patients' therapeutic adherence was divided into poor, partial, and good compliance.
Results:
Ninety-four patients were involved in the study, and fifty-four were women. Findings of DAI showed that 54 (57.4%) participants had negative attitudes toward medication, while 38 (40.4%) participants showed a negative attitude toward psychotherapy treatment. Additionally, the percentage of patients with good psychotherapy adherence (44.7%) was higher than that of patients with good medication adherence (31.9%). The most common reasons for discontinuation of treatment were medication side effects (53.1%), dissatisfaction with the therapist (40.3%), and then fear of medication dependence (40%). Patients with higher education levels and a positive history of hospitalization in a psychiatric ward had better adherence to psychotherapy (P < 0.05).
Conclusion:
Results of the current study show that attitude toward psychotherapy is more favorable than pharmacotherapy among patients with BPD. The rationale may be that medications are mainly prescribed for comorbid conditions and do not have substantial effects on the BPD symptoms, resulting in low medication adherence.
... Several studies have reported the relationship between suicide attempts and personality disorders. [65][66][67] In a meta-analysis study, Pompili et al. 68 People with borderline personality disorder experience rapid changes in mood, and their behavior is very unpredictable. These are dependent people, but they may lose their friends frequently due to frequent anger and lack of anger control. ...
... For this reason, the chance of suicide in them is higher than in general society. 65,68 Other findings of this study showed that 28.49% of respondents were children of divorce, and 30.30% reported emotional divorce among their parents. The results of a survey in Isfahan in 2020 on teenagers and young people from families on the verge of separation indicated that the tendency of teenagers and young people from families on the verge of divorce to commit suicide was significantly higher than ordinary people. ...
Background and aims:
Suicide is a global public health issue. The covid-19 epidemic has led to disturbance in daily life and economic activity. It is assumed that increased stress and anxiety cause suicide. This study aimed to describe the causes and methods of committing suicide during the COVID pandemic.
Methods:
This descriptive study was conducted on all outpatients, inpatients, and those who died during the period from March 21, 2021 to March 20, 2022 due to suicide attempts, referred to hospitals and clinics affiliated with Jahrom University of Medical Sciences or were identified by the social emergency and welfare organization.
Results:
A total of 330 suicide attempters with an average age of 26.74 ± 0.64 years were studied. They were 220 women (66.67%), 159 single (48.18%), and 309 (73.64%) people who had diplomas and high school degrees. In general, the three main reasons for committing suicide were emotional issues and problems with 169 people (51.21%), family violence with 127 people (38.48%), and economic issues and problems with 90 people (27.27%). In terms of suicide manners, 283 people (85.76%) used medicine (or pharmaceuticals), 16 people (4.85%) used agricultural pesticides, and 11 people (3.33%) used rodenticides. Furthermore, 164 people (49.70%) suffered from depression, 94 people (28.49%) were children of divorce, 60 people (18.18%) were drug users, 151 people (45.76%) had a history of alcohol consumption, and 116 people (35.15%) had a history of committing suicide. A total of 6 cases of complete suicide (leading to death) have occurred.
Conclusion:
The most important factors for suicide throughout the covid-19 epidemic were emotional issues, marital incompatibility, and economic issues. Medicine poisoning was the most important method of committing suicide. In times of crisis, a multisectoral public health approach is needed to prevent increased anxiety, stress, and subsequent suicide attempts.
... Furthermore, this risk also increases in cases where patients live in a highly stressful environment or have trouble with self-regulation [3]. Meta-analysis of BPD linked suicides show that out of 1179 patients selected from eight different studies 94 of those committed suicide [12]. Based on various research up to 10% of patients suffering from BPD die by suicide and the most effective evidence-based treatment methods that could help prevent that are specifically designed psychotherapies rather than hospitalizations [3]. ...
