Leo Sher, M.D.

Our research work, “Clinical features and psychiatric comorbidities of borderline personality disorder patients with versus without a history of suicide attempt” was published in the December 2016 issue of Psychiatry Research (1). In this study, we compared clinical features of borderline personality disorder (BPD) patients with or without a history of suicide attempts and healthy volunteers.

The sample consisted of 435 participants: 146 healthy controls, 241 BPD patients without a history of suicide attempt, and 48 BPD patients with a history of suicide attempt. Healthy controls had no psychiatric disorders including personality disorders. BPD suicide attempters had a mean lifetime history of 3.4±2.8 suicide attempts.

Compared with healthy volunteers, both BPD groups had higher Affective Lability Scale (ALS), ALS – Depression-Anxiety Subscale, Barratt Impulsivity Scale, and Lifetime History of Aggression (LHA) scores and were more likely to have a history of temper tantrums. BPD suicide attempters had higher ALS, ALS – Depression-Anxiety Subscale and LHA scores and were more likely to have a history of non-suicidal self-injury (NSSI) or temper tantrums compared to BPD non-attempters. Also, BPD suicide attempters were more likely to have a history of comorbid major depressive disorder (MDD) and less likely to have comorbid narcissistic personality disorder in comparison to BPD non-attempters. About 50% of study participants in each BPD group had a history of comorbid substance use disorder.

Our findings indicate that BPD patients with a history of suicide attempt(s) are more psychiatrically ill than BPD suicide non-attempters as indicated by higher levels of affective lability, aggression, depression, anxiety, and NSSI. BPD patients with a history of NSSI, MDD, and/or aggressive behavior should be regarded as individuals with high suicide risk.

Reference

1. Sher L, Fisher AM, Kelliher CH, Penner JD, Goodman M, Koenigsberg HW, New AS, Siever LJ, Hazlett EA. Clinical features and psychiatric comorbidities of borderline personality disorder patients with versus without a history of suicide attempt. Psychiatry Res. 2016 Dec 30;246:261-266. doi: 10.1016/j.psychres.2016.10.003. Epub 2016 Oct 2.