Among adults with personality disorders, borderline personality disorder in general—and 3 symptoms of the disorder in particular—were significantly associated with suicide attempts, according to a study published online in JAMA Psychiatry.
“In the multisite, longitudinal study of adults with personality disorders, identity disturbance, chronic feelings of emptiness, and frantic efforts to avoid abandonment were significantly associated with suicide attempts,” wrote lead author Shirley Yen, PhD, of Beth Israel Deaconess Medical Center, Boston, Massachusetts, and colleagues.
The study followed 701 adults with schizotypal, borderline, avoidant, and obsessive-compulsive disorders, as well as a comparison group of adults with major depressive disorder with minimal personality disorder features, over 10 years. Participants were assessed annually through diagnostic interviews and self-report measures.
‘Tragically High’ Suicide Rate Accompanies Schizophrenia Diagnosis
The most robust factor linked with observed suicide attempt was borderline personality disorder, even after controlling for significant demographic and other clinical risk factors, such as substance use disorder, childhood sexual abuse, and post-traumatic stress disorder. According to the study, the odds ratio of suicide attempt among participants with borderline personality disorder was 4.18.
Specific criteria of borderline personality disorder significantly linked with suicide attempt were identity disturbance, which had an odds ratio of 2.21; chronic feelings of emptiness, which had an odds ratio of 1.63; and frantic efforts to avoid abandonment, which had an odds ratio of 1.93.
“In light of the high rates of borderline personality disorder diagnostic remission, our findings suggest that these criteria should be independently assessed and targeted for further study as suicide risk factors,” researchers advised.
Yen S, Peters JR, Nishar S, et al. Association of borderline personality disorder criteria with suicide attempts: findings from the collaborative longitudinal study of personality disorders over 10 years of follow-up. JAMA Psychiatry. 2020 November 18;[Epub ahead of print].