Suicidal Behavior and Psychosocial Outcome in Borderline Personality Disorder at 8-Year Follow-Up
We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years and asked if there was a relationship between these outcomes. One hundred twenty-three BPD subjects, recruited from inpatient (35.8%), outpatient (30.9%) and community (33.3%) sources, w...
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Published in | Journal of personality disorders Vol. 31; no. 6; pp. 774 - 789 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
United States
Guilford Press
01.12.2017
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Online Access | Get full text |
ISSN | 0885-579X 1943-2763 1943-2763 |
DOI | 10.1521/pedi_2017_31_280 |
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Abstract | We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years and asked if there was a relationship between these outcomes. One hundred twenty-three BPD subjects, recruited from inpatient (35.8%), outpatient (30.9%) and community (33.3%) sources, were assessed annually for known risk factors for suicidal behavior. Interval attempts were reported by 25 subjects (20.2%). Increased risk of suicide attempt was associated with negative affectivity, aggression, inpatient recruitment, hospitalizations, minority race, and frequent changes in employment. Decreased risk was associated with increased education. Poor psychosocial outcome was predicted by impulsivity, negative affectivity, and antisocial traits at baseline, and by comorbid MDD at 8-year follow-up. There was no significant relationship between poor psychosocial outcome at 8-year follow-up and risk of suicidal behavior. Predictors of suicidality include modifiable risk factors. Rehabilitation models are needed to address educational and vocational deficits associated with suicidality, especially among minorities. |
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AbstractList | We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years and asked if there was a relationship between these outcomes. One hundred twenty-three BPD subjects, recruited from inpatient (35.8%), outpatient (30.9%) and community (33.3%) sources, were assessed annually for known risk factors for suicidal behavior. Interval attempts were reported by 25 subjects (20.2%). Increased risk of suicide attempt was associated with negative affectivity, aggression, inpatient recruitment, hospitalizations, minority race, and frequent changes in employment. Decreased risk was associated with increased education. Poor psychosocial outcome was predicted by impulsivity, negative affectivity, and antisocial traits at baseline, and by comorbid MDD at 8-year follow-up. There was no significant relationship between poor psychosocial outcome at 8-year follow-up and risk of suicidal behavior. Predictors of suicidality include modifiable risk factors. Rehabilitation models are needed to address educational and vocational deficits associated with suicidality, especially among minorities.We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years and asked if there was a relationship between these outcomes. One hundred twenty-three BPD subjects, recruited from inpatient (35.8%), outpatient (30.9%) and community (33.3%) sources, were assessed annually for known risk factors for suicidal behavior. Interval attempts were reported by 25 subjects (20.2%). Increased risk of suicide attempt was associated with negative affectivity, aggression, inpatient recruitment, hospitalizations, minority race, and frequent changes in employment. Decreased risk was associated with increased education. Poor psychosocial outcome was predicted by impulsivity, negative affectivity, and antisocial traits at baseline, and by comorbid MDD at 8-year follow-up. There was no significant relationship between poor psychosocial outcome at 8-year follow-up and risk of suicidal behavior. Predictors of suicidality include modifiable risk factors. Rehabilitation models are needed to address educational and vocational deficits associated with suicidality, especially among minorities. Long term outcome for most patients with BPD includes diagnostic and symptomatic remission; however, a majority never achieve psychosocial recovery and 3% - 10% die by suicide. We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years, and asked if there was a relationship between these outcomes. 123 BPD subjects, recruited from inpatient (35.8%), outpatient (30.9%) and community (33.3%) sources, were assessed annually for known risk factors for suicidal behavior, including demographic, diagnostic, clinical and socio-economic variables. Proportional hazards models examined predictive associations between risk factors, time-to-suicide attempt, and poor psychosocial outcome at 8 year follow-up (defined as GAS < 61). Interval attempts were reported by 25 subjects (20.2%). I ncreased risk of suicide attempt was associated with measures reflecting illness severity (negative affectivity, aggression, inpatient recruitment, hospitalizations), and socio-economic status (minority race, frequent changes in employment). Decreased risk was associated with increased education. Poor psychosocial outcome was predicted by personality dimensions of impulsivity, negative affectivity, and anti-social traits at baseline, and by co-morbid MDD at 8 year follow-up. There was no significant relationship between poor psychosocial outcome at 8 year follow-up and risk of suicidal behavior. Socio-economic status was indirectly related to suicide risk through minority race. Predictors of suicidal behavior and poor psychosocial outcomes include modifiable risk factors: negative affectivity, impulsivity, aggression, and chronic depression. Rehabilitation models are needed to address educational and vocational deficits associated with suicidality, especially in minority patients. We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years and asked if there was a relationship between these outcomes. One hundred twenty-three BPD subjects, recruited from inpatient (35.8%), outpatient 30.9%) and community (33.3%) sources, were assessed annually for known risk factors for suicidal behavior. Interval attempts were reported by 25 subjects (20.2%). Increased risk of suicide attempt was associated with negative affectivity, aggression, inpatient recruitment, hospitalizations, minority race, and frequent changes in employment. Decreased risk was associated with increased education. Poor psychosocial outcome was predicted by impulsivity, negative affectivity, and antisocial traits at baseline, and by comorbid MDD at 8-year follow-up. There was no significant relationship between poor psychosocial outcome at 8-year follow-up and risk of suicidal behavior. Predictors of suicidality include modifiable risk factors. Rehabilitation models are needed to address educational and vocational deficits associated with suicidality, especially among minorities. |
Author | Soloff, Paul H. Chiappetta, Laurel |
AuthorAffiliation | 1 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA 2 Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA |
AuthorAffiliation_xml | – name: 1 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA – name: 2 Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA |
Author_xml | – sequence: 1 givenname: Paul H. surname: Soloff fullname: Soloff, Paul H. organization: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania – sequence: 2 givenname: Laurel surname: Chiappetta fullname: Chiappetta, Laurel organization: Statistics Department, University of Pittsburgh |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28263092$$D View this record in MEDLINE/PubMed |
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Snippet | We sought predictors of both suicidal behavior and psychosocial outcome in subjects with BPD followed for 8 years and asked if there was a relationship between... Long term outcome for most patients with BPD includes diagnostic and symptomatic remission; however, a majority never achieve psychosocial recovery and 3% -... |
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SubjectTerms | Academic Achievement Adolescent Adult Adult Development Anatomy Borderline personality disorder Borderline Personality Disorder - psychology Comorbidity Depression (Psychology) Female Follow-Up Studies Humans Longitudinal Studies Male Mental Disorders Mental Health Middle Aged Patients Personality disorders Personality Problems Personality Studies Personality traits Psychology - methods Rating Scales Risk Factors Schizophrenia Self Destructive Behavior Semi Structured Interviews Slow Learners Social Adjustment Suicidal behavior Suicidal Ideation Suicide Suicides & suicide attempts Time Time Factors Young Adult |
Title | Suicidal Behavior and Psychosocial Outcome in Borderline Personality Disorder at 8-Year Follow-Up |
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