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 inJournal of personality disorders Vol. 31; no. 6; pp. 774 - 789
Main Authors Soloff, Paul H., Chiappetta, Laurel
Format Journal Article
LanguageEnglish
Published United States Guilford Press 01.12.2017
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ISSN0885-579X
1943-2763
1943-2763
DOI10.1521/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.
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
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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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Volume 31
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