Suicidality and hospitalisation in patients with borderline personality disorder who experience auditory verbal hallucinations

2017 ◽  
Vol 41 (1) ◽  
pp. 47-52 ◽  
Author(s):  
C.W. Slotema ◽  
M.B.A. Niemantsverdriet ◽  
J.D. Blom ◽  
M. van der Gaag ◽  
H.W. Hoek ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Rating Scales ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Borderline Personality ◽  
Convenience Sample ◽  
Auditory Verbal Hallucinations ◽  
Suicidal Plans ◽  
The Impact

AbstractBackgroundIn patients with borderline personality disorder (BPD), about 22–50% experience auditory verbal hallucinations (AVH). However, the impact of these hallucinations on suicidal ideation, suicide attempts, crisis-service interventions, and hospital admissions is unknown.MethodsIn a cross-sectional design, data were collected with the Psychotic Symptom Rating Scales (PSYRATS) and the MINI International Neuropsychiatric Interview Plus, as well as from the medical records of a convenience sample of outpatients fulfilling the DSM-IV criteria for BPD.ResultsOf the 89 included patients, 27 experienced AVH. In the latter group, the presence of AVH was associated with a significantly higher incidence of suicidal plans and attempts in the month prior to study participation, more hospitalisations, and a shorter interval until hospitalisation. All subscales of the PSYRATS correlated positively with suicide plans, while the phenomenological and emotional subscales also correlated positively with suicide attempts. Moreover, higher scores on the emotional subscale were associated with more hospital admissions.ConclusionsAVH experienced by patients with BPD might constitute a risk factor for suicide plans and attempts, and hospitalisation. This finding emphasises that this population requires adequate clinical attention, as well as effective treatment for AVH.

Differential Change of Borderline Personality Disorder Traits During Dialectical Behavior Therapy for Adolescents

2019 ◽  
Vol 33 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Arne Buerger ◽  
Gloria Fischer-Waldschmidt ◽  
Florian Hammerle ◽  
Kristin von Auer ◽  
Peter Parzer ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Suicide Attempts ◽  
Treatment Options ◽  
Skills Training ◽  
Borderline Personality ◽  
Secondary Outcomes ◽  
The Impact

Despite the expansion of treatment options for adults with borderline personality disorder (BPD), research on treatment options for adolescent BPD is scarce. The aim of this study was to investigate the impact of dialectical behavior therapy for adolescents (DBT-A) on the individual trait level as primary outcome; and the frequency of suicide attempts and nonsuicidal self-injury, self-reported BPD core pathology, and general psychopathology as secondary outcomes. Seventy-two adolescents (aged 12–17 years) with full- or subsyndromal BPD were treated with DBT-A (25 single sessions, 20 sessions of skills training), and 13 patients (18.1%) withdrew during treatment. From baseline to post-treatment, the number of BPD traits decreased significantly (p ≤ .001). All secondary outcomes decreased significantly as well (p ≤ .001). Results of this uncontrolled study suggest that beside self-harm, DBT-A may also have a beneficial impact on other features of BPD.

Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia

2012 ◽  
Vol 42 (9) ◽  
pp. 1873-1878 ◽  
Author(s):  
C. W. Slotema ◽  
K. Daalman ◽  
J. D. Blom ◽  
K. M. Diederen ◽  
H. W. Hoek ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Schizoaffective Disorder ◽  
Rating Scales ◽  
Borderline Personality ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Auditory Verbal Hallucinations ◽  
Almost All ◽  
Symptom Rating

BackgroundAuditory verbal hallucinations (AVH) in patients with borderline personality disorder (BPD) are frequently claimed to be brief, less severe and qualitatively different from those in schizophrenia, hence the term ‘pseudohallucinations’. AVH in BPD may be more similar to those experienced by healthy individuals, who experience AVH in a lower frequency and with a more positive content than AVH in schizophrenia. In this study the phenomenology of AVH in BPD patients was compared to that in schizophrenia and to AVH experienced by non-patients.MethodIn a cross-sectional setting, the phenomenological characteristics of AVH in 38 BPD patients were compared to those in 51 patients with schizophrenia/schizoaffective disorder and to AVH of 66 non-patients, using the Psychotic Symptom Rating Scales (PSYRATS).ResultsBPD patients experienced AVH for a mean duration of 18 years, with a mean frequency of at least daily lasting several minutes or more. The ensuing distress was high. No differences in the phenomenological characteristics of AVH were revealed among patients diagnosed with BPD and those with schizophrenia/schizoaffective disorder, except for ‘disruption of life’, which was higher in the latter group. Compared to non-patients experiencing AVH, BPD patients had higher scores on almost all items.ConclusionsAVH in BPD patients are phenomenologically similar to those in schizophrenia, and different from those in healthy individuals. As AVH in patients with BPD fulfil the criteria of hallucinations proper, we prefer the term AVH over ‘pseudohallucinations’, so as to prevent trivialization and to promote adequate diagnosis and treatment.

scholarly journals Clinical and Sociodemographic Variables as Risk Factors For Suicidal Behavior In Borderline Personality Disorder: A Restrospective Study

2020 ◽  
Author(s):  
Iñigo Alberdi-Paramo ◽  
Germán Montero-Hernández ◽  
María Dolores Sáiz-González ◽  
Marina Díaz-Marsá ◽  
José Luis Carrasco-Perera
Keyword(s):  
Risk Factors ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Negative Binomial ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Statistical Significance ◽  
Borderline Personality ◽  
Sociodemographic Variables

Abstract Background:Suicidal behavior (SB) is nuclear in Borderline Personality Disorder (BPD). It is considered a symptom clinically relevant and with an important prognostic value. The literature describes different variables related to SB in BPD such as impulsivity, aggressiveness or hopelessness. There are not hardly any studies focused on the role of sociodemographic variables and their specific relationship with SB in BPD. The objective of this work is to identify which clinical and sociodemographic parameters could act as markers of suicide risk in BPD.Methods:A cross-sectional, observational, and retrospective study was conducted of a sample of 134 patients diagnosed with BPD. The analysis of the association between variables was carried out with a multivariate negative binomial logistic regression model.Results:SB is related to the number of siblings with statistical significance. Likewise, a greater number of suicide attempts is significantly associated with female gender, parenthood, permanent work, sick leaves and the number of previous hospital admissions. Both the presence of SB and a greater number of suicide attempts are significantly related to history of trauma in childhood and to the score in Hamilton Anxiety Rating Scale.Conclusions: These parameters could act as risk factors for SB in BPD. The role of these variables could be the subject of further research projects in order to identify them in clinical practice.

Progression from interpersonal problems to suicidal ideation and suicidal behavior in borderline personality disorder

2020 ◽  
Author(s):  
Timothy Allen ◽  
Michael Hallquist ◽  
Aidan G.C. Wright ◽  
Alexandre Dombrovski
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Negative Affect ◽  
Structural Equation ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Interpersonal Dysfunction ◽  
Suicidal Crisis

Importance: Clinicians treating borderline personality disorder (BPD) are often faced with the difficult challenge of assessing when, and for whom, risk for suicide is greatest. Addressing this dilemma requires longitudinal, prospective data from high-risk samples with an elevated base rate of suicide attempts.Objective: To test whether dispositional characteristics modulate the pathway from interpersonal dysfunction to suicide in BPD. Design: This longitudinal, observational study was conducted between 1990 and 2020. Data were analyzed between April and July 2020. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Setting: Participants were recruited from inpatient, outpatient, and community referral sources.Participants: 458 individuals (Mean age = 28.59, 77% female) diagnosed with BPD.Main Outcomes and Measures: Presence or absence of a suicide attempt within one year of each follow-up assessment. Multilevel structural equation modeling was used to 1) examine longitudinal, within-person transitions from interpersonal dysfunction to suicidal ideation to suicide attempts (i.e., the [I]nterpersonal-[I]deation-[A]ttempt pathway); and 2) evaluate whether two maladaptive personality dimensions, negative affect and disinhibition, moderated these transitions.Results: At the within-person level, there was support for the I-I-A pathway: suicidal ideation accounted for the association between interpersonal dysfunction and suicide attempts. Personality further moderated each component of the I-I-A pathway: negative affect was associated with a stronger coupling between interpersonal dysfunction and ideation; and disinhibition was associated with a stronger coupling between ideation and attempts. Conclusions and Relevance: The escalation from interpersonal difficulties to a suicidal crisis in BPD involves two psychologically distinct process. An internalizing process links interpersonal dysfunction to suicidal ideation and is facilitated by trait negative. An additional externalizing process links suicidal ideation to suicide attempts, and is facilitated by trait disinhibition. Assessment of these intra- and interindividual risk factors may inform clinical decisions about when, and for whom, crisis intervention is necessary.

scholarly journals Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients

2017 ◽  
Vol 44 ◽  
pp. 53-60 ◽  
Author(s):  
K.I. Aaltonen ◽  
T. Rosenström ◽  
I. Baryshnikov ◽  
B. Karpov ◽  
T. Melartin ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Childhood Maltreatment ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Mediation Effect ◽  
Mediation Analyses ◽  
Borderline Personality Disorder Traits

AbstractBackground:Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders.Methods:Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n = 287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.Results:The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P = 0.002) and independent of current depressive symptoms.Conclusions:The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation.

Comorbid Bipolar Disorder and Borderline Personality Disorder and History of Suicide Attempts

2014 ◽  
Vol 28 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Mark Zimmerman ◽  
Jennifer Martinez ◽  
Diane Young ◽  
Iwona Chelminski ◽  
Theresa A. Morgan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
History Of

Neuropsychological function in bulimia with comorbid borderline personality disorder and depression

2006 ◽  
Vol 18 (3-4) ◽  
pp. 162-167 ◽  
Author(s):  
Cecilia M. Bourke ◽  
Richard J. Porter ◽  
Patrick Sullivan ◽  
Cynthia M. Bulik ◽  
Frances A. Carter ◽  
...  
Keyword(s):  
Executive Function ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Neuropsychological Tests ◽  
Neuropsychological Test ◽  
Borderline Personality ◽  
Neuropsychological Function ◽  
Test Results ◽  
Trail Making ◽  
The Impact

Background:In bulimia nervosa (BN), borderline personality disorder (BPD) and major depression (MDD) are frequently comorbid conditions. Executive function has been found to be impaired in BPD and MDD, but the impact of comorbidity on neuropsychological function has rarely been investigated.Objective:To investigate neuropsychological function in BN with a focus on comorbid BPD and MDD.Methods:One hundred forty-four medication-free female patients entering a study of psychological treatments for BN performed a brief battery of neuropsychological tests. Comorbid MDD and BPD were systematically identified using standard interviews. Neuropsychological test results were compared.Results:Forty-one subjects had comorbid BPD and 35 had comorbid MDD, while 15 had both. There was no effect of comorbid MDD, but there was a significant effect of BPD and a significant interaction between the diagnosis of MDD and BPD on executive tasks (trail making and Stroop). Thus, compared with subjects without BPD, subjects with BPD performed significantly worse on tests of executive function, while the group with both comorbidities performed even worse.Conclusions:There appears to be an additive effect of BPD and MDD resulting in impaired executive neuropsychological function. Future studies on either disorder and on BN should examine and account for the effect of comorbidity.

Impact of Childhood Maltreatment in Borderline Personality Disorder on Treatment Response to Intensive Dialectical Behavior Therapy

2019 ◽  
pp. 1-19 ◽  
Author(s):  
Sebastian Euler ◽  
Esther Stalujanis ◽  
Hannah J. Lindenmeyer ◽  
Rosetta Nicastro ◽  
Ueli Kramer ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Treatment Response ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Borderline Personality ◽  
The Impact

Childhood maltreatment (CM), including emotional, physical, and sexual abuse and emotional and physical neglect, is associated with severity of borderline personality disorder (BPD). However, knowledge on the impact of CM on treatment response is scarce. The authors investigated whether self-reported CM or one of its subtypes affected treatment retention, depressive symptoms, and impulsivity throughout short-term intensive dialectical behavior therapy (I-DBT) in 333 patients with BPD. Data were analyzed with linear and logistic regressions and linear mixed models, using a Bayesian approach. Patients who reported childhood emotional abuse had a higher dropout rate, whereas it was lower in patients who reported childhood emotional neglect. Emotional neglect predicted a greater decrease of depressive symptoms, and global CM predicted a greater decrease of impulsivity. The authors concluded that patients with BPD who experienced CM might benefit from I-DBT in specific symptom domains. Nonetheless, the impact of emotional abuse on higher dropout needs to be considered.

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