ETUDE RECHERCHE Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters

Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters

Aveline Aouidad,¹ David Cohen,² Bojan Mirkovic,³ Hugues Pellerin,¹ Sébastien Garny de La Rivière,⁴ Angèle Consoli,¹ Priscille Gérardin,³ and Jean-Marc Guilé⁴

¹Hopital Universitaire Pitie Salpetriere, Paris, France

²Institut des Systemes Intelligents et de Robotique, Paris, France

³Hopital Charles Nicolle, Rouen, France

⁴Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France

Aveline Aouidad, Email: rf.phpa@dadiuoa.enileva.

BMC Psychiatry. 2020; 20: 525.

Published online 2020 Nov 4. doi: 10.1186/s12888-020-02930-4

Abstract

Background

Borderline personality disorder (BPD) and history of prior suicide attempt (SA) have been shown to be high predictors for subsequent suicide. However, no previous study has examined how both factors interact to modify clinical and suicide severity among adolescents.

Methods

This study presents a comprehensive assessment of 302 adolescents (265 girls, mean age = 14.7 years) hospitalized after a SA. To test clinical interactions between BPD and history of prior SA, the sample was divided into single attempters without BPD (non-BPD-SA, N = 80), single attempters with BPD (BPD-SA, N = 127) and multiple attempters with BPD (BPD-MA, N = 95).

Results

Univariate analyses revealed a severity gradient among the 3 groups with an additive effect of BPD on the clinical and suicide severity already conferred by a history of SA. This gradient encompassed categorical (anxiety and conduct disorders and non-suicidal-self-injury [NSSI]) and dimensional comorbidities (substance use and depression severity) and suicide characteristics (age at first SA).

According to regression analyses, the BPD-MA group that was associated with the most severe clinical presentation also showed specific features: the first SA at a younger age and a higher prevalence of non-suicidal self-injury (NSSI) and anxiety disorders. The BPD-MA group was not associated with higher impulsivity or frequency of negative life events.

Conclusions

Based on these findings and to improve youth suicide prevention, future studies should systematically consider BPD and the efficacy of reinforcing early interventions for anxiety disorders and NSSI.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12888-020-02930-4.

Keywords: Borderline personality disorder, Suicide attempt, Adolescents, Anxiety disorder, Non-suicidal self-injury, Inpatients

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643473/