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Predictors of suicide attempts in patients with borderline personality disorder over 16 years of prospective follow-up
Open accessAbstract
BACKGROUND: It is clinically important to understand the factors that increase the likelihood of the frequent and recurrent suicide attempts seen in those with borderline personality disorder (BPD). Although several studies have examined this subject in a cross-sectional manner, the aim of this study was to determine the most clinically relevant baseline and time-varying predictors of suicide attempts over 16 years of prospective follow-up among patients with BPD. METHOD: Two-hundred and ninety in-patients meeting Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-III-R criteria for BPD were assessed during their index admission using a series of semistructured interviews and self-report measures. These subjects were then reassessed using the same instruments every 2 years. The generalized estimating equations (GEE) approach was used to model the odds of suicide attempts in longitudinal analyses, controlling for assessment period, yielding an odds ratio (OR) and 95% confidence interval (CI) for each predictor. RESULTS: Nineteen variables were found to be significant bivariate predictors of suicide attempts. Eight of these, seven of which were time-varying, remained significant in multivariate analyses: diagnosis of major depressive disorder (MDD), substance use disorder (SUD), post-traumatic stress disorder (PTSD), presence of self-harm, adult sexual assault, having a caretaker who has completed suicide, affective instability, and more severe dissociation. CONCLUSIONS: The results of this study suggest that prediction of suicide attempts among borderline patients is complex, involving co-occurring disorders, co-occurring symptoms of BPD (self-harm, affective reactivity and dissociation), adult adversity, and a family history of completed suicide.
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“Taken together, this constellation of co-occurring problems appears to be particularly intractable, with PTSD predicting a lower likelihood of remitting from BPD and a higher likelihood of attempting suicide among individuals with BPD across 10 to 16 years of naturalistic follow-up (Zanarini, Frankenburg, Hennen, Reich, & Silk, 2006; Wedig et al., 2012).”
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“Taken together, this constellation of co-occurring problems appears to be particularly intractable, with PTSD predicting a lower likelihood of remitting from BPD and a higher likelihood of attempting suicide among individuals with BPD across 10 to 16 years of naturalistic follow-up (Zanarini, Frankenburg, Hennen, Reich, & Silk, 2006; Wedig et al., 2012).”
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Metadata
- Authors
- Wedig, M. M., Silverman, M. H., Frankenburg, F. R., Reich, D. B., Fitzmaurice, G., & Zanarini, M. C.
- Affiliations
- Harvard University (US)
- McLean Hospital (US)
- Boston University (US)
- Corresponding author
- Wedig, M. M.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-03-22
- Volume
- 42
- Issue
- 11
- Pages
- 2395-2404
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC3600404
- OpenAlex
- W2051744096
- Cited by
- 137
- References
- 52
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 10 · 2023: 13 · 2022: 8 · 2021: 18 · 2020: 9 · 2019: 10 · 2018: 6 · 2017: 6 · 2016: 13 · 2015: 9 · 2014: 13 · 2013: 7 · 2012: 1
- FWCI
- 10.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- McLean Hospital
- National Institute of Mental Health (MH-62169, R29MH047588, R01MH062169, MH-47588)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- borderline personality disorder, suicide attempts, major depressive disorder, substance use disorders, post-traumatic stress disorder, self-harm, adult sexual assault, family history of suicide, neuroticism, dissociation, comorbidities
- MeSH terms
- Adult, Mental Disorders, Borderline Personality Disorder, Female, Humans, Longitudinal Studies, Male, Risk Factors, Suicide, Attempted, Comorbidity, Young Adult
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