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首页> 外文期刊>The journal of clinical psychiatry >Risk factors for suicide completion in borderline personality disorder: a case-control study of cluster B comorbidity and impulsive aggression.
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Risk factors for suicide completion in borderline personality disorder: a case-control study of cluster B comorbidity and impulsive aggression.

机译：边缘型人格障碍中自杀完成的危险因素：聚类B合并症和冲动性侵害的病例对照研究。

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BACKGROUND: Borderline personality disorder is a major risk factor for suicidal behavior, yet prediction of suicide completion remains unclear. It has been proposed that impulsivity and aggression interact to increase suicide risk. Death by suicide in borderline personality disorder, then, may be the result of impulsivity, a core feature of the disorder, interacting with violent-aggressive tendencies. Using a case-control design, this study investigated clinical and behavioral risk factors for suicide completion in borderline personality disorder. METHOD: One hundred twenty subjects meeting DSM-IV criteria for borderline personality disorder, 50 controls and 70 who died by suicide between 2001 and 2005, were investigated by means of proxy-based interviews using structured diagnostic instruments and personality trait assessments. RESULTS: Borderline personality disorder suicides had fewer psychiatric hospitalizations and suicide attempts than borderline personality disorder controls. Borderline personality disorder suicides were also more likely to meet criteria for current and lifetime substance dependence disorders. They had higher levels of current and lifetime Axis I comorbidity, novelty seeking, impulsivity, hostility, and comorbid personality disorders, while exhibiting lower levels of harm avoidance. Most importantly, borderline personality disorder suicides were more likely to have cluster B comorbidity. Impulsivity and aggression interacted to predict suicide, though not after controlling for cluster B comorbidity. CONCLUSIONS: Borderline personality disorder individuals who die by suicide differ from those borderlines typically encountered in acute psychiatric settings. Our results suggest that the lethality of borderline personality disorder suicide attempts results from an interaction between impulsivity and the violent-aggressive features associated with cluster B comorbidity. Further, the anxious trait of harm avoidance appears to be protective against suicidal behavior resulting in death.
机译：背景：边缘型人格障碍是自杀行为的主要危险因素，但自杀完成的预测仍不清楚。已经提出冲动性和攻击性相互作用以增加自杀风险。因此，在边缘性人格障碍中自杀死亡可能是冲动的结果，即冲动是该障碍的核心特征，与暴力侵略性倾向相互作用。使用病例对照设计，本研究调查了边缘性人格障碍中自杀完成的临床和行为危险因素。方法：通过使用结构化诊断工具和人格特质评估的基于代理人的访谈，调查了2001年至2005年间符合DSM-IV边缘型人格障碍标准的120名受试者，50名对照者和70名自杀死亡。结果：交际型人格障碍自杀者比交际型人格障碍对照者的精神病住院和自杀尝试少。边缘性人格障碍自杀也更可能符合当前和终生物质依赖障碍的标准。他们目前和一生中的轴I合并症，寻求新奇，冲动，敌意和合并性人格障碍的水平较高，而回避伤害的水平较低。最重要的是，交际型人格障碍自杀者更有可能患有B组合并症。冲动和攻击性相互作用以预测自杀，尽管在控制簇B合并症后并未发生。结论：死于自杀的边缘型人格障碍患者与急性精神病患者中通常遇到的那些边缘性患者不同。我们的研究结果表明，边缘性人格障碍自杀未遂的致死性是由冲动性和与群B合并症相关的暴力侵略特征之间的相互作用引起的。此外，避免伤害的焦虑特质似乎可以防止自杀行为导致死亡。

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