Conference Coverage

Don’t discount suicide attempts in borderline patients



LOS ANGELES – No matter how many times borderline personality disorder patients seem to cry wolf, the threat of suicide is real and needs to be taken seriously, according to investigators at the University of Mississippi Medical Center in Jackson.

"A common clinical assumption" about borderline patients "is that their suicide attempts are not ... medically serious. The assumption ... is not supported by our findings," they said.

Jalessa Perez

The team surveyed patients admitted to the university’s level 1 trauma center in Jackson within 24 hours of a suicide attempt and found no statistical difference in demographics, medical lethality, suicide intent, or problematic alcohol use between 62 patients with borderline features and 28 without them.

Meanwhile, patients with borderline features – defined as a score of at least 38 points on the Personality Assessment Inventory-Borderline Features Scale – were significantly more depressed and had higher problematic drug use (43.55% vs. 10.71%) and more previous attempts (70.97% vs. 46.43%).

"It’s very common to hear medical providers say attempts" by borderline patients "are just a gesture." In fact, "people presenting with these features need to be helped in the same way as people who present without them," and might need more help with depression and drug use in particular, lead investigator Jalessa Perez said at the annual conference of the American Association of Suicidology.

"If you are writing off their attempts, you are not really treating what needs to be treated," said Ms. Perez, a research assistant at the medical center.

The mean score on the Center for Epidemiologic Studies Depression Scale was 22.93 points in the borderline group, suggesting possible clinical depression, but 15.43 points among other patients, indicating milder symptoms.

Borderline patients scored a mean of 14.51 points and nonborderline patients a mean of 12.96 on the Beck Suicide Intent Scale, a nonsignificant difference indicating moderate intent. Borderline patients scored a mean of 2.25 points and nonborderline patient a mean of 2.39 on the 8-point Medical Lethality Rating Scale, indicating physical harm in both cases; with a score of 8 indicating death.

The mean age in both groups was about 35 years. About 70% were white in the borderline group, and about 61% women. In the nonborderline group, 54% were women and about 60% white.

Up to one in 10 patients with borderline personality disorder commit suicide, far more than in the general population.

Ms. Perez has no disclosures. The senior investigator, Courtney L. Bagge, Ph.D., of the medical center, has funding from the National Institute on Alcohol Abuse and Alcoholism and the Military Suicide Research Consortium.

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