AAPEL
The Borderline Personality Disorder and Suicide
Meme page en Francais / Same page in french
I'm not happy about going to tackle the subject but it is useless to look the other way
If not why not ask a person of your entourage which suffers "are you planning to commit suicide?", guess its answer!

If there are some cases where we ardently wish "to get it wrong" it is well this one.
We only wish one thing, to have the possibility to say "the author cry wolf" whereas there is not matter with...

Having a guarantee "That concerns only the patients most seriously sick, the exception"

But even if there is only one "bad luck" on a million so that the person we care suffer of a Borderline disorder and commit suicide, all the "quiet" circle of this person which have read this site or refuse to read this site would be entitled of damnation if by misfortune a such drama occur one day
.
Series of articles, extracts raised on the subject. Again, all theses texts result from the American literature
The result is that the suicide rate ("successes") among patients suffering from a borderline disorder is 8 to 10% (1/10) whereas the suicide rate in the United States (all populations) is 0.011% (1/10000) (source NIMH) except miscalculation 1000 times more !


from the page
http://www.laurapaxton.com/research.html#
Self-Injury and Suicide: A Review of Literature

Do people self-injure because they have BPD or because this is one way people cope with trauma, regardless of whether or not they have BPD?
A recent study showed that posttraumatic stress disorder, substance abuse and intermittent explosive disorder were significantly related to self-mutiliative behavior, regardless of whether or not the subjects had been diagnosed with BPD or antisocial personality disorder.  Also, high levels of dissociation were related to self-mutilation, after other factors, such as self-mutilation and BPD were controlled for (Zlotnick, 1999).

Is it nothing to worry about when a person almost completes suicide and stops before the completing the act?
A 1998 study discovered that the answer is "no."  Over half of the 135 subjects, who had been admitted to a hospital after an actual suicide attempt reported making at least 1 aborted suicide attempt previously.  Also, previous aborted suicide attempts were reported more often in subjects with a diagnosis of borderline personality disorder than in subjects with other diagnoses. Subjects who had made an aborted suicide attempt were nearly twice as likely to have made an actual suicide attempt as subjects with no aborted attempts (Barber, 1998)

What is the relationship between suicide and BPD?
A 1997 study closely examined the relationship between suicide and BPD and found that impulsivity was the only characteristic of borderline personality disorder (excluding the self-destructive criterion) that was associated with a higher number of previous suicide attempts after control for lifetime diagnoses of depression and substance abuse. History of childhood abuse correlated significantly with number of lifetime suicide attempts (Brodsky, 1997).

Many professionals don't take seriously threats of suicide by those whom have been diagnosed with Borderline Personality Disorder.  Perhaps they should review (Duberstein, 1997) which showed that  approximately 30-40% of suicides are committed by individuals with personality disorders, and (Bronisch, 1996) which showed that at least a third of completed suicides were made by those with personality disorders.

      A study done of 347 psychiatric patients at New York State Psychiatric Institute looked for reliable and generalizable predictors of suicidal behavior that would cross diagnostic boundaries.  What they found was that although certain diagnoses may cause stress, unless there was also a "diathesis" such as tendencies toward high suicidal ideation and impulsivity, a suicide attempt was not predictable based on diagnosis alone.  Since impulsive behavior is a strong facet of Borderline Personality Disorder, this information may help to explain why such a high percentage of completed suicides are by those with BPD (Mann, 1999).

Barber, Mary E.; Marzuk, Peter M.; Leon, Andrew C.; Portera, Laura.  (1998). Aborted suicide attempts: A new classification of suicidal behavior. American Journal of Psychiatry, 155(3) 385-389
Brodsky, Beth S.; Malone, Kevin M.; Ellis, Steven P.; Dulit, Rebecca A.; Mann, J. John. (1997).  Characteristics of borderline personality disorder associated with suicidal behavior. American Journal of Psychiatry, 154(12) 1715-1719
Bronisch, Thomas (1996).  The typology of personality disorders--Diagnostic problems and their relevance for suicidal behavior. Crisis, 17(2) 55-58
Duberstein, Paul R.; Conwell, Yeates.  (1997).  Personality disorders and completed suicide: A methodological and conceptual review.  Clinical Psychology: Science & Practice, 4(4) 359-376.
Kemperman, Ingrid; Russ, Mark J.; Clark, W. Crawford; Kakuma, Tatsuyuki; Zanine, Elizabeth; Harrison, Katherine (1997).  Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory. Psychiatry Research, 70(3) 175-183
Mann, J. John; Waternaux, Christine; Haas, Gretchen L.; Malone, Kevin M. (1999). Toward a clinical model of suicidal behavior in psychiatric patients. American Journal of Psychiatry, 156(2) 181-189.
Zlotnick, Caron; Mattia, Jill I.; Zimmerman, Mark (1999).  Clinical correlates of self-mutilation in a sample of general psychiatric patients. Journal of Nervous & Mental Disease, 187(5) 296-301


http://www.borderlinedisorder.com/conferences.htm
From Research To Community:
FAMILY PERSPECTIVES ON BORDERLINE PERSONALITY DISORDER
Saturday and Sunday, October 19-20, 2OO2
Columbia University-College of Physicians and Surgeons
New York, NY

CONFERENCE SPONSORS

National Education Alliance for Borderline Personality Disorder(NEA-BPD)
Columbia University-College of Physicians and Surgeons

CONFERENCE CHAIRMAN
Herbert Pardes, MD, President and Chief Executive Officer
New York-Presbyterian Hospital

  in association with
 National Institute of Mental Health
 National Alliance for the Mentally Ill
 New York State Office of Mental Health...
But de la CONFÉRENCE
...

Devastating psychiatric illness
Borderline personality disorder (BPD) is a devastating psychiatric illness.
The diagnosis encompasses patients with a pervasive pattern of affective instability, severe difficulties in interpersonal relationships, problems with behavioral or impulse control (including suicidal behaviors), and disrupted cognitive processes.
Ten percent of BPD patients eventually commit suicide (Linehan, et al, 1993), making the disorder a critical health problem. Estimated prevalence of BPD in the general population is 2-3% (Torgersen, et al, 2000), and it has been estimated that 11% of outpatients and 20% of psychiatric inpatients presenting for treatment meet DSM-IV criteria for the disorder (Widiger and Frances, 1989).
 

American Psychiatric Association
http://www.psych.org/clin_res/borderline.book-4.cfm

Practice Guideline for the Treatment of Patients With Borderline Personality Disorder






PART A:
TREATMENT RECOMMENDATIONS FOR PATIENTS WITH BORDERLINE PERSONALITY DISORDER


IV. RISK MANAGEMENT ISSUES

A. GENERAL CONSIDERATIONS 
...

B. SUICIDE 
Suicidal threats, gestures, and attempts are very common among patients with borderline personality disorder, and 8%Ė10% commit suicide. Managing suicide risk therefore poses important clinical and medicolegal challenges for clinicians.
However, it can be difficult to address suicide risk in these patients for a number of reasons.

  • First, suicidality can be acute, chronic, or both, and responses to these types of suicidality differ in some ways.
  • Second, given the tendency of patients with borderline personality disorder to be chronically suicidal and to engage in self-destructive behaviors, it can be difficult to discern when a patient is at imminent risk of making a serious suicide attempt.
  • Third, even with careful attention to suicide risk, it is often difficult to predict serious self-harm or suicide, since this behavior can occur impulsively and without warning.
  • Fourth, given the potential for difficulties in forming a good therapeutic alliance, it may be difficult to work collaboratively with the patient to protect him or her from serious self-harm or suicide. Last, even with good treatment, some patients will commit suicide. The following are risk management considerations for suicidal behavior in patients with borderline personality disorder:
  • C. ANGER, IMPULSIVITY, and VIOLENCE 
    ...

    D. BOUNDRY VIOLATIONS 
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    ..AAPEL - Back to BPD Borderline page
     

    ,
    Warning:
    All the informations on this site are with an aim of helping to understand a "particular" disease at the very least and puzzle
    But more especially to support peoples who suffer, sick or not.  In all cases, it is ESSENTIAL to have recourse to a therapist specialized in the disease to confirm or to cancel a diagnosis
    Though it is the name doesn't much matter, which is important, it is to apply "the right" treatment to each patient
     

    last update  2008
    Copyright AAPELTM - All rights reserved
    Author, Alain Tortosa, psychotherapist, founder president of the Aapel
    page created on august 21th 2OO2