Dervic Kanita, Oquendo Maria A, Currier Dianne, Grunebaum Michael F, Burke Ainsley K, Mann J John
Department of Neuroscience, Columbia University, New York, NY, USA.
J Clin Psychiatry. 2006 Apr;67(4):620-5.
Patients with cluster B personality disorder (CBPD) are particularly prone to suicidal behavior, yet possible protective mechanisms are not often studied. The present study investigated a possible protective role of moral objections to suicide (MOS) against suicidal behavior in patients with CBPD and current depression. The effect of MOS was then examined in relation to other mechanisms affecting suicide risk including trait aggressivity and the presence of effective coping strategies.
147 depressed patients with comorbid CBPD (DSM-III-R) were compared with 210 depressed patients without CBPD in terms of their history of suicide attempts and clinical and demographic characteristics. The relationship of MOS to suicide attempt was examined by logistic regression controlling for demographic and clinical differences between the groups as well as presence of comorbid CBPD. Data were collected from 1990 to 2003.
Subjects with comorbid CBPD had fewer MOS and reported more previous suicide attempts. In logistic regression, fewer MOS/religious beliefs, lower coping potential, and higher aggression level were associated with suicide attempt. A CBPD diagnosis did not affect the relationship between MOS and suicide attempts.
The results of this study suggest that the presence of MOS/religious beliefs may have a protective effect against suicidal behavior in depressed patients with comorbid CBPD and may be a target for therapeutic intervention.
B 类人格障碍（CBPD）患者特别容易出现自杀行为，但可能的保护机制却常常未被研究。本研究调查了对自杀的道德异议（MOS）在患有 CBPD 和当前抑郁症的患者中对自杀行为可能起到的保护作用。然后，研究了 MOS 的作用与其他影响自杀风险的机制之间的关系，这些机制包括特质攻击性和有效应对策略的存在情况。
将 147 例患有共病 CBPD（DSM-III-R）的抑郁症患者与 210 例无 CBPD 的抑郁症患者在自杀未遂史、临床和人口统计学特征方面进行比较。通过逻辑回归分析来研究 MOS 与自杀未遂之间的关系，该分析控制了两组之间的人口统计学和临床差异以及共病 CBPD 的存在情况。数据收集时间为 1990 年至 2003 年。
患有共病 CBPD 的受试者对自杀的道德异议较少，且报告的既往自杀未遂次数更多。在逻辑回归分析中，较少的 MOS/宗教信仰、较低的应对能力和较高的攻击水平与自杀未遂相关。CBPD 诊断并不影响 MOS 与自杀未遂之间的关系。
本研究结果表明，MOS/宗教信仰的存在可能对患有共病 CBPD 的抑郁症患者的自杀行为具有保护作用，并且可能是治疗干预的一个靶点。
