Bezerra Severino, Galvão-de-Almeida Amanda, Studart Paula, Martins Davi F, Caribé André C, Schwingel Paulo A, Miranda-Scippa Ângela
Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
Programa de Avaliação Continuada do Centro de Estudos de Transtornos de Humor e Ansiedade (CETHA), Hospital Universitário Professor Edgard Santos, UFBA, Salvador, BA, Brazil.
Braz J Psychiatry. 2017 Apr-Jun;39(2):133-139. doi: 10.1590/1516-4446-2016-1982. Epub 2017 Jan 9.
To evaluate the association between personality disorders (PDs) and suicide attempts (SAs) in euthymic patients with type I bipolar disorder (BD).
One-hundred twenty patients with type I BD, with and without history of SA, were evaluated during euthymia. The assessment included a clinical and sociodemographic questionnaire, the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Barratt Impulsiveness Scale, and Structured Clinical Interviews for DSM-IV Axis I and II Disorders. Logistic regression was employed to determine associations between history of SA and patient characteristics.
History of SA was significantly associated with comorbid axis I disorder, rapid cycling, high impulsivity (attentional, motor, non-planning, and total), having any PD, and cluster B and C PDs. Only cluster B PDs, high attentional impulsivity, and lack of paid occupation remained significant after multivariate analysis.
Cluster B PDs were significantly associated with SA in patients with type I BD. High attentional impulsivity and lack of gainful employment were also associated with SA, which suggests that some cluster B clinical and social characteristics may exacerbate suicidal behavior in this population. This finding offers alternatives for new therapeutic interventions.
评估I型双相情感障碍（BD）病情平稳期患者的人格障碍（PDs）与自杀未遂（SAs）之间的关联。
对120例I型BD患者在病情平稳期进行评估，这些患者有或无自杀未遂史。评估内容包括临床和社会人口学调查问卷、汉密尔顿抑郁量表、杨氏躁狂量表、巴拉特冲动量表，以及针对《精神疾病诊断与统计手册》第四版轴I和轴II障碍的结构化临床访谈。采用逻辑回归分析来确定自杀未遂史与患者特征之间的关联。
自杀未遂史与共病轴I障碍、快速循环发作、高冲动性（注意力、运动、无计划及总体冲动性）、存在任何人格障碍，以及B簇和C簇人格障碍显著相关。多因素分析后，仅B簇人格障碍、高注意力冲动性及无带薪工作仍具有显著性。
B簇人格障碍与I型BD患者的自杀未遂显著相关。高注意力冲动性及无收益性工作也与自杀未遂相关，这表明B簇的一些临床和社会特征可能会加剧该人群的自杀行为。这一发现为新的治疗干预措施提供了选择。
