Broadbear Jillian H, Dwyer Jeremy, Bugeja Lyndal, Rao Sathya
Spectrum Personality Disorder Service, 110 Church Street, Richmond, Victoria, 3121, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, Victoria, 3800, Australia.
Coroners Prevention Unit, Coroners Court of Victoria, 65 Kavanagh St, Southbank, Victoria, 3006, Australia; Department of Forensic Medicine, Monash University, 65 Kavanagh St, Southbank, Victoria, 3006, Australia.
J Psychiatr Res. 2020 Oct;129:241-249. doi: 10.1016/j.jpsychires.2020.07.007. Epub 2020 Jul 29.
Borderline Personality Disorder (BPD) is associated with a high risk of death by suicide. Our study describes a population-based analysis of Coroners' investigations of suicides where there was evidence of a BPD diagnosis. We utilised the Victorian Suicide Register to identify suicides occurring between 2009 and 2013 where evidence of a BPD diagnosis was recorded. Of the 2870 suicides during this period, 181 (6.3%) had a BPD diagnosis recorded. Evidence of other diagnosed personality disorders was recorded in an additional 14 (0.5%) suicides and BPD was suspected in another 72 (2.5%) suicides. Information coded in the 181 diagnosed BPD suicides was compared with the 2689 suicides without a BPD diagnosis. Compared to the 'no BPD suicide group', the 'BPD suicide group' was younger, comprised a smaller proportion of women, had greater diagnostic complexity, a higher proportion of death by drug overdose, and a higher proportion of social and contextual stressors. 99% of people with a BPD diagnosis who died from suicide had contact with emergency and mental health services within 12 months of death; 88% sought help from these services within 6 weeks of death. These findings demonstrate the magnitude of this most severe outcome of mental illness, confirming that BPD belongs in the same category as schizophrenia, bipolar disorder and depressive disorder with respect to suicide representation. The help-seeking behaviours evident in almost all cases highlight a critical window of opportunity for providing timely support and treatment to help avert future deaths.
边缘性人格障碍（BPD）与自杀死亡的高风险相关。我们的研究描述了一项基于人群的验尸官对自杀事件调查的分析，这些自杀事件有边缘性人格障碍诊断的证据。我们利用维多利亚州自杀登记册来识别2009年至2013年期间发生的自杀事件，其中记录了边缘性人格障碍诊断的证据。在这期间的2870起自杀事件中，有181起（6.3%）记录了边缘性人格障碍诊断。另外14起（0.5%）自杀事件记录了其他已诊断人格障碍的证据，另有72起（2.5%）自杀事件疑似边缘性人格障碍。将181例已诊断为边缘性人格障碍的自杀事件编码的信息与2689例无边缘性人格障碍诊断的自杀事件进行比较。与“无边缘性人格障碍自杀组”相比，“边缘性人格障碍自杀组”更年轻，女性比例更小，诊断复杂性更高，药物过量致死比例更高，社会和背景压力源比例更高。99%被诊断为边缘性人格障碍且自杀死亡的人在死亡前12个月内与急诊和心理健康服务机构有过接触；88%在死亡前6周内寻求过这些服务的帮助。这些发现表明了这种最严重精神疾病后果的严重性，证实就自杀表现而言，边缘性人格障碍与精神分裂症、双相情感障碍和抑郁症属于同一类别。几乎所有案例中明显的求助行为凸显了提供及时支持和治疗以帮助避免未来死亡的关键机会窗口。
