冲动性与精神共病作为边缘型人格障碍自杀未遂的危险因素
Impulsivity and psychiatric comorbidity as risk factors for suicide attempts in borderline personality disorder.
作者信息
Shorub Eman, Omar Abdel Nasser, Elshahawi Heba, Naoum Dina, Elsahrawy Tarek, Elhawary Yomna
机构信息
Department of Neurology and Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Al Mashfa Hospital, Cairo, Egypt.
出版信息
S Afr J Psychiatr. 2022 May 30;28:1544. doi: 10.4102/sajpsychiatry.v28i0.1544. eCollection 2022.
BACKGROUND
Addressing the risk of suicidality in borderline personality disorder (BPD) is a crucial issue. The notion that impulsive individuals are more likely to plan for suicide attempts is important for many reasons in both theoretical and clinical decision-making.
AIM
The aim of this study was to investigate potential risks of suicidality in BPD and to correlate it to impulsivity.
SETTING
The study was conducted at the Institute of Psychiatry, Ain Shams University and Al Mashfa Private Hospital.
METHODS
Ninety-one participants were included in the study: 30 patients were diagnosed as BPD without axis I comorbidities, 31 BPD patients had psychiatric comorbidities and 30 healthy subjects were assessed by using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II), Suicide Behavior Questionnaire-Revised (SBQ-R), the Arabic version of Barratt's Impulsiveness Scale-11 (BIS-11) and Global Assessment of Functioning scale.
RESULTS
There was a significant difference in suicidality using the SBQ-R between the healthy controls and BPDs without and with comorbidities. Healthy controls showed low suicidality in only 3.3%, while it was higher in both groups of BPD. The total score of BIS was as follows: 62.5 (±10.1 SD) in group A, 79.4 (±12 SD) in group B and 80.3 (±12.5 SD) in group C, which denote mild, moderate and moderate-to-severe degree of impulsivity in group A, B and C, respectively. Suicidality was positively correlated with (AI item: lack of span Attention in Attentional Facet) ( = 0.489, = 0.006), (PI item: lack of self-control in planning facet) ( = 0.401, = 0.028), as well as (MII item: lack perseverance in holding off impulsive acts in motor facet) ( = 0.471, = 0.009).
CONCLUSION
Proper assessment of associated psychiatric comorbidities and impulsivity among BPD patients will help preventing of future suicidal attempts.
背景
解决边缘型人格障碍（BPD）中的自杀风险是一个关键问题。冲动个体更有可能为自杀企图制定计划这一观念在理论和临床决策的诸多方面都很重要。
目的
本研究旨在调查BPD中自杀的潜在风险，并将其与冲动性相关联。
地点
该研究在艾因夏姆斯大学精神病学研究所和Al Mashfa私立医院进行。
方法
91名参与者纳入研究：30名被诊断为无轴I共病的BPD患者，31名有精神共病的BPD患者，以及30名健康受试者，使用《精神疾病诊断与统计手册》第四版轴I障碍结构化临床访谈（SCID - I）、《精神疾病诊断与统计手册》第四版轴II障碍结构化临床访谈（SCID - II）、修订版自杀行为问卷（SBQ - R）、阿拉伯语版巴雷特冲动性量表11（BIS - 11）和功能总体评估量表进行评估。
结果
使用SBQ - R评估，健康对照组与无共病和有共病的BPD患者在自杀方面存在显著差异。健康对照组仅有3.3%显示低自杀倾向，而两组BPD患者的自杀倾向更高。BIS总分如下：A组为62.5（±10.1标准差），B组为79.4（±12标准差），C组为80.3（±12.5标准差），分别表示A组、B组和C组的冲动程度为轻度、中度和中度至重度。自杀倾向与（AI项：注意方面注意力缺乏持续性）（r = 0.489, p = = 0.006）、（PI项：计划方面缺乏自我控制）（r = 0.401, p = 0.028）以及（MII项：运动方面抑制冲动行为缺乏毅力）（r = 0.471, p = 0.009）呈正相关。
结论
对BPD患者相关精神共病和冲动性进行恰当评估将有助于预防未来的自杀企图。
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