Sabo A N, Gunderson J G, Najavits L M, Chauncey D, Kisiel C
Department of Psychiatry and Behavioral Sciences, Berkshire Medical Center, Pittsfield, Massachusetts 01201, USA.
J Nerv Ment Dis. 1995 Jun;183(6):370-6. doi: 10.1097/00005053-199506000-00004.
Thirty-seven female inpatients with borderline personality disorder were followed prospectively for up to 5 years to assess changes in two forms of self-destructiveness: suicidal behavior/ideation, and self-harm behavior/ideation. It was found that suicidal behavior declined significantly at 1-, 2-, 3-, 4-, and 5-year follow-up; self-harm behavior showed trends but no significant decline over 5 years. Ideation (both suicidal ideation and self-harm) did not decline notably. Three alternate courses of self-harm behavior are identified: "fluctuating," "consistently low," and "steadily declining." The majority of patients fell in the fluctuating category. The fluctuating group showed higher baseline dysphoria than did the consistently low group, while the latter reported higher baseline drug use. Intercorrelations showed that self-harm behavior and suicidal behavior were not associated, nor were suicidal behavior and suicidal ideation. Clinical and research implications are discussed.
对37例边缘型人格障碍女性住院患者进行了长达5年的前瞻性随访，以评估两种自我毁灭形式的变化：自杀行为/意念，以及自我伤害行为/意念。研究发现，在1年、2年、3年、4年和5年的随访中，自杀行为显著下降；自我伤害行为呈下降趋势，但在5年中无显著下降。意念（自杀意念和自我伤害意念）没有明显下降。确定了自我伤害行为的三种不同轨迹：“波动型”、“持续低水平型”和“稳步下降型”。大多数患者属于波动型。波动型组的基线烦躁情绪高于持续低水平型组，而后者报告的基线药物使用量更高。相互关联分析表明，自我伤害行为与自杀行为无关，自杀行为与自杀意念也无关。文中讨论了其临床和研究意义。
