伴有共病性人格障碍的重度抑郁症患者的自杀行为

Suicidal behavior in patients with major depression and comorbid personality disorders.

作者信息

Corbitt E M, Malone K M, Haas G L, Mann J J

机构信息

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA, USA.

出版信息

J Affect Disord. 1996 Jun 20;39(1):61-72. doi: 10.1016/0165-0327(96)00023-7.

DOI:10.1016/0165-0327(96)00023-7

PMID:8835655

Abstract

We investigated the relationship of DSM-III-R personality disorder (PD) diagnoses and traits to suicidal behavior in patients with Major Depressive Disorder (MDD). Axis I and Axis II criteria and suicidal behavior were assessed using structured interviews of 102 psychiatric inpatients. Subjects with comorbid MDD and Borderline PD (BPD: n = 30) were more likely than other patients to have a history of multiple suicide attempts, and were equally likely to have made a highly lethal attempt. Number of BPD and other Cluster B (dramatic/erratic) criteria were better predictors of past suicidal behavior than were depressive symptoms. We conclude that patients with BPD symptomatology are at risk for serious suicide attempts. Moreover, severity of comorbid Cluster B PD psychopathology should be considered when assessing suicide risk in MDD patients even in those without a PD diagnosis.

摘要

我们研究了重度抑郁症（MDD）患者中，DSM-III-R人格障碍（PD）诊断及特质与自杀行为之间的关系。通过对102名精神科住院患者进行结构化访谈，评估了轴I和轴II标准以及自杀行为。患有共病性MDD和边缘型人格障碍（BPD：n = 30）的受试者比其他患者更有可能有多次自杀未遂史，且进行高度致命自杀未遂的可能性相同。与抑郁症状相比，BPD及其他B类（戏剧性/不稳定型）标准的数量是过去自杀行为更好的预测指标。我们得出结论，有BPD症状的患者存在严重自杀未遂的风险。此外，即使在没有PD诊断的MDD患者中，评估自杀风险时也应考虑共病B类PD精神病理学的严重程度。