Giuliana Grossi

The findings underscore the importance of considering both the severity of #BPD features and changes in depressive symptoms when assessing risk of #suicide.

John Söderholm, MD

A new study aimed to further the understanding of #suiciderisk in individuals with #majordepressivedisorder (#MDD), #bipolardisorder (#BD), and #borderlinepersonalitydisorder (#BPD), revealing the significant impact of comorbid BPD on the risk of #suicideattempt.1

#Suicide claims the lives of millions of people worldwide each year. The findings underscore the importance of considering both the severity of BPD features and changes in depressive symptoms when assessing risk of #suicide.

“Don’t try to manage their suicidality with repeated hospitalizations if you can do something different,” Choi-Kain said in a previous interview with HCPLive. “Don’t give them polypharmacy if it’s not guided. Give them reasonable expectations for what those medications could do.”2

Among individuals with #mentalhealthdisorders, those diagnosed with MDD, BD, and BPD face particularly high #suiciderisks. However, understanding the similarities and differences in suicidal ideation and #suicideattempts between these disorders is still an area of ongoing research.1

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John J Söderholm, Department of Psychiatry, University of Helsinki and Helsinki University Hospital, and investigators sought to summarize the findings of a study that examined the risk levels and factors associated with #suicideideation and #suicideattempt in #patients with MDD, BD, and BPD.

The cohort study followed a group of treatment-seeking #patients experiencing a major depressive episode (MDE) over a period of 6 months. The #patients were divided into 3 subcohorts: MDE/MDD, MDE/BD, and MDE/BPD.

Investigators utilized biweekly online surveys, specifically modified versions of the Patient Health Questionnaire 9, to assess #depression severity and #suicideideation. Multi-level modeling was employed to analyze the relationship between changes in #depression symptoms and #suicideideation over time.

Results revealed individuals diagnosed with BPD had a significantly higher risk of #suicideattempt (22.2%) compared with non-BPD #patients (4.23%). Regression models demonstrated that the severity of BPD symptoms was strongly correlated with the risk of #suicideattempt and clinically significant #suicide ideation.

Investigators noted that regardless of the specific diagnosis, the mean #depression severity and changes in depressive symptoms were associated with #suicideideation risk during the follow-up period.

These findings suggest an emphasis of consideration on comorbid BPD in individuals with #depression, as it appears to be a significant predictor of higher #suicideattempt risk. The severity of BPD features should be taken into account when assessing the risk of both #suicideattempt and #suicideideation in #patients experiencing a MDE.

Investigators wrote these changes in depressive symptoms can serve as an indicator of concurrent fluctuations in #suicideideation risk and monitoring depressive symptoms continuously may prove to be a useful index for assessing #suicide risk.

Further, the results highlight the need for clinicians to be vigilant in identifying and addressing #suiciderisk, particularly in #patients with comorbid BPD and depression, the study noted. The findings also emphasized the importance of ongoing monitoring of depressive symptoms to assess changes in #suiciderisk over time.

Investigators acknowledged further research is needed explore effective intervention strategies and identify specific factors contributing to the heightened #suiciderisk associated with BPD, as well as evaluate the impact of targeted treatments for reducing #suiciderisk in this population.

“Concurrent BPD in #depression seems predictive for high risk of SA. Severity of BPD features is relevant for assessing risk of SA and SI in MDE,” the team wrote. “Changes in depressive symptoms indicate concurrent changes in risk of SI. BPD status at intake can index risk for future SA, whereas depressive symptoms appear a useful continuously monitored risk index.”
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-borderlinepersonalitydisorder-increases-suiciderisk-in-depression-bipolardisorder/