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Personality disorders and suicide in China

  • Kathy Y. Liu (a1)
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Abstract
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References
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1 Tong, Y, Phillips, MR, Conner, KR. DSM-IV Axis II personality disorders and suicide and attempted suicide in China. Br J Psychiatry 2016; 209: 319–26.
2 Summerfield, D. The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. BMJ 2001; 322: 95–8.
3 Lester, D. The role of shame in suicide. Suicide Life Threat Behav 1997 27: 352–61.
4 Milner, A, De Leo, D. Suicide research and prevention in developing countries in Asia and the Pacific. Bull World Health Organ 2010; 88: 795–6.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Personality disorders and suicide in China

  • Kathy Y. Liu (a1)
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eLetters

Personality disorder and suicide

Tomoyuki Kawada, Professor, Nippon Medical School
16 February 2018

There are important discussion on the association between personality disorder (PD) and suicide (1). I want to present some information for the risk of suicide in patients with PD with special reference to subtype of PD.

Coleman et al. conducted a cross-sectional study to understand the relationship between narcissistic personality disorder (NPD) and suicidal behavior in 657 patients with mood disorders (2). Adjusted odds ratio (95% CI) of NPD for suicide attempt was 0.41 (0.19-0.88). In addition, male, substance use disorder, aggression and hostility also presented significant increase in odds ratio for suicide attempt, respectively. In contrast, adjusted odds ratio (95% CI) of borderline personality disorder (BPD) for suicide attempt was 4.96 (3.25-7.58). NPD in patients with mood disorders showed a protective effect for suicidal behavior, which was different from BPD. There is a report that patients with NPD have a risk of suicide behavior (3), and I recommend of stratified analysis with subtype of PD for the risk assessment of suicide.

Second, there is a difference between suicidal ideation and attempt (4). In addition, mood disorder is a risk factor for suicidal behavior (5). Wang et al. also conducted a prospective study to investigate the effect of stressful life events on subsequent suicidal behavior in patients with major depressive disorder (6). They clarified that financial stress was a strong predictor for suicide attempts after adjusting for sociodemographic variables, anxiety, substance use, and personality disorder. As Liu also pointed out, comprehensive analysis is recommended for the risk assessment of suicide.

References

1. Liu KY. Personality disorders and suicide in China. Br J Psychiatry 2017; 210: 167.

2. Coleman D, Lawrence R, Parekh A, Galfalvy H, Blasco-Fontecilla H, Brent DA, et al. Narcissistic Personality Disorder and suicidal behavior in mood disorders. J Psychiatr Res 2017;85:24-8.

3. Sher L. Narcissistic personality disorder and suicide. Psychiatr Danub 2016; 28: 307.

4. Lewitzka U, Spirling S, Ritter D, Smolka M, Goodday S, Bauer M, et al. Suicidal ideation vs. suicide attempts: clinical and psychosocial profile differences among depressed patients: a study on personality traits, psychopathological variables, and sociodemographic factors in 228 patients. J Nerv Ment Dis 2017; 205: 361-71.

5. Vilaplana M, Richard-Devantoy S, Turecki G, Jaafari N, Jollant F. Insight into mental disorders and suicidal behavior: a qualitative and quantitative multimodal investigation. J Clin Psychiatry 2015; 76: 303-18.

6. Wang Y, Sareen J, Afifi TO, Bolton SL, Johnson EA, Bolton JM. A population-based longitudinal study of recent stressful life events as risk factors for suicidal behavior in major depressive disorder. Arch Suicide Res 2015; 19: 202-17.

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Conflict of interest: None declared

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