[Is assessing for borderline personality disorder useful in the referral after a suicide attempt?].
BACKGROUND
Management of suicide attempters accounts for 10% of the psychiatric activity in the emergency room. In this population, the prevalence of borderline personality disorder (BPD) is high (10 - 55%). These patients present poorer psychosocial outcome and more frequent suicide attempts repetitions. However, the utility of the assessment of BPD in the referral to a specific treatment plan has not been yet studied.


OBJECTIVE
To examine the association between the assessment of a diagnosis of BPD after a suicide attempt and the referral from the emergency room to a specific treatment plan.


OBJECTIVE
Suicide attempters with BPD, according to clinicians diagnosis, differ in terms of severity from those without more risk factors of suicide attempt repetitions and poorer psychosocial functioning, and in psychiatric referral from the emergency room.


METHODS
Our case-control study took place during 10 months in the Geneva general hospital. We continuously enrolled patients admitted to the emergency room for deliberate self poisoning and separated them into two groups (BPD and control) according to the clinician's diagnosis. Data from medical records were systemically and anonymously gathered. We compared BPD patients' socio-demographic and clinical characteristics, as well as psychiatric referral, with the control group.


RESULTS
Of the 478 subjects admitted to the emergency room for deliberate self-poisoning, 99 (22.6%) were diagnosed BPD by clinicians. Compared to controls, they were more frequently female (OR=3.9) and living alone (OR=3.8) and more often resorted to psychiatric care (OR=2.9), notably to emergency care (OR=3.8). Past history of suicide attempt was also more frequent (OR=1.9) as was the use of neuroleptics in the attempt (OR=2.7). No difference was detected in terms of psychiatric referral after emergency room care.


CONCLUSIONS
Even if borderline personality disorder in suicide attempters is associated with more severity criteria, it is not associated with a referral to a specific treatment plan.
Service de psychiatrie et de psychologie médicale, hôpital universitaire de Purpan-Casselardit, 170, avenue de Casselardit, 31059 Toulouse cedex, France. cailhol.l@chu-toulouse.fr <cailhol.l@chu-toulouse.fr>
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L
Cailhol
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Damsa
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Bui
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R
Klein
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Adam
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L
Schmitt
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Andreoli
D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D011041:Poisoning / Q000453:epidemiology / Q000523:psychology; D011599:Psychopathology; D012008:Recurrence; D012017:Referral and Consultation; D012917:Social Adjustment; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D013557:Switzerland