An examination of DSM-IV borderline personality disorder symptoms and risk for death by suicide: a psychological autopsy study.
OBJECTIVE
To clarify whether certain Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), borderline personality disorder (BPD) symptoms are more prevalent among people who die by suicide, and thereby better predict suicide risk.


METHODS
A psychological autopsy method with best informants was used to investigate DSM-IV BPD symptoms and suicide risk among people who died by suicide and met criteria for BPD (n = 62), and BPD control subjects (n = 35).


RESULTS
BPD symptoms in people who died by suicide were less likely to include affective instability and paranoid ideation-dissociative symptoms. The negative association between paranoid ideation-dissociative symptoms and suicide was independent of all other BPD symptoms, Cluster B comorbidity, and alcohol dependence.


CONCLUSIONS
We found that discrete DSM-IV BPD symptoms differentiate people with BPD who die by suicide and those who do not. People with BPD who go on to die by suicide appear to constitute a specific subgroup of those who meet criteria for BPD, characterized by different general clinical presentation, but also by different characteristics within BPD.
McGirr
Alexander
A
University of Toronto, Toronto, Ontario; McGill Group for Suicide Studies, Douglas Hospital Research Centre, McGill University, Montreal, Quebec. alexander.mcgirr@mail.mcgill.ca
Paris
Joel
J
Lesage
Alain
A
Renaud
Johanne
J
Turecki
Gustavo
G
D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000401:mortality; D000437:Alcoholism / Q000175:diagnosis / Q000401:mortality; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004213:Dissociative Disorders / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010259:Paranoid Disorders / Q000175:diagnosis / Q000401:mortality; D012306:Risk; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*