title: Recurrent suicide attempts in patients with depressive and anxiety disorders: the role of borderline personality traits.
abstract: BACKGROUND
  The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide attempts.
  
  
  METHODS
  The Netherlands Study on Depression and Anxiety included 1838 respondents with lifetime depressive and/or anxiety disorders, of whom 309 reported at least one previous suicide attempt. A univariable negative binomial regression analysis was performed to examine the association between comorbid borderline personality traits and suicide attempts. Univariable and multivariable negative binomial regression analyses were performed to identify risk factors for the number of recurrent suicide attempts in four clusters (type and severity of axis-I disorders, BPD traits, determinants of suicide attempts and socio-demographics).
  
  
  RESULTS
  In the total sample the suicide attempt rate ratio increased with 33% for every unit increase in BPD traits. A lifetime diagnosis of dysthymia and comorbid BPD traits, especially the symptoms anger and fights, were independently and significantly associated with recurrent suicide attempts in the final model (n=309).
  
  
  CONCLUSIONS
  The screening of personality disorders was added to the NESDA assessments at the 4-year follow-up for the first time. Therefore we were not able to examine the influence of comorbid BPD traits on suicide attempts over time.
  
  
  CONCLUSIONS
  Persons with a lifetime diagnosis of dysthymia combined with borderline personality traits especially difficulties in coping with anger seemed to be at high risk for recurrent suicide attempts. For clinical practice, it is recommended to screen for comorbid borderline personality traits and to strengthen the patient's coping skills with regard to anger.
authors.affiliation: Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam/GGZ inGeest, Amsterdam, The Netherlands. b.stringer@ggzingeest.nl
authors.forename: Barbara
authors.initials: B
authors.lastname: Stringer
authors.forename: Berno
authors.initials: B
authors.lastname: van Meijel
authors.forename: Merijn
authors.initials: M
authors.lastname: Eikelenboom
authors.forename: Bauke
authors.initials: B
authors.lastname: Koekkoek
authors.forename: Carmilla M M
authors.initials: CM
authors.lastname: Licht
authors.forename: Ad J F M
authors.initials: AJ
authors.lastname: Kerkhof
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications* / Q000523:psychology; D001883:Borderline Personality Disorder / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Anxiety disorders; Borderline personality disorder; Borderline personality traits; Depressive disorders; Recurrent suicide attempts