title: Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm.
abstract: We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (β = .21, p < .001) and BPD (β = .27, p < .001). A structural model comprising two latent BPD factors, dysregulation and relationship problems, as well as PTSD and several other variables, demonstrated that PTSD was an important predictor of the number of self-harm admissions to general hospitals(B = 1.52, p < .01). Dysregulation predicted self-harm directly (B = 0.28, p < .05), and also through PTSD [corrected]. These results suggested that PTSD and related dysregulation problems could be important treatment targets for a reduction in the risk of severe self-harm in high-risk psychiatric patients.
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Liv
authors.initials: L
authors.lastname: Mellesdal
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Rolf
authors.initials: R
authors.lastname: Gjestad
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.|Clinical Institute 1, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Johnsen
authors.affiliation: Clinical Institute 1, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Jørgensen
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.|Clinical Institute 1, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Ketil J
authors.initials: KJ
authors.lastname: Oedegaard
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Rune A
authors.initials: RA
authors.lastname: Kroken
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Mehlum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D001883:Borderline Personality Disorder / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011897:Random Allocation; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult; D000092864:Suicide Prevention