OBJECTIVE: There have been few psychological autopsy studies of suicide
among individuals with personality disorders. The possible specificity of
characteristics of suicide among such individuals has been little
investigated. METHOD: A random sample of 229 subjects who committed
suicide, representing all suicide victims in Finland within a 12-month
period, were comprehensively examined by using the psychological autopsy
method and were diagnosed according to DSM-III-R criteria. Within this
random sample the authors investigated all subjects with axis II
personality disorders (N = 67) and divided them into clusters B (N = 43), C
(N = 23), and A (N = 1). Individuals with clusters B and C personality
disorders were separately compared with sex- and age- matched suicide
victims without personality disorder, in terms of sociodemographic
characteristics, comorbid axis I and III syndromes, treatment histories,
previous suicide attempts, communication of suicide intent, and suicide
methods. RESULTS: All suicide victims with a personality disorder received
at least one axis I diagnosis. In 95% this included a depressive syndrome,
a psychoactive substance use disorder, or both. Individuals with cluster B
personality disorders were more likely than comparison subjects to have
psychoactive substance use disorders (79% versus 40%) and previous nonfatal
suicide attempts (70% versus 37%) and were less likely to have axis III
physical disorders (29% versus 50%). Subjects with cluster C personality
disorders were not found to differ from the control subjects in any of the
variables examined. CONCLUSIONS: Suicide victims with personality disorders
were almost always found to have had current depressive syndromes,
psychoactive substance use disorders, or both. Suicide victims with cluster
B personality disorders differed from other suicide victims in several
characteristics, while those with cluster C personality disorders did
not.
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