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Am J Psychiatry 1996; 153:667-673
Copyright © 1996 by American Psychiatric Association
Suicide among subjects with personality disorders
ET Isometsa, MM Henriksson, ME Heikkinen, HM Aro, MJ Marttunen, KI Kuoppasalmi and JK Lonnqvist
Department of Mental Health, National Public Health Institute, Helsinki, Finland.
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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