Abstract:
BACKGROUND:Comorbid personality disorders may predispose patients with mood disorders to suicide attempts (SAs), but factors mediating this effect are not well known. METHODS:Altogether 597 patients from three prospective cohort studies (Vantaa Depression Study, Jorvi Bipolar Study, and Vantaa Primary Care Depression Study) were interviewed at baseline, at 18 months, and in VDS and PC-VDS at 5 years. Personality disorders (PDs) at baseline, number of previous SAs, life-charted time spent in major depressive episodes (MDEs), and precise timing of SAs during follow-up were determined and investigated. RESULTS:Overall, 219 (36.7%) patients had a total of 718 lifetime SAs; 88 (14.7%) patients had 242 SAs during the prospective follow-up. Having any PD diagnosis increased the SA rate, both lifetime and prospectively evaluated, by 90% and 102%, respectively. All PD clusters increased the rate of new SAs, although cluster C PDs more than the others. After adjusting for time spent in MDEs, only cluster C further increased the SA rate (by 52%). Mediation analyses of PD effects on prospectively ascertained SAs indicated significant mediated effects through time at risk in MDEs, but also some direct effects. LIMITATIONS:Findings generalizable only to patients with mood disorders. CONCLUSIONS:Among mood disorder patients, comorbid PDs increase the risk of SAs to approximately two-fold. The excess risk is mostly due to patients with comorbid PDs spending more time in depressive episodes than those without. Consequently, risk appears highest for PDs that most predispose to chronicity and recurrences. However, also direct risk-modifying effects of PDs exist.
journal_name
J Affect Disordjournal_title
Journal of affective disordersauthors
Jylhä P,Rosenström T,Mantere O,Suominen K,Melartin T,Vuorilehto M,Holma M,Riihimäki K,Oquendo MA,Keltikangas-Järvinen L,Isometsä ETdoi
10.1016/j.jad.2015.11.006subject
Has Abstractpub_date
2016-01-15 00:00:00pages
632-639eissn
0165-0327issn
1573-2517pii
S0165-0327(15)30763-1journal_volume
190pub_type
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