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Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients.
Eur Psychiatry. 2017 07; 44:53-60.EP

Abstract

BACKGROUND

Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders.

METHODS

Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n=287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.

RESULTS

The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P=0.002) and independent of current depressive symptoms.

CONCLUSIONS

The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland; Department of Health, Mental Health Unit, National Institute of Health and Welfare, Helsinki, Finland; Department of Social Services and Health Care, PO Box 6000, 00099 Helsinki, Finland.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, PO Box 9, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Social Services and Health Care, PO Box 6000, 00099 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland.

Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland. Electronic address: erkki.isometsa@hus.fi.

MeSH

AdultAdult Survivors of Child AbuseBipolar DisorderBorderline Personality DisorderDepressionDepressive DisorderFemaleFinlandHumansMaleMiddle AgedMood DisordersPsychiatric Status Rating ScalesSuicidal IdeationSuicideSuicide, Attempted

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28545009

Citation

Aaltonen, K I., et al. "Mediating Role of Borderline Personality Disorder Traits in the Effects of Childhood Maltreatment On Suicidal Behaviour Among Mood Disorder Patients." European Psychiatry : the Journal of the Association of European Psychiatrists, vol. 44, 2017, pp. 53-60.

Aaltonen KI, Rosenström T, Baryshnikov I, et al. Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients. Eur Psychiatry. 2017;44:53-60.

Aaltonen, K. I., Rosenström, T., Baryshnikov, I., Karpov, B., Melartin, T., Suominen, K., Heikkinen, M., Näätänen, P., Koivisto, M., Joffe, G., & Isometsä, E. (2017). Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients. European Psychiatry : the Journal of the Association of European Psychiatrists, 44, 53-60. https://doi.org/10.1016/j.eurpsy.2017.03.011

Aaltonen KI, et al. Mediating Role of Borderline Personality Disorder Traits in the Effects of Childhood Maltreatment On Suicidal Behaviour Among Mood Disorder Patients. Eur Psychiatry. 2017;44:53-60. PubMed PMID: 28545009.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients. AU - Aaltonen,K I, AU - Rosenström,T, AU - Baryshnikov,I, AU - Karpov,B, AU - Melartin,T, AU - Suominen,K, AU - Heikkinen,M, AU - Näätänen,P, AU - Koivisto,M, AU - Joffe,G, AU - Isometsä,E, Y1 - 2017/04/08/ PY - 2016/12/22/received PY - 2017/03/23/revised PY - 2017/03/23/accepted PY - 2017/5/26/pubmed PY - 2018/3/20/medline PY - 2017/5/26/entrez KW - Bipolar disorder KW - Borderline personality disorder KW - Childhood maltreatment KW - Depressive disorder KW - Suicidal behaviour SP - 53 EP - 60 JF - European psychiatry : the journal of the Association of European Psychiatrists JO - Eur Psychiatry VL - 44 N2 - BACKGROUND: Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders. METHODS: Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n=287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts. RESULTS: The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P=0.002) and independent of current depressive symptoms. CONCLUSIONS: The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation. SN - 1778-3585 UR - https://www.unboundmedicine.com/medline/citation/28545009/Mediating_role_of_borderline_personality_disorder_traits_in_the_effects_of_childhood_maltreatment_on_suicidal_behaviour_among_mood_disorder_patients_ DB - PRIME DP - Unbound Medicine ER -