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Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients

Published online by Cambridge University Press:  23 March 2020

K.I. Aaltonen ,
T. Rosenström ,
I. Baryshnikov ,
B. Karpov ,
T. Melartin ,
K. Suominen ,
M. Heikkinen ,
P. Näätänen ,
M. Koivisto  and
G. Joffe
...Show all authors
K.I. Aaltonen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, 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, 00099Helsinki, Finland
T. Rosenström
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, PO Box 9, 00014Helsinki, Finland
I. Baryshnikov
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
B. Karpov
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
T. Melartin
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
K. Suominen
Affiliation:
Department of Social Services and Health Care, PO Box 6000, 00099Helsinki, Finland
M. Heikkinen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
P. Näätänen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
M. Koivisto
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
G. Joffe
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
E. Isometsä*
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014Helsinki, Finland
*
* Corresponding author. Fax: +358 9 47163735. E-mail address:erkki.isometsa@hus.fi (E. Isometsä).
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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.

Keywords

Depressive disorderBipolar disorderBorderline personality disorderSuicidal behaviourChildhood maltreatment
Type
Original article
Information
European Psychiatry , Volume 44 , July 2017 , pp. 53 - 60
Copyright
Copyright © European Psychiatric Association 2017

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