Citation

Hayashi N, Igarashi M, Imai A, Yoshizawa Y, Asamura K, Ishikawa Y, Tokunaga T, Ishimoto K, Tatebayashi Y, Kumagai N, Ishii H, Okazaki Y. Psychiatry Clin. Neurosci. 2015; 69(9): 563-571.

Affiliation

Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan.

Copyright

(Copyright © 2015, John Wiley and Sons)

DOI

10.1111/pcn.12280

PMID

25645160

Abstract

AIMS: Suicidal behavior (SB) is a major mental health problem. The research has identified many factors related to SB such as problems in the developmental period and psychiatric and personality disorders. However, the interrelationship of these factors has not been clearly delineated.

METHODS: The subjects were 155 patients consecutively admitted with SB to a psychiatric center in Tokyo. Structured interviews including SCID-I and SCID-II were conducted to determine characteristics of the SB-related factors. To illustrate their interrelationship, this study applied the technique of structural equation modeling. The latent constructs of Life-historical events, BPD features and 3 symptomatic disorders (Depression, Anxiety disorders and Substance dependence) were aligned in the chronological order of their manifestation, and connected one another within the model. Indicator variables of life-historical events were maltreatment in the developmental period and early onset of problematic behaviors. Indicators of BPD features and symptomatic disorders included the scales composed of the items in SCID-I and II.

RESULTS: The constructed model with favorable goodness-of-fit indices confirmed that BPD features had a mediating role, in which they were influenced by life-historical events, and exerted an influence on the symptomatic disorders. Outside the BPD-mediating paths, the model suggested 3 clinically interpretable links between Life-historical events and symptomatic disorders.

CONCLUSION: The model of this study demonstrated the pathways from life-historical events and BPD to symptomatic disorders, and indicated a generating process of psychiatric comorbidity among suicidal patients. The wide-range view this study portrayed has important clinical implications, and deserves further substantiation by future studies.

Language: en