Citation

Lambert MT. Curr. Opin. Psychiatry 2003; 16(1): 71-76.

Copyright

(Copyright © 2003, Lippincott Williams and Wilkins)

DOI

10.1097/00001504-200301000-00014

PMID

unavailable

Abstract

PURPOSE of review: Suicide risk assessment and management can be particularly challenging in patients with personality disorders. This paper reviews recent research into the assessment and clinical management of suicide risk in patients with personality diagnoses. Recent findings: The DSM cluster B personality diagnoses carry the most serious suicide risk - similar to that of non-personality-disordered patients with major mood disorders. Factors increasing suicide risk in these patients include the presence of co-morbid mood or addiction disorders (often inadequately treated), severity of childhood sexual abuse, degree of antisocial or impulsive characteristics, and a history of irregular psychiatric care discharges. Complicating suicide risk management in this population, suicide gestures without lethal intent are common and suicide threats may be presented in a manipulative manner (contingent or instrumental suicidality). Hospitalization, the traditional intervention for imminent suicide risk, may be counterproductive and regressive in some personality-disordered patients. Summary: This review highlights the importance of a careful evaluation of personality-disordered patients with suicidal ideation and presents some suggestions for suicide risk management in this population.

Language: en

Keywords

Suicide risk; Hopelessness; Personality disorders; Contingent suicidal presentations