Citation

Urnes O. Tidsskr. Nor. Laegeforen. 2009; 129(9): 872-876.

Vernacular Title

Selvskading og personlighetsforstyrrelser.

Affiliation

oyvind.urnes@medisin.uio.no Avdeling for personlighetspsykiatri Oslo universitetssykehus, Ulleval 0407 Oslo.

Copyright

(Copyright © 2009, Norske Laegeforening)

DOI

10.4045/tidsskr.08.0140

PMID

19415088

Abstract

BACKGROUND: Clinical experience and recent research convey that patients with personality disorders who harm themselves with a suicidal intention should be treated differently than those who do so without a suicidal intention. The purpose of this article is to give an overview of non-suicidal self-harm in these patients. MATERIAL AND METHOD: The article is based on a non-systematic literature search in PsycINFO, Medline, Clinical Evidence and Cochrane and own clinical experience. RESULTS: Self-harm in patients with personality disorders is associated with borderline personality traits. Up to 70 % of patients with borderline personality disorders have reported non-suicidal self-harm. Non-suicidal self-harm is one of the risk factors for suicide. Borderline personality disorder develops due to interaction between genetic vulnerability and a traumatic and unsafe upbringing. The patients are often influenced by intense negative emotions and have reduced ability to regulate and handle these in interpersonal situations. Self-harm can give short-term alleviation of the inner pain associated with emotion dysregulation. Dialectical behavior therapy and mentalization-based therapy is shown to reduce the prevalence of self-harm in patients with borderline personality disorder. Acute referral to in-patient treatment should only be used in crises that cannot be handled in out-patient treatment. The regular general practitioner can function as a stable attachment figure and contribute to self-regulation. INTERPRETATION: Non-suicidal self-harm in patients with personality disorders should be given more attention.

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