Amedeo Ruberto

Suicide in borderline personality disorder: A meta-analysis

Suicide is the major cause of death among patients with borderline personality disorder; however, the literature on completed suicides in such disorder is inconclusive, as suicide rates vary greatly among cohorts of patients. We searched MedLine, Excerpta Medica and PsycLit from 1980 to 2005 to identify papers dealing with suicide in borderline personality disorder. We also searched the World Health Statistics Annual to ascertain the suicide rate in the age groups for specific years and country. We selected eight studies comprising 1179 patients with a diagnosis of borderline personality disorder. Of these patients, 94 committed suicide. Results obtained for each study were processed together to calculate the mean figure for each year of suicides for 100,000 individuals suffering from borderline personality disorder. Our meta-analysis shows that suicide among patients with borderline personality disorder is more frequent when compared with the general population. All study analyses reported that patients with borderline personality disorder committed suicide more often than their counterparts in the general population. Suicide seems more alarming in the first phases of follow-up than during chronic phases of illness.

Suicide in the epilepsies: A meta-analytic investigation of 29 cohorts

OBJECTIVES Suicide in epilepsy is a major cause of death and is very often underestimated. We conducted a meta-analysis to compare data reported in representative studies of suicide in epilepsy with data for the general population. METHODS We searched the Index Medicus until 2005 through MedLine. We also searched the World Health Statistics Annual to ascertain the suicide rates in the age groups indicated in the studies on epileptic patients for specific years and country. RESULTS We selected 29 studies comprising 50,814 patients, 187 of whom committed suicide. Results obtained for each study were processed together to calculate the mean number of suicides per 100,000 individuals suffering from epilepsy for each year. CONCLUSIONS Our meta-analysis shows that suicide in patients with epilepsy is more frequent than in the general population. Nevertheless, a number of cohorts of epileptic patients had a suicide rate lower than that of the general population. Possible explanations for this heterogeneous trend and risk factors are discussed.

Where Schizophrenic Patients Commit Suicide: A Review of Suicide among Inpatients and Former Inpatients

Objective: To review the literature on suicide of inpatients with schizophrenia, to identify suicide risk factors as well as typical patterns of behavior and to suggest a rationale and strategies for future interventions. Method: A computerized MedLine, Excerpta Medica and PsycLit search supplemented by an examination of cross-references and reviews. Results: Up to half the suicides among patients with schizophrenia occur during inpatient admission. Inpatient suicides were found among those of a young age group who were predominantly single, childless and socially isolated. The vast majority experienced an illness characterized by long duration and prolonged psychiatric hospitalizations or multiple admissions and discharges. Up to 50% of the suicides occurred in the first few weeks and months following discharge from the hospital. The paranoid subtype of schizophrenia, where positive symptoms prevail and negative symptoms are few, is associated with a suicide risk that is three times greater than that associated with nonparanoid subtypes and eight times greater than the risk associated with the deficit subtype. Conclusions: Treatment of suicide is a major problem among inpatients with schizophrenia. Evidence suggests that suicide is generally carried-out by patients who have been recently discharged or by those who manage to get away from the hospital. Strategies aimed at preventing this phenomenon have been introduced to the medical personnel, but suicide in these patients does not seem to have been reduced. We emphasize the need to establish guidelines for the prevention of suicide in hospitalized patients with schizophrenia.

Toward a New Prevention of Suicide in Schizophrenia

Summary Suicide is the primary cause of death among schizophrenic patients; follow-up studies suggested that 10-13% of schizophrenic patients die by suicide. Preventive measures based on early recognition of risk factors and the establishment of drug treatment protocols are no doubt of great help but have not resulted in a significant reduction of the number of suicides among these patients. Schizophrenia is a chronic disorder affecting all aspects of the individuals life. Prevention should therefore be addressed to various areas. This paper overviews studies dealing with major fields of interest in the prevention of suicide among patients with schizophrenia. The authors focus on the role of pharmacological treatment, psychosocial interventions and psychotherapy, the struggle against stigmatisation and the role of GPs. Prevention of suicide among inpatients with schizophrenia is also analysed. It is concluded that those integrated strategies already in use and the implementation of less known interventions should constitute a more effective prevention of self-inflicted deaths among these patients.

Personality and psychopathological profiles in individuals exposed to mobbing

Increasingly, mental health and medical professionals have been asked to assess claims of psychological harm arising from harassment at the workplace, or “mobbing.” This study assessed the personality and psychopathological profiles of 146 individuals exposed to mobbing using validity, clinical, and content scales of the Minnesota Multiphasic Personality Inventory 2. Profiles and factor analyses were obtained. Two major dimensions emerged among those exposed to mobbing: (a) depressed mood, difficulty in making decisions, change-related anguish, and passive-aggressive traits (b) somatic symptoms, and need for attention and affection. This cross-sectional pilot study provides evidence that personality profiles of mobbing victims and psychological damage resulting from mobbing may be evaluated using standardized assessments, though a longitudinal study is needed to delineate cause-and-effect relationships.

Body uneasiness and suicide risk in a non-clinical sample of university students

Attitudes and feelings towards the body may be a source of pleasure and well-being; on the other hand, bodily dissatisfaction may lead to suffering, depression and even suicide. The study population consisted of 500 university students (190 males, 310 females); mean age of participants was 21.62 (SD = 2.70). Participants were assessed by means of the Body Uneasiness Test (BUT), the Reason for Living Inventory (RFL), and the Zung Self Depression Scale (SDS). Data underline a linear relationship between uneasiness linked to body image and possible suicide risk. Such evidence suggests that body uneasiness can be a source of psychological pain and in serious cases expose the individuals to an increased suicide risk. Yet, depression was the strongest correlate of increased suicide risk.

Postpartum depression without delivering a child

Objective:  Depression in people related to delivering women is documented in their mates, but only anecdotal in other family members. We describe a case of depression in a woman who had previously experienced postpartum depression after the birth of her nephew.