Personality Disorders in Suicide Attempters and Completers: Preliminary Findings

Abstract

Personality disorders may play an important role in understanding suicide risk. The present study was designed to examine the frequency and type of personality disorder traits relevant to suicidal behavior. Four groups of subjects were compared: Suicide completers (n = 15), suicide attempters (n = 14), depressed natural deaths (n = 13), and nondepressed natural deaths (n = 15). The Structured Interview for DSM-III-R Personality Disorders – Revised (SIDP-R) was used to gather information needed to rate the presence and severity of 11 personality disorders. No differences were observed across groups on the categorical presence or absence of the different personality disorder diagnoses. However, dimensional ratings revealed that suicide completers displayed significant elevations in narcissistic, histrionic, and borderline personality traits. Suicide attempters displayed significant elevations on paranoid, avoidant, schizotypal, dependent, and borderline personality traits. At the level of specific personality traits, suicide completers displayed a sense of entitlement toward others, tended to be preoccupied with feelings of envy, and were likely to feel devastated when close relationships came to an end. The present findings suggest that personality traits are related to suicidal behavior, and that a focus on the dichotomous presence or absence of a diagnostic category fails to identify less severe forms of personality pathology. This research was supported in part by a grant from the NIMH (MH 45488) to the second author. We thank Herb Meltzer, M.D. for assistance with the psychiatric diagnoses, and Deval Shah for assistance with data entry.