伴忧郁特征抑郁症患者自杀未遂的危险因素

目的分析伴忧郁特征抑郁症患者发生自杀未遂的社会人口学及临床特征方面危险因素。方法来自全国13个研究中心的626例伴忧郁特征抑郁症患者,通过简明国际神经精神访谈(Mini International Neuropsychiatric Interview,MINI)5.0中文版自杀模块评估,分为自杀未遂组和无自杀未遂组。采用多因素logistic回归,分析伴忧郁特征抑郁症患者在社会人口学及临床特征方面可能与自杀未遂相关的因素。结果伴忧郁特征抑郁症患者自杀未遂的发生率为19.2%(120/626)。自杀未遂组相较无自杀未遂组的患者,既往住院次数多,抑郁发作频繁,更常伴非典型症状、伴自杀观念、伴不切实际的罪恶感,更多患者接受抗抑郁剂治疗(均P0.05)。logistic回归分析显示,抑郁发作频繁(OR=2.06,95%CI:1.23～3.47)、伴自杀观念(OR=2.34,95%CI:1.44～3.79)、既往住院次数多(OR=1.21,95%CI:1.04～1.42)、伴不切实际的罪恶感(OR=2.21,95%CI:1.38～3.54)与伴忧郁特征抑郁症患者的自杀未遂相关联(均P0.05)。结论发作频繁、既往住院次数多、有自杀观念或伴不切实际的罪恶感可能是伴忧郁特征抑郁症患者自杀未遂的危险因素。     

伴焦虑症状抑郁症患者自杀未遂的危险因素

目的分析伴焦虑症状抑郁症患者自杀未遂的人口学资料及临床特征方面的危险因素。方法来自全国13个中心的728例伴有焦虑症状抑郁症患者,根据简明国际神经精神访谈(mini international neuropsychiatric interview,MINI)5.0中文版自杀模块,评估其是否有自杀未遂行为。采用多因素logistic回归,分析伴焦虑症状抑郁症患者在性别、年龄、民族等人口学资料及伴精神病性症状、伴不典型特征等临床特征方面可能与自杀未遂相关的危险因素。结果伴焦虑症状抑郁症患者中,135例(18.5%)有自杀未遂,593例(81.5%)无自杀未遂。有自杀未遂组与无自杀未遂组相比,起病年龄早[(32.3±11.9)vs.(35.3±13.1)],既往抑郁发作次数多(中位数:2 vs.2),既往住院次数多(中位数:1 vs.0),更多患者出现抑郁发作频繁(14.8%vs.7.4%),更常伴不典型症状(25.9%vs.15.0%)和伴自杀意念(78.5%vs.50.3%),应用抗抑郁剂治疗者更多见(81.5%vs.71.2%),差异均具有统计学意义(P0.05)。Logistic回归分析显示,伴焦虑症状抑郁症患者既往住院次数多(OR=1.18,95%CI:1.02~1.37)、抑郁发作频繁(OR=2.05,95%CI:1.14~3.68)、伴自杀意念(OR=3.55,95%CI:2.28~5.54)与自杀未遂相关联(P0.05)。结论既往住院次数多、抑郁发作频繁、伴自杀意念可能是伴焦虑症状抑郁症患者自杀未遂的危险因素。     

伴精神病性症状抑郁症患者人口学及临床特征

目的比较伴与不伴精神病性症状抑郁症患者的人口学及临床特点。方法数据来源于"中国双相障碍患者诊断评估服务研究"项目,将来自全国13个研究中心的1172例抑郁症患者,根据有无精神病性症状,分为伴精神病性症状组和不伴精神病性症状组,采用自制调查问卷收集患者社会人口学及临床特征方面的资料,比较两组差异,并分析抑郁症患者伴精神病性症状的影响因素。结果 13.3%(156/1172)的抑郁症患者伴有精神病性症状。与不伴精神病性症状组相比,伴精神病性症状的抑郁症患者起病早,年龄小,更多已婚,既往抑郁发作次数多,因精神疾病住院次数多,抑郁发作频繁,更多患者伴非典型特征、有周期性或季节性特点、伴自杀观念及精神障碍家族史(均P0.05)。多因素logistic回归分析显示,起病年龄(OR=0.972,95%CI:0.957～0.987)、抑郁发作频繁(OR=2.099,95%CI:1.233～3.573)、伴非典型特征(OR=1.937,95%CI:1.277～2.939)、伴自杀观念(OR=1.654,95%CI:1.147～2.385)与抑郁症患者伴精神病性症状相关(均P0.05)。结论伴精神病性症状的抑郁症患者具有起病年龄早、抑郁发作频繁、更常伴非典型特征、伴自杀观念的特点。     

有精神疾病家族史抑郁症患者自杀未遂的危险因素

目的探讨有精神疾病家族史抑郁症患者自杀未遂的危险因素,为临床干预提供依据。方法采用自制调查表对1146例抑郁症患者进行调查,纳入其中有精神疾病家族史的患者150例,根据是否有自杀未遂行为,分为自杀未遂组和对照组,分析有精神疾病家族史的抑郁症患者在性别、年龄等社会人口学资料及既往抑郁发作次数、起病年龄等临床特征方面可能与自杀未遂相关的因素。结果有精神疾病家族史抑郁症患者自杀未遂发生率为24.0%(36/150),无精神病家族史患者自杀未遂发生率为7.1%(71/996),前者自杀未遂发生率更高(P0.01)。150例有精神疾病家族史抑郁症患者中,相较于无自杀未遂组,自杀未遂组患者既往因精神疾病住院次数较多(P0.01),自杀意念及合并有严重或慢性躯体疾病的比例更高(P0.05)。多因素logistic回归分析显示,既往因精神疾病住院次数(OR=3.714,95%CI:1.426～9.673,P=0.007)、自杀意念(OR=8.347,95%CI:2.339～29.790,P=0.001)与有精神病家族史抑郁症患者的自杀未遂相关联。结论有精神疾病家族史抑郁症患者自杀未遂风险较高。既往因精神疾病住院次数多、自杀意念等可能是有精神疾病家族史抑郁症患者自杀未遂的主要危险因素。     

伴精神病性症状的双相障碍患者自杀未遂的危险因素分析

目的:探讨伴有精神病性症状的双相障碍(BD)患者自杀未遂的危险因素。方法:对2010~2011年"中国BD患者诊断评估服务"项目的数据进行二次分析;对306例BD患者中伴有精神病性症状的99例(32.4%)患者应用简明国际神经精神访谈(MINI)中自杀模块分为自杀未遂组和对照组,比较两组的人口学及临床资料,Logistic回归分析伴有精神病性症状的BD患者自杀未遂的危险因素。结果:分别有36例(36.5%)及63例患者入自杀未遂组和对照组;自杀未遂组年龄明显高于对照组(t=-2.37,P=0.020);发作频繁(χ~2=8.526)、伴有不典型特征(χ~2=6.673)、有自杀观念(χ~2=6.314)、有季节性特征(χ~2=4.956)及有精神障碍家族史(χ~2=6.189)比率明显高于对照组(P0.05或P0.01)。Logistic回归分析显示,年龄及自杀观念与伴有精神病性症状BD患者的自杀未遂相关(OR=1.055,P=0.008,95%CI:1.014~1.098;OR=4.467,P=0.002,95%CI:1.750~11.403)。结论:年龄大及有自杀观念是伴有精神病性症状BD患者自杀未遂的主要危险因素。     

误诊为抑郁症的双相障碍Ⅰ型患者自杀风险的危险因素分析

目的探讨误诊为抑郁症的双相障碍Ⅰ型患者自杀风险的社会人口学与临床特征方面的危险因素。方法来自全国13个中心患者共1478例,收集社会人口学及临床特征等信息,通过简明国际神经精神访谈(the Mini International Neuropsychiatric Interview,MINI)5.0中文版确定诊断,其中116例被诊断为双相Ⅰ型。此116例患者采用MINI中自杀模块界定自杀风险,比较有、无自杀风险两组之间特征有无差异,通过Logistic回归分析探讨自杀风险的危险因素。结果与无自杀风险组相比,有自杀风险组发作频繁、更多伴不典型特征、自杀观念及精神病性症状、周期性或季节性、起病有诱因、更多次发病。Logistic回归分析显示,精神病性症状(OR=6.127)、伴有自杀观念(OR=3.940)及频繁发作(OR=3.283)与误诊为抑郁症的双相Ⅰ型患者自杀风险高相关(均P0.05)。结论精神病性症状、自杀观念及频繁发作可能是误诊为抑郁症的双相Ⅰ型患者自杀风险的独立危险因素。     

误诊为抑郁症的双相障碍Ⅱ型患者自杀风险的危险因素分析

目的探讨误诊为抑郁症的双相障碍Ⅱ型患者自杀风险的社会人口学及临床特征方面的危险因素。方法通过简明国际神经精神访谈(the Mini International Neuropsychiatric Interview,MINI)5.0中文版,对来自全国13个中心的1478例最初诊断为抑郁症的患者进行重新诊断,其中190例被诊断为双相障碍Ⅱ型,将这190例误诊患者按照有无自杀风险进行分组,从性别、年龄等社会人口学资料及起病年龄、是否伴有自杀观念等临床特征方面探讨被误诊患者自杀风险可能的危险因素。结果有自杀风险组共74例患者,无自杀风险组共116例。有自杀风险组与无自杀风险组相比,年龄更小[(34.45±11.18)vs.(37.23±13.22)],起病年龄更早[(26.20±9.16)vs.(30.37±11.59)],更常伴有自杀观念(82.4%vs.53.4%),差异均具有统计学意义(P<0.05)。Logistic回归分析显示,年龄(OR=0.969,95%CI:0.945~0.993)、伴有自杀观念(OR=4.129,95%CI:2.030~8.397)与误诊为抑郁症的双相障碍Ⅱ型患者发生自杀风险相关联(均P<0.05)。结论年龄小、伴有自杀观念可能是误诊为抑郁症的双相障碍Ⅱ型患者自杀风险的独立危险因素。     

伴忧郁特征的抑郁症患者自杀风险因素分析

目的:探讨伴忧郁特征的抑郁症患者的自杀风险因素。方法:对“中国双相障碍患者诊断评估服务研究项目”中626例符合伴忧郁特征的抑郁症患者采用《简明国际神经精神访谈》(MINI)自杀模块评估自杀风险,并将患者分为自杀风险组(300例)和无自杀风险组(326例),比较两组的人口学及临床资料,采用Logistic回归分析伴忧郁特征抑郁症患者的自杀风险因素。结果:自杀风险组起病年龄明显小于无自杀风险组(t=-4. 390,P=0. 032),出现抑郁发作频繁(χ2=8. 036,P=0. 005)、伴非典型症状(χ2=4. 586,P=0. 032)、伴精神病性症状(χ2=15. 580,P 0. 001)、症状晨重暮轻(χ2=4. 501,P=0. 034)、伴不切实际的罪恶感(χ2=33. 105,P 0. 001)的比率明显高于无自杀风险组。Logistic回归分析显示,伴精神病性症状(OR=2. 38,P 0. 001)、伴不切实际的罪恶感(OR=2. 51,P 0. 001)与伴忧郁特征抑郁症患者的自杀风险因素相关(P均0. 001)。结论:伴精神病性症状、伴不切实际的罪恶感可能是伴忧郁特征抑郁症患者的自杀风险因素。     

抑郁障碍患者自杀未遂的危险因素分析

目的:分析抑郁障碍(MDD)患者自杀未遂的危险因素。方法:入组332例MDD患者,分为自杀未遂组(95例)和非自杀未遂组(237例);对入组者进行人口学与临床资料调查、汉密尔顿抑郁量表(HAMD-24)及汉密尔顿焦虑量表(HAMA-14)评估及血清甲状腺功能检测,并进行组间比较;分析自杀未遂的危险因素。结果:自杀未遂组年龄、首次发病年龄明显小于非自杀未遂组,病程、既往住院次数明显多于非自杀未遂组;单身、无业、受教育程度低、家族史阳性、伴有精神病性症状、共病焦虑障碍比率明显高于非自杀未遂组(P<0.05或P<0.01)。HAMD总分与焦虑躯体化、认知障碍、阻滞、绝望感、体质量、日夜变化因子分及HAMA评分明显高于非自杀未遂组(P<0.05或P<0.01)。血清游离三碘甲状腺原氨酸(FT3)水平明显高于非自杀未遂组(P<0.05)。多因素Logistic回归分析显示,伴有精神病性症状、既往住院次数、HAMD评分中认知障碍、绝望感因子是影响抑郁症患者自杀未遂的主要危险因素。结论:伴有精神病性症状、既往住院次数、HAMD评分中的认知障碍、绝望感因子可能为MDD患者...     

首发未治疗抑郁症患者自杀风险与情感气质的关系

目的探讨抑郁症患者自杀风险在情感气质特征方面的危险因素。方法来自我院门诊103例首发未治疗抑郁症患者,根据简明国际神经精神访谈(the mini international neuropsychiatric interview,MINI)5.0中文版自杀模块访谈结果,分为有自杀风险组和无自杀风险组。用情感气质量表(temperament evaluation of the Memphis,Pisa,Paris,and San Diego-auto questionnaire,TEMPS-A)评估情感气质,用汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)评估抑郁症状的严重程度。结果 45.6%(47/103)的抑郁症患者伴有自杀风险。与无自杀风险组患者相比,有自杀风险组患者女性、无业及未婚者较多,发病年龄较早,HAMD总分以及TEMPSA中循环气质、抑郁气质、焦虑气质评分较高(均P 0.05)。logistic回归分析显示,女性(OR=3.392,95%CI:1.246～9.232)、发病年龄(OR=0.924,95%CI:0.844～0.966)、HAMD总分(OR=1.134,95%CI:1.022～1.258)和循环气质评分(OR=1.204,95%CI:1.015～1.427)与自杀风险相关。结论女性、发病年龄早、抑郁症状严重和循环气质突出可能为首发抑郁症患者自杀风险的危险因素。     

Rates and correlates of suicide attempts in first-admission psychotic patients

The relationship of attempted suicide to demographic characteristics, current and lifetime psychiatric diagnoses, clinical history, and current symptoms was assessed in a sample of 184 recently hospitalized psychotic patients. Forty-three patients (23%) had an attempt history, and 28 (15% of sample; 65% of attempters) made an attempt during the episode for which they were hospitalized. Demographic characteristics did not distinguish attempters from nonattempters. Variables significantly associated with having ever attempted suicide were current diagnosis of unipolar major depressive disorder but not bipolar; lifetime major depressive episode; a history characterized by a less acute onset, lower pre-admission psychosocial functioning, and episodes of physical violence; and a symptom picture characterized by greater depression, hopelessness, negative symptoms, hallucinations and less thought disorder. Those with a current attempt had significantly higher rates of lifetime history of major depression and less physical violence than those with past attempts only. The potential importance of the data for predicting future suicidal acts is discussed.     

Suicide attempters in the emergency department before hospitalization in a psychiatric ward

PURPOSE. The study aims to compare the current suicidal risk of mood disorder patients who had just attempted suicide, as compared with those who had not attempted suicide, admitted to an emergency department (ED), and then hospitalized in a psychiatric unit. METHOD. One hundred sixty‐one mood disorder patients admitted to the ED were studied. A total of 22.4% of the participants were admitted for a suicide attempt. Patients were assessed for psychopathology and diagnosis. FINDINGS. Suicide attempters were nearly 12 times more likely to report ongoing suicidal ideation during the psychiatric evaluation in the ED than nonattempters. Men and women did not differ for current and previous suicide attempts or for ongoing suicidal ideation. PRACTICAL IMPLICATIONS. It is important to conduct a suicide risk assessment when individuals are admitted to an ED.     

Psychiatric diagnoses in minority female adolescent suicide attempters

Psychiatric diagnoses were examined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children semistructured interview among three groups of minority adolescent females aged 12 to 17:61 suicide attempters, 31 psychiatrically disturbed nonattempters, and 23 nonattempting, nondisturbed girls. Major or minor depressive disorder was found in 42% of the suicide attempters; conduct disorder in 46%; multiple diagnoses in 38%, no diagnosis in 13%. These rates were very similar to those found in disturbed nonattempters. Only one symptom, suicidal ideation, distinguished attempters from disturbed nonattempters, while many symptoms distinguished these two groups from nondisturbed nonattempters.     

Protective factors against suicidal behavior in depressed adults reporting childhood abuse

Most previous studies compared suicidal behavior in subjects with and without a history of childhood abuse, whereas less attention was paid to the comparison of suicide attempters and nonattempters among subjects reporting childhood abuse. To identify risk and protective factors against suicidal behavior, we compared suicide attempters with nonattempters among the sample of 119 depressed inpatients who reported childhood abuse. Compared with nonattempters, suicide attempters were younger, had more self-rated depression severity and suicidal ideation, higher trait aggression and more cluster B personality disorder comorbidity, less coping potential, and fewer moral objections to suicide (MOS)/religious beliefs. Logistic regression showed that more severe suicidal ideation and fewer MOS/religious beliefs were associated with suicidal acts in subjects with reported childhood abuse. Furthermore, suicidal ideation and MOS/religious beliefs were significantly inversely correlated. The results of this clinical study add support to previous reports that religious/spiritual coping could serve as an additional resource in prevention of suicidal behavior for subjects with reported childhood abuse.     

Risk factors associated with lifetime suicide attempts in bipolar I patients: findings from a French National Cohort

Risk factors that may be associated with suicide attempts in bipolar disorder are still a matter of debate. We compared demographic, illness course, clinical, and temperamental features of suicide attempters vs those of nonattempters in a large sample of bipolar I patients admitted for an index manic episode. One thousand ninety patients (attempters = 382, nonattempters = 708) were included in the study. Multivariate analysis evidenced 8 risk factors associated with lifetime suicide attempts as follows: multiple hospitalizations, depressive or mixed polarity of first episode, presence of stressful life events before illness onset, younger age at onset, no free intervals between episodes, female sex, higher number of previous episodes, and cyclothymic temperament. These characteristics may help identify subjects at risk for suicide attempt throughout the course of bipolar disorder. We finally propose to integrate such characteristics into a stress-diathesis model of suicidal behavior, adapted to bipolar patients.     

Time to emergence of severe suicidal ideation among psychiatric patients as a function of suicide attempt history

BACKGROUND: Little is known about the emergence of suicidal ideation among psychiatric inpatients with histories of no, single, or multiple suicide attempts. We investigated differences in time to reemergence of severe suicidal ideation among psychiatric patients as a function of their suicide attempt histories. METHOD: One hundred seventeen individuals meeting criteria for a major depressive disorder who were recently discharged from a psychiatric hospital and participating in a larger study of treatments for depression were included in the current study. Suicidal ideation, depressive symptoms, hopelessness, and depressogenic cognitions were assessed at baseline, and suicidal ideation was assessed at 3-, 6-, 12-, and 18-month follow-up, as well as inpatient readmission if applicable. Time to the reemergence of severe suicidal ideation was analyzed using survival analysis. RESULTS: Twenty-two percent of our sample reported the occurrence of severe suicidal ideation over an 18-month period. Severe suicidal ideation emerged earlier among patients who had a history of prior suicide attempts than those who did not, but single and multiple suicide attempters did not differ significantly in time to severe suicidal ideation. Suicide attempt history remained a significant predictor of time to severe suicidal ideation when statistically controlling for hopelessness, depressive symptoms, depressogenic cognitions, and suicidal ideation at admission and initial treatment group assignment, especially between single attempters and nonattempters. CONCLUSIONS: Although nearly a quarter of participants endorsed severe, clinically significant suicidal ideation within 18 months of discharge, those with suicide attempt histories reported the occurrence of severe suicidal ideation significantly earlier than those without suicide attempt histories.     

Psychosocial profile of suicide ideators, attempters and completers in India

The study aims to determine the psychological profile of suicide ideators, attempters and completers in a tertiary care teaching hospital. A total of 260 suicidal ideators, 58 attempters and 55 completers were studied. The majority of ideators, attempters and completers were 26-35 years of age, males (except attempters who were predominantly females), married, literate up to high school, employed (ideators) or housewives (attempters and completers). The suicide ideators, attempters and completers who had a past history of attempt were 6.9%, 24.1% and 18.2% respectively. Family history of attempted suicide or completed suicide was also common among patients suffering from depression. In suicidal ideators, mixed anxiety and depressive disorder was the most common psychiatric diagnosis followed by major depression and schizophrenia. Among suicide attempters, adjustment disorder with depression was the most common diagnosis. The most common method of suicide attempt was organophosphorus compound intake whereas in suicide completers, the most common method in use was hanging. The patients with suicidal ideation or attempt need careful evaluation, early intervention and long term follow up.     

Comorbidity patterns in adolescents and young adults with suicide attempts

The role of comorbidity as a risk for suicide attempts is investigated in a random sample of 3021 young adults aged 14–24 years. The M-CIDI, a fully standardized and modified version of the Composite International Diagnostic Interview, was used for the assessment of various DSM-IV lifetime and 12-month diagnoses as well as suicidal ideation and suicide attempts. Of all suicide attempters, 91% had at least one mental disorder, 79% were comorbid or multimorbid respectively and 45% had four or more diagnoses (only 5% in the total sample reached such high levels of comorbidity). Suicide attempters with more than three diagnoses were 18 times more likely (OR = 18.4) to attempt suicide than subjects with no diagnosis. Regarding specific diagnoses, multivariate comorbidity analyses indicated the highest risk for suicide attempt in those suffering from anxiety disorder (OR = 4.3), particularly posttraumatic stress disorder followed by substance disorder (OR = 2.2) and depressive disorder (OR = 2.1). Comorbidity, especially when anxiety disorders are involved, increases the risk for suicide attempts considerably more than any other individual DSM-IV diagnoses. Received: 17 July 1997 / Accepted: 15 December 1997     

Suicidal ideation and attempts in bipolar I and II disorders

OBJECTIVE: Few studies have investigated the prevalence of and risk factors for suicidal ideation and attempts among representative samples of psychiatric patients with bipolar I and II disorders. METHOD: In the Jorvi Bipolar Study (JoBS), psychiatric inpatients and outpatients were screened for bipolar disorders with the Mood Disorder Questionnaire from January 1, 2002, to February 28, 2003. According to Structured Clinical Interviews for DSM-IV Axis I and II Disorders, 191 patients were diagnosed with bipolar disorders (bipolar I, N = 90; bipolar II, N = 101). Suicidal ideation was measured using the Scale for Suicidal Ideation. Prevalence of and risk factors for ideation and attempts were investigated. RESULTS: During the current episode, 39 (20%) of the patients had attempted suicide and 116 (61%) had suicidal ideation; all attempters also reported ideation. During their lifetime, 80% of patients (N = 152) had had suicidal behavior and 51% (N = 98) had attempted suicide. In nominal regression models, severity of depressive episode and hopelessness were independent risk factors for suicidal ideation, and hopelessness, comorbid personality disorder, and previous suicide attempt were independent risk factors for suicide attempts. There were no differences in prevalence of suicidal behavior between bipolar I and II disorder; the risk factors were overlapping but not identical. CONCLUSION: Over their lifetime, the vast majority (80%) of psychiatric patients with bipolar disorders have either suicidal ideation or ideation plus suicide attempts. Depression and hopelessness, comorbidity, and preceding suicidal behavior are key indicators of risk. The prevalence of suicidal behavior in bipolar I and II disorders is similar, but the risk factors for it may differ somewhat between the two.     

A comparison of the medical lethality of suicide attempts in bipolar and major depressive disorders

Objectives:  Among mood disorders, bipolar disorder (BPD) is often noted to involve the highest rates of suicide attempts and possibly of completion. This study sought to determine whether suicide attempters with BPD exhibit suicide attempts with higher lethality than attempters with major depressive disorder (MDD) and to explore differences in clinical features associated with suicidal acts.
Methods:  Mood disordered suicide attempters were interviewed about Axis I and II diagnoses, lifetime history of suicide attempts, suicidal intent, suicidal ideation, the medical lethality of their most severe suicide attempt, severity of depression, hopelessness, lifetime aggression, and impulsivity.
Results:  The maximum lethality of suicidal acts tended to be higher among BPD attempters compared with those with MDD. However, there were no differences in the number of suicide attempts, intent to die or suicidal ideation. Suicide attempters with BPD reported higher levels of aggression and impulsivity but less hopelessness compared with MDD attempters. These differences could not be explained by Cluster B personality disorder comorbidity. Of note, within the BPD group, but not the MDD group, males reported suicidal acts with higher lethality. Multivariate analyses suggested that risk for more lethal suicide attempts is associated with BPD and male sex and that bipolar males appear to be especially vulnerable to these behaviors.
Conclusions:  Males with BPD make more lethal suicide attempts than females with BPD, an effect not observed among the MDD sample. Our findings suggest that higher rates of suicidal behavior in BPD may be due to a specific effect of BPD on males, leading to more dangerous suicidal behaviors. This effect, together with the larger proportion of males in the BPD group compared with the MDD group may lead to higher rates of reported attempted and completed suicide.