K I Aaltonen1, T Rosenström2, I Baryshnikov3, B Karpov3, T Melartin3, K Suominen4, M Heikkinen3, P Näätänen3, M Koivisto3, G Joffe3, E Isometsä5. 1. Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland; Department of Health, Mental Health Unit, National Institute of Health and Welfare, Helsinki, Finland; Department of Social Services and Health Care, PO Box 6000, 00099 Helsinki, Finland. 2. Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, PO Box 9, 00014 Helsinki, Finland. 3. Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland. 4. Department of Social Services and Health Care, PO Box 6000, 00099 Helsinki, Finland. 5. Department of Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, 00014 Helsinki, Finland. Electronic address: erkki.isometsa@hus.fi.
Abstract
BACKGROUND: Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders. METHODS: Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n=287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts. RESULTS: The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P=0.002) and independent of current depressive symptoms. CONCLUSIONS: The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation.
BACKGROUND: Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders. METHODS:Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n=287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts. RESULTS: The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P=0.002) and independent of current depressive symptoms. CONCLUSIONS: The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatricpatients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation.
Authors: John J Söderholm; J Lumikukka Socada; Tom Rosenström; Jesper Ekelund; Erkki T Isometsä Journal: Front Psychiatry Date: 2020-04-17 Impact factor: 4.157
Authors: Kari I Aaltonen; Tom Rosenström; Pekka Jylhä; Irina Holma; Mikael Holma; Sanna Pallaskorpi; Kirsi Riihimäki; Kirsi Suominen; Maria Vuorilehto; Erkki T Isometsä Journal: Front Psychiatry Date: 2020-11-26 Impact factor: 4.157