Suicide Attempt in Self-Mutilators Should Not Be Discounted

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Suicide Attempt in Self-Mutilators Should Not Be Discounted

Individuals with personality disorders and a history of self-mutilation could be at a greater risk of suicide because they underestimate the lethality of their suicide attempts.

Researchers from New York warn that this may lead clinicians to be misled, unintentionally, in assessing suicide-risk among this group of patients as less serious than it is. Barbara Stanley of the New York State Psychiatric Institute and colleagues evaluated 53 suicide attempters with cluster B personality disorders, 30 of whom had a history of self-mutilation.

Stanley's team found no difference in the number, or severity, of suicide attempts between the two groups, although they note that the perceptions of the attempts differed. Self-mutilators perceived their suicide attempts as less lethal, with a greater likelihood of rescue and with less certainty of death.

This, together with the finding that these patients had higher levels of borderline pathology, depression, aggression, anxiety, impulsivity, and suicide ideation, placed suicide attempters with a history of self-mutilation at a high risk of suicide. In addition, self-mutilators had more persistent suicide ideation.

Writing in the American Journal of Psychiatry, the authors stress that their findings 'cast doubt on the clinical notion that suicide attempts of self-mutilators represent attention-seeking acts and do not have to be treated with the same seriousness as the attempts of other patients'. They emphasize that these patients 'should be referred for help and reassured that this is not a +hopeless problem'. They add: 'Dialectal behavior therapy can often help them develop other means for coping than self-injury.'

Am J Psychiatry 158: 427-432

Suicide Attempt in Self-Mutilators Should Not Be Discounted

http://www.psychiatrymatters.md/

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