PSYCHOBIOLOGY OF SUICIDAL BEHAVIOR IN BPD

BPD 自杀行为的心理生物学

• 批准号: 3387988
• 负责人: PAUL H SOLOFF
• 金额: $ 18.11万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-30 至 1996-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3387988
• 关键词: aggression; behavior prediction; behavior test; cerebrospinal fluid; environmental stressor; family structure /dynamics; functional ability; human subject; impulsive behavior; interpersonal relations; longitudinal human study; major depression; mental disorder diagnosis; neurochemistry; neuropharmacology; personality disorders; psychobiology; psychological tests; psychometrics; self destructive behavior; serotonin; social adjustment; social support network; statistics /biometry; substance abuse related disorder; suicide

We propose the Borderline Personality Disorder (BPD) as a unique and clinically relevant model for the study of suicidal behavior. BPD is a syndrome defined by affective instability, recurrent suicidal behavior and impulsive aggression in a context of chronic chaotic interpersonal relationships. It is among the most lethal of psychiatric disorders, with a rate of completed suicide of 3 - 9.5%. BPD is highly prevalent, accounting for 11% of outpatients and up to 23% of admissions to psychiatric hospitals. Borderline patients present a high incidence of suicidal behaviors in the group as a whole and a high frequency within individuals. This disorder is also characterized by a high frequency and broad diversity of "low lethality" self destructive behaviors providing a wide range of severity of attempt characteristics (e.g. objective planning, subjective intent and degree of medical damage). There have been no prospective multi-dimensional studies of suicidal behavior in this disorder. There is no treatment of choice for the suicidality of the borderline patient. We propose a first comprehensive multidimensional study-of the clinical, biological and psychosocial risk factors for suicidal behavior in a cohort of 120 criteria defined borderline inpatients, followed prospectively for 1 year. Two thirds will be prior suicide attempters and one-third lifetime non-attempters. We will compare groups at baseline on the following putative risk factors: a) Co-morbidity with affective and substance use disorders; b) disruption of interpersonal relationships, loss of social supports: c) degree of characterologic impulsivity and aggression; d) history of suicide attempts; e) absence of psychiatric treatment- f) decreased central serotonergic functioning. We will characterize the central serotonergic function of patients with BPD through a study of CSF 5-HIAA and Fenfluramine challenge, as these measures have previously indicated a strong inverse relationship between serotonin and suicidal behavior ih BPD. In addition to the prospective study of suicidal behavior in BPD. We will perform cross-sectional analyses comparing BPD attempters and non-attempters with normal controls, schizophrenic and depressed patients available in similar format through the Suicide MHCRC of WPIC at no additional cost to this proposal.

我们提出边缘型人格障碍（BPD）是一种独特的， 自杀行为研究的临床相关模型。 BPD是一个 综合征定义为情感不稳定、反复自杀行为和 慢性混乱人际关系中的冲动性攻击 关系。 它是最致命的精神疾病之一， 自杀率为3 - 9.5%。BPD非常普遍， 占门诊病人的11%，占住院病人的23%， 精神病院 边缘患者的高发病率 自杀行为在群体中作为一个整体和高频率内 个体 这种疾病的特征还在于高频率， 广泛多样的“低致命性”自我毁灭行为， 尝试特征的严重性的宽范围（例如，目标规划， 主观故意和医疗损害程度）。 没有发生 对自杀行为的前瞻性多维度研究， disorder. 没有治疗的选择自杀的 边缘病人 我们提出了第一个全面的多维 研究-临床、生物学和心理社会危险因素 在120个标准定义为临界的队列中， 住院患者，前瞻性随访1年。 三分之二将优先于 自杀者和三分之一的终生不自杀者。 我们将比较 在基线时对以下假定的风险因素进行评估： 情感和物质使用障碍; B）人际关系的破坏 关系，社会支持的丧失：c）性格学程度 冲动和攻击性; d）自杀企图史; e）没有 精神病治疗- f）降低中枢神经系统功能。 我们 将描述BPD患者的中枢神经系统功能 通过对CSF 5-HIAA和芬氟拉明激发的研究， 先前已经指出血清素和 和自杀行为 除了前瞻性研究， BPD的自杀行为 我们将进行横断面分析 将BPD患者和非BPD患者与正常对照进行比较， 精神分裂症和抑郁症患者， WPIC的自杀MHCRC没有额外的费用，这一建议。