PSYCHOBIOLOGY OF SUICIDAL BEHAVIOR IN BPD

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， 完全自杀率为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 临床、生物学和心理社会风险因素的研究 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。

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.