Impact on suicidality of the borderline personality traits impulsivity and affective instability

Zoltán Rihmer, Franco Benazzi

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BACKGROUND: The aim of this study was to test the impact on suicidality (suicide threats, attempts) of the borderline personality disorder (BPD) traits impulsivity and affective instability in mood disorders. METHODS: In a general psychiatry private practice (nontertiary care), consecutive remitted, non-substance-abusing outpatients - 138 with bipolar II disorder (BP II) and 71 with major depressive disorder (MDD) - self-assessed using the Structures Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) Questionnaire. RESULTS: The frequency (higher in BP II) of suicidality was 14%; impulsivity, 37%; and affective instability, 58%. The suicidality-positive patients (n = 30), when compared with the suicidality-negative patients (n = 179), had more BP II, more impulsivity (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.3 to 13.3), and more affective instability (OR, 2.4; 95% CI, 0.99 to 6.0). Logistic regression of suicidality vs impulsivity and affective instability (controlled for BP II; age; and interactions among BP II, age, impulsivity, and affective instability), showed that impulsivity was a strong independent predictor of suicidality (OR, 4.3; 95% CI, 1.7 to 10.6), and that affective instability was not an independent predictor of suicidality (OR,1.6; 95% CI, 0.6 to 4.1). BP II showed neither confounding nor interactions. CONCLUSION: Results showed a strong independent impact of impulsivity - but not affective instability - on suicidality in BPD. No confounding by mood and substance disorders supported the BPD nature of these associations.

Original languageEnglish
Pages (from-to)121-128
Number of pages8
JournalAnnals of Clinical Psychiatry
Issue number2
Publication statusPublished - May 2010



  • Affective instability
  • Bipolar II disorder
  • Borderline personality disorder
  • Impulsivity
  • Suicide attempts

ASJC Scopus subject areas

  • Psychiatry and Mental health

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