2670 – Comorbid Bipolar Disorder and Borderline Personality Disorder and History of Suicide Attempts

Abstract

Background:

Both bipolar disorder and borderline personality disorder are associated with elevated rates of completed and attempted suicide. No studies have examined whether there is an additive risk for suicidal behavior in patients diagnosed with both disorders. in the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we tested the hypothesis that patients diagnosed with both bipolar disorder and borderline personality disorder would have a higher rate of suicide attempts than patients with either diagnosis alone.

Methods:

Three thousand four hundred and sixty-five psychiatric outpatients were interviewed with semi-structured interviews.

Results:

The suicide attempt rate in both the bipolar disorder and borderline personality disorder groups was significantly higher than the rate in patients without either of these disorders. Compared to the bipolar patients without borderline personality disorder, the patients diagnosed with both bipolar and borderline personality disorder were significantly more likely to have made a prior suicide attempt (58.0% vs. 28.9%, p< .001) and to have made multiple suicide attempts (33.3% vs. 16.5%, p< .01). The patients with borderline personality disorder and bipolar disorder were nonsignificantly more likely than the borderline patients without bipolar disorder to have made a prior suicide attempt (58.0% vs. 46.7%, p=n.s.) and to have made multiple suicide attempts (33.3% vs. 24.2%, p=n.s.)

Conclusions:

While bipolar disorder and borderline personality disorder are each risk factors for suicidal behavior, the cooccurrence of these disorders confers an additive risk.