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A Mediation Analysis of Childhood Maltreatment and Suicidal Behavior among Patients with Depressive or Bipolar Disorders

Published online by Cambridge University Press:  23 March 2020

K. Aaltonen ,
T. Rosenström ,
I. Baryshnikov ,
B. Karpov ,
T. Melartin ,
P. Näätänen ,
M. Heikkinen ,
M. Koivisto ,
K. Suominen  and
G. Joffe
...Show all authors
K. Aaltonen
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland National Institute of Health and Welfare, Department of Health- Mental Health Unit, Helsinki, Finland
T. Rosenström
Affiliation:
University of Helsinki, Institute of Behavioural Sciences, Helsinki, Finland
I. Baryshnikov
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
B. Karpov
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
T. Melartin
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
P. Näätänen
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
M. Heikkinen
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
M. Koivisto
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
K. Suominen
Affiliation:
City of Helsinki, Department of Social Services and Health Care, Helsinki, Finland
G. Joffe
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
E. Isometsä
Affiliation:
University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland

Abstract

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Introduction

Substantial evidence supports association between childhood maltreatment and suicidal behaviour, however, a limited number of studies have examined psychological mechanisms mediating the relationship among patients with mood disorders.

Objective

To investigate directly the potential intermediating mechanisms between childhood maltreatment and suicidal behaviour among patients with mood disorders.

Aims

We examine by formal mediation analyses, if:

– the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits;

– the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.

Methods

Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n = 287) from the Helsinki university psychiatric consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts.

Results

The influence of childhood maltreatment on lifetime suicidal ideation and lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only 21% of the total effect on lifetime suicide ideation. The mediation effect was stronger for lifetime suicide attempts compared to ideation (P = 0.002) and independent of current depressive symptoms.

Conclusions

The mechanisms of the effect of childhood maltreatment on suicidal ideation and attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicide ideation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
Oral communications: E-mental health; bipolar disorders; child and adolescent psychiatry; eating disorders; intellectual disability and women, gender and mental health
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S85
Copyright
Copyright © European Psychiatric Association 2017
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