Elsevier

Comprehensive Psychiatry

Volume 44, Issue 4, July–August 2003, Pages 277-283
Comprehensive Psychiatry

A comparison of life events between suicidal adolescents with major depression and borderline personality disorder

https://doi.org/10.1016/S0010-440X(03)00091-9Get rights and content

Abstract

The current study compared the correlations of different types of stressful life events (SLE) between suicidal adolescents with major depressive disorder (MDD) and suicidal adolescents with borderline personality disorder (BPD). Both groups were referred following an attempted suicide. Twenty adolescents with MDD and 20 adolescents with BPD who were consecutively referred to an outpatient clinic following a suicide attempt were evaluated. A community control group of adolescents with no lifetime history of suicidal behavior was also assessed. The following measurements were employed: the Suicide Risk Scale (SRS) Beck Depression Inventory (BDI), the Life Events Checklist (LEC), and the Childhood Sexual Abuse Questionnaire (CSEQ). Both groups of suicidal subjects reported more SLE in general and more physical abuse than community controls in the 12 months before the suicide attempt. The MDD adolescents had more lifetime death-related SLE than the BPD and control groups, while the BPD adolescents reported more lifetime sex abuse-related SLE than the other two groups. Thus, suicidal behavior in general may be related to the amount of SLE. However, different disease-specific life events may precipitate suicide attempts in adolescents with MDD and BPD.

Section snippets

Population

Three groups of adolescents took part in the study: (1) a group of 20 adolescents who had made a first suicide attempt and were diagnosed as meeting DSM-IV criteria for MDD; (2) a group of 20 adolescents who had made a first suicide attempt and met DSM-IV criteria for BPD; and (3) a sex- and age-matched group of 20 adolescents who did not meet criteria for any psychiatric illness and had never made a suicide attempt during their lifetime. They were recruited from a high school in the clinic

Results

On analysis of variance (ANOVA) [F(2, 57) = 474.53, P < .001], the BDI significantly differentiated between the MDD group (52.91 ± 5.64), the BPD group (12.33 ± 4.58), and the controls (4.04 ± 6.09). A post hoc Scheffé test showed that the MDD group was higher than the BPD group (P < .05), which in turn was significantly higher than the control group (P < .05).

On ANOVA, SRS significantly distinguished between the groups [F(2, 57) = 366.21, P < .001] The SRS scores were not significantly

Limitations

The study is a retrospective one and conclusions must necessarily be correlational and not causal. The memory of the subjects may be misleading and life events may often be the result of behaviors and not the cause. Thus, life events may be both a result as well as a cause of psychiatric illness.33 Patients with a major depressive episode and BPD may tend to be more argumentative and irritable, especially at the time close to a suicide attempt and, thus, influence some of their life events. It

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