Belloc, V., Leichsenringb, F., & Chabrol, H. (2004). Relations entre les symptomatologies dépressive et limite et les idées suicidaires dans un échantillon de lycéens. Neuropsychiatrie de l'enfance et de l'adolescence, 52(4), 219-214.
Résumé: Un échantillon de 221 lycéens et de 240 lycéennes a répondu aux versions françaises d'un questionnaire d'évaluation de la symptomatologie dépressive, la Center for Epidemiological Studies-Depression scale, et du Borderline Personality Inventory qui explore différentes dimensions de la symptomatologie limite. Des analyses de régression multiple ont montré que les principaux prédicteurs indépendants des idées de suicide étaient la symptomatologie dépressive et l'impulsivité, chez les garçons comme chez les filles. Chez les filles, la symptomatologie dissociative/psychotique était également un prédicteur des idées de suicide. Les autres dimensions de la personnalité limite n'étaient pas des prédicteurs indépendants significatifs des idées de suicide.
Cote: JB 041 e

Justes, M., Ortega-Monasterio, L., Teruel, P., Fuentes, C., Navarro, T., & Vives, M. (2004). Discriminating deliberate self-harm (DSH) in young prison inmates through personality disorder. Journal of Forensic Sciences, 49(1), 137-140.
Résumé: This study investigated deliberate self-harm (DSH) in young inmates. The objectives are twofold: first, to identify the social and clinical characteristics of inmates who commit DSH; and secondly, to ascertain the types of personality who are vulnerable in order to be able to predict future inmates who may harm themselves. Across-sectional design was used to study psychosocial correctional personality characteristics and clinical pictures in inmates with DSH versus a control group without DSH. The measures used to evaluate different variables were a standard protocol and a self-report questionnaire (MCMI-II). Although the two groups compared are homogeneous and similar in terms of different psychosocial variables, inmates with DSH presented a significant background of maltreatment. Borderline, passive-aggressive, and antisocial personality disorders best discriminated both groups.The detection of borderline, negativistic, and antisocial disorders may help the medical services of penitentiary centers to predict youths with a possible risk of DSH. Despite the results obtained, longitudinal studies are needed to help clarify other risk factors, as well as other risk factors leading to self-harm behavior.
Cote: RJ 002

Dougherty, D.M., Mathias, C.W., Marsh, D.M., Moeller, F.G., & Swann, A.C. (2004). Suicidal behaviors and drug abuse: Impulsivity and its assessment. Drug and Alcohol Dependence, 76( Suppl), S93-S105
Résumé: Impulsivity appears to play an important role in suicidal behaviors and drug abuse, which are two psychiatric problems that may interact with one another. Interpretation of the literature on impulsivity in these behaviors may be complicated by the variety of measurement techniques for the assessment of impulsivity. There are three general types of impulsivity assessment: self-report, biological, and laboratory behavioral. Because laboratory behavioral measures both meet an operational definition of impulsivity and are sensitive to state-dependent changes in impulsivity, this paper presents data that focuses on laboratory behavioral performance among samples emitting suicidal behaviors or substance abuse. To better account for influence of impulsivity in these psychiatric disturbances, no single source of measurement should be used without the consideration of other types of instruments.
Cote: SD 007 e

Darke, S., Ross, J., Lynskey, M., & Teesson, M. (2004). Attempted suicide among entrants to three treatment modalities for heroin dependence in the Australian Treatment Outcome Study (ATOS): Prevalence and risk factors. Drug and Alcohol Dependence, 73(1), 1-10.
Résumé: AIMS: To determine the lifetime and recent histories of attempted suicide among entrants to treatment for heroin dependence in three treatment modalities and a non-treatment comparison group; and to ascertain factors associated with a recent history of attempted suicide. DESIGN: Cross-sectional structured interview. SETTING: Sydney, Australia. PARTICIPANTS: Six hundred and fifteen current heroin users: 201 entering methadone/buprenorphine maintenance (MT), 201 entering detoxification (DTX), 133 entering drug free residential rehabilitation (RR) and 80 not in treatment (NT). FINDINGS: A lifetime history of attempted suicide was reported by 34% of subjects, 13% had attempted suicide in the preceding year and 5% had done so in the preceding month. Females were more likely to have lifetime (44% versus 28%) and 12 month (21% versus 9%) suicide attempt histories. The 12 month prevalence of attempted suicide among treatment groups ranged between 11% (MT, NT) and 17% (RR). Factors associated with recent suicide attempts were: being an RR entrant, female gender, younger age, less education, more extensive polydrug use, benzodiazepine use, recent heroin overdose, Major Depression, current suicidal ideation, Borderline Personality Disorder (BPD)and Post-Traumatic Stress Disorder. CONCLUSIONS: Recent suicidal behaviour is a major clinical problem for heroin users, and for females and RR entrants in particular. An essential adjunct to treatment for heroin dependence is routine screening for depression and suicidal ideation, with the provision of appropriate treatment where needed.
Cote: SD 008 e

Carter, G.L., Lewin, T.J., Stoney, C., Whyte, I.M., & Bryant, J.L. (2005). Clinical management for hospital-treated deliberate self-poisoning: Comparisons between patients with major depression and borderline personality disorder. Australian and New Zealand Journal of Psychiatry, 39(4), 266-273.
Résumé: Objective: To compare the initial clinical management of hospital-treated deliberate self-poisoning patients with major depressive disorder (MDD) or borderline personality disorder (BPD) after controlling for demographic factors and level of suicide ideation. Method: This study compared sequential hospital treated deliberate self-poisoning patients (n = 570) with either MDD or BPD (but no major comorbid psychopathology) on four outcomes modelled using logistic regression: (i) length of stay in the general hospital; (ii) discharge to a psychiatric hospital; (iii) psychiatric follow-up; and (iv) general practitioner (GP) follow-up. Results: BPD and MDD patients were discharged to psychiatric inpatient care at very similar rates (33%-35%) and almost all subjects with high levels of suicidal ideation were discharged to psychiatric hospital. However, for mild to moderate levels of suicidal ideation BPD patients were more likely to be discharged to psychiatric hospital than MDD patients. After controlling for demographics and suicidal ideation, BPD patients were more likely to be referred for psychiatric hospitalization on discharge (adjusted OR = 1.79, 95% CI = 1.01-3.18) and less likely to be referred to GPs if discharged to home (adjusted OR = 0.44, 95% CI = 0.24-0.81). There were no differences in general hospital length of stay or arrangements made for psychiatric follow-up for those discharged to home. Conclusions: This suggests that for mild to moderate suicidal ideation levels clinicians are more likely to choose to send BPD patients, after deliberate self-poisoning, to inpatient psychiatric care than MDD patients. Clinicians are also apparently more likely to choose to manage MDD patients in primary care settings, for those patients discharged to home. This has implications for service planning and clinical guidelines.
Cote: TC 011 e

Mehran, F., & Guelfi, J.-D. (2004). Les stratégies cognitivo-comportementales pour les comportements suicidaires et parasuicidaires chez la personnalité borderline. Journal de thérapie comportementale et cognitive, 14(2), 71-76.
Résumé: Un des critères du trouble de personnalité borderline décrit par DSM-IV est : " menaces, comportement ou geste suicidaires ou comportement auto-mutilatoire répétés ". Un sujet sur dix souffrant de ce trouble commet un suicide. Menaces et tentatives de suicide doivent alarmer les thérapeutes. Bien que ceux qui tentent un suicide et ceux qui le [complètent] se ressemblent, ces deux groupes sont des populations cliniques distinctes. Ceux qui font des tentatives de suicide avec des comportements parasuicidaires embarquent dans des " carrières de suicide ".
Le comportement parasuicidaire peut être considéré comme un sérieux " marqueur de sévérité " dans le trouble de personnalité borderline et doit augmenter la vigilance du clinicien concernant le comportement de suicide. Cet article décrit les caractéristiques et les différences entre ceux qui tentent et ceux qui [complètent] leur suicide. Il passe également en revue les stratégies cognitivo-comportementales pour le suicide et comportements parasuicidaires, et le rôle des thérapeutes par rapport à la compréhension de ces comportements comme un moyen de l'expression de la détresse.
Cote: TM 009

Stevenson, J., Meares, R., & D'angelo, R. (2005). Five-year outcome of outpatient psychotherapy with borderline patients. Psychological Medicine, 35(1), 79-87.
Résumé: Background. Borderline personality disorder (BPD) is a serious mental illness. Due to scepticism about the effectiveness of its treatment, the care of these patients is neglected. In this study we evaluated the effect of treatment 5 years after its ending, of patients with BPD.Method. Thirty subjects were treated twice weekly for 1 year by psychotherapy based on the 'Conversational Model' of Hobson. Outcome measures included time in hospital, number of episodes of violence and self-harm, number of medical appointments, drug use and work history. A 'morbidity budget' made up of these items was collated for the year before treatment, the year following treatment, and for the year preceding the 5-year follow-up. Additional measures included DSM-III criteria and a self-report of symptoms. These outcomes were compared to a hypothetical natural history of BPD constructed from the DSM scores of 150 borderline patients aged between 18 and 52 years.Results. Except for one measure, the improvements evident 1 year following treatment were maintained 4 years later. This improvement was not predicted by the hypothetical natural history.Conclusion. A particular form of treatment of BPD has relatively long-lasting, beneficial effects.
Cote: TS 012 e

Arsenault-Lapierre, G., Kim, C., & Turecki, G. (2004). Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry, 4(1), 37
Résumé: BACKGROUND: It is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion. METHODS: We carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables. RESULTS: Twenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0%) had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78-4.61), personality disorders (OR = 2.01; 95% CI: 1.38-2.95) and childhood disorders (OR = 4.95; 95% CI: 2.69-9.31) were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53-0.83), including depressive disorders (OR = 0.53; 95% CI: 0.42-0.68) were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides. CONCLUSIONS: Although psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers.
Cote: XA 018 e

Black, D.W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behavior in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18(3), 226-239.
Résumé: Suicidal behavior is frequent in patients with borderline personality disorder (BPD); at least three-quarters of these patients attempt suicide and approximately 10% eventually complete suicide. Borderline patients at greatest risk for suicidal behavior include those with prior attempts, comorbid major depressive disorder, or a substance use disorder. Comorbidity with major depression serves to increase both the number and seriousness of the suicide attempts. Hopelessness and impulsivity independently increase the risk of suicidal behavior, as does a turbulent early life and the presence of antisocial traits. In summary, because BPD is frequently complicated by suicidal behavior, clinicians must avoid the mistake of thinking that a pattern of repeated attempts indicates little desire to die. Clinicians have an important role in preventing suicide attempts and completed suicides by understanding the risk factors.
Cote: XB 012.1

Berlin, H.A., & Rolls, E.T. (2004). Time perception, impulsivity, emotionality, and personality in self-harming borderline personality disorder patients. Journal of Personality Disorders, 18(4), 358-378.
Résumé: To investigate how time perception may contribute to the symptoms of self-harming Borderline Personality Disorder (BPD) patients, 19 self-harming BPD inpatients and 39 normal controls were given measures of time perception, impulsivity, personality, emotion, and BPD characteristics. A test sensitive to orbitofrontal cortex (OFC) function ("Frontal" Behavior Questionnaire) was also administered, as the OFC has been associated with impulsivity and time perception.BPD patients produced less time than controls, and this correlated with impulsiveness and other characteristics commonly associated with BPD. BPD patients were also less conscientious, extraverted, and open to experience, as well as more impulsive (self-report and behaviorally), emotional, neurotic, and reported more BPD characteristics, compared to controls. The results suggest that some of these core characteristics of BPD may be on a continuum with the normal population and, impulsivity in particular, may be related to time perception deficits (i.e., a faster subjective sense of time). Finally, BPD patients scored higher on the Frontal Behavior Questionnaire, suggesting that some symptoms of the BPD syndrome may be related to problems associated with the OFC. A control spatial working memory task (SWM) revealed that SWM deficits could not explain any of the BPD patients' poor performance.While impulsivity was correlated with time perception across all participants, emotionality, introversion, and lack of openness to experience were not. This suggests that different symptoms of the borderline personality syndrome may be separable, and therefore, related to different cognitive deficits, and potentially to different brain systems. This may have important implications for treatment strategies for BPD.
Cote: XB 028

Forman, E.M., Berk, M.S., Henriques, G.R., Brown, G.K., & Beck, A.T. (2004). History of multiple suicide attempts as a behavioral marker of severe psychopathology. American Journal of Psychiatry, 161 (3), 437-443.
Résumé: OBJECTIVE: Individuals with a differing number of past suicide attempts are generally considered a homogeneous group, despite emerging evidence to the contrary. The current study aimed to test the hypothesis that multiple suicide attempters would exhibit a more severe clinical profile than single suicide attempters. METHOD: A series of self-report batteries and clinical interviews was administered to 39 single attempters and 114 multiple attempters who came to an urban hospital emergency room after a suicide attempt. The participants were predominantly poor and nonwhite. RESULTS: Multiple suicide attempters versus single attempters exhibited a greater degree of deleterious background characteristics (e.g., a history of childhood emotional abuse, a history of family suicide), increased psychopathology (e.g., depression, substance abuse), higher levels of suicidality (e.g., ideation), and poorer interpersonal functioning. Profile differences existed even after control for borderline personality disorder. CONCLUSIONS: Results indicate that multiple attempters display more severe psychopathology, suicidality, and interpersonal difficulties and are more likely to have histories of deleterious background characteristics than single attempters. Moreover, these differences cannot be explained by the diagnosis of borderline personality disorder. Results suggest that the identification of attempt status is a simple, yet powerful, means of gauging levels of risk and psychopathology.
Cote: XF 008

Modai, I., Kuperman, J., Goldberg, I., Goldish, M., & Mendel, S. (2004). Suicide risk factors and suicide vulnerability in various major psychiatric disorders. Medical Informatics and the Internet in Medicine, 29(1), 65-74.
Résumé: Primary Objectives: There are many known suicide risk factors (SRF) common to major psychiatric disorders, but their impact on suicide vulnerability remains unclear. We used FALCON (Fuzzy Adaptive Learning Control Network) to evaluate those impacts. Methods: Staff psychiatrists completed computerized suicide risk scales (CSRS-111) including 27 SRF for 612 patients. Diagnoses were: schizophrenia, schizoaffective, major depression, anxiety disorder, bipolar affective disorder, personality disorder, organic brain syndromes, delusional disorder and other diagnoses. An optimal trained FALCON was obtained by running the network 10 times with 552 CSRS-111, validating with the balance. Medically serious suicide attempts (the vulnerability factor) served as the target variable. The significance of each variable in the trained network was determined by the magnitude of the change in output as affected by the consecutive change in all points of the variable input, then calculating the mean variance of all cases. The direction of influence was determined by the input on the entire scale of each variable, point by point, across all cases, then calculating the mean of all outputs. Results: The impact and direction of influence of the various SRF differed for each diagnosis. Conclusion: Evaluation of the individual patient with his/her specific impact profile, determination of direction of influence of the corresponding SRF's may assist in increasing the accuracy of individual suicide risk assessment.
Cote: XM 019

Paris, J. (2004). Half in love with easeful death: The meaning of chronic suicidality in borderline personality disorder. Harvard Review of Psychiatry, 12(1 ), 42-48.
Résumé: Chronic suicidality is a central feature of borderline personality disorder. While suicidal thoughts and attempts are highly prevalent in borderline patients, completion is relatively unpredictable. Self-cutting seems to function as a means of affective regulation. In borderline personality disorder, suicidality performs a set of psychological functions and can sometimes become "a way of life." Strategies developed for acutely suicidal patients may not be effective in chronic suicidality. Since there is no evidence that hospitalization prevents completion, an ambulatory approach to the management of chronically suicidal patients may be most useful.
Cote: XP 004.1

Paris, J. (2004). Is hospitalization useful for suicidal patients with borderline personality disorder? Journal of Personality Disorders, 18(3), 240-247.
Résumé: This article examines the value of hospitalization for chronically suicidal patients with borderline personality disorder (BPD). One in 10 of these patients will eventually complete suicide. However, this outcome is not readily predictable. Hospitalization is of unproven value for suicide prevention and can often produce negative effects. Day treatment is an evidence-based alternative to full admission. Chronic suicidality can best be managed in an outpatient setting.
Cote: XP 004.2

Sansone, R.A. (2004). Chronic suicidality and borderline personality. Journal fo Personality Disorders, 18(3), 215-225.
Résumé: Suicidal ideation is a complex clinical event. In this article, acute suicidal ideation is compared with chronic suicidal ideation, specifically their different meanings, relationships with Axis I and Axis II disorders, intrapsychic functions, approaches to assessment, and interventions. The potential risks of acute hospitalization of the chronically suicidal borderline personality disorder patient are discussed as well as a longitudinal, multidimensional treatment strategy for the chronically suicidal individual.
Cote: XS 021

Yen, S., Shea, M.T., Sanislow, C.A., Grilo, C.M., Skodol, A.E., Gunderson, J.G., McGlashan, T.H., Zanarini, M.C., & Morey, L.C. (2004). Borderline personality disorder criteria associated with prospectively observed suicidal behavior. American Journal of Psychiatry, 161(7), 1296-1298.
Résumé: OBJECTIVE: The authors prospectively examined associations between each DSM-IV borderline personality disorder criterion and suicidal behaviors. METHOD: Borderline personality disorder diagnosis and criteria, major depressive disorder, substance use disorders, and history of childhood sexual abuse were assessed with semistructured interviews. Participants (N=621) were followed for 2 years with repeated structured evaluations that included assessments of suicidality. RESULTS: With the self-injury criterion excluded, the borderline personality disorder criteria of affective instability, identity disturbance, and impulsivity significantly predicted suicidal behaviors. Only affective instability and childhood sexual abuse were significantly associated with suicide attempts (i.e., behavior with some intent to die). CONCLUSIONS: Affective instability is the borderline personality disorder criterion (excluding self-injury) most strongly associated with suicidal behaviors. Since major depressive disorder did not significantly predict suicidal behaviors, the reactivity associated with affective instability (more so than negative mood states) appears to be a critical element in predicting suicidal behaviors.
Cote: XY 003

Lester, D. (2005). Dialectical behavior therapy. In R. I. Yufit & D. Lester (Eds.), Assessment, Treatment, and Prevention of Suicidal Behavior. (pp. 279-290). Hoboken, NJ: John Wiley & Sons.
Résumé: (From the chapter ) Dialectical behavior therapy (DBT) has been widely disseminated and has become very popular. Although some commentators have noted that the empirical base for the effectiveness of DBT is slim (Swenson, 2000), the empirical base is comparable (if not superior) to that for other systems of psychotherapy. Swenson suggests that DBT's popularity is a result of the sound principles and strategies it proposes and the integration of several theoretical orientations that "reflect the Zeitgeist of today's mental health community" (p. 87). In this chapter, we review the basic principles of DBT, explore the application of DBT to suicidal clients, and then examine the reasons for its popularity.
Cote: YUFr.01 CHAPITRE 12

Ouellet, K. (2002). Comparaison d'individus ayant le trouble de la personnalité limite présentant ou non des conduites d'autodestruction quant aux mécanismes de défense au TAT. Trois-Rivières: Université du Québec à Trois-Rivières. 78 p.
Résumé: Une proportion inquiétante de tentatives de suicide est observée chez les individus souffrant du trouble de la personnalité limite. Plusieurs analyses préexistent quant à l'étiologie, la symptomatologie et les composantes intrapsychiques des individus limites. Kernberg (1997) circonscrit les caractéristiques de l'organisation limite de la personnalité. L'auteur établit la notion de sous-groupes d'individus limites à l'intérieur même de la problématique limite d'après la gravité du trouble. Kernberg mentionne que le trouble limite s'échelonne d'un niveau inférieur à celui moyen, selon les mécanismes de défense employés et selon le degré d'élaboration du surmoi. La variable mesurée dans cette étude est précisément la facture des mécanismes de défenses des individus souffrant du trouble de la personnalité limite. Cette recherche compare deux groupes d'individus qui présentent le trouble de la personnalité limite et qui adoptent (n = 15) ou non (n =9) des conduites d'autodestruction. Les instruments de mesure SCID-1-P et SCID-II ciblent la présence de divers troubles mentaux chez les participants dont celui du trouble de la personnalité limite. La configuration défensive présentée par les participants se mesure à l'aide du Thematic Aperception Test, un test non structuré. La méthode d'analyse utilisée est celle de Shentoub (1998). Elle permet de repérer les mécanismes de défenses en fonction de l'organisation du récit. Quant aux passages à l'acte autodestructeurs des participants, ils sont répertoriés grâce au questionnaire portant sur l'histoire des passages à l'acte. Les résultats indiquent que le nombre de défenses immatures (procédés d'évitement du conflit et processus primaires) est plus grand chez les individus agissants et que ces derniers utilisent plus les défenses de type narcissiques comparativement aux individus non agissants. D'autre part, il n'y a pas de différence significative à l'égard des mécanismes d'évitement du conflit, des processus primaires, du clivage et de la perte de distance entre les deux groupes. Les résultats permettent des réflexions sur le plan méthodologique et conceptuel. Ces réflexions encouragent la poursuite des recherches qui considèrent la notion de sous-groupes à l'intérieur du trouble limite.
Cote: OUEk.01 T&M

Paquet-Blouin, M.-È. (2002). Les mécanismes de défense et la perte de limites du moi des individus borderlines présentant ou non des comportements parasuicidaires. Trois-Rivières: Université du Québec à Trois-Rivières. 96 p.
Résumé: Le trouble de personnalité borderline, selon le DSM-IV (1996), se définit comme étant un mode général d'instabilité des relations interpersonnelles, des affects et de l'image de soi. Celui-ci est associé aux tendances suicidaires chroniques et aux comportements d'autodestruction (Waltz, 1994). La sévérité de la psychopathologie limite est déterminée, entre autres, par la présence de mécanismes de défense archaïques centrés autour du clivage et par la faiblesse du Moi qui se manifeste par la propension aux passages à l'acte suicidaire (Kemberg, 1989). Malgré un bon contact avec la réalité, les individus limites présentent un envahissement par les processus primaires qui affaiblissent leurs frontières du Moi. L'objectif de cette étude est de comparer deux groupes d'individus borderlines déterminés par la présence (n=16) ou l'absence (n=19) de comportements parasuicidaires (tentatives de suicide ou automutilations) quant aux mécanismes de défense et de la perte de limites du Moi. Les participants (N=35) présentent tous le diagnostic d'un trouble de personnalité borderline vérifié par le Structured Clinical Interviewfor DSM-IV (SCID-H). Le Rorschach est utilisé, d'une part, à partir de l'application de la grille de Lemer et Lemer (1980) ; Lerner Defense Scale (LDS) qui évalue les mécanismes de défense. D'autre part, la perte de limites du Moi est mesurée par les indices des troubles de la pensée tels que le FABCOM et le CONTAM au Rorschach.

Les résultats révèlent que les individus borderlines présentant des comportements parasuicidaires manifestent plus fréquemment le mécanisme de dévalorisation (niveau 2). Les individus borderfines sans comportement parasuicidaire présentent davantage d'intellectualisation, de minimisation et de dévalorisation (niveau 3). Cependant, les résultats ne présentent aucune différence significative quant aux variables de la perte de limites du Moi (FABCOM et CONTAM) et aux autres mécanismes de défense. Les résultats confirment la présence de sous-groupes à l'intérieur du trouble de personnalité borderline en ce qui a trait aux passages à l'acte parasuicidaire et à la présence de mécanismes de défense se situant Sur un continuum en fonction de la sévérité de la pathologie. L'étude du profil intrapsychique et des caractéristiques cliniques des individus borderlines s'avère importante, particulièrement lorsqu'il y a une présence de comportements parasuicidaires.
Cote: PAQm.01 T&M

Mishara, B., et Tousignant, M. (2004). Caractéristiques personnelles associées au suicide. In B. Mishara & M. Tousignant (Eds.), Comprendre le suicide. (pp. 55-78). Montréal: Les presses de l'Université de Montréal.
Résumé: Problèmes psychiatriques / Personnalité et facteurs psychologiques / Trajectoire de vie / Facteurs de protection et de résilience.
Cote: MISb.04 CHAPITRE 04

Overholser, J.C., Stocmeier, C., Dilley, G., & Freiheit, S. (2002). Personality disorders in suicide attempters and completers: Preliminary findings. Archives of Suicide Research , 6(2), 123-133.
Résumé: Personality disorders may play an important role in understanding suicide risk. The present study was designed to examine the frequency and type of personality disorder traits relevant to suicidal behavior. Four groups of subjects were compared: Suicide completers (n=15), suicide attempters (n=14), depressed natural deaths (n=13), and nondepressed natural deaths (n=15). The Structured Interview for DSM-III-R Personality Disorders - Revised (SIDP-R) was used to gather information needed to rate the presence and severity of 11 personality disorders. No differences were observed across groups on the categorical presence or absence of the different personality disorder diagnoses. However, dimensional ratings revealed that suicide completers displayed significant elevations in narcissistic, histrionic, and borderline personality traits. Suicide attempters displayed significant elevations on paranoid, avoidant, schizotypal, dependent, and borderline personality traits. At the level of specific personality traits, suicide completers displayed a sense of entitlement toward others, tended to be preoccupied with feelings of envy, and were likely to feel devastated when close relationships came to an end. The present findings suggest that personality traits are related to suicidal behavior, and that a focus on the dichotomous presence or absence of a diagnostic category fails to identify less sever forms of personality pathology.
Cote: REVUE-ASR-06.2.05

Gil, S. (2003). The role of personality traits in the understanding of suicide attempt behavior among psychiatric patients. Archives of Suicide Research, 7(2), 159-166.
Résumé: The main objective of the present study is to enrich our understanding regarding the role of personality traits in the explanation of suicide attempt behavior. More specifically, it employs Cloninger's three personality dimensions as a tool for predicting suicide attempt behavior among psychiatric patients. A total of 172 psychiatric outpatients, 80 with a history of suicide attempt and 92 without, participaded in the study. Multivariate analysis of variance (MANOVA) suggests that psychiatric patients with a history of suicide attempt express higher levels of both novelty seeking and harm avoidance than those without such a history. The findings of the present study confirm the major role played by personality traits in the understanding of suicide attempt behavior among psychiatric patients.
Cote: REVUE-ASR-07.2.07

Tilelman, D., Nilsson, A., Estari, J., & Wasserman, D. (2004). Depression, anxiety, and psychological defense in attempted suicide: A pilot study using PORT. Archives of Suicide Research, 8(3), 239-249.
Résumé: Depressive affect, anxiety, and psychological defenses were studied in the presented research with PORT, a projective test that exploits sublimainal perception of object-relation images. Protocols of 20 hospitalized suicide attempters were compared to those of 20 mached controls, 34 previouly studied non suicidal depressed patients, 18 patients with panic attack, and 32 patients with bordeline and psychotic disorders. The suicide attempters were anxious; their defenses resembled those seen in bordeline pathology; depressive reactions were limited in symbolic content; reality testing was poor. The closeness between depression and anxiety in suicidality is further discussed throughout this article. A constellation of signs using the PORT test was hypothesized to be a marker for suicidality. The test is deemed useful for future research on suicide.
Cote: REVUE-ASR-08.3.04

Williams, J.M.G., & Swales, M. (2004). The use of mindfulness-based approaches for suicidal patients. Archives of Suicide Research, 8(4), 315-329.
Résumé: Mindfulness-based approaches are becoming more widely used for individuals at risk of suicidal behavior, in the treatment of borderline personality disorder (in Dialectical Behavior Therapy), and as a way to reduce relapse in recurrent major depression (in Mindfulness-based Cognitive Therapy). This article describes and examines the commonalities and differences in the use of mindfulness in these two treatments. The reasons for considering the use of mindfulness-based approaches with suicidal individuals more widely are considered and potential risks outlined. The article closes with case examples to illustrate the use of mindfulness in the treatment of suicidal thoughts and behaviors.
Cote: REVUE-ASR-08.4.03

Hepp, U., Wittmann, L., Schnyder, U., & Michel, K. (2004). Psychological and psychosocial interventions after attempted suicide: An overview of treatment studies. Crisis, 25(3), 108-117.
Résumé: A literature search was conducted to collect randomized controlled studies evaluating the outcome of psychological and psychosocial interventions after attempted suicide and deliberate self-harm. Twenty-five studies meeting the inclusion criteria were identified. The studies are grouped according to the psychological approach chosen for the intervention. They are discussed with regard to both the various therapeutic strategies and models used, and the repetition of self-harming behavior as the main outcome.
Cote: REVUE-CRS-25.3.04

Bertolote, J.M., Fleischmann, A., De Leo, D., & Wasserman, D. (2004). Psychiatric diagnoses and suicide: Revisiting the evidence. Crisis, 25(4), 147-155.
Résumé: BACKGROUND: The key role of prevention and treatment of mental disorders in the prevention of suicide is widely acknowledged. Which specific disorders need to be targeted remains to be conclusively demonstrated. AIMS: To re-examine the presence of psychiatric diagnosis in cases of completed suicide from a global perspective. METHOD: A review of studies reporting diagnoses of mental disorders in cases of completed suicide with or without history of admission to mental hospitals. RESULTS: Most cases were from Europe and North America (82.2%). The majority (98%) of these had a diagnosis of at least one mental disorder. Among all diagnoses, mood disorders accounted for 30.2%, followed by substance-use related disorders (17.6%), schizophrenia (14.1%), and personality disorders (13.0%). CONCLUSIONS: The mental health paradigm in suicide prevention covers just a part of the problem. Antisuicide strategies focusing exclusively on the identification and treatment of depression need to be reconsidered. In addition to this, other mental disorders should be targeted, in particular alcohol-use disorders and schizophrenia. More emphasis should also be placed on psychosocial and environmental interventions diminishing and counteracting stress.
Cote: REVUE-CRS-25.4.02

Rathus, J.H., & Miller, A.L. (2002). Dialectical behavior therapy adapted for suicidal adolescents. Suicide and Life Threatening Behavior, 32(2), 146-157.
Résumé: We report a quasi-experimental investigation of an adaptation of Dialectical Behavior Therapy (DBT) with a group of suicidal adolescents with borderline personality features. The DBT group (n = 29) received 12 weeks of twice weekly therapy consisting of individual therapy and a multifamily skills training group. The treatment as usual (TAU) group (n = 82) received 12 weeks of twice weekly supportive-psychodynamic individual therapy plus weekly family therapy. Despite more severe pre-treatment symptomatology in the DBT group, at post-treatment this group had significantly fewer psychiatric hospitalizations during treatment, and a significantly higher rate of treatment completion than the TAU group. There were no significant differences in the number of suicide attempts made during treatment. Examining pre-post change within the DBT group, there were significant reductions in suicidal ideation, general psychiatric symptoms, and symptoms of borderline personality. DBT appears to be a promising treatment for suicidal adolescents with borderline personality characteristics.
Cote: REVUE-SLTB-32.2.06 e

Hendin, H., Maltsberger, J.T., Haas, A.P., Szanto, K., & Rabinowicz, H. (2004). Desperation and other affective states in suicidal patients. Suicide and Life Threatening Behavior, 34(4), 386-394. Résumé: Data collected from 26 therapists who were treating patients when they died by suicide were used to identify intense affective states in such patients preceding the suicide. Eleven therapists provided comparable data on 26 patients they had treated who were seriously depressed but not suicidal. Although the two groups had similar numbers diagnosed with MDD, the suicide patients showed a significantly higher total number of intense affects in addition to depression. The acute affective state most associated with a suicide crisis was desperation. Hopelessness, rage, abandonment, self-hatred, and anxiety were also significantly more frequently evidenced in the suicide patients.
Cote: REVUE-SLTB-34.4.05 e

État-limite (1990-2002) :

1. Goldsmith SJ, Fyer M, Frances A. Personality and suicide. Blumenthal J, Kupfer DJ, Éditeurs. Suicide over the life cycle. Washington: American Psychiatric Press Inc., 1990: 155-76.
Mots-clé: TROUBLE-PERSONNALITÉ/ FACTEUR-RISQUE/ PSYCHOPATHOLOGIE/ THÉRAPIE/ INTERVENTION/ ÉTAT-LIMITE/ AGRESSION/ IMPULSIVITÉ/ ADOLESCENT/ JEUNE-ADULTE/ INTERVENTION
No article: GG 031
Résumé: This article discusses the relation of personality disorders to suicidal behaviors. The authors present studies which show that those with personality disorders are at high risk for suicide, and often choose lethal methods. Clinical descriptions and management techniques for borderline and antisocial disorders are provided, as well as the results of studies on personality traits (aggressiveness, impulsivity) and suicide, with particular emphasis on traits in suicidal youths.

2. Runeson B. Psychoactive substance use disorder in youth suicide. Alcohol and Alcoholism 1990; 25(5):561-8.
Mots-clé: ABUS-SUBSTANCE/ ADOLESCENT/ JEUNE-ADULTE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ SCHIZOPHRÉNIE/ DÉPRESSION/ PSYCHOPATHOLOGIE/ FACTEUR-RISQUE/ ENFANCE/ ANTÉCÉDENT-FAMILIAL
No Article: SR 005
Résumé: Investigated 58 consecutive suicides committed between 1984 and 1987 by adolescents and young people (aged 15-29 yrs). Psychoactive substance use disorder in accordance with Diagnostic and Statistical Manual of Mental Disorders-III--Revised (DSM-III--R) was present in 27 of the suicides, predominantly as alcohol dependence. Substance use disorder often coexisted with a borderline personality disorder or schizophrenia. Secondary depression was a frequent final factor. Adverse conditions during childhood (i.e., parental divorce, substance misuse, parasuicide in the family) were more common in cases of substance use disorder. (PsycINFO Database Record (c) 2000 APA, all rights reserved)(unassigned)

3. Linehan MM et al. Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry 1991; 48(12):1060-4.
Mots-clé: APPROCHE-COGNITIVE/ APPROCHE-COMPORTEMENTALE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ ADULTE/ THÉRAPIE/ EFFICACITÉ/ ÉVALUATION
No Article: TL 009.1
Résumé: Compared 2 groups: 22 females (aged 18-45 yrs) with parasuicidal borderline personality disorder (PBPD) who underwent dialectical behavior therapy (DBT) for 1 yr and 22 matched females with PBPD who underwent treatment as usual in the community. Ss were assessed at pretreatment and at 4, 8, and 12 mo posttreatment. There was a significant reduction in the frequency and medical risk of parasuicidal behavior among Ss who received DBT compared with Ss who received treatment as usual. DBT effectively retained patients in therapy. The number of days of inpatient psychiatric hospitalization was fewer for Ss who received DBT than for controls. These effects occurred despite the fact that DBT was not differentially effective in improving patients' depression, hopelessness, suicide ideation, or reasons for living. (PsycLIT Database Copyright 1992 American Psychological Assn, all rights reserved)

4. Runeson B, Beskow J. Borderline personality disorder in young Swedish suicides. Journal of Nervous and Mental Disease 1991; 179(3):153-6.
Mots-clé: ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ ADOLESCENT/ ADULTE/ SUÈDE
No Article: XR 004
Résumé: Retrospectively investigated 58 consecutive suicides committed between 1984 and 1987 by adolescents and young adults (aged 15-29 yrs) in an urban community through interviews with survivors and analyses of medical records. Classification in accordance with Diagnostic and Statistical Manual of Mental Disorders-III--Revised (DSM-III--R) showed a large proportion of Axis II disorders. Borderline personality disorder (BPD) was found in 19 Ss (33%). When compared with Ss with other disorders, BPD Ss showed more antisocial traits and substance use disorders. Early parental absence, substance abuse in the homes, employment and financial problems, lack of a permanent residence, and sentence by court were also more frequent in BPD Ss. (PsycLIT Database Copyright 1991 American Psychological Assn, all rights reserved)

5. Plus de 60% des suicidés avaient une maladie dépressive. L'Actualité Médicale 1992; novembre:5.
Mots-clé: DÉPRESSION/ PSYCHOPATHOLOGIE/ ABUS-SUBSTANCE/ DROGUE/ ALCOOL/ SCHIZOPHRÉNIE/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ FACTEUR-RISQUE/ QUÉBEC/ TROUBLE-AFFECTIF
No Article: GD 013

6. Samy MH. Parental Aggression and Family Coexistence: A Psychodynamic View of Adolescent Suicide. 2nd World Congress on Violence and Human Coexistence. ?: 1992.
Mots-clé: APPROCHE-PSYCHODYNAMIQUE/ SYMBIOSE/ FAMILLE/ AGRESSION/ ADOLESCENT/ ÉMOTION/ ENFANT/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ DÉVELOPPEMENT
No Article: JS 008.2
Résumé: Family and Individual Dynamics/ Parental Aggression and the Emotional life of the Child/ Family Symbiosis and Sado-Masochistic Relation/ Parental Aggression and bodily Care/ Borderline and Narcissitic Adolescents/ The Developmental Context/ Symbol formation and the Suicide Option/

7. Brent DA et al. Personality disorder, tendency to impulsive violence, and suicidal behavior in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 1993; 32(1):69-75.
Mots-clé: TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ PATIENT/ HÔPITAL/ PROFESSIONNEL-SANTÉ-MENTALE/ PERSONNEL-MÉDICAL/ PRÉVALENCE/ FACTEUR-RISQUE/ VIOLENCE/ COMPORTEMENT-ANTISOCIAL/ AGRESSION/ AGRESSIVITÉ/ IMPULSIVITÉ/ ÉVÉNEMENT-VIE/ TENTATIVE/ TRAITEMENT/ INTERVENTION
No Article: XB 002.1
Résumé: 37 inpatient suicide attempters were compared with 29 never-suicidal inpatient psychiatric controls (all Ss aged 13-19 yrs) with respect to prevalence and severity of personality disorder (PD), history of aggression and assaultive behavior, and other measures of impulsive violence. Attempters were more likely to show evidence of PD or traits and showed greater number of borderline symptoms even after removing the item relating to suicidality. There were no differences between groups with respect to lifetime history of aggression, history of assaultive behavior, or self-report measures of a tendency toward impulsive aggression. Attempters with PD were much more likely to have made a previous attempt. The apparently high prevalence of PD among attempters indicates that the social impairment associated with PD should be viewed as an important aspect of treatment. (PsycINFO Database Record (c) 2000 APA, all rights reserved)(unassigned)

8. Fawcett J, Clark DC, Busch K. Assessing and treating the patient at risk for suicide. Italian Journal of Suicidology 1993; 3(1):9-23.
Mots-clé: POTENTIEL-SUICIDAIRE/ FACTEUR-RISQUE/ PSYCHOPATHOLOGIE/ ABUS-SUBSTANCE/ DÉPRESSION/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ SCHIZOPHRÉNIE/ TROUBLE-AFFECTIF
No Article: Revue
Résumé: While clinicians may be able to categorize groups of people as "high risk", it is extremely difficult to determine which individual patients definitely require strict supervision and medical care to prevent suicide. Complicating the problem is the recent discovery that the characteristics of persons in danger of imminent suicide are different from characteristics of a person likely to die by suicide more than a year into the future. This paper is a review of known risk factors and some guidelines for clinical management of patients judged to be at "high risk". Patients with the signs and symptoms of major affective disorder, alcoholism, drug abuse or dependence, schizophrenia, organic brain syndromes, and severe borderline personality disorders associated with depression are at significantly elevated risk for death by suicide. Beyond establishing the diagnosis, clinicians must conduct carefully structured risk assessment designated those individuals who are in imminent danger of suicide and who therefore require immediate clinical intervention. The suicide risk profiles associated with major depression, alcoholism, drug abuse or dependence, schizophrenia, are discussed in some details.

9. Kocmur M, Zavasnik A. Problems with borderline patients in a crisis intervention unit: A case history. Crisis 1993; 14(2):71-5, 89.
Mots-clé: INTERVENTION-CRISE/ ÉTAT-LIMITE/ ÉTUDE-CAS/ ADULTE/ TROUBLE-PERSONNALITÉ/ THÉRAPIE/ ADHÉRENCE-TRAITEMENT/ INTERVENTION
No Article: Revue
Résumé: Describes characteristics, advantages, and disadvantages of crisis intervention in patients with borderline personality disorder (BPD) . Theoretical issues are illustrated with a case study of a 29-yr-old man with BPD. Therapeutic proceedings are analyzed, with special focus on the treatment plan, goal-setting, and termination of therapy. The positive effects of the treatment and the S's unexpected loss of compliance are discussed. Suggestions are made for dealing with such patients in the light of mistakes made by the crisis therapist. (PsycLIT Database Copyright 1994 American Psychological Assn, all rights reserved)

10. Lesage A et al. Childhood separations, Axis II and suicide. Symposium "Youth suicide and personality disorders". 1993.
Mots-clé: ENFANT/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ SÉPARATION/ FAMILLE/ PSYCHOPATHOLOGIE/ SUICIDE-COMPLÉTÉ/ FACTEUR-RISQUE
No Article: EL 006
Résumé: This study examines the relationship and interaction between youth suicide, childhood separation experiences and Borderline Personality Disorder (BDL). The sampling frame for suicide (S group) and road traffic accident victims (A group) was Greater Montreal and Quebec City and the cases reported by the various coroners. The controlcases from the general population (C group) were chosen from the electoral lists. The latter group was matched for age, marital status, occupation and electoral poll to the S group; they did not know the suicide victim. Only males aged 18-35 were included. A standardized interview was performed with an informant that knew the proband best for all groups. Two psychiatrists, blind to the case status, reviewed a narrative edited by the interviewers to assess DSM-III-R diagnoses. Axis II personality disorders were identified in 60% of S compared to 42% in A and 28% in C. Borderline Personality Disorder (BPD) was present in 29% of the S group and 11% and 4% of the A and C groups respectively. Past childhood separation experiences due to parents' separation or divorce were more frequent among S than the other groups; such separation experiences were also more frequent among S than the other groups; such separation experiences were also more frequent for individuals with BPD or drug dependence. No third order interaction was found between separation experiences, disorders and suicide. In conclusion, there is an association between childhood separation experiences and BPD who committed suicide for averall groups and in particular the 6-10 years old.

11. Linehan MM, Heard HL, Armstrong HE. Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives-of-General-Psychiatry 1993; 50(12):971-4.
Mots-clé: FEMME/ PARASUICIDE/ SUIVI/ TRAITEMENT/ PSYCHOTHÉRAPIE/ PSYCHOPATHOLOGIE/ SOCIAL-ADJUSTMENT-SCALE/ GLOBAL-ASSESSMENT-SCALE/ STATE-TRAIT-ANGER-SCALE/ THÉRAPIE-INSTITUTIONNELLE/ PATIENT-PSYCHIATRIQUE/ LONGITUDINAL-INTERVIEW-FOLLOW-UP-EVALUATION-BASE-SCHEDULE/ TROUBLE-PERSONNALITÉ/ APPRENTISSAGE-SOCIAL/ APPROCHE-BÉHAVIORALE/ COMPORTEMENT-ANTISOCIAL/ ÉTUDE-LONGITUDINALE
No Article: XL 011.1
Résumé: BACKGROUND: A randomized clinical trial was conducted to evaluate whether the superior performance of dialectical behavior therapy (DBT), a psychosocial treatment for borderline personality disorder, compared with treatment-as-usual in the community, is maintained during a 1-year posttreatment follow-up. METHODS: We analyzed 39 women who met criteria for borderline personality disorder, defined by Gunderson's Diagnostic Interview for Borderline Personality Disorder and DSM-III-R criteria, and who had a history of parasuicidal behavior. Subjects were randomly assigned either to 1 year of DBT, a cognitive behavioral therapy that combines individual psychotherapy with group behavioral skills training, or to treatment-as-usual, which may or may not have included individual psychotherapy. Efficacy was measured on parasuicidal behavior (Parasuicide History Interview), psychiatric inpatient days (Treatment History Interview), anger (State-Trait Anger Scale), global functioning (Global Assessment Scale), and social adjustment (Social Adjustment Scale--Interview and Social Adjustment Scale--Self-Report). Subjects were assessed at 6 and 12 months into the follow-up year. RESULTS: Comparison of the two conditions revealed that throughout the follow-up year, DBT subjects had significantly higher Global Assessment Scale scores. During the initial 6 months of the follow-up, DBT subjects had significantly less parasuicidal behavior, less anger, and better self-reported social adjustment. During the final 6 months, DBT subjects had significantly fewer psychiatric inpatient days and better interviewer-rated social adjustment. CONCLUSION: In general, the superiority of DBT over treatment-as-usual, found in previous studies at the completion of 1 year of treatment, was retained during a 1-year follow-up.

12. West M, Keller A, Links P-S, Patrick J. Borderline disorder and attachment pathology. Canadian Journal of Psychiatry 1993; 38(Suppl 1):16-22.
Mots-clé: ATTACHEMENT/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ PATIENT-PSYCHIATRIQUE/ PSYCHOPATHOLOGIE/ ADULTE
No Article: XW 004
Résumé: Investigated the theoretical and empirical association between dysfunctions of the attachment system and borderline personality disorder (BPD). Based on a biological behavioral system, functional attachment relationships in adulthood rely on experiences and expectations of security within the relationship. These issues are also important to the definition and dynamics of BPD. The dimensions and patterns of reciprocal attachment were compared with other scales measuring components of psychopathology and interpersonal relationships. In a sample of 85 female outpatients, only 4 of the attachment scales (feared loss, secure base, compulsive care-seeking, and angry withdrawal) identified patients with high scores on a measure of BPD. Of these 4 scales, feared loss had the predominant effect. These results support the hypothesized relationship between dysfunctions of the attachment system and BPD. (French abstract) (PsycLIT Database Copyright 1993 American Psychological Assn, all rights reserved)

13. Boyer R et al. Les maladies mentales dans la problématique du suicide. 1994; 73 pages.
Mots-clé: PSYCHOPATHOLOGIE/ QUÉBEC/ SUICIDE-COMPLÉTÉ/ DÉPRESSION/ ABUS-SUBSTANCE/ SCHIZOPHRÉNIE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ COMORBIDITÉ/ TROUBLE-AFFECTIF
No Article: XB 003
Résumé: Dans une perspective d'une meilleure connaissance épidémiologique du phénomène du suicide au Québec, cette recherche poursuit quatre objectifs principaux: 1) estimer la prévalence (6 mois et à vie) des maladies mentales chez des personnes décédées suite à un suicide; 2) connaître précisément quels problèmes de santé mentale (quels diagnostics) se rencontrent le plus souvent chez les suicidés; 3) approfondir les connaissances sur les facteurs de risques psychosociaux associés à la mortalité par suicide.

14. Grunberg F et al. le suicide chez les jeunes adultes de sexe masculin au Québec. Psychopathologie et utilisation des services médicaux. Santé Mentale Au Québec 1994; 19(2):25-40.
Mots-clé: JEUNE-ADULTE/ AUTOPSIE-PSYCHOLOGIQUE/ ÉPIDÉMIOLOGIE/ PSYCHOPATHOLOGIE/ ABUS-SUBSTANCE/ FACTEUR-RISQUE/ CONSULTATION/ PROFESSIONNEL-SANTÉ-MENTALE/ PERSONNEL-MÉDICAL/ SENTINELLE
No Article: Revue
Résumé: On a apparié 75 jeunes gens de 18 à 35 ans qui s'étaient suicidés à 75 autres, toujours en vie, en fonction de l'âge, de la résidence, du statut conjugal et professionnel. Pour chacun des groupes, un répondant principal a été interviewé, et les dossiers médicaux ainsi que ceux du coroner ont été examinés afin de reconsttituer le profil psychologique des intéressés et leur utilisation des services . À six mois la prévalence de tous les diagnostics d'axe I (selon le DSM-III-R) était de 88% pour le groupe des suicidés et de 37,3% pour le groupe témoin. Parmi les suicidés, 38,7% souffraient de dépression majeure, 24% de dépendance à l'alcool, et de 28,7% aux drogues. La personnalité borderline a été identifiée chez 28% des suicidés contre 4% du groupe témoin. Chez les suicidés , 42,5% avaient consulté un professionnel de la santé mentale dans l'année précédente, contre 5% chez les témoins. Cependant, la grande majorité des suicidés (78,5%) avaient consulté un professionnel de la santé, tel un omni-praticien, contre 73,2% chez les témoins.

15. Lesage A-D. Suicide and mental disorders: A case-control study of young men. American Journal of Psychiatry 1994; 151(7):1063-8.
Mots-clé: PSYCHOPATHOLOGIE/ HOMME/ AUTOPSIE-PSYCHOLOGIQUE/ ADULTE
No Article: RL 001
Résumé: Examined the association of specific mental disorders and comorbidity with suicide among young men. 75 Ss (aged 18-35 yrs) whose deaths were adjudicated as completed suicides were compared with 75 living Ss who were matched for age, sex, neighborhood, marital status, and occupation. A respondent best acquainted with each of the Ss was interviewed, and information from the coroner and medical records was collected. Best-estimate Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) diagnoses were established. 88% of Ss who committed suicide and 37.3% of comparison Ss had at least 1 DSM-III--R 6-mo Axis I disorder, and 57.3% of suicide Ss and 25.3% of comparison Ss had at least 1 Axis II disorder. The most frequently diagnosed disorders were major depression, alcohol or drug dependence, and borderline personality disorder. Of Ss who committed suicide, 28% had at least 2 of these disorders, while the rate was 0% among comparison Ss. (PsycLIT Database Copyright 1994 American Psychological Assn, all rights reserved)

16. Paris J. Le suicide chez les patients présentant des troubles de la personnalité limite. Santé Mentale Au Québec 1994; 19(2):117-30.
Mots-clé: SUICIDAIRE-CHRONIQUE/ ÉTAT-LIMITE/ PSYCHOPATHOLOGIE/ TROUBLE-PERSONNALITÉ/ PRÉVENTION/ FACTEUR-RISQUE/ THÉRAPIE/ INTERVENTION
No Article: Revue
Résumé: Les patients qui soufrent de troubles liés à la personnalité limite (PL) représentent un défi clinique principalement en raison de leur tendance chronique au suicide. La recherche menée sur les résultats à long terme montre qu'environ 10% des patients présentant des troubles de la PL finiront par réussir leur suicide, mais qu'il reste difficile de prédire lesquels sont les plus à risque. Il n'existe encore aucune preuve qu'on puuisse prévenir le suicide grâce à un traitement. Des recommandations cliniques suggèrent que la prévention du suicide ne devrait pas être la préoccupation centrale de la thérapie pour ces patients.

17. Beautrais A. Youth suicide. New Zealand Annual Review of Education 1995; 5(-):3-21.
Mots-clé: ADOLESCENT/ SUICIDE-COMPLÉTÉ/ NOUVELLE-ZÉLANDE/ OCCIDENT/ FACTEUR-RISQUE/ PSYCHOPATHOLOGIE/ DÉPRESSION/ ABUS-SUBSTANCE/ COMPORTEMENT-ANTISOCIAL/ COMORBIDITÉ/ FAMILLE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ PRÉVENTION
No Article: JB 015.5
Résumé: Youth suicide rates have increased markedly in New Zealand during the last three decades and are now among the highest in the developed world. Major risk factors for suicidal behaviour include: psychiatric illness (notably, depressive disorders, substance abuse disorders and antisocial behaviours) previous suicide attempts and comorbid diagnoses of more than one mental disorder; exposure to adverse childhood and family experiences; social disadvantage; borderline and antisocial personality disorders; genetic and biologic factors. The best hope for substantial reduction in youth suicide rates may lie in reducing the number of young people with mental disorders. There is substancial scope for schools to participate in inter-sectoral efforts to promote and improve youth mental health in order to reduce vulnerability to mental disorders associated with suicidal behaviour.

18. Braun-Scharm H. Suicidality and personality disorders in adolescence. Crisis 1996; 17(2):64-8.
Mots-clé: TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ ADOLESCENT/ ÉTAT-LIMITE
No Article: Revue
Résumé: Examined the overlap of suicidality and personality disorders by an evaluation of files of 537 former patients (aged 14-18 yrs). Results show that the prevalence of personality disorders was higher among suicidal adolescent inpatients (25 out of 163 Ss) than among nonsuicidal adolescent inpatients (32 out of 374 Ss). Among the personality disorders, the borderline syndromes or emotionally unstable personality disorders were more frequent in the suicidal adolescents. Characteristics in suicidal adolescents included depressive symptoms on admission, self-harm before admission and during treatment, alcohol and drug abuse, and persistent suicidal behavior during inpatient treatment. (PsycLIT Database Copyright 1997 American Psychological Assn, all rights reserved)

19. Bronisch T. The typology of personality disorders--Diagnostic problems and their relevance for suicidal behavior. Crisis 1996; 17(2):55-8.
Mots-clé: TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ TAXINOMIE
No Article: Revue
Résumé: Personality disorders (PDs) play an important role in clinical psychiatry. The typologies of PDs found in different classification systems, such as the %DSM% and the International Classification of Diseases (ICD) are quite congruent. There are many methodological problems with reliability and validity of the diagnosis of PD. However, having a typology seems to be very helpful. Recent psychological autopsy studies reported that about one third of suicide victims met the criteria for a PD. Antisocial PD, borderline PD, narcissistic PD, and depressive PD in particular were often clinically associated with suicidal behavior. (PsycLIT Database Copyright 1997 American Psychological Assn, all rights reserved)

20. Callahan J. A specific therapeutic approach to suicide risk in borderline clients. Clinical Social Work Journal 1996; 24(4):443-59.
Mots-clé: ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ INTERVENTION-CRISE/ THÉRAPIE/ PRÉVENTION/ INTERVENTION
No Article: XC 006
Résumé: One of the most difficult clinical challenges facing social workers today is suicidal behavior in clients with borderline personality disorder. This article reviews the various types of suicidal behavior exhibited by these clients, including self-destructive behavior and overt suicide attempts. Management of these behaviors is essential if treatment is to be successful. Frameworks are offered for understanding and managing both kinds of behavior. (PsycLIT Database Copyright 1997 American Psychological Assn, all rights reserved)

21. Corbitt EM, Malone KM, Haas GL, Mann JJ. Suicidal behavior in patients with major depression and comorbid personality disorders. Journal of Affective Disorders 1996; 39(1):61-72.
Mots-clé: TENTATIVE/ PATIENT/ PSYCHOPATHOLOGIE/ DÉPRESSION/ TROUBLE-AFFECTIF/ TROUBLE-PERSONNALITÉ/ COMORBIDITÉ/ FACTEUR-RISQUE/ SANTÉ/ ÉVALUATION-CLINIQUE
No Article: XC 021
Résumé: Investigated the relationship of Mental Disorders-III-Revised (DSM-III-R) personality disorder (PD) diagnoses and traits to suicidal behavior in 120 patients (aged 18-64 yrs) with Major Depressive Disorder (MDD). Axis I and Axis II criteria and suicidal behavior were assessed using structured interviews. The 30 Ss with comorbid MDD and borderline PD (BPD) were more likely than other Ss to have a history of multiple suicide attempts, and were equally likely to have made a highly lethal attempt. Number of BPD and other Cluster B (dramatic/erratic) criteria were better predictors of past suicidal behavior than were depressive symptoms. It is concluded that patients with BPD symptomatology are at risk for serious suicide attempts. Severity of comorbid Cluster B PD psychopathology should be considered when assessing suicide risk in MDD patients, even in those without a PD diagnosis. (PsycINFO Database Record (c) 2000 APA, all rights reserved)

22. Runeson BS, Beskow J, Waern M. The suicidal process among young people. Acta Psychiatrica Scandinavica 1996; 93(1):35-42.
Mots-clé: ADOLESCENT/ SUICIDAIRE-CHRONIQUE/ AUTOPSIE-PSYCHOLOGIQUE/ SUICIDE-COMPLÉTÉ/ JEUNE-ADULTE/ PROCESSUS-SUICIDAIRE/ PERSONNEL-MÉDICAL/ TENTATIVE/ COMMUNICATION-ÉCRITE/ PSYCHOPATHOLOGIE/ SCHIZOPHRÉNIE/ ÉTAT-LIMITE/ PRÉVALENCE/ MODÈLE
No Article: JR 026
Résumé: Investigated 58 consecutive suicides among 15-29 yr olds by modified psychological autopsies and examined the suicidal process through interviews with relatives, friends, and medical personnel. Previous suicide attempts were evident in 66%, and more than 2 suicide attempts were found in 17% of men and in 56% of women. The median interval from 1st suicidal communication to the suicide was shorter in men than in women (12 vs 42 mo). The median interval was 47 mo in schizophrenia, 30 mo in borderline personality disorder, 3 mo in major depression and less than 1 mo in adjustment disorder. There were also differences in the prevalence of next-of-kin models for suicidal behavior, previous suicidal communication, and in the characteristics of the suicide. (PsycLIT Database Copyright 1997 American Psychological Assn, all rights reserved)

23. Verkes RJ, Kerkhof GA, Beld E, Hengeveld MW, et al. Suicidality, circadian activity rhythms and platelet serotonergic measures in patients with recurrent suicidal behaviour. Acta Psychiatrica Scandinavica 1996; 93(1):27-34.
Mots-clé: BIOLOGIE/ SUICIDAIRE-CHRONIQUE/ TENTATIVE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ IMPULSIVITÉ/ PSYCHOPATHOLOGIE/ DÉPRESSION/ DÉCOURAGEMENT/ SÉROTONINE/ NEUROLOGIE
No Article: BV 002.1
Résumé: Assessed the circadian activity rhythm over 1 wk using a wrist-worn activity monitor in 59 patients with a history of recurrent suicide attempts. In 40 Ss, a 2nd recording was made 6 mo later. Platelet 5-hydroxytryptamine (5-HT) and MAO were measured. Suicidal ideation, borderline personality disorder, and impulsiveness were associated with the absence of a clear 24-hr periodicity in motor activity. Depressive mood and hopelessness were associated with a less regular bedtime and a lower daytime activity. Platelet 5-HT as well as MAO correlated negatively with the amplitude of the circadian activity rhythm. Results support the suggested link between suicidality, altered circadian activity, and serotonergic function. ((c) 1999 APA/PsycINFO, all rights reserved) ¤

24. Zdanowicz N. Adolescence and diagnostics. Psychological Reports 1996; 78(2):459-66.
Mots-clé: ÉTAT-LIMITE/ DÉPRESSION/ SCHIZOPHRÉNIE/ PSYCHOPATHOLOGIE/ ADOLESCENT/ ÉVALUATION-CLINIQUE/ TROUBLE-PERSONNALITÉ/ TROUBLE-AFFECTIF
No Article: JZ 001
Résumé: Discusses the major diagnostic categories (schizophrenia, borderline disorder, and depression) and the difficulties in applying this "adult" classification to adolescence. Some of the main problems in applying this classification to adolescence include history of the discovery of diseases, similarities in psychodynamic functioning between the pathological and the "normal" in adolescence, and age-related prognosis. The use of diagnostics derived from adult nosography suggests an etiology and prognosis which are not valid in relation to adolescence. The concept of crisis as an alternative is unsatisfactory as there is a lack of consensus regarding the nature of the concept and the index of severity of the clinical picture. It is suggested that efforts should be directed toward establishing criteria regarding whether the manifestations observed in adolescence are susceptible to evolving toward a pathological condition in adulthood. (PsycLIT Database Copyright 1997 American Psychological Assn, all rights reserved)

25. Apter A. Suicide in children and adolescents. Botsis AJ, Soldatos CR, Stefanis CN, Éditeurs. Suicide: Biopsychosocial approaches. 1997: 215-28.
Mots-clé: ADOLESCENT/ ENFANT/ PSYCHOPATHOLOGIE/ MOYEN/ TENTATIVE/ SUICIDE-COMPLÉTÉ/ ÉVALUATION/ PROGRAMME/ PRÉVENTION/ FACTEUR-RISQUE/ SEXE/ AGRESSIVITÉ/ ABUS-SUBSTANCE/ DÉCOURAGEMENT/ SOUTIEN-SOCIAL/ TROUBLE-ALIMENTAIRE/ GROSSESSE/ HÔPITAL/ INTERVENTION
No article: LIVRE
Résumé: Completed suicide is rare before the age of 12. Adolescents are generally more prone to suicidal behavior. Actual suicide is more common in boys, while attempted suicide is more common in girls. Girls are often using suicidal behavior as a way of asking for help, while for boys the underlying force is usually severe psychopathology. Concomitant psychopathology in suicidal children and adolescents may be : depression, obsessive-compulsive disorder, substance abuse, eating disorders, borderline and other personality disorders, problems with gender identity. The most frequent means of completed suicide is use of a firearms, while the common way of attempting suicide is self-poisoning and wrist slashing. Programs of primary prevention are of doubtful effectiveness; it is estimated that through such school-based programs only 16 out of 12,000 suicides can be prevented. Secondary and tertiary prevention strategies aim at reducing the suicide rate among youngsters who are at high risk for suicide. High risk for suicide is indicated by: male sex, previous attempts, history of aggressive disorder, substance abuse, major mental disorder, hopelessness, severe social adversity, unwanted pregnancy or intractable eating disorder. In general adolescent suicide attempters should be hospitalized until suicide risk is no longer present.

26. Duberstein PR, Conwell Y. Personality disorders and completed suicide: A methodological and conceptual review. Clinical-Psychology:-Science-and-Practice. 1997; 4(4):359-76.
Mots-clé: PSYCHOPATHOLOGIE/ SUICIDE-COMPLÉTÉ/ FACTEUR-RISQUE/ ÉTAT-LIMITE/ COHORTE/ TROUBLE-PERSONNALITÉ/ ÉVITEMENT/ COMPORTEMENT-ANTISOCIAL/ MÉTHODOLOGIE/ ÉTUDE-CAS/ ÉVALUATION
No Article: XD 007
Résumé: Case-based and cohort studies on personality disorders (PD) and completed suicide are reviewed. Approximately 30-40% of suicides are committed by individuals with PD; borderline, antisocial, and possibly avoidant and schizoid PD increase risk. Although longitudinal, or cohort, designs are increasingly popular in psychopathology research, they have tended to yield small, nonrepresentative samples of suicides. Moreover,case-based studies have identified putative risk factors that cohort studies have overlooked. Only the case-control design can identify risk factors in a representative sample of suicides. Ideally, future use of that design would examine more rigorously whether avoidant PD, schizoid PD, and unusual combinations of personality traits increase suicide risk. ((c) 1999 APA/PsycINFO, all rights reserved)(journal abstract) ¤

27. Engstrom G, Alling C, Gustavsson P, Oreland L, Traskman Bendz L. Clinical characteristics and biological parameters in temperamental clusters of suicide attempters. Journal of Affective Disorder 1997; 44(1):45-55.
Mots-clé: NEUROLOGIE/ ADOLESCENT/ SUICIDE-EN-SÉRIE/ ADULTE/ AÎNÉ/ DÉPRESSION/ DÉCOURAGEMENT/ PSYCHOPATHOLOGIE/ BIOLOGIE/ FACTEUR-RISQUE/ PRÉDICTION/ TENTATIVE/ SUICIDE-COMPLÉTÉ/ TROUBLE-AFFECTIF
No Article: GE 007
Résumé: A sample of 215 suicide attempters was categorized in a cluster analysis into four groups according to temperamental trails. Monoamine metabolites in the cerebrospinal fluid were analysed ( n = 106). Dexamethasone suppression tests (DST) were performed ( n = 154) and the activity of the enzyme monoamine oxidase in platelets (pl-MAO) was assessed (n = 103). Patients belonging to the two clusters with the most deviant temperament profiles (nos 2 and 3) were young and scored high on the Beck Hopelessness Scale and the Suicide Assessment Scale. "Cluster 3" ("neurotic, impulsive, aggressive") patients often had dysthymia and axis II, cluster B diagnoses (e.g. borderline or histrionic personality). "Cluster 2" ("neurotic and introverted") patients often had major depression. The "Cluster 1", with on the whole a normal temperament profile, had significantly higher levels of post-DST cortisol than the other clusters. The "Cluster 4" had a normal temperament profile. Adjustment disorders were most common in "Cluster 1" and "Cluster 4". The monoamine metabolite levels did not differ between the clusters, and the differences in pl-MAO activity disappeared after adjusting for age and gender. The results suggest that temperament profiles in suicide attempters are related to psychiatric diagnoses, suicidality, hopelessness, and post-DST cortisol, but are not predictive of completed suicide.

28. Maltsberger JT. Ecstatic suicide. Archives-of-Suicide-Research 1997; 3(4):283-301.
Mots-clé: POTENTIEL-SUICIDAIRE/ EUPHORISME/ PSYCHOPATHOLOGIE/ TAXINOMIE/ TROUBLE-PERSONNALITÉ/ TROUBLE-AFFECTIF/ ÉTAT-LIMITE/ NARCISSISME/ TROUBLE-SEXUEL/ TEST-RÉALITÉ/ ATTITUDE/ MORT/ DÉPISTAGE/ PROFESSIONNEL-SANTÉ-MENTALE/ DÉPRESSION-BIPOLAIRE/ FACTEUR-RISQUE/ SIGNE-PRÉCURSEUR
No Article: XM 010
Résumé: Argues that suicide is not an epiphenomenon of depression; it occurs in conditions other than major depressive episodes. Some anguished, excited patients in the grips of ecdysial or apotheotic fantasies attempt suicide when reality testing fails, feeling it a thrill. When malignant narcissism colors severe borderline personality disorder such suicides may occur. Three illustrative cases are presented and are then placed in the perspective of mass suicides and the ecstatic experiences of the 3rd century Christian martyrs. Elated, grandiose suicide material is to be found in the lives and writings of Yukio Mishima and Sylvia Plath, and in some perverse sexual fantasies. Some persons kill themselves not feeling depressed in the melancholic sense; they are delighted. Their suicides are acts of omnipotent, death-defying magic. Correct suicide risk assessment must take elation of mood and grandiose beliefs about the nature of death into account, because certain individuals are convinced that suicide is passage to glory. ((c) 1999 APA/PsycINFO, all rights reserved) ¤

29. Range LM et al. Suicide in special populations and circumstances: A review. Aggression and Violent Behavior 1997; 2(1):53-63.
Mots-clé: PSYCHOPATHOLOGIE/ CULTURE/ CONTAGION/ MÉDIA/ ABUS-SEXUEL/ ABUS/ SIDA/ ADOLESCENT/ AÎNÉ/ DÉMENCE/ MULTICULTUREL
No Article: GR 010.2
Résumé: Suicide is associated with certain diagnoses. In addition to its association with depression, suicide is related to panic disorder, borderline personality disorder, and schizophrenia, more so than other psychological disorders. Therefore, full understanding of the individual, including his or her psychiatric diagnosis, is important in dealing with someone who is suicidal. Suicide is associated with certain traumas. The trauma of physical and sexual abuse as a child increases risk both in childhood and in adulthood. In studying the connection between different types of abuse and suicide, prospective research is needed that use clear definitions and distinguishes between physical, sexual and combined abuse. Also, the trauma of contracting AIDS may heighten suicide risk, particularly near the time of HIV testing or if dementia or drug treatment clouds conciousness. At these times clinicians should take special care to assess for suicidality. Suicide is associated with certain groups more than others. Adolescents, elderly , and certain ethnic groups, such as Caucasians, have higher rates than others. Prevention strategies that acknowledge the uniqueness of the individual and take place at home, in school, and in the community have become extremely important. Suicide may be contagious. Contagion is more likely if the model is a celebrity, if the publicity is extensive, and if people are asked about others rather than themselves. Suicide is so complex that current knowledge, though enabling us to predict which special populations and circumstances increase risk, is not sufficient to predict the specific individuals who will attempt or succeed in killng themselves.

30. Woodruff Borden J, Stanley MA, Lister SC, Tabacchi MR. Nonclinical panic and suicidality: prevalence and psychopathology. Behavioral Research Therapy 1997; 35(2):109-16.
Mots-clé: ADOLESCENT/ ADULTE/ TROUBLE-ANXIEUX/ PSYCHOPATHOLOGIE/ PERSONNALITÉ/ PSYCHOMÉTRIE
No Article: XW 003
Résumé: Recent epidemiological studies have reported an increased risk of suicide in patients with panic disorder, raising the possibility that there may be a unique relationship between panic and suicide. However, other studies, such as large chart reviews, have not found a meaningful increase in suicidal behavior among panic patients, except in these patients with comorbid borderline personality diagnoses. The present study examined nonclinical panickers to explore the specificity of the relationship between panic and suicide. Six hundred and twenty-seven undergraduates were surveyed to assess experiences of panic, suicidal behavior in relation to panic and general levels of pathology. Forty-two percent of the sample had experienced at least one panic attack in the past year, and of those 18% had considered suicide and 2.65% had made a suicide attempt in relation to their panic attacks. In comparison to nonclinical panickers who did not consider suicide, ideating nonclinical panickers had more frequent attacks, considered their attacks to be more severe, and viewed themselves as more fearful and in less control of their attacks. They also endorsed significantly higher levels of pathology across every dimension assessed. Results are discussed in terms of the prevalence of suicidal ideation among nonclinical samples, associated psychopathology, and extrapolation of the findings to clinical samples allowing development of models to understand the relationship between panic and suicide.

31. Caroli F, Gauillard J, Vacheron MN. Conduites suicidaires et dépression: aspects psychopathologiques. Neuro-Psy 1998; avril:14-9.
Mots-clé: PSYCHOPATHOLOGIE/ DÉPRESSION/ TROUBLE-PSYCHOTIQUE/ SCHIZOPHRÉNIE/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ SOMATISATION/ ABUS-SUBSTANCE/ ALCOOL/ DROGUE/ FACTEUR-RISQUE/ ANXIÉTÉ/ PACTE/ SUICIDE-COLLECTIF/ TROUBLE-AFFECTIF
No Article: Revue
Résumé: Le but de cet article est de privilégier la psychopathologie dans ses liens à la dépression et aux conduites suicidaires. Pour cela il s'agit de repérer ce qui, cliniquement, chez le déprimé se réfère à un fonctionnement psychique lié à une maladie mentale donnée, puis d'étudier la survenue des conduites suicidaires dans le cadre de psychoses, des névrose, des troubles de la personnalité, des conduites addictives et des maladies somatiques graves. Enfin, l'auteur clôt l'article en distinguant le pacte suicidaire impliquant deux individus et le suicide collectif.

32. Goldblatt MJ et al. Psychopharmacological treatment of suicidal inpatients. Bongar B et al., Éditeurs. Risk management with suicidal patients. New York: Guilford Press, 1998: 110-29.
Mots-clé: HÔPITAL/ PSYCHOPATHOLOGIE/ PHARMACOTHÉRAPIE/ INTERVENTION/ BIOLOGIE/ DÉPRESSION/ ABUS-SUBSTANCE/ ALCOOL/ SCHIZOPHRÉNIE/ DROGUE/ TROUBLE-ANXIEUX/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ TROUBLE-AFFECTIF
No article: BB664.02-CHAPITRE
Résumé: In this chapter we focus on the psychopharmacological treatment of patients hospitalized as a result of suicidal behaviors, or with psychiatric disorders that are closely associated with suicidal behaviors. Following a brief overview of the biochemistry of suicide, we review current standards of care in the pharmacological management of psychiatric disorders and behavioral dysfunctions associated with the range of suicidal behaviors most often encountered in hospital settings.

33. Kjellander CBBKA. Suicidality in bordeline personality disorder. Crisis 1998; 19(3):125-35.
Mots-clé: ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ TENTATIVE/ FACTEUR-RISQUE/ SUICIDE-COMPLÉTÉ/ INTERVENTION/ THÉRAPIE/ SUICIDAIRE-CHRONIQUE/ INTERVENTION
No Article: Revue
Résumé: REcent research on the relationship between bordeline personality disorder (BPD) and suicidal behavior is reviewd. Risk factors for attempted and completed suicide as well as the effect of the comorbidity of BPD with other axis I and II disorders are considered. explanations of suicidality in BPD are discussed. General assessment strategies are offered along with treatment recommandations. Specifically, research has shown that borderline patients improve in the long-term, decreasing in suicidality, self-destructiveneness and interpersonal maladjustment, if survival is effectively managed during the turbulent years of youth. Clinical lore at times can lead clinicians to disregard the danger of suicide completion amog chronically parasuicidal patients, which can prevent effective intervention during suicidal crises and result in unfortunate outcomes.

34. Verkes RJ et al. Platelet serotonin, monoamine oxidase activity, and [-sup-3H]paroxetine binding related to impulsive suicide attempts and borderline personality disorder. Biological-Psychiatry 1998; 43(10):740-6.
Mots-clé: SÉROTONINE/ IMPULSIVITÉ/ BIOLOGIE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ PSYCHOPATHOLOGIE/ FACTEUR-RISQUE/ TENTATIVE/ SUICIDAIRE-CHRONIQUE/ NEUROLOGIE
No Article: BV 002.2
Résumé: Examined the relationship between suicidal behavior and impulsiveness, and more generally borderline personality disorder on the one hand, and platelet indicators of central serotonergic function on the other. After a suicide attempt platelet serotonergic measures were obtained from 144 patients (aged 18-70 yrs) with at least 1 previous attempt. A major Mental Disorders-III-Revised (DSM-III-R) Axis I diagnosis and the use of antidepressants were reasons for exclusion. Platelet monoamine oxidase (MAO) activity was negatively correlated with the personality traits "multi- impulsive behavior" and "disinhibition." In accordance, platelet MAO activity was also lower in patients with less-planned suicide attempts. Platelet serotonin (5-hydroxytryptamine [5-HT]) and recidivism were positively correlated with borderline personality disorder, in particular chronic feelings of emptiness. Platelet 5-HT was lower in patients with alcohol abuse. The maximum number of binding sites (B-sub(max)) for paroxetine binding was positively correlated with sensation seeking. Findings support the hypothesis that serotonergic involvement in impulsive suicidal behavior is mediated by the relationship between serotonergic function and impulsiveness as a personality trait. ((c) 1999 APA/PsycINFO, all rights reserved) ¤

35. Wasserman D. A critical evaluation of psychotherapy in the treatment of depression and in suicide prevention. De Leo D, Schmidtke A, Diekstra RFW, Éditeurs. Suicide prevention: A holistic approach. Dordrecht: 1998: 173-83.
Mots-clé: THÉRAPIE/ ÉVALUATION/ DÉPRESSION/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ PSYCHOPATHOLOGIE/ INTERVENTION/ TROUBLE-AFFECTIF
No article: LIVRE
Résumé: In attempting to answer the question of what effect psychotherapeutic methods have on the treatment of depression and prevention of suicide, the author would like to focus on the results of two recent studies. One of them deals with the treatment of depressed patients. Since depression is closely associated with suicidality, it is helpful to scrutinize these results and learn from them. The second study deals with the treatment of borderline suicidal females.

36. Bateman A, Fonagy P. Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. American Jouranl of Psychiatry 1999; 156(10):1563-9.
Mots-clé: TRAITEMENT/ HÔPITAL/ PSYCHOPATHOLOGIE/ ÉTAT-LIMITE/ TROUBLE-PERSONNALITÉ/ FRÉQUENCE/ TENTATIVE/ SUICIDAIRE-CHRONIQUE/ COMPORTEMENT-AUTODESTRUCTEUR/ DÉPRESSION/ ANXIÉTÉ/ PHARMACOTHÉRAPIE/ DÉTRESSE/ ÉTUDE
No Article: XB 019
Résumé: OBJECTIVE: This study compared the effectiveness of psychoanalytically oriented partial hospitalization with standard psychiatric care for patients with borderline personality disorder. METHOD: Thirty-eight patients with borderline personality disorder, diagnosed according to standardized criteria, were allocated either to a partially hospitalized group or to a standard psychiatric care (control) group in a randomized controlled design. Treatment, which included individual and group psychoanalytic psychotherapy, was for a maximum of 18 months. Outcome measures included the frequency of suicide attempts and acts of self-harm, the number and duration of inpatient admissions, the use of psychotropic medication, and self-report measures of depression, anxiety, general symptom distress, interpersonal function, and social adjustment. Data analysis used repeated measures analysis of covariance and nonparametric tests of trend. RESULTS: Patients who were partially hospitalized showed a statistically significant decrease on all measures in contrast to the control group, which showed limited change or deterioration over the same period. An improvement in depressive symptoms, a decrease in suicidal and self-mutilatory acts, reduced inpatient days, and better social and interpersonal function began at 6 months and continued until the end of treatment at 18 months. CONCLUSIONS: Psychoanalytically oriented partial hospitalization is superior to standard psychiatric care for patients with borderline personality disorder. Replication is needed with larger groups, but these results suggest that partial hospitalization may offer an alternative to inpatient treatment.

37. Why Do the Young Commit Suicide? Chia BH. Too young to die. Singapore-Kuala Lumpur: Times Books International, 1999: 28-54.
Mots-clé: SUICIDE-COMPLÉTÉ/ ÉVÉNEMENT-VIE/ STRESS/ RELATION-INTERPERSONNELLE/ SÉPARATION-AMOUREUSE/ FAMILLE/ DEUIL/ ÉCONOMIE/ MALADIE-PHYSIQUE/ PSYCHOPATHOLOGIE/ SCHIZOPHRÉNIE/ DÉPRESSION/ TROUBLE-PERSONNALITÉ/ TROUBLE-PANIQUE/ TROUBLE-AFFECTIF/ ABUS-SUBSTANCE/ DROGUE/ ALCOOL/ ÉTAT-LIMITE/ SEXUALITÉ/ TRANSEXUALISME/ FACTEUR-RISQUE/ NOTE
No article: LIVRE - CHAPITRE
Résumé: Stressful life events/ Relationship problems/ Love problems/ Family-problems/ Bereavement/ Social-problems/Job and financial problems/ Illness and personality disorder/ Physical illness/ Mental illness/ Schizophrenia/ Examples from suicide letters/ Types of mental illness/ Affective disorders/ What is depressive disorder?/ Paranoid disorder/ Panic disorder/ Alcohol and drug abuse/ Borderline personality/ Antisocial personality/ Sexual problems/ Transsexualism/

38. Davis T, Gunderson JG, Myers M. Borderline personality disorder. Douglas G, Jacobs MD, Éditeur. The Havard Medical School Guide to Suicide Assessment and Intervention. San Francisco: Jossey-Bass, 1999: 311-31.
Mots-clé: PSYCHOPATHOLOGIE/ TROUBLE-PERSONNALITÉ/ ÉTAT-LIMITE/ ÉPIDÉMIOLOGIE/ FACTEUR-RISQUE/ POTENTIEL-SUICIDAIRE/ COMORBIDITÉ/ MÉDICAMENT/ FAMILLE/ INTERVENTION/ PATIENT
No article: LIVRE
Résumé: (from the chapter) This chapter highlights the distinctive features of suicidality in BPD (borderline personality disorder). A review of the epidemiological data, including risk factors for completed suicide, in conjunction with an elucidation of the unique interpersonal dynamics of suicidality in BPD, provides a framework for the assessment of immediate suicide risk and a foundation for the treatment of both acute and chronic suicidality. /// Topics include: epidemiology; identification of risk factors (impact of comorbid disorders, suicide risk levels following hospitalization); assessment of suicide risk in BPD (use of the D. G. Jacobs model to assess risk, significant attachments and suicidal risk); management of suicidality; use of hospitalization; use of medication; family interventions; countertransference with BPD patients; and implications for the clinician. ((c) 1999 APA/PsycINFO, all rights reserved)

39. Douglas G, Jacobs M.D. éditeurs. The Havard Medical School Guide to suicide Assessment and Intervention. San Francisco: Jossey-Bass, 1999: 703 pages.
Mots-clé: FACTEUR-RISQUE/ PSYCHOPATHOLOGIE/ MALADIE-PHYSIQUE/ ABUS-SUBSTANCE/ PROFESSIONNEL-SANTÉ-MENTALE/ CONTRAT/ INTERVENTION
No Article: LIVRE - ÉTAGÈRE
Résumé: This hands-on guide is written for those who have the common yet complex task of assessing suicidality in a patient or client -psychiatrists, primary care physicians, schools conselors, psychologists, psychotherapists, and other mental health professionals. Comprehensive in scope, the book offers a wealth of information and practical advice on specific topics, including working with special at-risk populations such as adolescents, the physically ill, and those with major mental illness, alcoholism, or borderline personality disorder. The book also addresses the somatic treatment of the suicidal patient, including important new findings about the possible antisuicidal effect of lithium. In addition, the guide contains important cautions regarding suicide contracts and offers timely information about liability prevention from an authority in the field of suicide and malpractice lawsuits.

40. Ravndal EVP. Overdoses and Suicide Attempts: Different Relations to Psychopathology and Substance Abuse? A 5-Year Prospective Study of Drug Abusers. European Addiction Research 1999; 5(-):63-70.
Mots-clé: TENTATIVE/ NORVÈGE/ ABUS-SUBSTANCE/ DROGUE/ RELANCE/ PSYCHOPATHOLOGIE/ DÉPRESSION/ PRÉVENTION/ FACTEUR-RISQUE/ ÉPIDÉMIOLOGIE/ TRAITEMENT
No Article: SR 004
Résumé: Two hundred Norwegian drug abusers who consecutively applied for treatment in a therapeuthic community were interviewed at intake and personally followed up an average 5 years after. Millon Clinical Multiaxial In