Systematic review of risk factors for suicide and suicide attempt among psychiatric patients in Latin America and Caribbean

OBJECTIVE: To analyze published evidence from the Latin America and Caribbean (LAC) region pertaining to risk factors for completed suicide and suicide attempts among psychiatric populations. METHODS: Potential studies were identified through systematic electronic searches in MEDLINE and LILACS. Included studies were cohort, case-control, and cross-sectional designed investigations of psychiatric samples in which suicide or a suicide attempt was reported as an outcome and evaluated with some measure of impact (odds ratio, risk ratio, or hazard ratio). Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. RESULTS: Of the 2 987 identified studies, a total of 17 studies were reviewed to determine potential suicidal risk factors. Eleven studies used a case-control design, five used a cross-sectional design, and only one study used a prospective-cohort design. The main risk factors for suicide attempts in LAC included major depressive disorder (MDD), family dysfunction, and prior suicide attempt, while the main risk factors for completed suicide were male gender and MDD. The methodological quality of most of the studies was low. CONCLUSIONS: This review provides evidence that the majority of relevant risk factors for suicide and suicide attempts in the LAC region are similar to those observed in Western societies but different from those reported in Eastern societies. Studies of higher methodological quality from the region are needed to support these results

Types of Borderline Personality Disorder (BPD) in patients admitted for suicide-related behavior

Borderline personality disorder (BPD) is determined by the presence of any five of nine diagnostic criteria, leading patients with heterogeneous clinical features to be diagnosed under the same label without an individualized clinical and therapeutic approach. In response to this problem, Oldham proposed five types of BPD: affective, impulsive, aggressive, dependent and empty. The present study categorized a sample of BPD patients hospitalized due to suicide-related behavior according to Oldham’s BPD proposed subtypes, and evaluated their clinical and demographic characteristics. Data were obtained from a sample of 93 female patients admitted to the « Dr. Braulio A. Moyano » Neuropsychiatric Hospital following suicide-related behavior. A total of 87 patients were classified as affective (26 %), impulsive (37 %), aggressive (4 %), dependent (29 %), and empty (5 %). Patients classified as dependent were significantly older at the time of first suicide-related behavior (p = 0.0008) and reported significantly less events of previous suicide-related behaviors (p = 0.03), while patients classified as impulsive reported significantly higher rates of drug use (p = 0.02). Dependent, impulsive and affective BPD types were observed most frequently in our sample. Findings are discussed specific to demographic and clinical implications of BPD patients reporting concurrent suicidal behavior.Fil: Rebok, Federico. Universidad de Buenos Aires. Facultad de Medicina. Cátedra de Farmacología; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Braulio A. Moyano"; Argentina. Gobierno de la Ciudad de Buenos Aires; ArgentinaFil: Teti, Germán L.. Universidad de Buenos Aires. Facultad de Medicina. Cátedra de Farmacología; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Braulio A. Moyano"; ArgentinaFil: Fantini, Adrián P.. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Braulio A. Moyano"; ArgentinaFil: Cárdenas Delgado, Christian. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Braulio A. Moyano"; ArgentinaFil: Rojas, Sasha M.. University of Arkansas; Estados UnidosFil: Derito, María N. C.. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Braulio A. Moyano"; ArgentinaFil: Daray, Federico Manuel. Universidad de Buenos Aires. Facultad de Medicina. Cátedra de Farmacología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin