492. Comparative one-year follow-up of suicide attempters with and without borderline personality disorder

Abstract

Abstract Background Suicide attempts are a major public health challenge and are associated with a high risk of recurrence, especially during the months following the initial episode. This risk is strongly influenced by underlying psychiatric conditions, particularly personality disorders. Among these, Borderline Personality Disorder (BPD) is characterized by emotional instability, impulsivity, and persistent suicidal behaviour, contributing to a more severe and chronic course. Personality pathology, especially disorders in cluster B, is associated with earlier onset of psychopathology, greater depressive burden, clinical severity, and risk of repeated suicidal behaviour. Despite this, the sociodemographic and clinical profiles of individuals who have attempted suicide with and without BPD remain insufficiently characterized. Identifying these differences may help to detect vulnerable subgroups and guide specific follow-up strategies. Aims & Objectives To compare, at the start of the study, the sociodemographic characteristics, suicide history, and clinical profiles of people who have attempted suicide, differentiating between those with and without BPD. Likewise, to describe the most relevant differences for clinical follow-up over the course of a year. Method This prospective observational cohort study included adults admitted after a suicide attempt to emergency departments and psychiatric services in the Community of Madrid (Spain). Participants were classified at the start of the study as “without BPD” or “clinical diagnosis of BPD” Sociodemographic variables (gender, age, family situation, children, living conditions, income, religion) and clinical characteristics (history of suicide attempts, depressive symptoms, other symptomatic dimensions, health-related quality of life) were collected. Participants were followed up for 12 months from the index event within routine care without experimental intervention. Results Compared to the group without BPD (n=122), participants in the group with a clinical diagnosis of BPD (n 145) were younger, with more people aged 18–25 and fewer aged 50–65 (χ2(4)=28.56, p<0.01) and a lower mean age at inclusion (F(1,265)=35.67, p<0.01). The BPD group included fewer men and participants with children, but more single individuals (all p<0.01). They were more likely to live with their parents and had a more chronic suicide history, with more attempts prior to the previous year (p<0.01). Depressive burden was higher in the BPD group. No differences were found in terms of immigrant status, income, religion, general living conditions, quality of life, or other clinical scales. Discussion & Conclusions People who attempt suicide and suffer from BPD have a distinctive basic profile in Madrid, characterized by younger age, less social and family autonomy, more chronic suicidal behaviour, and greater depressive burden. Socioeconomic factors and overall quality of life were similar in both groups. These findings highlight the importance of specific follow-up and personalized interventions during the first year after a suicide attempt, particularly addressing chronic suicidal tendencies and depressive symptoms in patients diagnosed with BPD.