Suicidal Risk and Management in Borderline Personality Disorder A Clinical Update

Abstract

This article provides an update from Goodman and colleagues’ 2012 article “Suicidal Risk and Management in Borderline Personality Disorder.” This review will cover the importance of assessing suicide risk in Borderline Personality Disorder (BPD), the differences in “No-Suicide Contracts” versus “Safety Plans,” and treatment options for suicidality in BPD. While there have been developments in treatments for suicide in BPD, up to 84% of patients with BPD display suicidal behaviors and have an average of at least three suicide attempts in their lifetime. Since 2012 limited research has focused on assessment of suicide risk or prevention for those with BPD and more research has focused on treatment. Further research has examined several different types of psychotherapies that have emerged to treat suicidality in patients with BPD, which are discussed including Dialectical Behavioral-Therapy, Collaborative Assessment and Management of Suicidality Treatment, Abandonment Psychotherapy, Mentalization-Based Therapy, and Project Life Force have emerged since the 2012 review. The efficacy of involving family members in treatment and use of medication when treating this population are also reviewed. This literature search suggests there are several well-established modifiable and non-modifiable risk factors for suicide across diagnoses, but there is a paucity of research on BPD specific risk factors or protective factors when treating suicide in BPD patients, which may be helpful to better understand treatment of suicidality in this population.

Keywords: Borderline personality disorder, BPD, Suicide, Risk assessment