Investigating suicidality across the autistic-catatonic continuum in a clinical sample of subjects with major depressive disorder and borderline personality disorder

Liliana Dell'Osso; Benedetta Nardi; Chiara Bonelli; Davide Gravina; Francesca Benedetti; Giulia Amatori; Simone Battaglini; Gabriele Massimetti; Mario Luciano; Isabella Berardelli; Natascia Brondino; Marianna De Gregorio; Giacomo Deste; Marta Nola; Antonino Reitano; Maria Rosaria Anna Muscatello; Maurizio Pompili; Pierluigi Politi; Antonio Vita; Claudia Carmassi; Ivan Mirko Cremone; Barbara Carpita; Mario Maj

doi:10.3389/fpsyt.2023.1124241

Investigating suicidality across the autistic-catatonic continuum in a clinical sample of subjects with major depressive disorder and borderline personality disorder

Front Psychiatry. 2023 May 18:14:1124241. doi: 10.3389/fpsyt.2023.1124241. eCollection 2023.

Authors

Liliana Dell'Osso¹, Benedetta Nardi¹, Chiara Bonelli¹, Davide Gravina¹, Francesca Benedetti¹, Giulia Amatori¹, Simone Battaglini¹, Gabriele Massimetti¹, Mario Luciano², Isabella Berardelli³, Natascia Brondino⁴, Marianna De Gregorio⁵, Giacomo Deste⁶, Marta Nola⁴, Antonino Reitano⁵, Maria Rosaria Anna Muscatello⁵, Maurizio Pompili³, Pierluigi Politi⁴, Antonio Vita⁶, Claudia Carmassi¹, Ivan Mirko Cremone¹, Barbara Carpita¹, Mario Maj²

Affiliations

¹ Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
² Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
³ Department of Neuroscience, Mental Health and Sense Organs, University of Roma "La Sapienza", Rome, Italy.
⁴ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
⁵ Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
⁶ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Abstract

Background: Recent literature has highlighted that catatonia may be more prevalent among psychiatric patients than previously thought, beginning from autism spectrum disorders (ASD), for which it has been suggested to represent a severe late consequence, but also among individuals with mood disorders and borderline personality disorder (BPD). Interestingly, one critical point shared by these conditions is the increased risk of suicidality. The aim of this study was to evaluate how the presence and the prevalence of catatonic symptoms may shape and correlate with suicidal risk in a sample of individuals with major depressive disorder (MDD) or BPD.

Methods: We recruited two clinical samples of subjects (BPD and MDD) and a control group without a diagnosis according to DSM-5 (CTL). Subjects were assessed with the catatonia spectrum (CS) and the MOODS-SR for evaluating suicidality.

Results: In the total sample, suicidality score was significantly and positively correlated with all CS domains and CS total score. Correlation and regression analyses highlighted specific patterns of association among Catatonia spectrum domains and suicidality in the MDD and BPD group and in the total sample.

Conclusion: In both disorders, higher catatonic traits are linked to higher suicidal tendencies, confirming the high risk of suicide for this population. However, different patterns of association between catatonic symptoms and suicidality were highlighted in the two disorders.

Keywords: autistic-catatonic continuum; borderline personality disorder (BPD); catatonia; catatonia spectrum; catatonic traits; major depression disorder (MDD); mood disorder; suicide.

Copyright © 2023 Dell’Osso, Nardi, Bonelli, Gravina, Benedetti, Amatori, Battaglini, Massimetti, Luciano, Berardelli, Brondino, De Gregorio, Deste, Nola, Reitano, Muscatello, Pompili, Politi, Vita, Carmassi, Cremone, Carpita and Maj.