The prevalence of suicide ideation, suicide attempt and suicide in borderline personality disorder patients: A systematic review and meta-analysis

Abstract

Background: Borderline personality disorder (BPD) is associated with a high risk of suicidality, including suicide ideation, suicide attempts, and suicide. This meta-analysis aims to determine the lifetime prevalence of these dimensions in patients with BPD and to identify associated factors to inform clinical practice and intervention strategies.

Methods: We searched PubMed, Scopus, Web of Science, and Embase for observational articles (cross-sectional, cohort, longitudinal and case-control) reporting suicide ideation, suicide attempts, and suicide in patients with BPD. Data including age, sex, diagnostic criteria, inpatient/outpatient care, comorbidity, and rates of suicide ideation, suicide attempts, and suicide were extracted. A pooled analysis with a random effects model was performed using STATA.

Results: 35 studies including 34,832 patients with BPD were included in the final analysis. The pooled rate of suicidal ideation, suicide attempts, and suicides in patients with BPD was 80 % (95 % CI: 61 %-94 %), 52 % (95 % CI: 47 %-58 %), and 6 % (95 % CI: 4 %-8 %), respectively. The younger age group of BPD patients had a significantly higher lifetime prevalence of suicide ideation, and suicide attempt (p < 0.001). The inpatient group of BPD patients had a significantly higher lifetime prevalence of suicidal attempt (p < 0.001), while the outpatient group had a significantly higher lifetime prevalence of suicide (p = 0.003).

Conclusion: BPD carries a high suicide risk, influenced by factors like age and clinical setting, while the impact of comorbid depression remains unclear. Future research should standardize diagnostics and use longitudinal studies to better understand and mitigate suicide risk in BPD.

Keywords: Borderline personality disorder; Suicide; Suicide attempt; Suicide ideation.