Borderline personality disorder and psychiatric suicides. An analysis of eleven consecutive cases

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Abstract
Suicidal behaviour is a prominent feature in borderline personality disorder and creates severe treatment problems in psychiatric units. Self-destructive behaviour, projections of strong negative feelings and manipulative behaviour might evoke countertransference reactions among staff, leading to rejective or repressive elements in treatment. This might further generate regressive behaviour, ultimately leading to a completed suicide. The purpose of this study is to describe and analyse these problems in a clinical material. Eleven consecutive cases, where borderline patients committed suicide during psychiatric inpatient treatment, are described and analysed, with a focus on the treatment situation preceding the suicides. In seven out of eleven cases treatment factors with rejective or repressive character relevant to the suicides could be identified. These included premature discharges, restrictions in treatment, and medication with repressive characteristics. Increased diagnostic competence and improved psychological education and supervision are of importance to avoid these pitfalls in the psychiatric treatment of borderline patients. Borderline personality, suicide, countertransference

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