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Suicídio e comportamentos autolesivos na perturbação de personalidade borderline : uma revisão narrativa
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O suicídio é uma comorbilidade frequente em várias doenças psiquiátricas, sendo uma importante causa de morte evitável nestes doentes. Segundo dados recentes, 8 a 10% dos pacientes com perturbação de personalidade borderline cometem suicídio, sendo a presença de comportamentos suicidas ou autolesivos um dos critérios diagnósticos considerados no DSM-V para esta perturbação. Os comportamentos autolesivos, apesar de poderem ser independentes da ideação suicida e suicídio consumado, têm também impacto nestes doentes, como causa importante de sofrimento e de sequelas físicas e mentais. Assim, sendo esta uma perturbação caracterizada pela impulsividade e instabilidade, é uma população onde é fundamental estar alerta para os sinais que possam prever eventuais comportamentos deste tipo de forma que se possa intervir o mais precoce e adequadamente para evitá-los e, sobretudo, mitigar o impacto na vida destes doentes. Assim, neste trabalho pretende-se explorar, em vários aspetos, a relação entre perturbação de personalidade borderline, suicídio e comportamentos autolesivos nomeadamente, as características clínicas que mais se correlacionam, fatores de risco e comorbilidades psiquiátricas mais associados à sua perpetuação e tratamentos mais adequados na abordagem destes doentes. Neste sentido realizou-se uma pesquisa e seleção de artigos na base de dados PubMed com os termos “borderline personality disorder”, “nonsuicidal self-injury”, “suicide” e “self-harm”. Pretende-se assim com este trabalho fazer um resumo daquela que é a literatura mais atual e relevante neste tema, dando assim uma perspetiva do que já existe e do que se poderá investir no futuro de forma a melhorar a abordagem a estes doentes e, consequentemente, a sua qualidade de vida.
Suicide is a frequent comorbidity in several psychiatric disorders, being an important cause of preventable death in these patients. According to the most recent data, 8 to 10% patients who suffer from borderline personality disorder commit suicide, with the presence of suicidal or self-injurious behavior being one of the diagnostic criteria considered by the DSM-V in this disorder. Self-injurious behaviors, although they may be independent of suicidal ideation and completed suicide, also have an impact on these patients, as an important cause of physical and psychological suffering. Therefore, as this is a disorder characterized by impulsivity and instability, it is fundamental to be alert to signs that may predict possible behavior of this type so that early and preventive interventions can be taken to avoid them and, above all, mitigate the impact on patients’ lives. Therefore, we intend to explore, in several aspects, the relationship between borderline personality disorder, suicide and self-injurious behaviors, namely, the clinical characteristics that are most correlated, risk factors and psychiatric comorbidities most associated with their perpetuation and treatments that are most appropriate in the management of these patients. In this regard, we conducted a search and selection of articles in the PubMed database with the terms “borderline personality disorder”, “nonsuicidal self-injury”, “suicide” and “self-harm”. In this dissertation, we intend to summarize the most recent and relevant literature on this topic, thus giving a perspective of what already exists and what could be invested in the future in order to improve the approach to these patients and, consequently, their quality of life.
Suicide is a frequent comorbidity in several psychiatric disorders, being an important cause of preventable death in these patients. According to the most recent data, 8 to 10% patients who suffer from borderline personality disorder commit suicide, with the presence of suicidal or self-injurious behavior being one of the diagnostic criteria considered by the DSM-V in this disorder. Self-injurious behaviors, although they may be independent of suicidal ideation and completed suicide, also have an impact on these patients, as an important cause of physical and psychological suffering. Therefore, as this is a disorder characterized by impulsivity and instability, it is fundamental to be alert to signs that may predict possible behavior of this type so that early and preventive interventions can be taken to avoid them and, above all, mitigate the impact on patients’ lives. Therefore, we intend to explore, in several aspects, the relationship between borderline personality disorder, suicide and self-injurious behaviors, namely, the clinical characteristics that are most correlated, risk factors and psychiatric comorbidities most associated with their perpetuation and treatments that are most appropriate in the management of these patients. In this regard, we conducted a search and selection of articles in the PubMed database with the terms “borderline personality disorder”, “nonsuicidal self-injury”, “suicide” and “self-harm”. In this dissertation, we intend to summarize the most recent and relevant literature on this topic, thus giving a perspective of what already exists and what could be invested in the future in order to improve the approach to these patients and, consequently, their quality of life.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Perturbação de personalidade borderline Suicídio Ideação suicida Comportamentos autolesivos Psiquiatria