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Tidsskr Nor Laegeforen. 2009 Apr 30;129(9):872-6. doi: 10.4045/tidsskr.08.0140.

[Self-harm and personality disorders].

[Article in Norwegian]

Author information

  • 1Avdeling for personlighetspsykiatri Oslo universitetssykehus, Ullevål 0407 Oslo. oyvind.urnes@medisin.uio.no

Abstract

BACKGROUND:

Clinical experience and recent research convey that patients with personality disorders who harm themselves with a suicidal intention should be treated differently than those who do so without a suicidal intention. The purpose of this article is to give an overview of non-suicidal self-harm in these patients.

MATERIAL AND METHOD:

The article is based on a non-systematic literature search in PsycINFO, Medline, Clinical Evidence and Cochrane and own clinical experience.

RESULTS:

Self-harm in patients with personality disorders is associated with borderline personality traits. Up to 70 % of patients with borderline personality disorders have reported non-suicidal self-harm. Non-suicidal self-harm is one of the risk factors for suicide. Borderline personality disorder develops due to interaction between genetic vulnerability and a traumatic and unsafe upbringing. The patients are often influenced by intense negative emotions and have reduced ability to regulate and handle these in interpersonal situations. Self-harm can give short-term alleviation of the inner pain associated with emotion dysregulation. Dialectical behavior therapy and mentalization-based therapy is shown to reduce the prevalence of self-harm in patients with borderline personality disorder. Acute referral to in-patient treatment should only be used in crises that cannot be handled in out-patient treatment. The regular general practitioner can function as a stable attachment figure and contribute to self-regulation.

INTERPRETATION:

Non-suicidal self-harm in patients with personality disorders should be given more attention.

PMID:
19415088
[PubMed - indexed for MEDLINE]
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