Effects of Psychiatric Admissions on Self-harm and Suicide in People With Borderline Personality Disorder

NCT06424509 | Recruiting

• 1 other identifier: 2024-00589-01
• Study Type: observational
• Target: 390
• Locations: 1 country
• Sites: 1

Brief Summary

The current study aims to evaluate the impact of long (\>5 days) and/or compulsory psychiatric inpatient care on subsequent healthcare utilization for self-harm and suicide in people with borderline personality disorder, a condition characterized by frequent self-harm. The basis for this study is the diversity of clinical practices across Swedish regions. By categorizing clinics based on their practices with respect to long and/or compulsory psychiatric inpatient care, it is possible to explore the impact of these practices on subsequent somatic and psychiatric healthcare, including emergency care due to self-harm as well as on completed suicides. All psychiatric clinics across Sweden authorized to administer compulsory care for adults, totalling 78 clinics will be included. Each clinic per specific calendar year will represent one participant, identified by the clinic's name and the respective year (e.g., Umeå2010, Linköping2013, Malmö2022). Data collection will involve the utilization of the national registers to capture outcome measures and account for confounding factors. The participants will be ranked based on a composite variable, which includes the average number of days spent in inpatient compulsory care and other psychiatric inpatient care exceeding 5 days, among individuals diagnosed with BPD. The top quartile of participants will be compared with the bottom quartile.

Conditions

Borderline Personality Disorder; Self-harm; Non-suicidal Self-injury; Suicide

Outcome Measures

Primary Outcomes (3)

• Number of healthcare visits due to self-harm

  Number of healthcare visits due to self-harm in specialized inpatient or outpatient care, as defined in the NPR (X60-X84; Intentional self-harm) divided by the number of individuals diagnosed with BPD per clinic and calendar year.

  1 year

• Number of deaths by suicide

  Number of deaths by suicide (X60-X84; Intentional self-harm or Y10-34; Events of undetermined intent) in individuals diagnosed with BPD divided by the number of individuals diagnosed with BPD per clinic and calendar year.

  1 year

• Number of deaths by suicide within 30 days after discharge

  Number of deaths by suicide (X60-X84; Intentional self-harm or Y10-34; Events of undetermined intent) within 30 days after discharge, in individuals diagnosed with BPD divided by the number of individuals diagnosed with BPD, per clinic and calendar year

  1 year

Secondary Outcomes (3)

• Number of days between admissions to psychiatric inpatient care

  1 year

• Number of days between death by suicide and discharge

  1 year

• Number of days in somatic (non-psychiatric) inpatient care after self-harm

  1 year

Study Arms (2)

High admission

The quartile of participants using the highest degree of long (\>5 days) and/or compulsory psychiatric inpatient care.

Other: High degree of long (>5 days) and/or compulsory psychiatric inpatient care

Low admission

The quartile of participants using the lowest degree of long (\>5 days) and/or compulsory psychiatric inpatient care.

Interventions

High degree of long (>5 days) and/or compulsory psychiatric inpatient care OTHER

High degree of long (\>5 days) and/or compulsory psychiatric inpatient care

High admission

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

All psychiatric clinics across Sweden authorized to administer compulsory care for adults, totalling 78 clinics. Each clinic per specific calendar year will represent one participant, identified by the clinic's name and the respective year (e.g., Umeå2010, Linköping2013, Malmö2022).

You may qualify if:

• Psychiatric clinic in Sweden authorized to administer compulsory care for adults. Each clinic per specific calendar year will represent one participant, identified by the clinic's name and the respective year (e.g., Umeå2010, Linköping2013, Malmö2022).

You may not qualify if:

• No authorization to administer compulsory care for adults

Sponsors & Collaborators

• Lund University: lead
• Linkoeping University: collaborator

Study Sites (1)

Lund University

Lund, 22185, Sweden

RECRUITING

MeSH Terms

Conditions

Borderline Personality Disorder; Self-Injurious Behavior; Suicide

Condition Hierarchy (Ancestors)

Personality Disorders; Mental Disorders; Behavioral Symptoms; Behavior

Study Officials

• Sofie Westling, MD, PhD

  Lund University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sofie Westling, MD, PhD

CONTACT

+46735626099; sofie.westling@med.lu.se

Josefin Vikström Eckevall, MD, PhD

CONTACT

+46703320527; josefin.vikstrom@liu.se

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: OTHER
• Target Duration: 1 Year
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 16, 2024
• First Posted: May 22, 2024
• Study Start: January 1, 2010
• Primary Completion: January 1, 2026
• Study Completion (Estimated): January 1, 2027
• Last Updated: August 12, 2025

Record last verified: 2025-08

Locations

SE (1)