Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-18T17:07:08.143Z Has data issue: false hasContentIssue false

Relaciones entre intento de suicidio, vulnerabilidad temperamental y delitos violentos en una población psiquiátrica forense sueca

Published online by Cambridge University Press:  12 May 2020

E. Gunilla Stålenheim*
Affiliation:
Departamento de Neurociencia, Psiquiatría, Hospital Universitario, SE75185Upsala, Suecia
Get access

Resumen

Se investigó la relación entre los intentos de suicidio y diferentes factores de vulnerabilidad en 61 sujetos varones durante el examen psiquiátrico forense. Los rasgos de personalidad y la psicopatía se determinaron por medio de las Escalas Karolinska de la Personalidad (KSP) y la Lista de Psicopatía Revisada (PCL-R). Los diagnósticos clínicos se determinaron por el uso de la Entrevista Clínica Estructurada para el DSM-III-R (SCID). La actividad de la monoaminooxidasa (MAO) de las plaquetas se investigó en 58 sujetos. Los pacientes que intentaron suicidarse tenían puntuaciones sumamente bajas en socialización y altas en agresión impulsiva. Esto era independiente de que existieran antecedentes de reincidencia en delitos violentos o no. Estos sujetos tenían puntuaciones más altas en la PCL-R y niveles más bajos de actividad de la MAO de las plaquetas que los que no intentaron suicidarse. No se encontró relación entre los intentos de suicidio y la reincidencia en delitos violentos. Sin embargo, entre los sujetos con reincidencia en delitos violentos había una diferencia muy significativa entre quienes intentaron suicidarse y quienes no, lo que indica perfiles de personalidad diferentes en los delincuentes violentos con y sin comportamiento suicida. El comportamiento suicida se asociaba significativamente con el trastorno límite de la personalidad, pero no con ningún otro trastorno individual del DSM-III-R. Los resultados muestran una perturbación de la personalidad mucho más grave en los pacientes que intentaron suicidarse que en otros pacientes violentos en este tipo de población. Por tanto, la conducta suicida se debería evaluar y tratar per se.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Alm, Paf Klinteberg, BHumble, KLeppert, JSorensen, SThorell, L-H, et al.Psychopathy, platelet MAO activity and criminality among formar juvenile delinquents. Acta Psychiatr Stand 1996;94:105-11.CrossRefGoogle Scholar
APA. Diagnostic and statistical manual of mental disorders, 3rd ed. American Psychiatric Association: rev. Washington DC; 1987.Google Scholar
Apter, AKotler, MSevy, SPlutchik, RBrown, SLFoster, H, et al.Correlates of risk of suicide in violent and non-violent psychiatric patients. Am J Psychiatry 1991;148:883-7.Google Scholar
Asberg, M.Neurotransmitters and suicidal behavior. The evidence from cerebrospinal fluid studies. Ann N Y Acad Sci 1997;836:158-81.CrossRefGoogle ScholarPubMed
Asberg, MTraskman, LThorén, P.5-HIAA in the cero-brospinal fluid: a biochemical suicide predictor? Arch Gen Psychiatry 1976;33:1193-7.CrossRefGoogle ScholarPubMed
Asberg, MSchalling, DTraskman-Bendz, LWagner, A.Psychobiology of suicide, impulsivity, and relatad phe-nomena. Psychopharmacol 1987;65:655-68.Google Scholar
Brodsky, BSMalone, KMEllis, SPDulit, RAMann, N.Characteristics of borderline personality disorder associated with suicidal behavior. Am J Psychiatry 1997;154:1715-9.CrossRefGoogle ScholarPubMed
Buchsbaum, MSCoursey, RDMurphy, DL.The biochemical high-risk paradigm: behavioural and familial correlates of low platelet monoamine oxidase activity. Science 1976;194:339-41.CrossRefGoogle ScholarPubMed
Buss, AH.The psychology of aggression. New York: Wiley; 1961.CrossRefGoogle Scholar
Coccaro, EF.Central serotonin and impulsive aggression. Br J Psychiatry 1989;155:52-62.CrossRefGoogle Scholar
Engstrom, GAlsén, MGustavsson, PSchalling, DTraskman-Bendz, L.Classification of suicide attempters by cluster analysis: a study of the temperamental hete-rogeneity in suicidal patients. Pers Individ Differ 1996;21:687-95.CrossRefGoogle Scholar
Engstrom, GAlling, CBlennow, KRegnell, GTraskman-Bendz, L.Reduced cerebrospinal HVA concentrations and HVAI 5-HIAA ratios in suicide attempters. Monoamine metabolites in 120 suicide attempters and 47 controls. Eur Neuropsychopharmacol 1999;9:399-405.CrossRefGoogle Scholar
Engstrom, GPersson, BLevander, S.Temperament traits in male suicide attempters and violent offenders. Eur Psychiatry 1999;14:278-83.CrossRefGoogle ScholarPubMed
Freud, S.Trauer und Melancholie. In: Freud, ABibring, EHoffer, W, Eds. Siegmund Freud-Gesammelte Werke. Fischer: Frankfurt am Main; 1973. p. 428-46.Google Scholar
Gustavsson, JPPedersen, NLAsberg, MSchalling, D.Exploration into the sources of individual differences in aggression-, hostility-and anger-related (AHA) personality traits. Pers Individ Differ 1996;21:1067-71.CrossRefGoogle Scholar
Hallman, JOreland, LEdrnan, GSchalling, D.Thrombocyte amine oxidase activity and personality traits in women with severe premenstrual syndrome. Acta Psychiatr Stand 1987;76:225-34.CrossRefGoogle Scholar
Hare, RD.The Hare Psychopathy Checklist-Revised. Toronto, Ontario: Multi-Health Systems, Canada; 1991.Google Scholar
Haycock, J.Double jeopardy: suicide rates in forensic hospitals. Suicide Life Threat Behav 1993;23:130-8.Google ScholarPubMed
Kjoller, MHelweg-Larsen, M.Suicidal ideation and suicide attempts among adult Danes. Stand J Public Health 2000;28:54-61.CrossRefGoogle ScholarPubMed
Kullgren, GTengstrom, AGrann, M.Suicide among per-sonality-disordered offenders: a follow-up study of 1943 male criminal offenders. Soc Psychiatry Psychiatr Epidemiol 1998;33(Suppl 1):102-6.CrossRefGoogle ScholarPubMed
Lidberg, LWiklund, NJakobsson, SW.Mortality among criminals with suspected mental disturbance. Scand J Soc Med 1989;17:59-65.CrossRefGoogle ScholarPubMed
Linnoila, MVirkkunen, MScheinin, MNuutila, ARimon, RGoodwin, FK.Low cerebrospinal fluid 5-hydroxyin-doleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior. Life Sci 1983;33:2609-14.CrossRefGoogle Scholar
Mann, JJWaternaux, CHaas, GLMalone, KM.Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 1999;156:181-9.Google Scholar
Nordstrom, PAsberg, MAberg-Wistedt, ANordin, C.Attempted suicide predicts suicide risk in mood disorders. Acta Psychiatr Scand 1995;92:345-50.CrossRefGoogle ScholarPubMed
Nordstrom, PSamuelsson, MAsberg, M.Survival analysis of suicide risk after attempted suicide. Acta Psychiatr Scand 1995;91:336-40.CrossRefGoogle ScholarPubMed
Nordstrom, PGustavsson, PEdman, GAsberg, M.Temperamental vulnerability and suicide risk after attempted suicide. Suicide Life Threat Behav 1996;26:380-94.Google ScholarPubMed
Nordstrom, P.Survival analytic studies of suicide risk. Stockholm: Karolinska Institute; 1995.Google Scholar
Oquendo, MAMann, JJ.The biology of impulsivity and suicidality. Psychiatr Clin N Am 2000;23:11-25.CrossRefGoogle ScholarPubMed
Oreland, LHallman, J.The correlation between platelet MAO activity and personality-a short review of fin-dings and a discussion on possible mechanisms. In: Yu, PUTipton, KFBoulton, AA, Eds. Progress in brain rese-arch. Vol. 106. Current neurochemical and pharmacolo-gical aspects of biogenic amines: their function, oxida-tive deamination and inhibition. New York: Elsevier; 1995. p. 77-84.CrossRefGoogle Scholar
Plutchik, Rvan Praag, H.The measurement of suicidality, aggressivity and impulsivity. Prog Psychopharmacol Biolo Psychiatry 1989;13:523-34.Google ScholarPubMed
Plutchik, Rvan Praag, HMConte, HR.Correlates of suicide and violence risk: III. A two-stage model of coun-tervailing forces. Psychiatry Res 1989;28:215-25.CrossRefGoogle ScholarPubMed
Pritchard, CCox, MDawson, A.Suicide and ‘violent’ death in a six-year cohort of male probationers compared with pattern of mortality in the general population: evidence of accumulative socio-psychiatric vulnerability. J R Soc Health 1997;117:180-5.CrossRefGoogle Scholar
Roy, ALinnoila, M.Suicidal behavior, impulsiveness and serotonin. Acta Psychiatr Stand 1988;78:529-35.CrossRefGoogle ScholarPubMed
Schalling, D.Psychopathy-related personality variables and the psychophysiology of Socialization. In: Hare, RDSchalling, D, Eds. Psychopathic behaviour: approaches to research. New York: Wiley; 1978. p. 85-106.Google Scholar
Schalling, DAsberg, MEdman, GOreland, L.Markers for vulnerability to psychopathology: temperament traits associated with platelet MAO activity. Acta Psychiatr Scand 1987;76:172-82.CrossRefGoogle ScholarPubMed
Schalling, DEdman, G.The Karolinska Scales of Personality (KSP). An inventory for assessing temperament dimensions associated with vulnerability for psychosocial deviance. Manual. Stencil. Stockholm: The Department of Psychiatry, The Karolinska Institute; 1993.Google Scholar
Soloff, PHLis, JAKelly, TCornelius, JUlrich, R.Risk factors for suicidal behavior in borderline personality disorder. AmJ Psychiatry 1994;151:1316-23.Google ScholarPubMed
Spitzer, RLWilliams, JBWGibbon, M.Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Biometrics Research. New York: New York State Psychiatric Institute; 1987.Google Scholar
Spitzer, RLWilliams, JBWGibbon, MFirst, MB.The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Arch Gen Psychiatry 1992;49:624-9.CrossRefGoogle ScholarPubMed
Stålenheim, EGvon Knorring, L.Psychopathy and Axis I and Axis II disorders in a forensic psychiatric popula-tion in Sweden. Acta Psychiatr Stand 1996;94:217-23.CrossRefGoogle Scholar
Stålenheim, EG.Karolinska Scales of personality in a forensic psychiatric population: stability over time and between situations. NordJ Psychiatry 1997;51:379-84.CrossRefGoogle Scholar
Stålenheim, EGvon Knorring, LOreland, L.Platelet monoamine oxidase activity as a biological marker in a Swedish psychiatric population. Psychiatry Res 1997;69:79-87.CrossRefGoogle Scholar
Stålenheim, EGvon Knorring, L.Personality traits and psychopathy in a forensic psychiatric population. Eur J Psychiatry 1998;12:83-94.Google Scholar
Tripodianakis, JMarkianos, MSarantidis, DIstikoglou, CAndara, ABistolai, E.Platelet monoamine oxidase in attempted suicide. Relations to sex, psychiatric diagnosis, mode of attempt, and previous attempts. Eur J Psychiatry 1995;10:44-8.CrossRefGoogle ScholarPubMed
Tripodianakis, JMarkianos, MSarantidis, DLeotsakou, C.Neurochemical variables in subjects with adjustment disorder after suicide attempts. Eur Psychiatry 2000;15:190-5.CrossRefGoogle ScholarPubMed
Weissman, MMBland, RCCanino, GJGreenwald, SHwu, HGJoyce, PR, et al.Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 1999;29:9-17.CrossRefGoogle ScholarPubMed