Particular vulnerability of patients with borderline personality disorder during the COVID-19 pandemic - a retrospective chart review

• Published in: BMC psychiatry 2024-12, Vol.24 (1), p.950-10, Article 950
• Main Authors: Kippe, Yann David, Gutwinski, Stefan, Adam, Maia, Finck, Anna, Schouler-Ocak, Meryam, Goldschmidt, Thomas
• Format: Article
• Language: English
• Subjects: Adult; Borderline personality disorder; Borderline Personality Disorder - epidemiology; Borderline Personality Disorder - psychology; Complications and side effects; COVID-19; COVID-19 - epidemiology; COVID-19 - psychology; COVID-19 pandemic; Drug use; Emergency medical care; Emergency Service, Hospital - statistics & numerical data; Epidemics; Female; Follow-Up Studies; Germany; Germany - epidemiology; Humans; Infections; Male; Mental disorders; Mental health; Mental institutions; Middle Aged; Pandemics; Patients; Personality; Psychiatric emergency department; Psychological aspects; Psychopathology; Psychosis; Psychotic Disorders - epidemiology; Psychotic Disorders - psychology; Public health; Retrospective Studies; Risk factors; Schizophrenia; Schizophrenia - epidemiology; Sensitivity analysis; Social aspects; Social distancing; Social isolation; Statistical analysis; Statistical models; Suicidal behavior; Suicidal ideation; Suicide; Suicide attempt; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Suicides & suicide attempts; Young Adult
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-024-06366-y

Mental health consequences of the COVID-19 pandemic have been a major research focus since its beginning. A specific vulnerability of patients with borderline personality disorder (BPD) following social distancing measures has been reported, however there is a lack of adequately sized studies that provide evidence of this vulnerability. Suicide attempts may reflect mental health effects of the COVID-19 pandemic in psychiatric settings. Retrospective follow-up analysis of clinical documentation in a psychiatric emergency department (pED) of a major academic psychiatric hospital in Berlin, Germany. Observation periods include the first- (3/2/2020-5/24/2020) and second-wave (9/15/2020-3/1/2021) of the COVID-19 pandemic in Germany and respective periods one year earlier as control-periods. Poisson-regression was used for statistical modelling of individual counts of pED presentations after a suicide attempt. N = 4110 patients attended the pED during the four observation periods. BPD patients were associated with elevated risk of pED presentation after a suicide attempt during COVID-periods (RR = 3.4; p = .014). Schizophrenia and psychotic disorders showed lower risk of pED presentation after a suicide attempt during COVID-periods (RR = 0.4; p = .048). Other diagnostic groups did not show significant interaction effects with COVID-periods. The first-wave was a risk factor for pED presentation after a suicide attempt affecting the sample across all diagnostic groups (RR = 3.1; p = .006). BPD patients seem to be particularly vulnerable during the COVID-19 pandemic showing increased rates of suicide attempts during both COVID-periods. This should be addressed in future health crises by ensuring availability of psychosocial help. There is a need for further research regarding BPD patients in public health crisis situations.