Suicide prediction is a clinical challenge in psychiatry, especially in borderline personality disorder (BPD) which presents a wide range of self injurious behaviors including consummated suicide. Interviews based on biographical and clinical factors are insufficient in suicide prevention. Treatment with ISSRs is accepted as effective to reduce ideation and suicidal behavior in BPD and other diagnoses.

To evaluate the relation between neuroticism and suicide response to ISSRs in BPD.

59 patients were recruited, all meet DSM IV criteria for BPD according to IPDE. They did not fulfill criteria for axis I diagnoses or other personality disorders at the moment of the evaluation. Patients were treated with fluoxetine (Prozac®) for 12 weeks, in doses 20 to 60 mg. Suicidality was evaluated with OAS-M self aggression score (ideation and conduct measurement). Temperament was evaluated with NEO-PI-R.

Multiple regression analysis of OAS-M self aggression reduction at endpoint as dependent variable, and temperament as independent variables shown a significant predictive model with neuroticism as a direct predictor factor (ß = 0.32, p = 0.044).

ISSRs are a useful treatment for suicidal behavior in BPD. Neuroticism is a good predictor of suicide response to ISSRs treatment in BPD.