Approximately 1 in 10 individuals are believed to have a personality disorder (PD), which can result in troubling behavior patterns. Studies have shown that individuals with a PD diagnosis make up about 20% of those involved in suicidal behaviors and violent acts. Antipsychotic medications, often prescribed for individuals with PD, have been found to alleviate symptoms like false beliefs and hallucinations. Research indicates that antipsychotics may decrease rates of violent crime and reduce the number of suicide attempts.
A recent study by Herttua et al. (2023) aimed to explore the benefits of antipsychotic medications in managing risks associated with PD. Researchers analyzed data from Danish national registers from 2007 to 2016, focusing on 166,328 individuals aged 18-64 with personality disorders. Antipsychotic treatment was studied as the exposure, with violent crime and suicidal behavior as the outcomes.
Results showed that individuals with PD who were prescribed antipsychotics had lower rates of violent crime suspicions and suicidal behavior. Men and women prescribed antipsychotics were less likely to engage in violent crimes and show signs of suicidal behavior. Antipsychotics were particularly effective in reducing violent crime suspicions in individuals with dissocial and emotionally unstable personality disorders.
Strengths of the study include a large cohort size and a within-comparison group design, which minimized biases. Limitations include lack of clear definitions for violent crime and suicidal behavior, uncertainty about medication adherence, and limited generalizability beyond Denmark.
Clinicians may consider prescribing antipsychotics to individuals with PD to reduce the risk of violent and suicidal behavior, but the potential side effects should also be taken into account. Further research is needed to understand the mechanisms behind the observed effects and to explore other treatment options, such as psychological interventions, for managing symptoms of PD.
In conclusion, while the study provides valuable insights, formal changes to clinical guidelines for PD treatment may not be justified at this time. More research is needed to fully understand the impact of antipsychotic medications on individuals with personality disorders.
