{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T23:30:01Z","timestamp":1769211001303,"version":"3.49.0"},"reference-count":33,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Prevalence of suicidal thoughts and behaviours is higher among patients with borderline personality disorder than the general population. However, evidence concerning the role of specific borderline symptoms for predicting suicide-related outcomes is lacking and no systematic review\/meta-analysis (SR\/MA) investigated this topic. Our aim will be to investigate the relationship between any borderline symptom (except criterion 5) and suicide-related outcomes both through an SR\/MA and an individual patient data meta-analysis (IPD-MA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We will search PubMed\/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, CINAHL and Cochrane Library databases from 1974 until September 2021. Both published and unpublished studies showing the association between any borderline symptom (except criterion 5) and suicide-related outcomes (death wish, suicidal ideation, suicidal plan, non-suicidal self-injury, deliberate self-harm, suicide attempt, suicidal behaviour disorder, suicide) will be included. Two team members will independently perform the selection of the studies and data extraction, with the supervision of two other members in case of discrepancies; and assess each study with study quality assessment tools by National Institutes of Health and Grading of Recommendations Assessment, Development and Evaluation. Each author will be contacted. If possible, we will perform both random-effect meta-analyses on the collected data (odds, risk, rate ratios or correlations) and an IPD-MA on collected databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>This study does not require an ethical approval. Results will be publicly disseminated, included in research presentations and published in peer-review journals.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42018078696.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2021-056492","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T17:39:45Z","timestamp":1656610785000},"page":"e056492","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["BOrderliNe symptoms and suIcide-related outcomes: proTOcol for a systematic review\/meta-analysis and an individual patient data meta-analysis (BONITO study)"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8130-437X","authenticated-orcid":false,"given":"Raffaella","family":"Calati","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Romano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Lopez-Castroman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Turolla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6975-2356","authenticated-orcid":false,"given":"Johannes","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Madeddu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Courtet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5207-4579","authenticated-orcid":false,"given":"Emanuele","family":"Preti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"2022063010170887000_12.5.e056492.1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . Diagnostic and statistical manual of mental disorders. Dsm-5. American Psychiatric Publishing, 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2022063010170887000_12.5.e056492.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61422-5"},{"key":"2022063010170887000_12.5.e056492.3","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1016\/S0140-6736(21)00476-1","article-title":"Borderline personality disorder","volume":"398","author":"Bohus","year":"2021","journal-title":"Lancet"},{"key":"2022063010170887000_12.5.e056492.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16770-6"},{"key":"2022063010170887000_12.5.e056492.5","doi-asserted-by":"publisher","DOI":"10.1037\/a0021078"},{"key":"2022063010170887000_12.5.e056492.6","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000033"},{"key":"2022063010170887000_12.5.e056492.7","doi-asserted-by":"crossref","unstructured":"Wright AGC , Zimmermann J . At the nexus of science and practice: Answering basic clinical questions in personality disorder assessment and diagnosis with quantitative modeling techniques. In: Huprich S , ed. Personality disorders: assessment, diagnosis, and research. Washington, DC: American Psychological Association, 2015: 109\u201344.","DOI":"10.1037\/14549-006"},{"key":"2022063010170887000_12.5.e056492.8","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1521\/pedi_2015_29_193","article-title":"The clinical significance of single features of borderline personality disorder: anger, affective instability, impulsivity, and chronic Emptiness in psychiatric outpatients","volume":"30","author":"Ellison","year":"2016","journal-title":"J Pers Disord"},{"key":"2022063010170887000_12.5.e056492.9","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/pmh.1432","article-title":"A 1-year follow-up study of capacity to love and work: what components of borderline personality disorder most impair interpersonal and vocational functioning?","volume":"12","author":"Miller","year":"2018","journal-title":"Personal Ment Health"},{"key":"2022063010170887000_12.5.e056492.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c221"},{"key":"2022063010170887000_12.5.e056492.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647"},{"key":"2022063010170887000_12.5.e056492.12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"2022063010170887000_12.5.e056492.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00234-2"},{"key":"2022063010170887000_12.5.e056492.14","unstructured":"Janet BW , Spitzer F , Gibbon RobertL . DSM-III. diagnostic and statistical manual of mental disorders. 3rd edn. American Psychiatric Press, 1980."},{"key":"2022063010170887000_12.5.e056492.15","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(87)90012-5"},{"key":"2022063010170887000_12.5.e056492.16","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.17.6.568.25355"},{"key":"2022063010170887000_12.5.e056492.17","doi-asserted-by":"crossref","unstructured":"Hyler SE . Personality diagnostic Questionnaire-4 (PDQ-4. New York State Psychiatric Institute, 1994.","DOI":"10.1037\/t07759-000"},{"key":"2022063010170887000_12.5.e056492.18","unstructured":"First MB , Williams JBW , Benjamin LS . Structured clinical interview for DSM-5 personality disorders (SCID-II-PD. Arlington, VA: American Psychiatric Association Publishing, 2016."},{"key":"2022063010170887000_12.5.e056492.19","unstructured":"Pfohl B , Blum N , LISW MSW . APA - structured interview for DSM-IV personality SIDP-IV. Wasington DC: American Psychiatric Press, 1997."},{"key":"2022063010170887000_12.5.e056492.20","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.134.4.382"},{"key":"2022063010170887000_12.5.e056492.21","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"2022063010170887000_12.5.e056492.22","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.10111704"},{"key":"2022063010170887000_12.5.e056492.23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"2022063010170887000_12.5.e056492.24","unstructured":"Higgins JPT , Thomas J , Chandler J , et al , eds. Cochrane Handbook for Systematic Reviews of Interventions version 6.2. Cochrane."},{"key":"2022063010170887000_12.5.e056492.25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7121.1533"},{"key":"2022063010170887000_12.5.e056492.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"2022063010170887000_12.5.e056492.27","doi-asserted-by":"publisher","DOI":"10.1002\/sim.918"},{"key":"2022063010170887000_12.5.e056492.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jml.2012.11.001"},{"key":"2022063010170887000_12.5.e056492.29","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6837"},{"key":"2022063010170887000_12.5.e056492.30","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1037\/met0000228","article-title":"A model-based imputation procedure for multilevel regression models with random coefficients, interaction effects, and nonlinear terms","volume":"25","author":"Enders","year":"2020","journal-title":"Psychol Methods"},{"key":"2022063010170887000_12.5.e056492.31","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1037\/abn0000656","article-title":"Symptoms as rapidly fluctuating over time: revealing the close psychological interconnections among borderline personality disorder symptoms via within-person structures","volume":"130","author":"Mneimne","year":"2021","journal-title":"J Abnorm Psychol"},{"key":"2022063010170887000_12.5.e056492.32","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1037\/per0000086","article-title":"The structure of borderline personality disorder symptoms: a multi-method, multi-sample examination","volume":"5","author":"Hawkins","year":"2014","journal-title":"Personal Disord"},{"key":"2022063010170887000_12.5.e056492.33","doi-asserted-by":"publisher","DOI":"10.1037\/a0023678"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-056492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T17:39:58Z","timestamp":1656610798000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-056492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,26]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/bmjopen-2021-056492"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-056492","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}