Traumatic stress/dissociation, major depression and borderline personality disorders exhibit extensive overlapping and appear to be both concurrent and sequential over time. The purpose of the study was to conduct a longitudinal investigation of the association of these diagnostic dimensions over time among acutely suicidal patients. An additional aim was to determine which symptom co-variance profile was associated with the most acute clinical phase of the disorder, treatment failure and service consume.

100 patients aged 18-55, referred to emergency room with major depression, bordeline personality disorder and traumatic life event were prospectively investigated in a naturalistic follow-up design.

Subjects almost recovered early in the follow-up (3 month and 6-month) from all disorders. The analyses indicated that traumatic stress/dissociation but not major depression and borderline personality disorder are a factor in the suicidal crisis of these patients. Comment. Stress related dissociative disorder may be an underestimated factor among acutely suicidal patients requiring intensive treatment.