Clinical Characteristics Associated with Suicide Attempt in Patients with Bipolar Disorder

IntroductionBipolar disorder (BD) is a chronic, highly disabling condition, associated with a high burden of morbidity and mortality, often secondary to suicidal behaviors. In previous reports, different variables have been associated with a higher risk of suicidal acts, with variable effect.ObjectivesTo evaluate which socio-demographic and clinical variables correlate with suicide attempts in bipolar patients.AimsTo enrich literature data about suicidal behaviour in BD.MethodsA sample of 362 BD patients (DSM IV-TR) was retrospectively collected and divided in two subgroups, in relation to the presence of a previous suicide attempt. Socio-demographic and clinical variables were compared between attempters and non-attempters using Corrected multivariate analysis of covariance (MANCOVA).ResultsA total of 26,2% of analyzed patients attempted suicide in their lifespan, and approximately one third of them had multiple suicide attempts (i.e. ≥ 2; 31%). Depressive polarity at index mood episode, higher number of psychiatric hospitalizations, comorbidity with alcohol abuse, eating disorders and psychiatric poly-comorbidity were significantly associated with suicide attempt. Additionally, treatment with lithium, poly-pharmacotherapy (≥ 4 current drugs) and higher recurrence of psychosocial rehabilitation were significantly more frequent in patients who attempted suicide.ConclusionsThe present paper reported a correlation with some specific clinical variables and the lifetime presence of suicide attempt in patients with BD. Although these retrospective findings did not address the causality issue, they may be of clinical relevance in order to better understand suicidal behavior in BD and to adopt proper strategies to prevent suicide in higher risk patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Bipolar disorder and co-occurring cannabis use disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.522 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S466-S466

Author(s):

S. Ben Mustapha ◽

W. Homri ◽

L. Jouini ◽

R. Labbane

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Term Treatment ◽

Cannabis Use ◽

Family Dynamic ◽

Long Term Treatment ◽

Cannabis Use Disorders ◽

Competing Interest ◽

Bipolar Patients ◽

Psychotic Features

AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Psychosocial functioning impairment in euthymic patients with bipolar disorder II: The role of clinical factors

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1164 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S333-S333

Author(s):

R.S. Ilhan ◽

V. Senturk-Cankorur

Keyword(s):

Bipolar Disorder ◽

Psychosocial Functioning ◽

Rating Scale ◽

Healthy Individuals ◽

Young Mania ◽

Clinical Variables ◽

Hamilton Anxiety Rating Scale ◽

Short Test ◽

Competing Interest ◽

Bipolar Patients

IntroductionGrowing body of evidence have showed that euthymic bipolar patients have poor psychosocial functioning. Most of the studies have focused on the psychosocial functioning in euthymic bipolar disorder (BD)-I patients. On the contrary, there have been limited researches investigating psychosocial functioning in euthymic BD-II patients. Moreover, the factors associated with psychosocial functioning in euthymic patients with BD II have been also understudied.Objectives/aimsAim of our study was to investigate the association between clinical variables and poor psychosocial functioning in euthymic BD-II patients. Hypothesis of this study was that euthymic BD-II patients would have low level of psychosocial functioning compared with healthy individuals.MethodsBD-II (n = 37) and healthy subjects (n = 35) were compared in terms of their psychosocial functioning which were assessed by Functional Assessment Short Test (FAST). The euthymic state was confirmed by low scores both on the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). Anxiety symptoms were also assessed by Hamilton Anxiety Rating Scale (HARS) in both groups. Clinical variables were taken as independent variables and FAST scores were taken as dependent variable in order to run correlation analysis in BD-II group.ResultsNo socio-demographic differences were found between two groups. Euthymic BD-II patients had significantly higher FAST, HARS, HDRS YMRS scores compared with healthy individuals. Only HDRS scores correlated with FAST scores of BD-II patients.ConclusionsThis study indicated that euthymic BD-II patients had poorer psychosocial functioning. And subclinical depressive symptoms were associated with poor psychosocial functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Economic impact of suicidality in manic patients with depressive features

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2255 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S603-S603

Author(s):

U. Ösby ◽

E. Jonas ◽

J. Hällgren ◽

M. Pompili

Keyword(s):

Bipolar Disorder ◽

Cause Of Death ◽

Suicidal Behaviour ◽

Attempted Suicide ◽

Limited Information ◽

Mixed Features ◽

First Results ◽

Discharged Patients ◽

Competing Interest ◽

Bipolar Patients

IntroductionThere is limited information published on the specific financial costs of completed and/or attempted suicide in bipolar patients. In the last 15 years, only 6 studies were published. Their results vary considerably due to differences in methods used. Also, information on cost for pure manic versus mixed episodes is lacking. This is surprising, since studies have shown that suicidal behaviour is more common among patients with depressive symptoms than with pure mania, and this difference increases considerably when the mixed-features specifier is applied.ObjectivesWe conducted a registry study with the aim to expand the epidemiological information on suicidal behaviour by episode type in bipolar disorder, and its associated costs.MethodsHealth data were retrieved from the Swedish Patient Register. Data covered the period 1990–2014 and included the number of discharged patients with bipolar diagnosis, hospital re-admissions, and attempted and/or completed suicides. Moreover, we retrieved data on suicide and cause of death from the Swedish Cause of Death register. Analyses were done for the whole sample and stratified by subtypes (mania, depression and mixed forms).ResultsFirst results will be presented at the EPA meeting.ConclusionsThis is a nation-wide Swedish study of completed and attempted suicide in bipolar patients. The hypothesis we will test is that there is a substantial variation between different bipolar disorder subtypes, and that most of the expenditures due to suicidal behaviour in bipolar disorder are linked to mixed forms, mania in combination with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Temperament and character traits among suicidal patients during depressive episode of bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1810 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s890-s891

Author(s):

A. Petek Eric ◽

I. Eric ◽

K. Dodig-Curkovic ◽

K. Kralik ◽

P. Filakovic

Keyword(s):

Bipolar Disorder ◽

General Population ◽

Mood Disorders ◽

Depressive Episode ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Treatment ◽

Bipolar Patients ◽

Personality Features ◽

Suicidal Patients

IntroductionBoth suicide and mood disorders represent current and future global burden on public health system. Bipolar disorder (BD), part of a diagnostic group of mood disorders, is characterized by manic, depressive and mixed episodes with life-expectancy much shorter than in general population. Patients with BD have 30 times higher suicide rate than the general population and 25–50% of these patients attempts suicide. About 15% of patients who attempted suicide eventually end their lives with completed suicide.AimThe aim of our research was to distinguish personality features among bipolar patients with current depressive episode (BD-D) who attempted suicide.Materials and methodsThe research was conducted among patients with depressive episode of BD (according to diagnostic criteria of ICD–10) who attempted suicide and had been admitted for hospital psychiatric treatment. For assessment of personality, we used the Temperament and Character Inventory (TCI, Cloninger R.) upon admittance. Our sample consisted of 31 (n = 31) patient who met the above mentioned criteria. All patients given their written informed consent. The statistical analysis was performed using SPSS 17.0.ResultsIn our sample, we found, higher scores on harm-avoidance (HA), significantly higher scores on novelty seeking (NS) with significantly lower scores on persistence (P), self-directedness (SD) and cooperativeness (C) scales of the TCI. The Mann–Whitney-U test was used to compare samples.ConclusionIn our sample, suicide attempts are associated with temperament and character dimensions. These results confirmed our initial hypotheses on existence of specific personality features among that group of suicidal patients with BD–D.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Obesity is associated with previous suicide attempts in bipolar disorder

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2010.00452.x ◽

2010 ◽

Vol 22 (2) ◽

pp. 63-67 ◽

Cited By ~ 23

Author(s):

Fabiano A. Gomes ◽

Márcia Kauer-Sant’Anna ◽

Pedro V. Magalhães ◽

Felice N. Jacka ◽

Seetal Dodd ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicide Attempt ◽

Suicide Attempts ◽

University Hospital ◽

Comprehensive Management ◽

History Of ◽

Axis I ◽

Dsm Iv ◽

Bipolar Patients ◽

The University

Gomes FA, Kauer-Sant’Anna M, Magalhães PV, Jacka FN, Dodd S, Gama CS, Cunha Â, Berk M, Kapczinski F. Obesity is associated with previous suicide attempts in bipolar disorder.Objective:There is a paucity of data about risk factors for suicide attempts in bipolar disorder. The aim of this study is to examine the association between suicide attempts and obesity in people with bipolar disorder.Methods:Two hundred fifty-five DSM-IV out-patients with bipolar disorder were consecutively recruited from the Bipolar Disorder Program at Hospital das Clínicas de Porto Alegre and the University Hospital at the Universidade Federal de Santa Maria, Brazil. Diagnosis and clinical variables were assessed with Structured Clinical Interview for DSM-IV-axis I (SCID I) and Program structured protocol. History of suicide attempts was obtained from multiple information sources including patients, relatives and review of medical records. Patients with body mass index (BMI) ≥ 30 were classified as obese.Results:Over 30% of the sample was obese and over 50% had a history of suicide attempt. In the multivariate model, obese patients were nearly twice (OR = 1.97, 95% CI: 1.06–3.69, p = 0.03) as likely to have a history of suicide attempt(s).Conclusion:Our results emphasise the relevance of obesity as an associated factor of suicide attempts in bipolar disorder. Obesity may be seen as correlate of severity and as such, must be considered in the comprehensive management of bipolar patients.

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Clinical and Sociodemographic Correlates of Suicidality in Bipolar Patients

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.245 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S77-S77

Author(s):

U. Ouali

Keyword(s):

Attempted Suicide ◽

Suicide Attempts ◽

Diagnostic Delay ◽

Type I ◽

Cross Sectional ◽

Mixed Features ◽

Sociodemographic Correlates ◽

Competing Interest ◽

Bipolar Patients ◽

Depressive Episodes

IntroductionA major concern in patients with BIPOLAR Disorder (BD) is the high frequency of suicidality. It is important to determine the subgroup of patients particularly exposed to this risk.ObjectivesTo explore sociodemographic and clinical characteristics of BD patients with a history of suicide attempts and compare them to those who never attempted suicide.MethodsThis is a retrospective, cross-sectional, descriptive and comparative study on 100 patients followed in our department and diagnosed with BD type I according to DSM 5. Demographic and clinical data was compared across the groups: suicide+ (S + ) and suicide–(S-).ResultsOverall, 77 patients never attempted suicide (S−), whereas 23 had made at least one suicide attempt (S+). Females represented 61,9% of the S+ group. S+ patients had more relatives with psychiatric illness (82,6% vs. 57.1%) and affective illness (43.5% vs. 33,8%). The mean diagnostic delay was 6.61 years in the S+ group vs. 4.58 in the S− group, with 78,3% of S+ patients first receiving another diagnosis than BD. S+ patients had significantly more depressive episodes and manic episodes with mixed features. Quality of intervals was worse in S+ patients. Anxiety comorbidity was significantly higher in the S+ group (52.2% vs. 13%; P = 0,000). Hyperthymic temperament was significantly associated with the S− group.ConclusionsDepressive polarity, anxiety comorbidity, as well as diagnostic delay seem to elevate the risk for suicidality in bipolar patients. Suicidality should be closely monitored in patients with these characteristics.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Comparison of selected clinical and personality variables in alcohol–dependent patients with or without a history of suicide attempts

Current Problems of Psychiatry ◽

10.2478/cpp-2018-0013 ◽

2018 ◽

Vol 19 (3) ◽

pp. 155-173 ◽

Cited By ~ 1

Author(s):

Aneta Gerhant ◽

Ewa Krzewicka-Romaniuk ◽

Dagna Siedlecka ◽

Magdalena Derewianka-Polak ◽

Marcin Olajossy

Keyword(s):

Suicide Attempt ◽

Alcohol Dependence ◽

Alcohol Drinking ◽

Attempted Suicide ◽

Suicide Attempts ◽

Demographic Variables ◽

Coping With Stress ◽

Clinical Variables ◽

The Past ◽

History Of

Summary Objective: The aim of the study was to determine differences in the range of socio-demographic variables, selected clinical variables, temperament and character traits, coping with stress strategies and the level of aggression in alcohol addicts with or without a history of suicide attempt(s). Methods: The study involved 90 people addicted to alcohol, treated in inpatient alcohol dependence treatment program. In order to collect data on socio - demographic variables and selected clinical variables, a self-made questionnaire was used. The severity of alcohol dependence was verified using the MAST and SADD scales. Characteristics of temperament and character were examined with the TCI questionnaire. The BPAQ and COPE questionnaires were used to examine the level of aggression and styles of coping with stress. Results:Out of 90 subjects with alcohol dependence syndrom, 20% had attempted suicide in the past. The respondents with a history of suicide attempts were statistically significantly younger, were characterized by a younger age of alcohol drinking initiation and the initiation of regular alcohol drinking, and a greater severity of alcohol dependence in the MAST and SADD scales. A significantly larger percentage of respondents who had attempted suicide inflicted self-injury in the past, used other psychoactive substances as well as hypnotics and sedatives. The subjects with a suicide attempt in the interview obtained statistically significantly higher scores in terms of the level of aggression, harm avoidance and self-directedness, and more often used the style of coping with stress based on avoidance and accepting the situation. Conclusions: The obtained results correspond with data available in the literature and may provide a foundation for theoretical models explaining the phenomenon of suicidal behavior in alcohol addicts as well as for suicide prevention programs in this group of patients.

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Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽

10.1027/0227-5910/a000361 ◽

2016 ◽

Vol 37 (2) ◽

pp. 155-160 ◽

Cited By ~ 2

Author(s):

Jin Kim ◽

Han Joon Kim ◽

Soo Hyun Kim ◽

Sang Hoon Oh ◽

Kyu Nam Park

Keyword(s):

Emergency Department ◽

Medical Records ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Interview ◽

Clinical Variables ◽

Completed Suicide ◽

Number Of Patients ◽

Group A ◽

Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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Attempted suicide attention at an emergency room: A hospital-based descriptive approach

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2252 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S603-S603

Author(s):

D. Torres ◽

G. Martinez-Ales ◽

M. Quintana ◽

V. Pastor ◽

M.F. Bravo

Keyword(s):

Emergency Room ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Hospitalization ◽

Study Results ◽

History Of ◽

Competing Interest ◽

Reported Data ◽

Medium Cost ◽

Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Baseline and prodromal characteristics of first- versus multiple-episode mania in a French cohort of bipolar patients

European Psychiatry ◽

10.1016/j.eurpsy.2010.11.001 ◽

2011 ◽

Vol 27 (8) ◽

pp. 557-562 ◽

Cited By ~ 8

Author(s):

J.-M. Azorin ◽

A. Kaladjian ◽

M. Adida ◽

E. Fakra ◽

E. Hantouche ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Correct Diagnosis ◽

Manic Episode ◽

Psychotic Symptoms ◽

First Episode ◽

Prodromal Phase ◽

Multiple Episode ◽

Patients At Risk ◽

Bipolar Patients

AbstractObjective:To identify some of the main features of bipolar disorder for both first-episode (FE) mania and the preceding prodromal phase, in order to increase earlier recognition.Methods:One thousand and ninety manic patients (FE=81, multiple-episodes [ME]=1009) were assessed for clinical and temperamental characteristics.Results:Compared to ME, FE patients reported more psychotic and less depressive symptoms but were comparable with respect to temperamental measures and comorbid anxiety. The following independent variables were associated with FE mania: a shorter delay before correct diagnosis, greater substance use, being not divorced, greater stressors before current mania, a prior diagnosis of an anxiety disorder, lower levels of depression during index manic episode, and more suicide attempts in the past year.Conclusion:In FE patients, the diagnosis of mania may be overlooked, as they present with more psychotic symptoms than ME patients. The prodromal phase is characterised by high levels of stress, suicide attempts, anxiety disorders and alcohol or substance abuse. Data suggest to consider these prodromes as harmful consequences of temperamental predispositions to bipolar disorder that may concur to precipitate mania onset. Their occurrence should therefore incite clinicians to screen for the presence of such predispositions, in order to identify patients at risk of FE mania.

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