Scope and Characteristics of Suicide Attempts Among Manic Patients With Bipolar Disorder

Crisis ◽  
2018 ◽  
Vol 39 (6) ◽  
pp. 489-492
Author(s):  
Marnina Swartz-Vanetik ◽  
Mark Zeevin ◽  
Yoram Barak
Keyword(s):  
Bipolar Disorder ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Clinical Severity ◽  
Mixed States ◽  
Retrospective Design ◽  
Raising Awareness ◽  
Increased Risk ◽  
Dsm Iv ◽  
Manic Patients

Abstract. Background: Suicide is often associated with depression in patients suffering from bipolar disorder (BD) and less is known about its relation to mania. Available data suggest that patients in the manic phase of BD may be at risk of suicide. Aim: We characterized suicide attempts in a cohort of patients with BD in manic and mixed phases. Method: We focused on the scope, rate, and characteristics of suicide attempts among BD patients during manic or mixed states. Associations between suicide as well as clinical and sociodemographic variables were analyzed using computerized medical chart data from 209 adult inpatients diagnosed (DSM-IV) as experiencing manic and mixed BD episodes. Results: The rate of recent suicide attempts among BD inpatients with manic and mixed episodes was 10.5%. Married patients had a decreased rate of suicide attempts. Comorbid alcohol or substance abuse were correlated with an increased risk of suicide attempts. Presence of suicidal ideation increased suicide risk while older age was linked to a decrease in the rate of suicide attempts. Limitations: The retrospective design of the study and overrepresentation of the clinical severity of BD were limitations. Conclusion: The rate of suicide attempts in the manic and mixed phases of BD is substantial and calls for raising awareness among psychiatrists.

scholarly journals Comorbid medical illness in bipolar disorder

2014 ◽  
Vol 205 (6) ◽  
pp. 465-472 ◽  
Author(s):  
Liz Forty ◽  
Anna Ulanova ◽  
Lisa Jones ◽  
Ian Jones ◽  
Katherine Gordon-Smith ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Mental Health Disorder ◽  
Acute Onset ◽  
Medical Illness ◽  
Illness Burden ◽  
Increased Risk ◽  
History Of ◽  
Dsm Iv ◽  
The Uk

BackgroundIndividuals with a mental health disorder appear to be at increased risk of medical illness.AimsTo examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden.MethodParticipants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria.ResultsWe found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset.ConclusionsBipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role.Declarations of interestNone.

scholarly journals Dissecting clinical heterogeneity of bipolar disorder using multiple polygenic risk scores

2020 ◽  
Author(s):  
Brandon J. Coombes ◽  
Matej Markota ◽  
J. John Mann ◽  
Colin Colby ◽  
Eli Stahl ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Risk Scores ◽  
Rapid Cycling ◽  
Clinical Heterogeneity ◽  
Polygenic Risk ◽  
Clinical Observations ◽  
History Of ◽  
Dsm Iv

AbstractBipolar disorder (BD) has high clinical heterogeneity, frequent psychiatric comorbidities, and elevated suicide risk. To determine genetic differences between common clinical sub-phenotypes of BD, we performed a systematic PRS analysis using multiple polygenic risk scores (PRSs) from a range of psychiatric, personality, and lifestyle traits to dissect differences in BD sub-phenotypes in two BD cohorts: the Mayo Clinic BD Biobank (N = 968) and Genetic Association Information Network (N = 1001). Participants were assessed for history of psychosis, early-onset BD, rapid cycling (defined as four or more episodes in a year), and suicide attempts using questionnaires and the Structured Clinical Interview for DSM-IV. In a combined sample of 1969 bipolar cases (45.5% male), those with psychosis had higher PRS for SCZ (OR = 1.3 per S.D.; p = 3e-5) but lower PRSs for anhedonia (OR = 0.87; p = 0.003) and BMI (OR = 0.87; p = 0.003). Rapid cycling cases had higher PRS for ADHD (OR = 1.23; p = 7e-5) and MDD (OR = 1.23; p = 4e-5) and lower BD PRS (OR = 0.8; p = 0.004). Cases with a suicide attempt had higher PRS for MDD (OR = 1.26; p = 1e-6) and anhedonia (OR = 1.22; p = 2e-5) as well as lower PRS for educational attainment (OR = 0.87; p = 0.003). The observed novel PRS associations with sub-phenotypes align with clinical observations such as rapid cycling BD patients having a greater lifetime prevalence of ADHD. Our findings confirm that genetic heterogeneity underlies the clinical heterogeneity of BD and consideration of genetic contribution to psychopathologic components of psychiatric disorders may improve genetic prediction of complex psychiatric disorders.

scholarly journals Antiepileptic drugs and suicide-related outcomes in bipolar disorder: A descriptive review of published data

2018 ◽  
Vol 8 (3) ◽  
pp. 138-147 ◽  
Author(s):  
Charles F. Caley ◽  
Emily Perriello ◽  
Julia Golden
Keyword(s):  
Bipolar Disorder ◽  
Antiepileptic Drugs ◽  
Suicide Attempts ◽  
Reference Group ◽  
Lithium Treatment ◽  
Reporting Rate ◽  
Published Data ◽  
Suicide Death ◽  
Suicidal Thinking ◽  
Increased Risk

Abstract Introduction: In January 2008 the US Food and Drug Administration issued a warning to healthcare professionals about the potential for an increased risk of suicidal thinking and behavior associated with antiepileptic drugs (AEDs). Given that AEDs are important for treating bipolar disorder (BD), a better understanding of suicide-related events is necessary. Methods: A PubMed search was performed using the following search terms: anticonvulsant OR valpro* OR carbamazepine OR lamotrigine OR oxcarbazepine OR topiramate AND bipolar AND suicid*. The objective was to identify published investigations reporting rate and/or risk data of suicide-related outcomes in BD patients treated with AED monotherapy. Results: The search identified 323 reviewable citations, with 13 of these studies (4.0%) being reviewed. Valproate was studied most often, and lithium treatment was frequently used as a reference group. Carbamazepine and lamotrigine had small treatment exposure durations. Suicide attempts and suicide deaths were studied the most; a few trials investigated suicidal thinking and/or hospitalizations for suicidal behavior. Suicide attempt rates occurred in the following order: no treatment > carbamazepine > valproate > lithium, while suicide death rates were: no treatment > valproate > lithium > carbamazepine. For valproate, the risk of suicide attempts and suicide death appeared higher than lithium, but lower than no treatment. Discussion: Investigating suicide-related events for AEDs in BD is difficult; more data are necessary for valproate, carbamazepine, and lamotrigine. An improved understanding of AED treatment and suicide-related events in BD may help pharmacists become more effective at supporting their patients with BD.

scholarly journals DSM-IV Axis II personality disorders and suicide and attempted suicide in China

2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner
Keyword(s):  
Personality Disorders ◽  
Suicidal Behaviour ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Control Group ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Increased Risk ◽  
Axis I ◽  
Dsm Iv

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.

scholarly journals Comorbidity Between ADHD and Symptoms of Bipolar Disorder in a Community Sample of Children and Adolescents

2005 ◽  
Vol 8 (5) ◽  
pp. 459-466 ◽  
Author(s):  
Wendy Reich ◽  
Rosalind J. Neuman ◽  
Heather E. Volk ◽  
Cynthia A. Joyner ◽  
Richard D. Todd
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Latent Class ◽  
Community Sample ◽  
Control Sample ◽  
Bipolar Disorders ◽  
Adhd Subtypes ◽  
Population Prevalence ◽  
Increased Risk ◽  
Dsm Iv

AbstractThe prevalence and frequency of comorbidity of possible bipolar disorder was examined with attention-deficit hyperactivity disorder (ADHD) in a nonreferred population of twins. Children and adolescents aged 7 to 18 years with a history of manic symptoms were identified from a population-based twin sample obtained from state birth records (n = 1610). The sample was enriched for ADHD; however, there was also a random control sample (n = 466), which allowed a look at the population prevalence of the disorder. Juveniles with threshold or below threshold manic episodes were further assessed for comorbidity with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and population-defined ADHD subtypes (from latent class analysis) using Fisher's exact test. Nine juveniles who exhibited DSM-IV manic (n = 1), hypomanic (n = 2) or below threshold episodes (n = 6) were identified. The population prevalence of broadly defined mania in the random sample was 0.2%. The possible manic episodes showed significant comorbidity with population-defined severe combined and talkative ADHD subtypes. It can be concluded that there is a significant association of bipolar symptoms with two population-defined subtypes of ADHD. Episodes of possible bipolar disorders as defined by DSM-IV are uncommon in this nonreferred sample. Children and adolescents with ADHD appear to be only modestly at increased risk for bipolar disorders.

Suicide Ideation and Attempts in Children With Psychiatric Disorders and Typical Development

Crisis ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Susan Dickerson Mayes ◽  
Susan L. Calhoun ◽  
Raman Baweja ◽  
Fauzia Mahr
Keyword(s):  
Children And Adolescents ◽  
Psychiatric Disorders ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Typical Development ◽  
Oppositional Defiant ◽  
Suicide Behavior ◽  
Increased Risk ◽  
Inattentive Type

Background: Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. Aims: This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Method: Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6–18 years of age. Results: For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0–4% of patients in the other psychiatric groups. Conclusion: It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.

scholarly journals The Use of Cannabis as a Predictor of Early Onset of Bipolar Disorder and Suicide Attempts

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Rafaela Torres Portugal Leite ◽  
Sarah de Oliveira Nogueira ◽  
João Paulo Rodrigues do Nascimento ◽  
Laisa Soares de Lima ◽  
Taís Bastos da Nóbrega ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Early Onset ◽  
Suicide Attempts ◽  
Age At Onset ◽  
Prognostic Significance ◽  
Manic Episode ◽  
Cannabis Use ◽  
Pubmed Database ◽  
Increased Risk ◽  
Bipolar Patients

Introduction. Bipolar disorder (BD) implies risk of suicide. The age at onset (AAO) of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts.Materials and Methods. PubMed database was searched for articles using key words “bipolar disorder,” “suicide attempts,” “cannabis,” “marijuana,” “early age at onset,” and “early onset.”Results. The following percentages in bipolar patients were found: suicide attempts 3.6–42%; suicide attempts and substance use 5–60%; suicide attempts and cannabis use 15–42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD) was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide.Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear.

The Effect of Parental Remarriage following Parental Divorce on Offspring Suicide Attempt

2010 ◽  
Vol 91 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Dana M. Lizardi ◽  
Ronald G. Thompson ◽  
Katherine M. Keyes ◽  
Deborah S. Hasin
Keyword(s):  
Suicide Attempt ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Parental Divorce ◽  
Female Offspring ◽  
Female Adult ◽  
History Of Childhood ◽  
Epidemiologic Survey ◽  
Increased Risk ◽  
History Of

Parental divorce during childhood is associated with an increased risk of suicide attempts for male but not female offspring. This study examines whether parental remarriage has a differential effect on suicide risk for male and female adult offspring. Using the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the sample consists of respondents who experienced parental divorce ( N = 6,436). Multivariable regressions were estimated. Females who lived with a stepparent were significantly more likely to report a lifetime suicide attempt compared with females who had not. Clinicians should note that female depressed patients who have a history of childhood parental divorce and remarriage may be at more risk for suicide attempt than previously recognized.

scholarly journals Graph theory analysis of whole brain functional connectivity to assess disturbances associated with suicide attempts in bipolar disorder

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Anjali Sankar ◽  
Dustin Scheinost ◽  
Danielle A. Goldman ◽  
Rebecca Drachman ◽  
Lejla Colic ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Functional Connectivity ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Imaging Data ◽  
Significant Group ◽  
Whole Brain ◽  
Graph Theoretical Approach ◽  
Suicide Behaviors

AbstractBrain targets to lower the high risk of suicide in Bipolar Disorder (BD) are needed. Neuroimaging studies employing analyses dependent on regional assumptions could miss hubs of dysfunction critical to the pathophysiology of suicide behaviors and their prevention. This study applied intrinsic connectivity distribution (ICD), a whole brain graph‐theoretical approach, to identify hubs of functional connectivity (FC) disturbances associated with suicide attempts in BD. ICD, from functional magnetic resonance imaging data acquired while performing a task involving implicit emotion regulation processes important in BD and suicide behaviors, was compared across 40 adults with BD with prior suicide attempts (SAs), 49 with BD with no prior attempts (NSAs) and 51 healthy volunteers (HVs). Areas of significant group differences were used as seeds to identify regional FC differences and explore associations with suicide risk-related measures. ICD was significantly lower in SAs than in NSAs and HVs in bilateral ventromedial prefrontal cortex (vmPFC) and right anterior insula (RaIns). Seed connectivity revealed altered FC from vmPFC to bilateral anteromedial orbitofrontal cortex, left ventrolateral PFC (vlPFC) and cerebellum, and from RaIns to right vlPFC and temporopolar cortices. VmPFC and RaIns ICD were negatively associated with suicidal ideation severity, and vmPFC ICD with hopelessness and attempt lethality severity. The findings suggest that SAs with BD have vmPFC and RaIns hubs of dysfunction associated with altered FC to other ventral frontal, temporopolar and cerebellar cortices, and with suicidal ideation, hopelessness, and attempt lethality. These hubs may be targets for novel therapeutics to reduce suicide risk in BD.

The Pathways of Aggression – Differential Indirect Associations Between Anxiety Sensitivity Cognitive Concerns and Suicidality

Crisis ◽  
2020 ◽  
pp. 1-8
Author(s):  
Rachel L. Martin ◽  
Nicole S. Smith ◽  
Nicole M. Caulfield ◽  
Daniel W. Capron
Keyword(s):  
Suicidal Ideation ◽  
Anxiety Sensitivity ◽  
Physical Aggression ◽  
Indirect Effects ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Verbal Aggression ◽  
Cross Sectional ◽  
Increased Risk ◽  
Foundational Research

Abstract. Background: Suicide prevention efforts have focused on risk factors that help identify people with an increased risk for suicide. One risk factor related to suicide risk is anxiety sensitivity cognitive concerns (ASCC), which is the "fear of going crazy." The association between ASCC and suicidal ideation is hypothesized to result from the depression–distress amplification model, which postulates that ASCC exacerbates feelings of depression and concurrent distress. Furthermore, there is evidence for associations between ASCC/dysregulated anger and dysregulated anger/suicidal ideation. We hypothesized that aggression may provide pathways from ASCC to suicidality. The current study examined how facets of aggression (described as elevated agitation) meditated the association between ASCC and suicidality. Aims: The current study aimed to extend prior research by examining how different facets of aggression mediate the association between ASCC and suicidality. Method: Participants were 440 adults recruited online, 32.7% of whom endorsed experiencing lifetime suicidal ideation. Results: Our hypotheses were partially supported with two significant indirect effects. Results indicated that physical aggression and hostility provided significant indirect effects; however, verbal aggression and anger did not. Limitations: The study was cross-sectional in nature, limiting causal interpretations about the indirect effects. The sample included primarily White participants. Conclusion: Specific facets of aggression provide pathways through which ASCC is associated with suicidality. Aggression may be a catalyst for individuals to progress to suicidality. The current study provides foundational research for continued examination of physical aggression as a catalyst for suicide attempts.

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