Mixed features and suicidal behavior in bipolar disorder: A clinical relationship that calls for lithium treatment

2021 ◽  
Author(s):  
Francesco Bartoli
1993 ◽  
Vol 3 (3) ◽  
pp. 336
Author(s):  
S. Spada ◽  
F. Silvetti ◽  
L. Tondo ◽  
M. Masia ◽  
A. Tarquini ◽  
...  

2016 ◽  
Vol 39 ◽  
pp. 91-96 ◽  
Author(s):  
Hye-Jin Seo ◽  
Hee-Ryung Wang ◽  
Tae-Youn Jun ◽  
Young Sup Woo ◽  
Won-Myong Bahk

2009 ◽  
Vol 18 (3) ◽  
pp. 179-183 ◽  
Author(s):  
Leonardo Tondo ◽  
Ross J. Baldessarini

AbstractWe reviewed available research findings, including meta-analyses on effects of lithium-treatment associated with rates of suicidal behavior in bipolar disorder or unipolar major depressive disorder patients, and for comparisons of lithium to mood-stabilizing anticonvulsants. Data from meta-analyses consistently indicate marked reductions of suicidal behavior and mortality during long-term treatment with lithium salts in bipolar disorder patients, and possibly also in unipolar, recurrent major depressive, perhaps even more effectively than with anticonvulsants proposed as mood-stabilizers. Suicidal risk is frequently associated with dysphoric-agitated symptoms, anger, aggression, and impulsivity-all of which may respond better to treatment with lithium or other mood-stabilizing medicines than to antidepressants. In these conditions, antidepressant treatment may not provide a beneficial effect on risk of suicidal thoughts and perhaps attempts, particularly in juveniles, whereas, lithium, perhaps even more than anticonvulsants, seems to be remarkably effective in the preventing suicidal behavior. The mechanism of action is not well defined and may be associated with either a prevention of mood recurrences or a more specific “antisuicidal” activity.Declaration of Interest: Dr. Tondo has received research support from Janssen and Eli Lilly Corporations and has served as a consultant to Glaxo-SmithKline and Merck Corporations. Dr. Baldessarini has recently been a consultant or investigator-initiated research collaborator with: AstraZeneca, Auritec, Biotrofix, Janssen, JDS-Noven, Lilly, Luitpold, NeuroHealing, Novartis, Pfizer, and SK-BioPharmaceutical Corporations. Neither author is a member of pharmaceutical speakers’ bureaus, nor do they or any family member hold equity positions in biomedical or pharmaceutical corporations.


2016 ◽  
Vol 33 (S1) ◽  
pp. s270-s271
Author(s):  
H.J. Seo ◽  
H.R. Wang ◽  
Y.S. Woo ◽  
H.C. Kim ◽  
W.M. Bahk ◽  
...  

IntroductionThe aim of the present study was to investigate various risk factors of suicidal behaviors, including the mixed features specifier, in Korean patients with bipolar disorder.MethodsWe retrospectively reviewed medical charts from 2005 to 2014. A total of 334 patients diagnosed with bipolar disorder using the DSM-IV TR were enrolled. Subjects were categorized into two groups according to their history of suicidal behavior and the demographic and clinical characteristics of the groups were compared, including the mixed features specifier. We re-evaluated the index episode using DSM-5 criteria and classified subjects into an index episode with mixed features group and an index episode without mixed features group. Logistic regression was performed to evaluate significant risk factors associated with suicidal behavior.ResultsSuicidal behavior had an independent relationship with mixed features at the index episode using DSM-5 criteria (OR = 3.39; 95% CI: 1.57–7.34) and number of previous depressive episodes (OR = 1.62; 95% CI: 1.34–1.95) in Korean bipolar patients. The mixed feature specifier was the strongest risk factor for suicidal behavior in the present study. Limitations: this was a retrospective study and structured psychiatric interviews were not conducted.ConclusionsThis study may help clinicians understand potential risk factors and manage bipolar disorders with suicidal behaviors. Clinicians should carefully monitor patients with bipolar disorder who exhibit numerous depressive episodes or mixed features for suicidal behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1998 ◽  
Vol 59 (8) ◽  
pp. 405-414 ◽  
Author(s):  
Leonardo Tondo ◽  
Ross J. Baldessarini ◽  
John Hennen ◽  
Gianfranco Floris ◽  
Francesco Silvetti ◽  
...  

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