Lifetime history of suicide attempts is associated with poorer social skills in patients with bipolar disorder type I

OBJECTIVE: The objective of this study was to test the hypothesis that the polarity of the first mood episode may be a marker for suicidal behavior, particularly the violent subtype. METHOD: One hundred and sixty-eight patients diagnosed with bipolar disorder (DSM-IV) were grouped according to type of first episode: depression or manic/hypomanic. Groups were compared for demographic and clinical variables. We performed logistic regression in order to test the association between first episode polarity and suicidal behavior. RESULTS: We found that depressed patients have a lifetime history of more suicide attempts. However, univariate analysis of number of suicide attempts showed that the best model fits the bipolar II subtype (mean square = 15.022; p = 0.010) and lifetime history of psychotic episodes (mean square = 17.359; p = 0.021). Subgrouping the suicide attempts by subtype (violent or non-violent) revealed that manic/hypomanic patients had a greater tendency toward attempting violent suicide (21.2 vs. 14.7%, X² = 7.028, p = 0.03). Multiple logistic regression analysis confirmed this result. CONCLUSION: Depressed patients had more suicide attempts over time, which could be explained by the higher prevalence of bipolar II subtype in this group, whereas manic/hypomanic patients had a lifelong history of more frequent violent suicide attempts, not explained by any of the variables studied. Our results support the evidence that non-violent suicide attempters and violent suicide attempters tend to belong to different phenotypic groups.

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Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I

Comprehensive Psychiatry ◽

10.1016/j.comppsych.2011.03.003 ◽

2012 ◽

Vol 53 (2) ◽

pp. 125-129 ◽

Cited By ~ 29

Author(s):

Lena Nabuco de Abreu ◽

Fabiano G. Nery ◽

Jill M. Harkavy-Friedman ◽

Karla Matias de Almeida ◽

Bernardo Carramao Gomes ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Suicide Attempts ◽

Type I ◽

Disorder Type

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Affective Temperaments and Clinical Course of Bipolar Disorder: An Exploratory Study of Differences among Patients with and without a History of Violent Suicide Attempts

Medicina ◽

10.3390/medicina55070390 ◽

2019 ◽

Vol 55 (7) ◽

pp. 390 ◽

Cited By ~ 3

Author(s):

Fico ◽

Caivano ◽

Zinno ◽

Carfagno ◽

Steardo ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Clinical History ◽

Short Version ◽

Type I ◽

Affective Temperaments ◽

Character Inventory ◽

History Of ◽

Predictive Role ◽

The Relationship

Background and Objectives: Suicide is the leading cause of death in patients with Bipolar Disorder (BD). In particular, the high mortality rate is due to violent suicide attempts. Several risk factors associated with suicide attempts in patients with BD have been identified. Affective temperaments are associated with suicidal risk, but their predictive role is still understudied. The aim of this study is to assess the relationship between affective temperaments and personal history of violent suicide attempts. Materials and Methods: 74 patients with Bipolar Disorder type I (BD-I) or II (BD-II) were included. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (short TEMPS-M) and the Temperament and Character Inventory, revised version (TCI-R). The sample was divided into two groups on the basis of a positive history for suicidal attempts and the suicidal group was further divided into two subgroups according to violent suicide attempts. Results: Violent suicide attempts were positively associated with the cyclothymic temperament and inversely to the hyperthymic one. BD-I patients and patients with a clinical history of rapid cycling were significantly more represented in the group of patients with a history of violent suicide attempts. Conclusions: Our study highlights that several clinical and temperamental characteristics are associated with violent suicide attempts, suggesting the importance of affective temperaments in the clinical management of patients with BPI.

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Prevalence of bipolar disorder in a sample of older adults

Scientia Medica ◽

10.15448/1980-6108.2017.4.28026 ◽

2017 ◽

Vol 27 (4) ◽

pp. 28026

Author(s):

Luísa Weber Bisol ◽

Letícia Rodrigues Porciúncula ◽

Elisa Fasolin Mello ◽

Eduardo Lopes Nogueira ◽

Irênio Gomes ◽

...

Keyword(s):

Older Adults ◽

Bipolar Disorder ◽

Suicide Attempt ◽

Suicide Risk ◽

Suicide Attempts ◽

Categorical Variables ◽

Elderly Subjects ◽

Type I ◽

Type Ii ◽

History Of

***Prevalence of bipolar disorder in a sample of older adults***AIMS: To estimate the prevalence of bipolar disorder in a sample of older adults and to examine associated socio-demographic and clinical factors.METHODS: Cross-sectional population-based study of individuals aged 60 years or older registered with the Family Health Strategy in Porto Alegre, Rio Grande do Sul, Brazil, selected randomly from 30 different basic health units. Participants were subjected to diagnostic assessment for bipolar disorder and suicide risk using the Mini International Neuropsychiatric Interview Plus 5.0.0. Categorical variables were described as absolute and relative frequencies. Quantitative variables were expressed as means and standard deviations. The Pearson chi-square or Fisher’s exact tests were used as appropriate to evaluate potential associations between the independent variables suicide attempt and risk of suicide. To control for possible confounders and assess variables independently associated with the outcome of interest, the strength association among different risk factors was assessed by means of prevalence ratios, which were estimated with a controlled Poisson model or multivariate Poisson regression. The significance level was set at 5% (p≤0.05).RESULTS: The sample comprised 550 older adults. The lifetime prevalence of bipolar disorder in the sample was 5.8% and the point prevalence was 1.5%. In those with bipolar disorder, 59.4% were type I and 40.6% type II. Significant associations were observed between bipolar disorder regardless of type and female gender (prevalence rate [PR] 2.42, 95% confidence interval [CI] 1.01-5.81), living with a partner (PR 2.52, 95%CI 1.21-5.24), history of suicide attempt (PR 3.16, 95%CI 1.53-6.25), and suicide risk (PR 2.98, 95%CI 1.47-6.06). When analyzed each type of bipolar disorder, statistically significant associations were found between age under 70 years and type I bipolar disorder; having companion and type II bipolar disorder; and risk of suicide was associated with both types of bipolar disorder.CONCLUSIONS: Regardless of the type of bipolar disorder, women and those living with a partner were more affected. History of suicide attempts and suicide risk were more frequent in elderly subjects with bipolar disorder than in those without the disorder.

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Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462009005000003 ◽

2009 ◽

Vol 31 (3) ◽

pp. 271-280 ◽

Cited By ~ 54

Author(s):

Lena Nabuco de Abreu ◽

Beny Lafer ◽

Enrique Baca-Garcia ◽

Maria A. Oquendo

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Suicidal Ideation ◽

Suicidal Behavior ◽

Suicide Ideation ◽

Suicide Attempts ◽

Clinical Samples ◽

Type I ◽

History Of ◽

Axis I

OBJECTIVE: This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder. METHOD: Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation. RESULTS: Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse. CONCLUSION: Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.

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Can Risk-Taking Be an Endophenotype for Bipolar Disorder? A Study on Patients with Bipolar Disorder Type I and Their First-Degree Relatives

Journal of the International Neuropsychological Society ◽

10.1017/s1355617713000015 ◽

2013 ◽

Vol 19 (4) ◽

pp. 474-482 ◽

Cited By ~ 15

Author(s):

Ceren Hıdıroğlu ◽

Özlem Demirci Esen ◽

Zeliha Tunca ◽

Şehnaz Neslihan Gűrz Yalçìn ◽

Lauren Lombardo ◽

...

Keyword(s):

Bipolar Disorder ◽

Risk Taking ◽

Outcome Measure ◽

Bipolar Disorders ◽

Type I ◽

Balloon Analogue Risk Task ◽

First Degree Relatives ◽

Risk Taking Behavior ◽

Disorder Type ◽

Core Features

AbstractRisk-taking behavior and impulsivity are core features of bipolar disorder. Whether they are part of the inherited aspect of the illness is not clear. We aimed to evaluate risk-taking behavior as a potential endophenotype for bipolar disorders, and its relationship with impulsivity and illness features. The Balloon Analogue Risk Task (BART) and Barratt Impulsiveness Scale-11 (BIS-11) were used to assess risk-taking behavior and impulsivity respectively in 30 euthymic bipolar I patients (BD), their 25 asymptomatic first-degree relatives (BD-R), and 30 healthy controls (HC). The primary BART outcome measure was the behavioral adjustment score (number of pumps after trials where the balloon did not pop minus the number of pumps after trials where the balloon popped). BD (p< .001) and BD-R (p= .001) had similar and significantly lower adjustment scores than HC. Only BD scored significantly higher on BIS-11 total (p= .01) and motor (p= .04) subscales than HC. Neither the BART, nor impulsivity scores associated with illness features. A limitation of this study is medicated patients and a heterogeneous BD-R were included. Riskiness may be a candidate endophenotype for bipolar disorder as it appears independently from illness features, presents similarly in BD and BD-R groups and differs from impulsivity. (JINS, 2013,19, 1–9)

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Cytokine Polymorphisms in the Pathophysiology of Mood Disorders

CNS Spectrums ◽

10.1017/s1092852900020393 ◽

2009 ◽

Vol 14 (8) ◽

pp. 419-425 ◽

Cited By ~ 52

Author(s):

Mario Clerici ◽

Beatrice Arosio ◽

Emanuela Mundo ◽

Elisabetta Cattaneo ◽

Sara Pozzoli ◽

...

Keyword(s):

Bipolar Disorder ◽

Mood Disorders ◽

Lower Percentage ◽

Genetic Profile ◽

Type I ◽

Genotype Distribution ◽

Bipolar Ii ◽

Tnf Α ◽

Ifn Γ ◽

Disorder Type

ABSTRACTIntroduction: An increasing amount of data suggests that dysregulation of the immune system, including the cytokine network, is associated with the etiology and pathophysiology of mood disorders. Genes encoding cytokines are highly polymorphic and single nucleotide polymorphisms, associated with increased or reduced cytokine production, have been described. The aim of this study was to define the genetic immunologic scenario associated with major depressive disorder (MDD) and bipolar disorder.Methods: Eighty-four Italian outpatients affected by bipolar disorder type I, bipolar disorder type II, or MDD, and 363 healthy controls were enrolled into the study. We analyzed allele and genotype distribution of −308 (G/A) tumor necrosis factor-α (TNF-α), +874 (T/A) interferon-γ (IFN-γ), -174 (G/C) interleukin (IL)-6, and −1082 (G/A) IL-10 promoter polymorphisms by Polymerase Chain Reaction Sequence Specific Primers technique.Results: We observed different genotype and allele distributions of TNF-α, IFN-γ, and IL-10 polymorphisms in the three groups of patients analyzed. In particular, bipolar II patients were characterized by an absence of adenine (A) high producer allele of TNF-α (P<.001) and a lower percentage of TT high producer genotype of IFN-γ (P <.001); bipolar I individuals showed reduced percentage of AA low producer genotype of IL-10 (P<.001). Both bipolar I and bipolar II patients not carrying guanine (G) high producer IL-6 allele showed a lower mean age at onset (P=.048).Conclusion: These data support the existence of a genetic profile related to pro-inflammatory cytokines in patients affected by mood disorders. The differences observed across the three clinical phenotypes suggest the presence of different pathogenetic mechanisms involved in the susceptibility of phenotypically different mood disorders.

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Lifetime prevalence of non-suicidal self-injury in patients with eating disorders: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291716000027 ◽

2016 ◽

Vol 46 (7) ◽

pp. 1345-1358 ◽

Cited By ~ 49

Author(s):

A. Cucchi ◽

D. Ryan ◽

G. Konstantakopoulos ◽

S. Stroumpa ◽

A. Ş. Kaçar ◽

...

Keyword(s):

Substance Abuse ◽

Eating Disorders ◽

Suicide Attempts ◽

Meta Analysis ◽

Weighted Average ◽

Average Percentage ◽

Lifetime History ◽

Self Injury ◽

History Of ◽

Meta Analyses

BackgroundAgainst a backdrop of increasing research, clinical and taxonomic attention in non-suicidal self-injury (NSSI), evidence suggests a link between NSSI and eating disorders (ED). The frequency estimates of NSSI in ED vary widely. Little is known about the sources of this variation, and no meta-analysis has quantified the association between ED and NSSI.MethodUsing random-effects meta-analyses, meta-regression analyses, and 1816–6466 unique participants with various ED, we estimated the weighted average percentage of individuals with ED, those with anorexia nervosa (AN) and those with bulimia nervosa (BN) who are reported to have a lifetime history of NSSI across studies. We further examined predictors of NSSI in ED.ResultsThe weighted average percentage of patients with a lifetime history of NSSI was 27.3% [95% confidence interval (CI) 23.8–31.0%] for ED, 21.8% (95% CI 18.5–25.6%) for AN, and 32.7% (95% CI 26.9–39.1%) for BN. The difference between BN and AN was statistically significant [odds ratio (OR) 1.77, 95% CI 1.14–2.77, p = 0.013]. The odds of NSSI increased by 24% for every 10% increase in the percentage of participants with histories of suicide attempts (OR 1.24, 95% CI 1.04–1.48, p = 0.020) and decreased by 26% for every 10% increase in the percentage of participants with histories of substance abuse (OR 0.74, 95% CI 0.58–0.95, p = 0.023).ConclusionsIn the specific context of ED, NSSI is highly prevalent and correlates positively with attempted suicide, urging for NSSI-focused treatments. A novel finding is that NSSI is potentially antagonized by substance abuse.

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Frontolimbic brain volume abnormalities in bipolar disorder with suicide attempts

10.1101/2020.05.07.20093245 ◽

2020 ◽

Author(s):

Mbemba Jabbi ◽

Wade Weber ◽

Jeffrey Welge ◽

Fabiano Nery ◽

Maxwell Tallman ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Suicide Attempts ◽

The United States ◽

Anterior Cingulate ◽

Type I ◽

Brain Volumes ◽

Major Health Problem ◽

Dorsolateral Prefrontal

ABSTRACTOver 2.3 million people in the United States live with bipolar disorder. Sixty percent of those with a bipolar disorder diagnosis attempt suicide at least once in their lifetime, and up to 19% die by suicide. However, the neurobiology of suicide attempts in bipolar disorder remains unclear. Here, we studied the neuroanatomical basis for suicide attempt history in bipolar disorder by measuring gray matter volumes (GMV) to identify differences in brain-volumes in 121 participants with bipolar disorder type I, and healthy participants (n=40). The bipolar group consisted of individuals with suicide attempt history (n=23) and no suicide attempt history (n=58). All participants completed behavioral/diagnostic assessments and MRI measures of GMV. We focused on a predefined frontolimbic circuitry in bipolar disorder versus (vs.) healthy to first identify diagnostic GMV markers and to specifically identify markers for suicide attempt history. We found reduced GMV markers for bipolar diagnosis (i.e., bipolar<healthy) in the anterior cingulate cortex (ACC), and dorsolateral prefrontal cortices (DLPFC). Our observed frontolimbic GMV abnormalities were associated with suicide attempt history and measures of individual variations in current suicidal ideation at the time of scanning. These results identified a frontolimbic-GMV marker for bipolar diagnosis and suicidal behavioral risk tendencies.HighlightsSuicide is a major health problem especially in bipolar disorder but the neurobiological basis for suicide attempts remains obscure. We identified an anterior cingulate and dorsolateral prefrontal cortical volume correlate for suicide attempt history and suicidal ideation and thereby demonstrates a convergent brain marker for suicidal behaviors.

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