Suicidal Risk Factors in Bipolar I and II Disorder Patients

被引:81
作者
Undurraga, Juan [1 ,2 ]
Baldessarini, Ross J. [1 ]
Valenti, Marc [2 ]
Pacchiarotti, Isabella [2 ]
Vieta, Eduard [1 ,2 ]
机构
[1] McLean Hosp, Int Consortium Bipolar Disorder Res, Boston, MA USA
[2] Univ Barcelona, Dept Psychiat, Bipolar Disorder Program, Hosp Clin,IDIBAPS,CIBERSAM, Barcelona, Spain
关键词
ALL-CAUSE MORTALITY; PREDOMINANT POLARITY; HEALTH-CARE; LITHIUM; DEPRESSION; PREVENTION; CLOZAPINE; MORBIDITY; BEHAVIOR;
D O I
10.4088/JCP.11m07041
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background: Suicidal risks may be similar in bipolar I and II disorders, but predictive risk factors are not well established for each disorder type or across cultures. Method: Accordingly, we compared selected demographic and clinical factors for long-term association with nonlethal suicidal acts or ideation in 290 DSM-IV bipolar I (n=204) and II (n=86) disorder patients followed for a mean of 9.3 years at the University of Barcelona, using preliminary bivariate comparisons followed by multivariate logistic regression modeling. Results: Rates of suicidal ideation (41.5%) and acts (19.7%) were similarly prevalent with bipolar I and II disorders and somewhat more common among women. Factors significantly and independently associated with suicidal acts were determined by multivariate modeling and ranked in order of their strength of association: suicidal ideation, more mixed episodes, Axis II comorbidity, female sex, more antidepressant trials, rapid cycling, predominant lifetime depression, having been hospitalized, older onset, and longer delay of diagnosis. Suicidal ideation was associated with suicidal acts, more antidepressant trials, predominant depressions, more mixed-episodes/year, depressive first-lifetime episodes, electroconvulsive therapy use, delay of bipolar disorder diagnosis, unemployment, melancholic features, Axis II disorders, rapid cycling, and more depressions per year. Risk factors selectively associated with suicidal risk, overall, included more mixed-states per year and melancholic features, whereas hospitalization, unemployment, and predominantly depressive recurrences were more characteristic of diagnostic subtypes. Conclusions: Suicidal risk-factors found to be independent of bipolar disorder diagnostic subtype included mixed-states, melancholic depressive features, and more antidepressant trials. J Clin Psychiatry 2012;73(6):778-782 (c) Copyright 2011 Physicians Postgraduate Press, Inc.
引用
收藏
页码:778 / 782
页数:5
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