SUICIDE BEHAVIORS IN BIPOLAR DISORDER: REVIEW & UPDATE
- Posted by Alan Eppel
- Posted in Editorials & Commentary
Psychiatr Clin North Am. 2016 Mar;39(1):111-23. doi: 10.1016/j.psc.2015.09.002.
Epub 2015 Dec 22.
SUICIDE BEHAVIORS IN BIPOLAR DISORDER:
A REVIEW AND UPDATE FOR THE CLINICIAN.
Beyer JL, Weisler RH.
Duke University Medical Center, Box 3519, Durham, NC 27710, USA.
Suicide behaviors (ideation, attempts, and completions) are unfortunately common in patients with bipolar disorder. It is estimated that 25 to 50% attempt suicide at least once during their lifetime, and 6% to 19% complete suicide. Risk factors include a family history of suicide, previous suicide attempts, younger age of onset, comorbid psychiatric illnesses, and psychological constructs like hopelessness.
Pharmacologic treatment may impact suicidal behaviors, either
increasing vulnerability or resilience. Clinicians need to be particularly
sensitive to their patient’s thoughts and beliefs about death, particularly
during stressful times of life or when in a depressive/mixed episode of bipolar disorder.
Bipolar disorder is highly associated with suicide behaviors; among all the psychiatric illnesses, bipolar disorder seems to have the highest risk for suicide attempts and completions.
The greatest risk factors for suicide completion are previous suicide attempts and a family history of suicide.
Although frequently used to treat bipolar depression, antidepressants may have a suicideprovoking effect in younger adults and adolescents.
Lithium seems to have suicide-preventing effects.