Attempted Suicide in Manic-Depressive Disorder

Abstract

Structured interviews were used to study rates of past suicide attempts among 123 outpatients treated for affective disorders. Subjects met the Feighner criteria for major affective illness, and bipolar and unipolar groups were identified in accordance with the Fieve-Dunner criteria. Although a small group (N = 6), the women with a history of hospitalization for depression and outpatient treatment for hypomania (BP II) had the highest rate of past suicide attempts. (66 percent). This confirms previous findings. Women showed higher rates overall (39 percent vs. 28 percent for men). Suicide attempters were found to be significantly younger than nonattempters, which is in line with previous reports that suicide risk is high early in the course of bipolar illness. A trend for attempters to have received their first treatment at a younger age suggests that early onset may be a risk factor. No differences in marital status were found between attempters and nonattempters. Males and females did not differ in number, seriousness, or lethality of attempts.

Heterogeneity of the risk of suicidal behavior in bipolar‐spectrum disorders

“…Although we made no distinction between attempts and completed suicides for the purposes of this investigation, we acknowledge the potential significance of differences between these manifestations of suicidal behavior. For instance, other studies have demonstrated that bipolar women attempt suicide more frequently than men (49, 50), though men tend to succeed more frequently (19), a finding demonstrated in our data as well. However, some of these results show only statistical trends.…”

Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies

“…Bipolar II disorder and highly recurrent depression are closely related (610). Bipolar II disorder appears to be associated with a significant risk of suicide (614–617). Patients with a diagnosis of bipolar II disorder are more likely to have demonstrated an earlier age of onset, have a family history of bipolar II, and will experience higher rates of recurrence, anxiety disorders and substance abuse compared to patients with MDD (76, 609, 610, 618, 619).…”

Bipolar II disorder: arguments for and against a distinct diagnostic entity

“…Several studies have reported a higher risk of suicide in bipolar II patients (63, 91–93). Rihmer and Pestality (94) reviewed the rate of lifetime history of suicide attempts and found it was attempted by 17% of bipolar I patients, 24% of bipolar II patients, and 12% of unipolar major depressive patients.…”