Characterization of depressed bipolar patients with current suicidal ideation

Nobile, Bénédicte; Dubois, Jonathan; Aouizerate, Bruno; Aubin, V.; Loftus, J.; Bellivier, Frank; Belzeaux, Raoul; Dubertret, Caroline; Gard, Sébastien; Haffen, Emmanuel; Schwan, Raymund; Llorca, Pierre‐Michel; Passerieux, Christine; Roux, Paul; Polosan, Mircea; Étain, Bruno; Leboyer, Marion; Courtet, Philippe; Olié, Émilie

doi:10.1177/0004867420963744

Cited by 16 publications

(16 citation statements)

References 51 publications

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“…Indeed, patients with suicidal depression have more severe baseline clinical features, respond less well to antidepressants, may have a different clinical course (e.g., depression remission) and have higher suicidal risk than depressed patients without SI [21][22][23][24][25]. We previously reported similar results in a study on two large cohorts of outpatients with unipolar depression [24].…”

Section: Introductionsupporting

confidence: 55%

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Characterization of suicidal depression: A 1 year prospective study

et al. 2022

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Background Suicidal ideation (SI) is an important risk factor of death by suicide. Recent data suggest that suicidal depression (i.e., moderate to severe depression with SI) could be a specific depression subtype with worse clinical outcomes than nonsuicidal depression (i.e., without SI). Methods Among 898 French adult inpatients (67% women, mean age: 41.23 [SD: 14.33]) with unipolar depression, 71.94% had moderate to severe depression (defined using the cut-offs of validated scales: beck depression inventory, clinician-rated 30-item inventory depression symptomatology, and quick inventory of depressive symptomatology) and among them, 63.6% had SI according to the suicidal item (score ≥ 2) of the depression scale they filled in. Clinical features (anxiety, psychological pain, and hopelessness) were assessed at baseline. The occurrence of a suicide attempt (SA) or a suicide event (SE) (i.e., actual, aborted or interrupted SA, or hospitalization for SI) was recorded during the 1-year follow-up. The risk of actual SA and SE was compared between groups with adjusted Cox regression models. Results The risk of actual SA and SE during the follow-up was 2- and 1.8-fold higher, respectively, in patients with suicidal depression, independently of potential cofounders such as history of lifetime SA, age, sex, and baseline depression severity. Conclusions Suicidal depression is associated with poorer prognosis in terms of actual SA/SE, despite optimal care (i.e., care in a hospital department specialized in the management of suicidal crisis). Specific therapeutic strategies might be needed for these patients.

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Section: Introductionsupporting

confidence: 55%

“…Thus, SI presence was defined by a score ≥ 2 for the suicide item of the IDSC30 (IDSC30-SI), the QIDS (QIDS-SI), or the BDI (BDI-SI). This BDI-SI cut-off was previously used [23] and is associated with a 7-fold higher risk of future death by suicide [57].…”

Section: Definition Of Suicidal Depressionmentioning

confidence: 99%

Characterization of suicidal depression: A 1 year prospective study

et al. 2022

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“…Another study showed that depressive symptomatology and its course were significantly different in suicidal and non-suicidal depressed patients (van Ballegooijen et al, 2019). About 20% of patients present persistent SI despite the improvement or remission of depression (Batterham et al, 2019; Nobile et al 2021; Seo et al, 2014). Finally, growing evidence suggests SB has its own physiopathology (e.g.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and treatment outcome of suicidal depression: Two large naturalistic cohorts of depressed outpatients

Nobile

Olié

Dubois

et al. 2021

Aust N Z J Psychiatry

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Objective: The emergence of new drugs for managing suicidal ideation (e.g. ketamine) raises the question of whether suicidal depression (i.e. moderate to severe depression with concomitant suicidal ideation) is a specific depression phenotype. Therefore, this study characterized patients with suicidal depression (baseline clinical characteristics, suicidal ideation and depression evolutions, suicide risk) in two large cohorts of outpatients with depression. Methods: LUEUR and GENESE are two large, prospective, naturalistic cohorts of French adult outpatients with depression (Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria), treated and followed up for 6 weeks. Depression severity was assessed with the Hospital Anxiety and Depression Scale, and suicidal ideation with the suicidal item of the Montgomery–Åsberg Depression Rating Scale. Patients with moderate or severe depression (Hospital Anxiety and Depression Scale–Depression subscale score >11) were selected and classified as without suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale <2), with moderate suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale [2; 3]) and with severe suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale ⩾4). Results: Baseline clinical features were more severe (e.g. higher anxiety and depression scores) in depressed patients with moderate/severe suicidal ideation. Depression remission after treatment was less frequent among patients with severe suicidal ideation. The risk of suicide attempt during the follow-up was threefold higher in patients with suicidal ideation among those 10% had persistent suicidal ideation. Conclusion: Suicidal depression could be a specific depression phenotype with more severe clinical characteristics, less frequent depression remission, suicidal ideation persistence and higher suicide attempt risk, despite antidepressant treatment. It seems that novel therapeutic strategies could be needed.

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“…The Quick Inventory of Depressive Symptoms (QIDS) scale, without the item on suicidal ideation, was used to assess the depression level. Suicidal ideation was self-evaluated with item 12 of the QIDS, as conducted in previous studies [42]. The anxious state was self-evaluated with the Spielberg Anxiety Inventory (STAI).…”

Section: Affective Statesmentioning

confidence: 99%

Self-Reported Pain and Emotional Reactivity in Bipolar Disorder: A Prospective FACE-BD Study

Risch

Dubois

M’Baïlara

et al. 2022

JCM

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In patients with bipolar disorder (BD), pain prevalence is close to 30%. It is important to determine whether pain influences BD course and to identify factors associated with pain in BD in order to guide BD management. This naturalistic, prospective study used data on 880 patients with BD from the French FACE-BD cohort who were divided into two groups according to the presence or absence of pain. Multivariate models were used to test whether pain was associated with affective states and personality traits while controlling for confounders. Then, multivariate models were used to test whether pain at baseline predicted global life functioning and depressive symptomatology at one year. At baseline, 22% of patients self-reported pain. The pain was associated with depressive symptomatology, levels of emotional reactivity in a quadratic relationship, and a composite variable of personality traits (affective lability, affective intensity, hostility/anger, and impulsivity). At one year, the pain was predictive of depression and lower global life functioning. Pain worsens mental health and well-being in patients with BD. The role of emotions, depression, and personality traits in pain has to be elucidated to better understand the high prevalence of pain in BD and to promote specific therapeutic strategies for patients experiencing pain.

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Characterization of depressed bipolar patients with current suicidal ideation

Cited by 16 publications

References 51 publications

Characterization of suicidal depression: A 1 year prospective study

Characterization of suicidal depression: A 1 year prospective study

Characteristics and treatment outcome of suicidal depression: Two large naturalistic cohorts of depressed outpatients

Self-Reported Pain and Emotional Reactivity in Bipolar Disorder: A Prospective FACE-BD Study

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