Current Suicide Ideation and Prior Suicide Attempts of Bipolar Patients as Influences on Caregiver Burden

Abstract

We examined whether caregivers of bipolar patients reporting current suicidal ideation and/or a history of a suicide attempt reported higher levels of burden and/or poorer health compared to caregivers of patients without these suicidality indices. In a cross-sectional design, caregivers (N = 480) associated with (a) patients with current suicidal ideation or (b) patients with a positive lifetime history of at least one suicide attempt, reported lower general health scores than caregivers associated with patients with neither of these indices. Parents of patients with at least one lifetime attempt reported more burden secondary to role dysfunction than spouses. Levels of depression in caregivers varied with whether the caregiver was a spouse or a parent, and whether patients had a history of suicide attempts, current suicidal ideation, or both.

Surrogate Endpoints in Suicide Research

“…While the study of suicide attempts as a proxy for suicide completion appears to be of limited value, there remains substantial inherent value in the study and prevention of suicide attempts for its own sake. Suicide attempts are sources of suffering, are disruptive to lives, and are taxing to healthcare systems and caregivers (Chessick et al, 2007; Sun & Long, 2008; Yang & Lester, 2007). The justification for studying attempts lies in these realities, and not in the notion that we can thereby infer something about completed suicide.…”

‘Between a rock and a hard place’: family members’ experiences of supporting a relative with bipolar disorder

“…However, the distinction between Type I (characterised by mania) and Type II (characterised by hypomania) is often made (APA, 2013). Symptoms and difficulties associated with bipolar disorder such as unpredictable changes in mood, high risk of suicide, risk-taking and irritability can place substantial demands on caregivers Beentjes, Goossens & Poslawsky, 2012;Chessick et al, 2007;Reinares et al, 2006). Many people with bipolar disorder also experience sub-syndromal symptoms and functional impairment between episodes (NCCMH, 2014a).…”

Family‐focused treatment for caregivers of patients with bipolar disorder

“…From 89% to 91% of family members report feelings of emotional distress (i.e., ‘subjective burden’) in relation to the severity of the patient’s illness symptoms (1, 2); between 24% and 38% score above the standard cutoffs on self-report measures of depressive symptoms (2). Patient suicidal ideation and behavior in particular have been associated with increased symptoms of caregiver depression (3). For family members with their own history of mood disorders, caregiving more than doubles the risk of recurrence of an episode of major depression in the caregiver compared to the risk of recurrence among persons with a history of mood disorder but without caregiving responsibilities (4).…”