Does first episode polarity predict risk for suicide attempt in bipolar disorder?

Abstract

Background-Defining bipolar disorder (BD) subtypes with increased risk of suicidal behavior may help clinical management. We tested the hypothesis that the polarity of a patient's first mood episode would be a marker for BD subtypes with differential risk for suicidality.

Bipolar disorder first episode and suicidal behavior: are there differences according to type of suicide attempt?

“…Our results are only partially in accordance with those reported by Chaudhury et al 10 These authors found a significant association between the FD group and a more frequent lifetime history of suicide attempt and number of suicide attempts. In our sample, the frequency of suicide attempters in the FD group was not statistically different from the frequency of suicide attempters in the FM group (51 vs. 37.9%, respectively, p = 0.08).…”

“…Nevertheless, as found in the Chaudhury et al, 2007 study, suicide attempters belonging to the FD group made more suicide attempts than suicide attempters belonging to the FM group. 10 In our sample, FD and FM were different in terms of the percentage of bipolar type II, which was higher in the FD group (38.2 vs. 15.2%), as well as proportion of female gender (77.5 vs. 56.1%), lifetime history of psychotic symptoms and finally, number of lifetime suicide attempts (1.48 vs. 0.92). After performing a zero-inflated Poisson regression analysis in order to verify the independence of these variables regarding suicidal behavior, we found that the only characteristics associated with number of suicide attempts were diagnosis of bipolar II and lifetime history of psychotic symptoms.…”

“…[4][5][6][7][8][9] Recently, a study carried out by Chaudhury et al, replicating previous results, 4,9 showed that patients presenting depression as the first episode were at higher risk of suicide attempts even when adjusting for years with disease and total number of lifetime major depressive episodes. 10 These studies are important, since they can provide a better understanding of BD clinical heterogeneity and particularly of suicidal behavior in BD.…”

Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

“…35 Chaudhury et al, in a mixed sample of bipolar type I and type II, demonstrated that patients who had a first mood episode of depression had eight-fold greater odds of suicide attempts, had more severe course of illness and more alcohol misuse and psychotic episodes. 58 In several studies, the number of hospitalizations for depression was also an independent predictive risk factor. 48,49,55 Although the severity of depression is a risk factor as well, studies have previously shown that prior suicidal behavior does not appear to be related only to the objective severity of depression, i.e., the clinician's rating of how severe is the depression as measured by depression rating scales such as the Montgomery-Asberg Depression Rating Scale (MADRS) 59 and the Hamilton Depression Rating Scale (HAM-D).…”

Time to Diagnosis Possibly Reflects Bipolar II Disorder Heterogeneity

“…It is a neurodevelopmental psychiatric disorder [2], but little is known about its biological mechanism. If some marker of (BDII), that is easy to detect and can predict important prognoses as to the risk of suicidal behavior [3], response to treatment [4], etc., is identified, it would be very helpful in clinical settings. Twenty outpatients visiting a psychiatric practice in Tokyo on June 1, 2012, who were diagnosed with BDII (DSM-IV-TR) [5], were investigated.…”