Suicide in bipolar patients: is it possible to predict & prevent?

Abstract

Background and Aim:Risk of suicide in bipolar disorder (BP) patients is one of the highest in psychiatric disorders. It is stated that long term treatment with lithium, selectively, can reduce the risk of suicide commitments and attempts. In our study, rates of suicide attempts of BP patients before and after treatment with a mood stabilizer (MS) and the relationship between suicide and other risk factors are investigated in a specialized tertiary outpatient mood disorder clinic in Istanbul, Turkey.Method:Charts of 608 bipolar disorder patients (DSM-IV) followed in our outpatient mood disorder clinic were evaluated retrospectively and 89 containing incomplete or unreliable data about the suicide history were excluded.Results and Conclusion:Lifetime rates of suicide attempts were 19,9% for BP-I patients (n=95), 50% for BP-II patients (n=8), 8,3% for BP-NOS patients (n=2) respectively. The rate of suicide was higher in BP-II patients. Duration of illness and onset as depressive episode were found as significant predictors of suicide attempt in logistic regression analysis. The rate of suicide attempt before treatment with MS was higher than the rate after treatment with MS (15,6% vs. 6,2%; p<0,001). Our findings suggest that the risk of suicide attempts in bipolar patients and especially in BP-II is highly increased, predicting the factors of suicide earlier and treating patients adequately could prevent this risk efficiently.