Risk factors for suicide in patients with bipolar disorder
Leo Sher, M.D.
A research report, “Risk factors for suicide in bipolar disorder: a cohort study of 12 850 patients” has been published in Acta Psychiatrica Scandinavica online ahead of print (1). The authors examined risk factors for suicide in a large cohort of patients with bipolar disorder.
The data from the Swedish National Quality Register for Bipolar Affective Disorder were used. This register was created in 2004 with the aim of improving the quality of care for individuals with bipolar disorder in Sweden. All patients that entered in the Register between 2004 and 2013 were included in the study. The outcome variable was suicide registered in the Cause of Death Register between 2004 and 2014. Multiple variables were tested for their association with suicide.
The research group identified 12,850 persons (4,844 men and 8,006 women) with bipolar disorder of whom 90 (55 men and 35 women) died by suicide during the follow‐up period. The follow‐up time ranged from 1 year to 10 years. The mean follow‐up time was 4.05 years.
Male sex, living alone, previous suicide attempts, any comorbid psychiatric disorder, comorbid substance use disorder, anxiety disorder, and personality disorder, recent affective episode(s), recent depressive episode(s), a history of criminal conviction, psychiatric inpatient care, and involuntary commitment were risk factors for death by suicide. When the data were analyzed for men and women separately, the authors found that living alone, comorbid substance use disorder, involuntary commitment, and having had at least one affective episode in the previous year were predictors of suicide in men, but not in women. Conversely, the authors found that a history of criminal conviction, comorbid personality disorder, and having had at least one depressive episode in the previous year were predictors of suicide in women, but not in men.
References
- Hansson C, Joas E, Pålsson E, Hawton K, Runeson B, Landén M. Risk factors for suicide in bipolar disorder: a cohort study of 12 850 patients. Acta Psychiatr Scand. 2018 Aug 3. doi: 10.1111/acps.12946. [Epub ahead of print]