ABSTRACT
Psychiatr Clin North Am. 2016
Mar;39(1):111-23. doi: 10.1016/j.psc.2015.09.002.
Epub 2015 Dec 22.
SUICIDE BEHAVIORS IN BIPOLAR
DISORDER:
A REVIEW AND UPDATE FOR THE CLINICIAN.
Beyer JL, Weisler RH.
Author information:
Duke University Medical Center, Box
3519, Durham, NC 27710, USA.
Suicide behaviors (ideation,
attempts, and completions) are unfortunately common in patients with bipolar
disorder. It is estimated that 25 to 50% attempt suicide at least once during
their lifetime, and 6% to 19% complete suicide. Risk factors include a family
history of suicide, previous suicide attempts, younger age of onset, comorbid
psychiatric illnesses, and psychological constructs like hopelessness.
Pharmacologic treatment may impact
suicidal behaviors, either
increasing vulnerability or
resilience. Clinicians need to be particularly
sensitive to their patient's thoughts
and beliefs about death, particularly
during stressful times of life or
when in a depressive/mixed episode of bipolar disorder.
KEY POINTS
Bipolar disorder is highly associated
with suicide behaviors; among all the psychiatric illnesses, bipolar disorder
seems to have the highest risk for suicide attempts and completions.
The greatest risk factors for suicide
completion are previous suicide attempts and a family history of suicide.
Although frequently used to treat
bipolar depression, antidepressants may have a suicideprovoking effect in
younger adults and adolescents.
Lithium seems to have
suicide-preventing effects.
