title: Attempted suicide and alcoholism in bipolar disorder: clinical and familial relationships.
abstract: OBJECTIVE
  This study examined the clinical and familial relationships between comorbid alcoholism and attempted suicide in affectively ill relatives of probands with bipolar I disorder.
  
  
  METHODS
  In 71 families ascertained for a genetic linkage study, 337 subjects with major affective disorder were assessed by using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version.
  
  
  RESULTS
  Subjects with bipolar disorder and alcoholism had a 38.4% lifetime rate of attempted suicide, whereas those without alcoholism had a 21.7% rate. Attempted suicide among subjects with bipolar disorder and alcoholism clustered in a subset of seven families. Families with alcoholic and suicidal probands had a 40.7% rate of attempted suicide in first-degree relatives with bipolar disorder, whereas other families had a 19.0% rate.
  
  
  CONCLUSIONS
  Comorbid alcoholism was associated with a higher rate of attempted suicide among family members with bipolar disorder. Attempted suicide and alcoholism clustered in a subset of families. These relationships may have a genetic origin and may be mediated by intoxication, mixed states, and/or temperamental instability.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. jpotash@jhmi.edu
authors.forename: J B
authors.initials: JB
authors.lastname: Potash
authors.forename: H S
authors.initials: HS
authors.lastname: Kane
authors.forename: Y F
authors.initials: YF
authors.lastname: Chiu
authors.forename: S G
authors.initials: SG
authors.lastname: Simpson
authors.forename: D F
authors.initials: DF
authors.lastname: MacKinnon
authors.forename: M G
authors.initials: MG
authors.lastname: McInnis
authors.forename: F J
authors.initials: FJ
authors.lastname: McMahon
authors.forename: J R
authors.initials: JR
authors.lastname: DePaulo
mesh_terms: D000435:Alcoholic Intoxication / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D015897:Comorbidity; D005190:Family; D020022:Genetic Predisposition to Disease; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology / Q000523:psychology; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D013694:Temperament / Q000145:classification