Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality.
OBJECTIVE
The aims of this cross-sectional pilot study were to ascertain the rates of post-traumatic stress disorder (PTSD) among adolescents with bipolar disorder (BPD) and major depressive disorder (MDD) relative to a comparison group comprised of non-affectively ill patients, and to determine whether PTSD is related to suicidal ideation and attempts. The impetus for the study was born of clinical impressions derived in the course of routine clinical practice.


METHODS
Patients were screened by a single interviewer for BPD, MDD and PTSD, panic disorder, obsessive-compulsive disorder (OCD) and social phobia using the apposite modules from the Structured Clinical Interview for DSM-IV (SCID) and histories of suicidal ideation and attempts. The data were subjected to analysis using a logistic regression model.


RESULTS
The database included 34 patients with BPD, 79 with MDD and 26 with a non-affective disorder. The risk for PTSD for a patient with BPD significantly exceeded that for a patient with MDD [odds ratio (OR) = 4.9, 95% confidence interval (CI) = 1.9-12.2, p = 0.001]. Patients with PTSD had an insignificantly increased risk for suicidal ideation (OR = 2.8, 95% CI = 0.9-8.9, p = 0.069), and a 4.5-fold significantly increased risk of having had a suicide attempt (OR = 4.5, 95% CI = 1.7-11.7, p = 0.002). The relationship between PTSD and suicide attempts remained significant even after controlling for the confounding effects of concurrent panic disorder, OCD and social phobia (OR = 3.4, 95% CI = 1.1-10.0, p = 0.023).


CONCLUSIONS
Patients with BPD have a greater risk for PTSD than those with MDD. Post-traumatic stress disorder is significantly related to history of suicide attempts.
Dilsaver
Steven C
SC
Mental Health Mental Retardation Clinic, Rio Grande City, TX, USA. stevendilsaver@aol.com
Benazzi
Franco
F
Akiskal
Hagop S
HS
Akiskal
Kareen K
KK
D000293:Adolescent; D001714:Bipolar Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D013406:Suicide, Attempted