Family history of suicidal behavior and early traumatic experiences: additive effect on suicidality and course of bipolar illness?
BACKGROUND
Bipolar disorder (BD) is associated with a high prevalence of suicide attempt and completion. Family history of suicidal behavior and personal history of childhood abuse are reported risk factors for suicide among BD subjects.


METHODS
BD individuals with family history of suicidal behavior and personal history of childhood abuse (BD-BOTH), BD individuals with family history of suicidal behavior or personal history of childhood abuse (BD-ONE), and BD individuals with neither of these two risk factors (BD-NONE) were compared with regard to demographic variables and clinical measures.


RESULTS
Almost 70% of the sample had a history of a previous suicide attempt. There were significantly higher rates of previous suicide attempts in the BD-BOTH and BD-ONE relative to the BD-NONE group. BD-BOTH were significantly younger at the time of their first suicide attempt and had higher number of suicide attempts compared with BD-NONE. BD-BOTH were significantly younger at the time of their first episode of mood disorder and first psychiatric hospitalization and had significantly higher rates of substance use and borderline personality disorders compared to BD-NONE.


CONCLUSIONS
Retrospective study. Use of semi-structured interview for the assessment of risk factors.


CONCLUSIONS
BD individuals with a familial liability for suicidal behavior and exposed to physical and/or sexual abuse during childhood are at a greater risk to have a more impaired course of bipolar illness and greater suicidality compared to those subjects with either only one or none of these risk factors. Prospective studies are needed to confirm these findings.
Carballo
Juan J
JJ
Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY 10032, United States.
Harkavy-Friedman
Jill
J
Burke
Ainsley K
AK
Sher
Leo
L
Baca-Garcia
Enrique
E
Sullivan
Gregory M
GM
Grunebaum
Michael F
MF
Parsey
Ramin V
RV
Mann
J John
JJ
Oquendo
Maria A
MA
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000235:genetics*; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data