Risk factors associated with lifetime suicide attempts in bipolar I patients: findings from a French National Cohort.
Risk factors that may be associated with suicide attempts in bipolar disorder are still a matter of debate. We compared demographic, illness course, clinical, and temperamental features of suicide attempters vs those of nonattempters in a large sample of bipolar I patients admitted for an index manic episode. One thousand ninety patients (attempters = 382, nonattempters = 708) were included in the study. Multivariate analysis evidenced 8 risk factors associated with lifetime suicide attempts as follows: multiple hospitalizations, depressive or mixed polarity of first episode, presence of stressful life events before illness onset, younger age at onset, no free intervals between episodes, female sex, higher number of previous episodes, and cyclothymic temperament. These characteristics may help identify subjects at risk for suicide attempt throughout the course of bipolar disorder. We finally propose to integrate such characteristics into a stress-diathesis model of suicidal behavior, adapted to bipolar patients.
Azorin
Jean-Michel
JM
Department of Psychiatry, Sainte Marguerite Hospital, Marseille, France. jazorin@ap-hm.fr
Kaladjian
Arthur
A
Adida
Marc
M
Hantouche
Elie
E
Hameg
Ahcene
A
Lancrenon
Sylvie
S
Akiskal
Hagop Souren
HS
D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013406:Suicide, Attempted / Q000523:psychology*; D013694:Temperament