title: Risk factors associated with lifetime suicide attempts in bipolar I patients: findings from a French National Cohort.
abstract: 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.
authors.affiliation: Department of Psychiatry, Sainte Marguerite Hospital, Marseille, France. jazorin@ap-hm.fr
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Azorin
authors.forename: Arthur
authors.initials: A
authors.lastname: Kaladjian
authors.forename: Marc
authors.initials: M
authors.lastname: Adida
authors.forename: Elie
authors.initials: E
authors.lastname: Hantouche
authors.forename: Ahcene
authors.initials: A
authors.lastname: Hameg
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lancrenon
authors.forename: Hagop Souren
authors.initials: HS
authors.lastname: Akiskal
mesh_terms: 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