Are high-lethality suicide attempters with bipolar disorder a distinct phenotype?
Because Bipolar Disorder (BD) individuals making highly lethal suicide attempts have greater injury burden and risk for suicide, early identification is critical. BD patients were classified as high- or low-lethality attempters. High-lethality attempts required inpatient medical treatment. Mixed effects logistic regression models and permutation analyses examined correlations between lethality, number, and order of attempts. High-lethality attempters reported greater suicidal intent and more previous attempts. Multiple attempters showed no pattern of incremental lethality increase with subsequent attempts, but individuals with early high-lethality attempts more often made high-lethality attempts later. A subset of high-lethality attempters make only high-lethality attempts. However, presence of previous low-lethality attempts does not indicate that risk for more lethal, possibly successful, attempts is reduced.
Oquendo
Maria A
MA
Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY 10032, USA. mao4@columbia.edu
Carballo
Juan Jose
JJ
Rajouria
Namita
N
Currier
Dianne
D
Tin
Adrienne
A
Merville
Jessica
J
Galfalvy
Hanga C
HC
Sher
Leo
L
Grunebaum
Michael F
MF
Burke
Ainsley K
AK
Mann
J John
JJ
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D010641:Phenotype; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires