title: Initial depressive episodes affect the risk of suicide attempts in Korean patients with bipolar disorder.
abstract: OBJECTIVE
  Suicide is a major concern for increasing mortality in bipolar patients, but risk factors for suicide in bipolar disorder remain complex, including Korean patients. Medical records of bipolar patients were retrospectively reviewed to detect significant clinical characteristics associated with suicide attempts.
  
  
  METHODS
  A total of 579 medical records were retrospectively reviewed. Bipolar patients were divided into two groups with the presence of a history of suicide attempts. We compared demographic characteristics and clinical features between the two groups using an analysis of covariance and chi-square tests. Finally, logistic regression was performed to evaluate significant risk factors associated with suicide attempts in bipolar disorder.
  
  
  RESULTS
  The prevalence of suicide attempt was 13.1% in our patient group. The presence of a depressive first episode was significantly different between attempters and nonattempters. Logistic regression analysis revealed that depressive first episodes and bipolar II disorder were significantly associated with suicide attempts in those patients.
  
  
  CONCLUSIONS
  Clinicians should consider the polarity of the first mood episode when evaluating suicide risk in bipolar patients. This study has some limitations as a retrospective study and further studies with a prospective design are needed to replicate and evaluate risk factors for suicide in patients with bipolar disorder.
authors.affiliation: Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Vin
authors.initials: V
authors.lastname: Ryu
authors.forename: Duk-In
authors.initials: DI
authors.lastname: Jon
authors.forename: Hyun Sang
authors.initials: HS
authors.lastname: Cho
authors.forename: Se Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Kim
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Seok
mesh_terms: D000328:Adult; D044466:Asian People; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult