title: Bipolar disorder: What effect does treatment adherence have on risk of suicidal behavior?
abstract: Bipolar disorder is associated with high risk for suicidal behavior. Lack of adherence to treatment is one factor that may be partly responsible for this common complication. We searched MEDLINE with the combination of the key words "compliance" or "adherence" with "suicide" and "bipolar", limited to English language papers published between 1990 and July 2008.We evaluate the existent literature studying the influence of treatment adherence on suicidality among these patients. Our findings show a limited number of studies addressing this issue, mostly conducted with patients enrolled in lithium clinics. Results suggest an association between non-adherence and an increased risk of suicidal behavior among bipolar patients. Whether non-adherence leads to increase risk of suicidality due to specific properties of interventions such as lithium treatment or simply is secondary to mood stabilization is still an open question.
authors.affiliation: Departamento de Psiquiatría, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España. Electronic address: jorgecastroman@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: López-Castroman
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-García
authors.forename: María A
authors.initials: MA
authors.lastname: Oquendo