title: Epidemiology of suicide in bipolar disorders: a systematic review of the literature.
abstract: OBJECTIVE
  Suicidal behavior is a major public health problem worldwide, and its prediction and prevention represent a challenge for everyone, including clinicians. The aim of the present paper is to provide a systematic review of the existing literature on the epidemiology of completed suicides in adult patients with bipolar disorder (BD).
  
  
  METHODS
  We performed a Pubmed/Medline, Scopus, PsycLit, PsycInfo, and Cochrane database search to identify all relevant papers published between 1980 and 2011. A total of 34 articles meeting our inclusion criteria were included in the present review.
  
  
  RESULTS
  Several prospective follow-up contributions, many retrospective analyses, and a few psychological autopsy studies and review articles investigated the epidemiology of completed suicides in patients with BD. The main finding of the present review was that the risk for suicide among BD patients was up to 20-30 times greater than that for the general population.
  
  
  CONCLUSIONS
  Special attention should be given to the characteristics of suicides in patients with BD. Better insight and understanding of suicide and suicidal risk in this very disabling illness should ultimately help clinicians to adequately detect, and thus prevent, suicidal acts in patients with BD.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. maurizio.pompili@uniroma1.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.forename: Marco
authors.initials: M
authors.lastname: Innamorati
authors.forename: Leo
authors.initials: L
authors.lastname: Sher
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Rihmer
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: adults; bipolar disorder; completed suicides; risk factors; suicide rates