title: International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder.
abstract: OBJECTIVE
  Bipolar disorder is associated with a high risk of suicide attempts and suicide death. The main objective of the present study was to identify and quantify the demographic and clinical correlates of attempted and completed suicide in people with bipolar disorder.
  
  
  METHODS
  Within the framework of the International Society for Bipolar Disorders Task Force on Suicide, a systematic review of articles published since 1980, characterized by the key terms bipolar disorder and 'suicide attempts' or 'suicide', was conducted, and data extracted for analysis from all eligible articles. Demographic and clinical variables for which ≥ 3 studies with usable data were available were meta-analyzed using fixed or random-effects models for association with suicide attempts and suicide deaths. There was considerable heterogeneity in the methods employed by the included studies.
  
  
  RESULTS
  Variables significantly associated with suicide attempts were: female gender, younger age at illness onset, depressive polarity of first illness episode, depressive polarity of current or most recent episode, comorbid anxiety disorder, any comorbid substance use disorder, alcohol use disorder, any illicit substance use, comorbid cluster B/borderline personality disorder, and first-degree family history of suicide. Suicide deaths were significantly associated with male gender and first-degree family history of suicide.
  
  
  CONCLUSIONS
  This paper reports on the presence and magnitude of the correlates of suicide attempts and suicide deaths in bipolar disorder. These findings do not address causation, and the heterogeneity of data sources should limit the direct clinical ranking of correlates. Our results nonetheless support the notion of incorporating diagnosis-specific data in the development of models of understanding suicide in bipolar disorder.
authors.affiliation: Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Ayal
authors.initials: A
authors.lastname: Schaffer
authors.forename: Erkki T
authors.initials: ET
authors.lastname: Isometsä
authors.forename: Leonardo
authors.initials: L
authors.lastname: Tondo
authors.forename: Doris
authors.initials: D
authors.lastname: H Moreno
authors.forename: Gustavo
authors.initials: G
authors.lastname: Turecki
authors.forename: Catherine
authors.initials: C
authors.lastname: Reis
authors.forename: Frederick
authors.initials: F
authors.lastname: Cassidy
authors.forename: Mark
authors.initials: M
authors.lastname: Sinyor
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Azorin
authors.forename: Lars Vedel
authors.initials: LV
authors.lastname: Kessing
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
authors.forename: Tina
authors.initials: T
authors.lastname: Goldstein
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Annette
authors.initials: A
authors.lastname: Beautrais
authors.forename: Yuan-Hwa
authors.initials: YH
authors.lastname: Chou
authors.forename: Nancy
authors.initials: N
authors.lastname: Diazgranados
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Levitt
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Zarate
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Rihmer
authors.forename: Lakshmi N
authors.initials: LN
authors.lastname: Yatham
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000453:epidemiology; D011316:Preventive Psychiatry; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention
keywords: bipolar disorder; meta-analysis; suicide