Functional impairment and previous suicide attempts in bipolar disorder.
OBJECTIVE
The aim of the present study was to assess the association between previous suicide attempts and functional impairment among euthymic patients with bipolar disorder (BD).


METHODS
Seventy-one Diagnostic Statistical Manual IV (DSM-IV) patients with BD and 61 healthy volunteers were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. Patients with (n = 36, 50.7%) and without (n = 35, 49.3%) previous suicide attempts were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID-P). Previous suicide attempts were carefully investigated by means of patient and caregiver interview and by a standard structured interview from the protocol of our BD Program. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment.


RESULTS
Euthymic patients with previous suicide attempts showed functional impairment, particularly in occupational (F = 30.39; p = 0.001) and cognitive functioning (F = 18.43; p = 0.001). In addition, family history of psychiatric illness (χ2: 6.49; degrees of freedom (df) = 2;132; p = 0.010), family history of affective disorders (χ2 = 5.57; p = 0.017), psychotic symptoms (χ2 = 5.88; p = 0.014) and axis II comorbidity were associated with previous suicide attempts (χ2 = 5.16; p = 0.021).


CONCLUSIONS
Bipolar patients with previous suicide attempts had lower overall functioning than patients who did not attempt suicide. Previous suicide attempts were particularly associated with the occupational and cognitive domains of functioning.
1Bípolar Disorders Program, Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos, Porto Alegre, RS, Brazil.
Adriane R
AR
Rosa
2Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain.
Carolina
C
Franco
2Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain.
Anabel
A
Martínez-Aran
2Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain.
Jose
J
Sánchez-Moreno
2Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain.
Manel
M
Salamero
2Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain.
M
M
Valenti
5Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Spain.
Rafael
R
Tabarés-Seisdedos
6Department of Psychiatry, Santiago Apostol Hospital, Osakidetza Mental Health System, CIBERSAM, Vitoria, Spain.
Ana
A
González-Pinto
1Bípolar Disorders Program, Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos, Porto Alegre, RS, Brazil.
Flávio
F
Kapczinski
2Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain.
Eduard
E
Vieta