title: Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder.
abstract: OBJECTIVE
  Our aim was to analyse sociodemographic and clinical differences between non-suicidal (NS) bipolar patients (BP), BP reporting only suicidal ideation (SI) and BP suicide attempters according to Columbia-Suicide Severity Rating Scale (C-SRSS) criteria. Secondarily, we also investigated whether the C-SRSS Intensity Scale was associated with emergence of suicidal behaviour (SB).
  
  
  METHODS
  A total of 215 euthymic bipolar out-patients were recruited. Semistructured interviews including the C-SRSS were used to assess sociodemographic and clinical data. Patients were grouped according to C-SRSS criteria: patients who scored ≤1 on the Severity Scale were classified as NS. The remaining patients were grouped into two groups: 'patients with history of SI' and 'patients with history of SI and SB' according to whether they did or did not have a past actual suicide attempt respectively.
  
  
  RESULTS
  Patients from the three groups differed in illness onset, diagnosis, number of episodes and admissions, family history, comorbidities, rapid cycling and medication, as well as level of education, functioning, impulsivity and temperamental profile.
  
  
  CONCLUSIONS
  Our results suggest that increased impulsivity, higher rates of psychiatric admissions and a reported poor controllability of SI significantly increased the risk for suicidal acts among patients presenting SI.
authors.affiliation: Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Jiménez
authors.affiliation: Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Arias
authors.affiliation: Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.|Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Mitjans
authors.affiliation: Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Goikolea
authors.affiliation: Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Ruíz
authors.affiliation: Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Brat
authors.affiliation: Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.|Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.
authors.forename: P A
authors.initials: PA
authors.lastname: Sáiz
authors.affiliation: Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.|Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.
authors.forename: M P
authors.initials: MP
authors.lastname: García-Portilla
authors.affiliation: Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Burón
authors.affiliation: Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.|Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Bobes
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Oquendo
authors.affiliation: Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vieta
authors.affiliation: Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Benabarre
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D013694:Temperament
keywords: Columbia-Suicide Severity Rating Scale; bipolar disorder; suicidal behaviour; suicidal ideation