Clinical characteristics associated with suicide attempt in patients with bipolar disorder

Introduction Bipolar disorder (BD) is a chronic, highly disabling condition, associated with a high burden of morbidity and mortality, often secondary to suicidal behaviors. In previous reports, different variables have been associated with a higher risk of suicidal acts, with variable effect. Objectives To evaluate which socio-demographic and clinical variables correlate with suicide attempts in bipolar patients. Aims To enrich literature data about suicidal behaviour in BD. Methods A sample of 362 BD patients (DSM IV-TR) was retrospectively collected and divided in two subgroups, in relation to the presence of a previous suicide attempt. Socio-demographic and clinical variables were compared between attempters and non-attempters using Corrected multivariate analysis of covariance (MANCOVA). Results A total of 26,2% of analyzed patients attempted suicide in their lifespan, and approximately one third of them had multiple suicide attempts (i.e. ≥ 2; 31%). Depressive polarity at index mood episode, higher number of psychiatric hospitalizations, comorbidity with alcohol abuse, eating disorders and psychiatric poly-comorbidity were significantly associated with suicide attempt. Additionally, treatment with lithium, poly-pharmacotherapy (≥ 4 current drugs) and higher recurrence of psychosocial rehabilitation were significantly more frequent in patients who attempted suicide. Conclusions The present paper reported a correlation with some specific clinical variables and the lifetime presence of suicide attempt in patients with BD. Although these retrospective findings did not address the causality issue, they may be of clinical relevance in order to better understand suicidal behavior in BD and to adopt proper strategies to prevent suicide in higher risk patients.