Association between completed suicide and bipolar disorder: A systematic review of the literature

Plans, Laura; Barrot, C.; Nieto, E.; Ríos, José; Schulze, Thomas G.; Papiol, Sergi; Mitjans, Marina; Vieta, Eduard; Benabarre, Antoni

doi:10.1016/j.jad.2018.08.054

Cited by 175 publications

(138 citation statements)

References 200 publications

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“…This diagnosis is marked by a considerable degree of morbi‐mortality, and it is frequently associated with significant impacts in several domains of patients’ lives 3‐5 . In addition, BD is considered a potentially lethal illness: the risk of suicide attempts averages 31.1% in this population, 6 with suicide rates estimated to be 20‐ to 30‐fold greater than in the general population 7 …”

Section: Introductionmentioning

confidence: 99%

Functioning in euthymic patients with bipolar disorder: A systematic review and meta‐analysis using the Functioning Assessment Short Test

2020

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Objectives Systematically review the prevalence of functional impairment (FI) in euthymic patients with bipolar disorder (BD), as assessed only with the Functioning Assessment Short Test (FAST), explore the prevalence of this impairment among all the domains, identify the most compromised of them and the clinical variables associated with low functioning in this population. Methods Meta‐analyses were performed, searching for relevant papers published from 2007 to 2019 in Medline, Embase, Cochrane, PsycINFO databases and via hand‐searching, without language restrictions. 1128 studies were initially identified, 13 of which were ultimately chosen based on the eligibility criteria. A two‐step meta‐analysis was performed using the mean difference with a 95% confidence interval for continuous variables and proportion estimation with a fixed‐effects model for categorical variables. Results In the first step, all FAST domains showed worse FI in patients than in healthy controls, with significant differences between groups. In the second step, the prevalence of FI domains were as follows: global, 58.6%; occupational, 65.6%; cognitive, 49.2%; autonomy, 42.6%; interpersonal relationships, 42.1%; leisure, 29.2%; and financial issues, 28.8%. Residual depressive symptoms were the most frequently cited variable associated with FI. Conclusions This study reinforces the relevant functional impact of BD in this population and suggests that the occupational domain may be the most impaired. Greater efforts should be directed toward targeting functioning in patient care, as it constitutes the most meaningful endpoint of response to treatment, especially with occupational and cognitive rehabilitation, thus allowing patients to overcome the course of illness and carry fulfilling lives.

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Section: Introductionmentioning

confidence: 99%

Functioning in euthymic patients with bipolar disorder: A systematic review and meta‐analysis using the Functioning Assessment Short Test

2020

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“…At the same time, in other works there is evidence both that such effectiveness in lithium is manifested only in combination therapy with antidepressants [21], and its absence [22]. There is also evidence of antisuicidal efficacy in patients with BAD of valproate and carbamazepine, but their effect is regarded as lower [16].…”

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confidence: 95%

“…The presence of suicidal attempts at the https://суицидология.рф/ Научно-практический журнал Том 10, № 4 (37), 2019 Суицидология 89 терапию, связан с тем, что отсутствие лечения в таких случаях сопряжено со значительно менее выраженными проявлениями депрессивной симптоматики, поэтому проводить подобное сравнение некорректно [15]. Наличие суицидальных попыток на начальных этапах терапии антидепрессантами может быть связано с развитием инверсии аффекта и смешанных эпизодов у пациентов с недиагностированным ранее биполярным аффективным расстройством (БАР) [16]. В то же время, имеются сведения о том, что число суицидов при инициации антидепрессивной терапии у пациентов с БАР значимо выше, чем у пациентов с униполярной депрессией [17].…”

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“…В то же время, в других работах есть сведения как о том, что подобная эффективность у лития проявляется только при сочетанной терапии с антидепрессантами [21], так и об её отсутствии [22]. Имеются также сведения об антисуицидальной эффективности у пациентов с БАР вальпроатов и карбамазепина, но их эффект расценивается как более низкий [16].…”

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“…Важным аспектом влияния антидепрессивной терапии на риск суицида могут быть собственно структура и особенности течения депрессии. Так имеются све-initial stages of antidepressant therapy may be associated with the development of affect inversion and mixed episodes in patients with previously undiagnosed bipolar affective disorder (BAD) [16]. At the same time, there is evidence that the number of suicides during initiation of antidepressant therapy in patients with BAD is significantly higher than in patients with unipolar depression [17].…”

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Повышают Ли Антидепрессанты Риск Суицида?

Касьянов¹,

Рукавишников²,

Розанов³

et al. 2019

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Diagnosis and Treatment of Bipolar Disorder

Nierenberg,

Agustini,

Köhler-Forsberg

et al. 2023

JAMA

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ImportanceBipolar disorder affects approximately 8 million adults in the US and approximately 40 million individuals worldwide.ObservationsBipolar disorder is characterized by recurrent episodes of depression and mania or hypomania. Bipolar depressive episodes are similar to major depressive episodes. Manic and hypomanic episodes are characterized by a distinct change in mood and behavior during discrete time periods. The age of onset is usually between 15 and 25 years, and depression is the most frequent initial presentation. Approximately 75% of symptomatic time consists of depressive episodes or symptoms. Early diagnosis and treatment are associated with a more favorable prognosis. Diagnosis and optimal treatment are often delayed by a mean of approximately 9 years following an initial depressive episode. Long-term treatment consists of mood stabilizers, such as lithium, valproate, and lamotrigine. Antipsychotic agents, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine, are recommended, but some are associated with weight gain. Antidepressants are not recommended as monotherapy. More than 50% of patients with bipolar disorder are not adherent to treatment. Life expectancy is reduced by approximately 12 to 14 years in people with bipolar disorder, with a 1.6-fold to 2-fold increase in cardiovascular mortality occurring a mean of 17 years earlier compared with the general population. Prevalence rates of metabolic syndrome (37%), obesity (21%), cigarette smoking (45%), and type 2 diabetes (14%) are higher among people with bipolar disorder, contributing to the risk of early mortality. The annual suicide rate is approximately 0.9% among individuals with bipolar disorder, compared with 0.014% in the general population. Approximately 15% to 20% of people with bipolar disorder die by suicide.Conclusions and RelevanceBipolar disorder affects approximately 8 million adults in the US. First-line therapy includes mood stabilizers, such as lithium, anticonvulsants, such as valproate and lamotrigine, and atypical antipsychotic drugs, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine.

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Association between completed suicide and bipolar disorder: A systematic review of the literature

Cited by 175 publications

References 200 publications

Functioning in euthymic patients with bipolar disorder: A systematic review and meta‐analysis using the Functioning Assessment Short Test

Functioning in euthymic patients with bipolar disorder: A systematic review and meta‐analysis using the Functioning Assessment Short Test

Повышают Ли Антидепрессанты Риск Суицида?

Diagnosis and Treatment of Bipolar Disorder

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