Bipolar Patients With Suicidal Behavior

Slama, Frédéric; Bellivier, Frank; Henry, Chantal; Rousseva, Angela; Étain, Bruno; Rouillon, Frédéric; Leboyer, Marion

doi:10.4088/jcp.v65n0802

Cited by 119 publications

(5 citation statements)

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“…Those studies highlight longer latencies in individuals with a constellation of characteristics, namely, they were younger, female and had a prior history of attempted suicide and/or of childhood abuse. 46,76,77,84 While this is "soft evidence," it does mirror research findings that suggest that many young females with BD were previously diagnosed with borderline personality disorder (BLPD). [94][95][96][97][98][99] However, it is acknowldged that, in some instances, it can be difficult to differentiate BLPD from early presentations of BD, and these two disorders may co-occur.…”

Section: Discussionmentioning

confidence: 76%

“…As shown in the PRISMA flow chart (Figure 1), after reviewing titles and abstracts, we identified that 102 articles required detailed examination of the full text. From these records, we identified 59 independent datasets (reported in 66 publications) that met eligibility criteria for the systematic review and planned meta‐analyses 10,26–91 . Key characteristics of the 59 included studies are summarized in Table 1, while Tables 1S–4S (Appendix S3) provide full details of each study, including descriptions of each sample and the latency constructs reported are provided in Data S1.…”

Section: Resultsmentioning

confidence: 99%

“…The pooled analysis of DHS was based on findings from eight datasets 30,33,46,64,71,80,81 ; DD on findings from 20 datasets 29,33,38–40,45,48,51–53,55,60,61,71,73–75,86–89 ; and DUB on findings from 45 datasets 26,27,29–32,34–36,38,41–44,46–50,53,54,56–58,63,64,66–73,75,78,79,81–84,86,91 …”

Section: Resultsmentioning

confidence: 99%

“…Next, the findings regarding females with BD‐II or other subtypes of BD (see Table 2B) have frequently been noted in descriptive studies (as summarized in the narrative review in Appendix S4). Those studies highlight longer latencies in individuals with a constellation of characteristics, namely, they were younger, female and had a prior history of attempted suicide and/or of childhood abuse 46,76,77,84 . While this is “soft evidence,” it does mirror research findings that suggest that many young females with BD were previously diagnosed with borderline personality disorder (BLPD) 94–99 .…”

Section: Discussionmentioning

confidence: 97%

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A systematic review and meta‐analysis of delayed help‐seeking, delayed diagnosis and duration of untreated illness in bipolar disorders

Scott

Graham²,

Yung

et al. 2022

Acta Psychiatr Scand

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Objectives To examine the time delay between the age at onset of symptoms or episodes of bipolar disorders (BD) and the age at diagnosis of and/or receipt of clinical practice guideline recommended interventions for BD. Methods Systematic search of five databases to identify publications from January 2000 to July 2022 that reported one or more of the following reliable and valid estimates of latency: delay in help seeking (DHS), delay in diagnosis (DD) and duration of untreated BD (DUB). Eligible studies were included in random effects meta‐analyses and multivariate meta‐regression was used to assess factors associated with each latency construct. Results Screening of 1074 publications identified 59 eligible studies (reported in 66 publications) of >40,000 individuals that estimated DHS (8 studies), DD (20 studies) and/or DUB (45 studies). The median DHS, DD and DUB were 3.5 (IQR: 2.8, 8.48), 6.7 (IQR: 5.6, 8.9) and 5.9 years (IQR: 1.1, 8.2), respectively. Key factors associated with shorter DD included older age and residing outside North America; shorter DUB was associated with psychotic or manic onset and access to early intervention services. Conclusions Greater consensus on definitions of latency constructs and better‐quality targeted research is required regarding DHS, DD and DUB. This review suggests that, while the peak age at onset of BD is 15–25, diagnosis and guideline recommended interventions (e.g., mood stabilizers) are likely to be delayed until age 25–35 years except for a minority of individuals with access to early intervention services.

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Section: Discussionmentioning

confidence: 76%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

See 2 more Smart Citations

A systematic review and meta‐analysis of delayed help‐seeking, delayed diagnosis and duration of untreated illness in bipolar disorders

Scott

Graham²,

Yung

et al. 2022

Acta Psychiatr Scand

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“…In our study, active (3.5%) or passive (15.3%) suicidal ideations were observed in approximately one-fifth of the patients. In the literature, lifelong risk of potential suicide for depressive bipolar patients was reported to vary between 25% and 56% (30)(31)(32). These relatively low percentages with regard to suicidal ideation or suicide attempts can be explained to a certain extent, by the placement of patients in a specialized center.…”

Section: Discussionmentioning

confidence: 99%

Does follow-up in a specialized center influence symptom profile and severity of bipolar depression?

Altınbaş¹,

Gülöksüz²,

Yiğiter³

et al. 2010

Dusunen Adam

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Uzmanlaşmış bir merkezde izlem iki uçlu depresyon belirti sayısını ve şiddetini etkiler mi? Amaç: İki uçlu bozukluk hastaları, hayatlarının önemli bir bölümünde depresif belirtiler yaşamaktadırlar. Buna karşın, iki uçlu depresyon belirti örüntüsü oldukça az çalışılmıştır. İki uçlu depresif dönemde, hastaların daha çok atipik depresyon belirtileri yaşaması beklenirken, etnokültürel farklılıklar ve düzenli izlem, klinik belirtilerin ortaya çıkış şeklini ve dışavurumunu etkileyebilmektedir. Buradan hareketle, bu çalışmada özelleşmiş bir duygudurum merkezinde takip edilen iki uçlu hastaların depresif dönemde yaşadıkları belirtilerin gözden geçirilmesi amaçlanmıştır. Yöntem: Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Hastanesi Raşit Tahsin Duygudurum Merkezi'nde iki uçlu bozukluk tanısıyla takip edilmekte olan 144 hastanın en şiddetli depresif dönemine ilişkin belirtileri kaydedilmiştir. Klinik belirtiler yapılandırılmış bir veri formundan ve hastane kayıtlarından elde edilmiştir. Depresif belirtiler, tanımlayıcı istatistikle değerlendirilmiştir. Bulgular: Hastaların %10'undan daha azında depresif belirtilerin şiddetli olduğu saptandı. Suçluluk duygusu ve benlik saygısında azalma hastaların yaklaşık yarısında görülmezken (%45,8), aktif (%3,5) ya da pasif (%15,3) intihar fikri yaklaşık beşte bir oranında görülmekteydi. Psikotik belirtilerin görülme oranı ise oldukça düşüktü (%4,2). Ayrıca enerji kaybı ve dikkat-konsantrasyon güçlüğü dışındaki vejetatif bulgular hastaların yarısından daha çoğunda görülmemekteydi. Tedavide ise, duygudurum dengeleyici ekleme ya da doz titrasyonu ve terapötik görüşmenin hastaların yaklaşık üçte birinde remisyon için yeterli olduğu saptandı. Tartışma ve Sonuç: İki uçlu depresyonun, daha şiddetli seyrettiği ve daha sık özkıyım girişimiyle ilişkili olduğu bildirilmesine karşın, tüm belirtiler için, şiddetli olan vakaların oranının %10'un altında ve aktif özkıyım fikrine sahip vakaların oranının %3,5 olduğu tesbit edilmiştir. Ayrıca, psikotik bulguların sıklığı %4,2 olarak bulunmuştur. Daha hafif şiddette belirtilerin görülmesi literatürle çelişse de, bu durum hastaların uzmanlaşmış bir birimde takip edilmesi ve belirtilerin şiddetlenmeden müdahale edilmesi ile açıklanabilmektedir. Hastalara daha az farmakolojik tedavi müdahalesinde bulunma ihtiyacı da, aynı nedenden kaynaklanabilmektedir.

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Suicidal disorders: A nosological entity per se?

Leboyer

Slama²,

Siever³

et al. 2005

American J of Med Genetics Pt C

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An extensive body of data has repeatedly shown in the past decades that suicidal behaviors are associated with several external validators such as low serotonergic activity in body fluids and in brains of suicide victims, genetic transmission of suicide risk independently of transmission of associated major psychiatric disorders, and more recently association with several serotonin-related genes. Despite these concordant findings, suicidal behaviors are still not considered as a nosological entity per se in standardized classification. The aim of this study is to review the existing literature establishing the validity of this entity through clinical, genetic, biochemical, and therapeutic arguments all leading to the need to recognizing suicidal behavior as an independent and possibly dimensional clinical entity.

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Bipolar Patients With Suicidal Behavior

Cited by 119 publications

References 0 publications

A systematic review and meta‐analysis of delayed help‐seeking, delayed diagnosis and duration of untreated illness in bipolar disorders

A systematic review and meta‐analysis of delayed help‐seeking, delayed diagnosis and duration of untreated illness in bipolar disorders

Does follow-up in a specialized center influence symptom profile and severity of bipolar depression?

Suicidal disorders: A nosological entity per se?

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