Initial Depressive Episodes Affect the Risk of Suicide Attempts in Korean Patients with Bipolar Disorder

Abstract

PurposeSuicide is a major concern for increasing mortality in bipolar patients, but risk factors for suicide in bipolar disorder remain complex, including Korean patients. Medical records of bipolar patients were retrospectively reviewed to detect significant clinical characteristics associated with suicide attempts.Materials and MethodsA total of 579 medical records were retrospectively reviewed. Bipolar patients were divided into two groups with the presence of a history of suicide attempts. We compared demographic characteristics and clinical features between the two groups using an analysis of covariance and chi-square tests. Finally, logistic regression was performed to evaluate significant risk factors associated with suicide attempts in bipolar disorder.ResultsThe prevalence of suicide attempt was 13.1% in our patient group. The presence of a depressive first episode was significantly different between attempters and nonattempters. Logistic regression analysis revealed that depressive first episodes and bipolar II disorder were significantly associated with suicide attempts in those patients.ConclusionClinicians should consider the polarity of the first mood episode when evaluating suicide risk in bipolar patients. This study has some limitations as a retrospective study and further studies with a prospective design are needed to replicate and evaluate risk factors for suicide in patients with bipolar disorder.

Risk factors for suicide in bipolar disorder: A systematic review

“…Risk factors associated with sociodemographic components (seven studies) (Huber et al, 2014;De Abreu et al, 2012;Ruengorn et al, 2012;Algorta et al, 2011;Cassidy, 2011;Antypa et al, 2013;Ryu et al, 2010); Risk factors associated with genetic components (six studies) (Manchia et al, 2013;Sears et al, 2013;Neves et al, 2010;Magno et al, 2011;Jiménez et al, 2013;Kerner et al, 2013); Risk factors associated with Medicines and Drugs in general that interfere with bipolar disorder (eight studies) (Bellivier et al, 2011;Yoon et al, 2011;Leon et al, 2012;Arias et al, 2013;Clements et al, 2013;Finseth et al, 2012;Oquendo et al, 2010;Kenneson et al, 2013); Risk factors associated with Biological components (three studies) (Kamali et al, 2012;Evans et al, 2012;Gomes et al, 2010); Risk factors associated with Psychological causes (seven studies) (Parmentier et al, 2012;Shabani et al, 2013;Acosta et al, 2012;Song et al, 2012;Suttajit et al, 2013;Stewart et al, 2009); and Risk factors associated with components of Religious and Spiritual (three studies) components (Azorin et al, 2013;Dervic et al, 2011;. Among the 42 studies, 8 discussed about "suicide risk factors in Bipolar Affective disorder" -more broadly (Goldstein et al, 2012;Eroglu et al, 2013;Kheirabadi et al, 2012;Undurraga et al, 2012;…”

“…Table 1 provides an overview of all studies included in the final sample and of all data elements used during the data analysis process. Study designs included one case report (Kerner et al, 2013), seven transversal studies (Goldstein et al, 2012;Kheirabadi et al, 2012;Undurraga et al, 2012;De Abreu et al, 2012;Algorta et al, 2011;Evans et al, 2012;Gomes et al, 2010), nineteen cohort studies (Parmentier et al, 2012;Huber et al, 2014;Ruengorn et al, 2012;Etain et al, 2013;Cassidy, 2011;Baldessarini et al, 2012;Bellivier et al, 2011;Sears et al, 2013;Jiménez et al, 2013;Leon et al, 2012;Finseth et al, 2012;Oquendo et al, 2010;Kenneson et al, 2013;Gilbert et al, 2011;Shabani et al, 2013;Acosta et al, 2012;Song et al, 2012;Suttajit et al, 2013), and fifteen case-control studies (Eroglu et al, 2013;Antypa et al, 2013;Ryu et al, 2010;Manchia et al, 2013;Neves et al, 2010;Magno et al, 2011;Yoon et al, 2011;Arias et al, 2013;Clements et al, 2013;Kamali et al, 2012;de Moraes et al, 2013;Azorin et al, 2013;…”

“…It is possible that familial depression contributes to offspring suicide risk via multiple avenues, including decreased familial support and increased conflict (Goldstein et al, 2012;Brent et al, 1994). Ryu et al (2010) investigated the descriptive characteristics of suicide attempts and the risk factors for suicide attempts in Korean bipolar patients by assessing sociodemographic factors, clinical factors, and the methods of suicide attempts using retrospective reviews of medical records . Ryu et al (2010) reviewed medical records of all 601 patients who were admitted to the psychiatric wards in one mental hospital and three general hospitals (Ryu et al, 2010).…”

“…Ryu et al (2010) investigated the descriptive characteristics of suicide attempts and the risk factors for suicide attempts in Korean bipolar patients by assessing sociodemographic factors, clinical factors, and the methods of suicide attempts using retrospective reviews of medical records . Ryu et al (2010) reviewed medical records of all 601 patients who were admitted to the psychiatric wards in one mental hospital and three general hospitals (Ryu et al, 2010). The 579 subjects who were included in the final analysis was comprised of 262 (45.3%) men and 317 (54.7%) women (Ryu et al, 2010).…”

“…Ryu et al (2010) reviewed medical records of all 601 patients who were admitted to the psychiatric wards in one mental hospital and three general hospitals (Ryu et al, 2010). The 579 subjects who were included in the final analysis was comprised of 262 (45.3%) men and 317 (54.7%) women (Ryu et al, 2010). Ryu et al (2010) found two significant risk factors associated.…”