Suicide attempts: differences between unipolar and bipolar patients and among groups with different lethality risk

Hypomanic symptoms among first‐time suicide attempters predict future multiple attempt status

“…In fact, nearly half (43%) of the future multiple attempters met criteria for a DSM diagnosis of a bipolar disorder, in contrast to only 12% of the true single attempters. It is well established that suicide risk is significantly elevated in bipolar disorders (e.g., Raja & Azzoni, 2004) owing primarily to the link between hypomanic symptoms-irritability, psychomotor agitation, and racing/crowded thoughts in particular-and increased suicidal ideation and behaviors Benazzi, 2005;Rihmer & Kiss, 2002;Rihmer & Pestality, 1999). Results of this study not only converge with this body of research, but also suggest that hypomanic symptoms are a uniquely significant predictor of a very high-risk group-multiple attempters.…”

Targeting suicide prevention to modifiable risk factors: has bipolar II been overlooked?

“…Valproate could be relevant (37), in light of the fact that mixed states are increasingly being implicated in suicidality as shown, among others (38,39), by a previous contribution of Tondo et al (40). Lamotrigine should also be considered, because state depression and its recurrence in bipolar patients contribute significantly to suicidality (41,42).…”

Seriousness and lethality of attempted suicide: A systematic review

“…In fact, subjects with a prior history of suicidal attempts have a 5-to 6-fold increased risk of trying again, especially in the 3 months following the first attempt (Raja & Azzoni, 2004), and about 2% of suicide attempters end their own life during the 12 months subsequent to the index event (Owens, Horrocks, & House, 2002). In a classic study Hawton and Fagg (1988) found that the rate of suicidal deaths among suicide attempters was 26.9 times the expected rate in the eight years following the first attempt, with the highest risk in the first six months.…”