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Suicide attempts in bipolar disorders: comprehensive review of 101 reports
Author(s) -
Tondo L.,
Pompili M.,
Forte A.,
Baldessarini R. J.
Publication year - 2016
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12517
Subject(s) - incidence (geometry) , medicine , bipolar disorder , meta analysis , demography , poison control , psychiatry , pediatrics , emergency medicine , physics , cognition , sociology , optics
Objective Assess reported risk of suicide attempts by patients with bipolar disorder ( BD ). Method Systematic searching yielded 101 reports from 22 countries (79 937 subjects). We analyzed for risk (%) and incidence rates (%/year) of attempts, comparing sex and diagnostic types, including by meta‐analysis. Results Attempt risk averaged 31.1% [ CI : 27.9–34.3] of subjects, or 4.24 [3.78–4.70]%/year. In BD ‐I (43 studies) and BD ‐ II subjects (30 studies), risks (29.9%, 31.4%) and incidence rates (4.01, 4.11%/year) were similar and not different by meta‐analysis. Among women vs. men, risks (33.7% vs. 25.5%) and incidence (4.50 vs. 3.21%/year) were greater (also supported by meta‐analysis: RR = 1.35 [ CI : 1.25–1.45], P < 0.0001). Neither measure was related to reporting year, % women/study, or to onset or current age. Risks were greater with longer exposure, whereas incidence rates decreased with longer time at risk, possibly through ‘dilution’ by longer exposure. Conclusion This systematic update of international experience underscores high risks of suicide attempts among patients with BD ( BD ‐I = BD ‐ II ; women > men). Future studies should routinely include exposure times and incidence rates by diagnostic type and sex for those who attempt suicide or not.