Risk factors for suicidal ideations in patients with bipolar disorder

Authors

  • Vanamoorthy Umamaheswari,

    1. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Ajit Avasthi,

    1. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Sandeep Grover

    Corresponding author
    1. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    • Corresponding author:

      Dr. Sandeep Grover

      Department of Psychiatry

      Postgraduate Institute of Medical Education & Research

      Chandigarh 160012

      India

      Fax: +91-172-2744401

      E-mail: drsandeepg2002@yahoo.com

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Abstract

Objective

To identify the risk factors for suicidal ideation in subjects with bipolar depression.

Methods

One-hundred and thirty subjects diagnosed with bipolar depression were evaluated on the following scales: Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Patient Health Questionnaire-15 (PHQ-15), Barrat's Impulsivity Scale (BIS), Irritability, Anxiety, and Depression (IDA) Scale, Young Mania Rating Scale (YMRS), Buss–Durke Hostile Inventory (BDHI), and Brief Psychiatric Rating Scale (BPRS).

Results

Based on the BDI suicidal thoughts and wishes item (score of ≥1), the study sample was divided into those with and those without suicidal ideation. On binary logistic regression analysis, the odds ratio (OR) for the presence of suicidal ideations was highest for grade of severity of current episode [OR = 22.601, 95% confidence interval (CI): 6.39–79.92], followed by the presence of a family history of suicide attempt (OR = 18.06, 95% CI: 1.36–238.39), any preceding life event (OR = 3.797, 95% CI: 1.195–12.067), and past history of suicide attempt (OR = 3.11, 95% CI: 0.649–14.96). Other risk factors for the presence of suicidal ideations were severity of subsyndromal manic symptoms, family history of bipolar disorder, past history of hospitalization, severity of subsyndromal anxiety, hopelessness, hostility, presence of psychotic symptoms, and duration of current episode.

Conclusion

Among the various predictors of suicidal ideations, the severity of the current episode, the presence of a family history of suicide attempt, preceding life event, and past history of suicide attempt are the most important risk factors for suicidal ideations in patients with bipolar disorder. Hence, patients with these risk factors should be closely monitored to prevent suicide attempts and completed suicides.

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