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Suicidal risks among 2826 Sardinian major affective disorder patients

Authors

  • L. Tondo,

    1. Department of Psychiatry and Neuroscience Program, Harvard Medical School and McLean Division of Massachusetts General Hospital, Boston, MA, USA
    2. Lucio Bini Mood Disorders Research Center, Cagliari, and Department of Psychology, University of Cagliari, Sardinia, Italy
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  • B. Lepri,

    1. Lucio Bini Mood Disorders Research Center, Cagliari, and Department of Psychology, University of Cagliari, Sardinia, Italy
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  • R. J. Baldessarini

    1. Department of Psychiatry and Neuroscience Program, Harvard Medical School and McLean Division of Massachusetts General Hospital, Boston, MA, USA
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Dr R. J. Baldessarini, Mailman Research Center, McLean Hospital, 115 Mill Street, Elmont, MA 02478-9106, USA.
E-mail: rjb@mclean.org

Abstract

Objective:  We estimated risks of suicidal behaviors in 2826 mood-disorder patients evaluated and followed in a Sardinian mood disorders research center over the past 30 years.

Method:  We determined rates of suicidal ideation, attempts, and suicides, with associated risk factors, in men and women with DSM-IV bipolar I (BP-I; n = 529), BP-II; (= 314), or major depressive disorders (MDD; = 1983), at risk for an average of 11 years of illness.

Results:  Observed rates (% of patients/year) of suicide ranked: BP-II (0.16) ≥ BP-I (0.14) > MDD (0.05); attempts: BP-I (1.52) > BP-II (0.82) > MDD (0.48); ideation: BP-II (42.7) > MDD (33.8) > BP-I (22.7). The ratio of attempts/suicides (lethality index) ranked: BP-II (5.12) < MDD (9.60) ≤ BP-I (10.8). Male/female risk-ratios were greater for suicide than attempts or ideation. One-third of all reported acts occurred within the first year of illness, and earliest among MDD patients. Factors associated independently with suicidal acts included BP diagnosis, hospitalizations/person, and early illness-onset; factors associated with suicidal ideation were having an affective temperament, BP-II diagnosis, and higher suicidality-corrected depression score at intake.

Conclusion:  Suicidal behaviors were more prevalent among BPD than MDD out-patients.

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