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Clinical characterization of Italian suicide attempters with bipolar disorder

Published online by Cambridge University Press:  20 June 2017

Bernardo Dell’Osso ,
Matteo Vismara ,
Cristina Dobrea ,
Laura Cremaschi ,
Benedetta Grancini ,
Chiara Arici ,
Beatrice Benatti ,
Massimiliano Buoli ,
Terence A. Ketter  and
A. Carlo Altamura
Bernardo Dell’Osso*
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, California, USA
Matteo Vismara
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Cristina Dobrea
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Laura Cremaschi
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Benedetta Grancini
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Chiara Arici
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Beatrice Benatti
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Massimiliano Buoli
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
Terence A. Ketter
Affiliation:
Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, California, USA
A. Carlo Altamura
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy
*
*Address for correspondence: Dr Bernardo Dell’Osso, Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Policlinico, Via F. Sforza, 35, 20122 Milan, Italy. (Email: [email protected])
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Abstract

Introduction

Bipolar disorder (BD) is a chronic, highly disabling condition associated with psychiatric/medical comorbidity and substantive morbidity, mortality, and suicide risks. In prior reports, varying parameters have been associated with suicide risk.

Objectives

To evaluate sociodemographic and clinical variables characterizing Italian individuals with BD with versus without prior suicide attempt (PSA).

Methods

A sample of 362 Italian patients categorized as BD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) was assessed and divided in 2 subgroups: with and without PSA. Sociodemographic and clinical variables were compared between prior attempters and non-attempters using corrected multivariate analysis of variance (MANOVA).

Results

More than one-fourth of BD patients (26.2%) had a PSA, with approximately one-third (31%) of these having>1 PSA. Depressive polarity at onset, higher number of psychiatric hospitalizations, comorbid alcohol abuse, comorbid eating disorders, and psychiatric poly-comorbidity were significantly more frequent (p<.05) in patients with versus without PSA. Additionally, treatment with lithium, polypharmacotherapy (≥4 current drugs) and previous psychosocial rehabilitation were significantly more often present in patients with versus without PSA.

Conclusions

We found several clinical variables associated with PSA in BD patients. Even though these retrospective findings did not address causality, they could be clinically relevant to better understanding suicidal behavior in BD and adopting proper strategies to prevent suicide in higher risk patients.

Keywords

Bipolar disorderclinical characterizationpharmacological treatmentprior suicide attemptsuicide
Type
Original Research
Information
CNS Spectrums , Volume 23 , Issue 4 , August 2018 , pp. 271 - 277
Copyright
© Cambridge University Press 2017 

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