Skip to main content Accessibility help
×
Home

Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies

  • Min Dong (a1) (a2), Li Lu (a2), Ling Zhang (a3), Qinge Zhang (a3), Gabor S. Ungvari (a4) (a5), Chee H. Ng (a6), Zhen Yuan (a2), Yifan Xiang (a7), Gang Wang (a3) and Yu-Tao Xiang (a2) (a8)...

Abstract

Aims

Bipolar disorder (BD) is a severe psychiatric disorder associated with a high risk of suicide. This meta-analysis examined the prevalence of suicide attempts (SA) in patients with BD and its associated factors.

Methods

A systematic literature search was conducted in the PubMed, PsycINFO, EMBASE and Web of Science databases from their inception to 11 June 2018. The prevalence of SA in BD was synthesised using the random-effects model.

Results

The search identified 3451 articles of which 79 studies with 33 719 subjects met the study entry criteria. The lifetime prevalence of SA was 33.9% (95% CI 31.3–36.6%; I2 = 96.4%). Subgroup and meta-regression analyses revealed that the lifetime prevalence of SA was positively associated with female gender, BD-I, BD Not Otherwise Specified and rapid cycling BD subtypes, income level and geographic region.

Conclusion

This meta-analysis confirmed that SA is common in BD and identified a number of factors related to SA. Further efforts are necessary to facilitate the identification and prevention of SA in BD. Long-term use of mood stabilisers coupled with psycho-social interventions should be available to BD patients to reduce the risk of suicidal behaviour.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Yu-Tao Xiang, E-mail: xyutly@gmail.com

Footnotes

Hide All
*

These authors contributed equally to the work.

Footnotes

References

Hide All
Altamura, AC, Buoli, M, Cesana, B, Dell'Osso, B, Tacchini, G, Albert, U, Fagiolini, A, de Bartolomeis, A, Maina, G and Sacchetti, E (2018) Socio-demographic and clinical characterization of patients with bipolar disorder I vs II: a Nationwide Italian Study. European Archives of Psychiatry and Clinical Neuroscience 268, 169177.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Washington, DC: American Psychiatric Association.
Angst, J (2004) Bipolar disorder – a seriously underestimated health burden. European Archives of Psychiatry and Clinical Neuroscience 254, 5960.
Angst, J, Angst, F, Gerber-Werder, R and Gamma, A (2005) Suicide in 406 mood-disorder patients with and without long-term medication: a 40 to 44 years’ follow-up. Archives of Suicide Research 9, 279300.
Antypa, N, Antonioli, M and Serretti, A (2013) Clinical, psychological and environmental predictors of prospective suicide events in patients with Bipolar Disorder. Journal of Psychiatric Research 47, 18001808.
Baldessarini, RJ, Pompili, M and Tondo, L (2006) Suicide in bipolar disorder: risks and management. CNS Spectrums 11, 465471.
Baldessarini, RJ, Innamorati, M, Erbuto, D, Serafini, G, Fiorillo, A, Amore, M, Girardi, P and Pompili, M (2017) Differential associations of affective temperaments and diagnosis of major affective disorders with suicidal behavior. Journal of Affective Disorders 210, 1921.
Bellivier, F, Belzeaux, R, Scott, J, Courtet, P, Golmard, JL and Azorin, JM (2017) Anticonvulsants and suicide attempts in bipolar I disorders. Acta Psychiatrica Scandinavica 135, 470478.
Benard, V, Vaiva, G, Masson, M and Geoffroy, PA (2016) Lithium and suicide prevention in bipolar disorder. L'Encephale 42, 234241.
Berk, M, Dodd, S, Callaly, P, Berk, L, Fitzgerald, P, De Castella, A, Filia, S, Filia, K, Tahtalian, S and Biffin, F (2007) History of illness prior to a diagnosis of bipolar disorder or schizoaffective disorder. Journal of Affective Disorders 103, 181186.
Bernal, M, Haro, JM, Bernert, S, Brugha, T, de Graaf, R, Bruffaerts, R, Lepine, JP, de Girolamo, G, Vilagut, G, Gasquet, I, Torres, JV, Kovess, V, Heider, D, Neeleman, J, Kessler, R and Alonso, J (2007) Risk factors for suicidality in Europe: results from the ESEMED study. Journal of Affective Disorders 101, 2734.
Beyer, JL and Weisler, RH (2016) Suicide behaviors in bipolar disorder: a review and update for the clinician. Psychiatric Clinics 39, 111123.
Bezerra, S, Galvao-de-Almeida, A, Studart, P, Martins, DF, Caribe, AC, Schwingel, PA and Miranda-Scippa, A (2017) Suicide attempts in bipolar I patients: impact of comorbid personality disorders. Revista Brasileira de Psiquiatria 39, 133139.
Bobo, WV, Na, PJ, Geske, JR, McElroy, SL, Frye, MA and Biernacka, JM (2018) The relative influence of individual risk factors for attempted suicide in patients with bipolar I versus bipolar II disorder. Journal of Affective Disorders 225, 489494.
Boyle, MH (1998) Guidelines for evaluating prevalence studies. Evidence-based Mental Health 1, 3739.
Brown, GK, Beck, AT, Steer, RA and Grisham, JR (2000) Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. Journal of Consulting and Clinical Psychology 68, 371.
Cao, XL, Zhong, BL, Xiang, YT, Ungvari, GS, Lai, KY, Chiu, HF and Caine, ED (2015) Prevalence of suicidal ideation and suicide attempts in the general population of China: a meta-analysis. International Journal of Psychiatry in Medicine 49, 296308.
Carballo, JJ, Harkavy-Friedman, J, Burke, AK, Sher, L, Baca-Garcia, E, Sullivan, GM, Grunebaum, MF, Parsey, RV, Mann, JJ and Oquendo, MA (2008) Family history of suicidal behavior and early traumatic experiences: additive effect on suicidality and course of bipolar illness? Journal of Affective Disorders 109, 5763.
Cremaschi, L, Dell'Osso, B, Vismara, M, Dobrea, C, Buoli, M, Ketter, TA and Altamura, AC (2017) Onset polarity in bipolar disorder: a strong association between first depressive episode and suicide attempts. Journal of Affective Disorders 209, 182187.
Cruz, N, Vieta, E, Comes, M, Haro, JM, Reed, C and Bertsch, J (2008) Rapid-cycling bipolar I disorder: course and treatment outcome of a large sample across Europe. Journal of Psychiatric Research 42, 10681075.
Depp, CA, Harmell, AL, Savla, GN, Mausbach, BT, Jeste, DV and Palmer, BW (2014) A prospective study of the trajectories of clinical insight, affective symptoms, and cognitive ability in bipolar disorder. Journal of Affective Disorders 152, 250255.
Dong, M, Wang, SB, Wang, F, Zhang, L, Ungvari, GS, Ng, CH, Meng, X, Yuan, Z, Wang, G and Xiang, YT (2017) Suicide-related behaviours in schizophrenia in China: a comprehensive meta-analysis. Epidemiology and Psychiatric Sciences, 110.
Dong, M, Zeng, LN, Lu, L, Li, XH, Ungvari, GS, Ng, CH, Chow, IHI, Zhang, L, Zhou, Y and Xiang, YT (2018) Prevalence of suicide attempt in individuals with major depressive disorder: a meta-analysis of observational surveys. Psychological Medicine, 114.
Drake, RE, Gates, C, Whitaker, A and Cotton, PG (1985) Suicide among schizophrenics: a review. Comprehensive Psychiatry 26, 90100.
Duko, B and Ayano, G (2018) Suicidal ideation and attempts among people with severe mental disorder, Addis Ababa, Ethiopia, comparative cross-sectional study. Annals of General Psychiatry 17, 23.
Elizabeth Sublette, M, Carballo, JJ, Moreno, C, Galfalvy, HC, Brent, DA, Birmaher, B, John Mann, J and Oquendo, MA (2009) Substance use disorders and suicide attempts in bipolar subtypes. Journal of Psychiatric Research 43, 230238.
Gigante, AD, Barenboim, IY, Dias, RD, Toniolo, RA, Mendonca, T, Miranda-Scippa, A, Kapczinski, F and Lafer, B (2016) Psychiatric and clinical correlates of rapid cycling bipolar disorder: a cross-sectional study. Revista Brasileira de Psiquiatria 38, 270274.
Gonda, X, Pompili, M, Serafini, G, Montebovi, F, Campi, S, Dome, P, Duleba, T, Girardi, P and Rihmer, Z (2012) Suicidal behavior in bipolar disorder: epidemiology, characteristics and major risk factors. Journal of Affective Disorders 143, 1626.
Goodwin, FK and Jamison, KR (2007) Manic-depressive Illness: Bipolar Disorders and Recurrent Depression. United Kingdom: Oxford University Press.
Harkavy-Friedman, JM, Restifo, K, Malaspina, D, Kaufmann, CA, Amador, XF, Yale, SA and Gorman, JM (1999) Suicidal behavior in schizophrenia: characteristics of individuals who had and had not attempted suicide. American Journal of Psychiatry 156, 12761278.
Hawton, K, Sutton, L, Haw, C, Sinclair, J and Harriss, L (2005) Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. The Journal of Clinical Psychiatry 66, 693704.
Higgins, JP and Green, S (2008) Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration.
Holma, KM, Haukka, J, Suominen, K, Valtonen, HM, Mantere, O, Melartin, TK, Sokero, TP, Oquendo, MA and Isometsa, ET (2014) Differences in incidence of suicide attempts between bipolar I and II disorders and major depressive disorder. Bipolar Disorders 16, 652661.
Howe, AS, Leung, T, Bani-Fatemi, A, Souza, R, Tampakeras, M, Zai, C, Kennedy, JL, Strauss, J and De Luca, V (2014) Lack of association between dopamine-beta hydroxylase gene and a history of suicide attempt in schizophrenia: comparison of molecular and statistical haplotype analyses. Psychiatric Genetics 24, 110115.
Karch, DL, Barker, L and Strine, TW (2006) Race/ethnicity, substance abuse, and mental illness among suicide victims in 13 US states: 2004 data from the National Violent Death Reporting System. Injury Prevention 12(Suppl 2), ii22ii27.
Kattimani, S, Subramanian, K, Sarkar, S, Rajkumar, RP and Balasubramanian, S (2017) Lifetime suicide attempt in bipolar I disorder: its correlates and effect on illness course. International Journal of Psychiatry in Clinical Practice 21, 118124.
Kessler, RC, Berglund, P, Borges, G, Nock, M and Wang, PS (2005) Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. JAMA 293, 24872495.
Kung, KC, Liu, X and Juon, HS (1998) Risk factors for suicide in Caucasians and in African-Americans: a matched case-control study. Social Psychiatry and Psychiatric Epidemiology 33, 155161.
Kupka, RW, Luckenbaugh, DA, Post, RM, Suppes, T, Altshuler, LL, Keck, PE Jr, Frye, MA, Denicoff, KD, Grunze, H, Leverich, GS, McElroy, SL, Walden, J and Nolen, WA (2005) Comparison of rapid-cycling and non-rapid-cycling bipolar disorder based on prospective mood ratings in 539 outpatients. American Journal of Psychiatry 162, 12731280.
Latalova, K, Kamaradova, D and Prasko, J (2014) Suicide in bipolar disorder: a review. Psychiatria Danubina 26, 108114.
Leverich, GS, Altshuler, LL, Frye, MA, Suppes, T, Keck, PE, McElroy, SL, Denicoff, KD, Obrocea, G, Nolen, WA, Kupka, R, Walden, J, Grunze, H, Perez, S, Luckenbaugh, DA and Post, RM (2003) Factors associated with suicide attempts in 648 patients with bipolar disorder in the Stanley Foundation Bipolar Network. Journal of Clinical Psychiatry 64, 506515.
Loney, PL, Chambers, LW, Bennett, KJ, Roberts, JG and Stratford, PW (1998) Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Diseases in Canada 19, 170176.
Long, J, Huang, G, Liang, W, Liang, B, Chen, Q, Xie, J, Jiang, J and Su, L (2014) The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys. Acta Psychiatrica Scandinavica 130, 244256.
Mackin, P (2005) Rapid cycling is equivalently prevalent in bipolar I and bipolar II disorder, and is associated with female gender and greater severity of illness. Evidence-based Mental Health 8, 52.
MacKinnon, DF, Potash, JB, McMahon, FJ, Simpson, SG, Raymond Depaulo, J Jr, Initiative NIoMHBDG and Zandi, PP (2005) Rapid mood switching and suicidality in familial bipolar disorder. Bipolar Disorders 7, 441448.
Matte, DL, Pizzichini, MM, Hoepers, AT, Diaz, AP, Karloh, M, Dias, M and Pizzichini, E (2016) Prevalence of depression in COPD: a systematic review and meta-analysis of controlled studies. Respiratory Medicine 117, 154161.
Merikangas, KR, Jin, R, He, J-P, Kessler, RC, Lee, S, Sampson, NA, Viana, MC, Andrade, LH, Hu, C and Karam, EG (2011) Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Archives of General Psychiatry 68, 241251.
Neves, FS, Malloy-Diniz, LF and Correa, H (2009) Suicidal behavior in bipolar disorder: what is the influence of psychiatric comorbidities? Journal of Clinical Psychiatry 70, 1318.
Nierenberg, AA, Gray, SM and Grandin, LD (2001) Mood disorders and suicide. The Journal of Clinical Psychiatry.
Novick, DM, Swartz, HA and Frank, E (2010) Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disorders 12, 19.
Oquendo, MA, Waternaux, C, Brodsky, B, Parsons, B, Haas, GL, Malone, KM and Mann, JJ (2000) Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters. Journal of Affective Disorders 59, 107117.
Oquendo, MA, Currier, D, Liu, SM, Hasin, DS, Grant, BF and Blanco, C (2010) Increased risk for suicidal behavior in comorbid bipolar disorder and alcohol use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 71, 902909.
Passos, IC, Jansen, K, Cardoso, TD, Colpo, GD, Zeni, CP, Quevedo, J, Kauer-Sant'Anna, M, Zunta-Soares, G, Soares, JC and Kapczinski, F (2016) Clinical outcomes associated With comorbid posttraumatic stress disorder among patients with bipolar disorder. Journal of Clinical Psychiatry 77, E555E560.
Patel, R, Shetty, H, Jackson, R, Broadbent, M, Stewart, R, Boydell, J, McGuire, P and Taylor, M (2015) Delays before diagnosis and initiation of treatment in patients presenting to mental health services with bipolar disorder. PLoS ONE 10, e0126530.
Pawlak, J, Dmitrzak-Weglarz, M, Skibinska, M, Szczepankiewicz, A, Leszczynska-Rodziewicz, A, Rajewska-Rager, A, Maciukiewicz, M, Czerski, P and Hauser, J (2013) Suicide attempts and psychological risk factors in patients with bipolar and unipolar affective disorder. General Hospital Psychiatry 35, 309313.
Perlis, RH (2005) Misdiagnosis of bipolar disorder. The American Journal of Managed Care 11, S271S274.
Plans, L, Barrot, C, Nieto, E, Rios, J, Schulze, TG, Papiol, S, Mitjans, M, Vieta, E and Benabarre, A (2019) Association between completed suicide and bipolar disorder: a systematic review of the literature. Journal of Affective Disorders 242, 111122.
Pompili, M, Rihmer, Z, Innamorati, M, Lester, D, Girardi, P and Tatarelli, R (2009) Assessment and treatment of suicide risk in bipolar disorders. Expert Review of Neurotherapeutics 9, 109136.
Popovic, D, Vieta, E, Azorin, JM, Angst, J, Bowden, CL, Mosolov, S, Young, AH and Perugi, G (2015) Suicide attempts in major depressive episode: evidence from the BRIDGE-II-Mix study. Bipolar Disorders 17, 795803.
Rihmer, Z (2008) Prediction and prevention of suicide in mood disorders. European Psychiatry 23, S45.
Rosa, AR, Cruz, N, Franco, C, Haro, JM, Bertsch, J, Reed, C, Aarre, TF, Sanchez-Moreno, J and Vieta, E (2010) Why do clinicians maintain antidepressants in some patients with acute mania? Hints from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM), a large naturalistic study. The Journal of Clinical Psychiatry 71, 10001006.
Rotenstein, LS, Ramos, MA, Torre, M, Segal, JB, Peluso, MJ, Guille, C, Sen, S and Mata, DA (2016) Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA 316, 22142236.
Sachs, GS, Thase, ME, Otto, MW, Bauer, M, Miklowitz, D, Wisniewski, SR, Lavori, P, Lebowitz, B, Rudorfer, M and Frank, E (2003) Rationale, design, and methods of the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biological Psychiatry 53, 10281042.
Schaffer, A, Isometsä, ET, Azorin, J-M, Cassidy, F, Goldstein, T, Rihmer, Z, Sinyor, M, Tondo, L, Moreno, DH and Turecki, G (2015 a) A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Australian and New Zealand Journal of Psychiatry 49, 10061020.
Schaffer, A, Isometsä, ET, Tondo, L, Moreno, DH, Turecki, G, Reis, C, Cassidy, F, Sinyor, M, Azorin, JM and Kessing, LV (2015 b) International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disorders 17, 116.
Schneck, CD, Miklowitz, DJ, Calabrese, JR, Allen, MH, Thomas, MR, Wisniewski, SR, Miyahara, S, Shelton, MD, Ketter, TA and Goldberg, JF (2004) Phenomenology of rapid-cycling bipolar disorder: data from the first 500 participants in the Systematic Treatment Enhancement Program. American Journal of Psychiatry 161, 19021908.
Schneck, CD, Miklowitz, DJ, Miyahara, S, Araga, M, Wisniewski, S, Gyulai, L, Allen, MH, Thase, ME and Sachs, GS (2008) The prospective course of rapid-cycling bipolar disorder: findings from the STEP-BD. American Journal of Psychiatry 165, 370377, quiz 410.
Shabani, A, Teimurinejad, S, Kokar, S, Ahmadzad Asl, M, Shariati, B, Mousavi Behbahani, Z, Ghasemzadeh, MR, Hasani, S, Taban, M, Shirekhoda, S, Ghorbani, Z, Tat, S, Nohesara, S and Shariat, SV (2013) Suicide risk factors in Iranian patients with bipolar disorder: a 21-month follow-up from BDPF study. Iranian Journal of Psychiatry and Behavioral Sciences 7, 1623.
Silva, RdAd, Mograbi, DC, Camelo, EV, Bifano, J, Wainstok, M, Silveira, LAS and Cheniaux, E (2015) Insight in bipolar disorder: a comparison between mania, depression and euthymia using the Insight Scale for Affective Disorders. Trends in Psychiatry and Psychotherapy 37, 152156.
Simon, GE, Hunkeler, E, Fireman, B, Lee, JY and Savarino, J (2007) Risk of suicide attempt and suicide death in patients treated for bipolar disorder. Bipolar Disorders 9, 526530.
Song, JY, Yu, HY, Kim, SH, Hwang, SSH, Cho, HS, Kim, YS, Ha, K and Ahn, YM (2012) Assessment of risk factors related to suicide attempts in patients with bipolar disorder. Journal of Nervous and Mental Disease 200, 978984.
Spitzer, RL, Endicott, J and Robins, E (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773782.
Stefanello, S, Cais, CFdS, Mauro, MLF, Freitas, GVSd and Botega, NJ (2008) Gender differences in suicide attempts: preliminary results of the multisite intervention study on suicidal behavior (SUPRE-MISS) from Campinas, Brazil. Revista Brasileira de Psiquiatria 30, 139143.
Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D, Moher, D, Becker, BJ, Sipe, TA and Thacker, SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283, 20082012.
Studart, P, Galvao-de Almeida, A, Bezerra, S, Caribe, A, Afonso, NR, Daltro, C and Miranda-Scippa, AA (2016) Is history of suicidal behavior related to social support and quality of life in outpatients with bipolar I disorder? Psychiatry Research 246, 796802.
Swann, AC, Dougherty, DM, Pazzaglia, PJ, Pham, M, Steinberg, JL and Moeller, FG (2005) Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder. American Journal of Psychiatry 162, 16801687.
Szadoczky, E, Vitrai, J, Rihmer, Z and Furedi, J (2000) Suicide attempts in the Hungarian adult population. Their relation with DIS/DSM-III-R affective and anxiety disorders. European Psychiatry 15, 343347.
Tondo, L and Baldessarini, RJ (2005) Suicidal risk in bipolar disorder. Clinical Neuropsychiatry 2, 5565.
Tondo, L, Baldessarini, RJ, Hennen, J, Minnai, GP, Salis, P, Scamonatti, L, Masia, M, Ghiani, C and Mannu, P (1999) Suicide attempts in major affective disorder patients with comorbid substance use disorders. Journal of Clinical Psychiatry 60(Suppl 2), 6369; discussion 75-66, 113–116.
Tondo, L, Isacsson, G and Baldessarini, R (2003) Suicidal behaviour in bipolar disorder: risk and prevention. CNS Drugs 17, 491511.
Tondo, L, Pompili, M, Forte, A and Baldessarini, RJ (2016) Suicide attempts in bipolar disorders: comprehensive review of 101 reports. Acta Psychiatrica Scandinavica 133, 174186.
van der Werf-Eldering, MJ, van der Meer, L, Burger, H, Holthausen, EA, Nolen, WA and Aleman, A (2011) Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics. Bipolar Disorders 13, 343354.
Walker, J, Holm Hansen, C, Martin, P, Sawhney, A, Thekkumpurath, P, Beale, C, Symeonides, S, Wall, L, Murray, G and Sharpe, M (2013) Prevalence of depression in adults with cancer: a systematic review. Annals of Oncology 24, 895900.
Wan, Y, Hu, Q, Li, T, Jiang, L, Du, Y, Feng, L, Wong, JC-M and Li, C (2013) Prevalence of autism spectrum disorders among children in China: a systematic review. Shanghai Archives of Psychiatry 25, 70.
Westman, J, Hasselstrom, J, Johansson, SE and Sundquist, J (2003) The influences of place of birth and socioeconomic factors on attempted suicide in a defined population of 4.5 million people. Archives of General Psychiatry 60, 409414.
Winsper, C, Ganapathy, R, Marwaha, S, Large, M, Birchwood, M and Singh, S (2013) A systematic review and meta-regression analysis of aggression during the First Episode of Psychosis. Acta Psychiatrica Scandinavica 128, 413421.
Yang, C, Zhang, L, Zhu, P, Zhu, C and Guo, Q (2016) The prevalence of tic disorders for children in China: a systematic review and meta-analysis. Medicine (Baltimore) 95, e4354.

Keywords

Type Description Title
WORD
Supplementary materials

Dong et al. supplementary material
Dong et al. supplementary material 1

 Word (199 KB)
199 KB
WORD
Supplementary materials

Dong et al. supplementary material
Dong et al. supplementary material 2

 Word (47 KB)
47 KB

Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies

  • Min Dong (a1) (a2), Li Lu (a2), Ling Zhang (a3), Qinge Zhang (a3), Gabor S. Ungvari (a4) (a5), Chee H. Ng (a6), Zhen Yuan (a2), Yifan Xiang (a7), Gang Wang (a3) and Yu-Tao Xiang (a2) (a8)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.