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Bipolar disorders and suicide: stumbling twice with the same stone?

Published online by Cambridge University Press:  01 September 2022

M. Sagué-Vilavella*
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
G. Fico
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
G. Anmella
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
A. Giménez-Palomo
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
M. Gómez-Ramiro
Affiliation:
Complejo Hospitalario Universitario de Pontevedra. SERGAS., Department Of Psychiatry, Pontevedra, Spain
M. Pons Cabrera
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
S. Madero
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
E. Vieta
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
A. Murru
Affiliation:
Hospital Clínic de Barcelona, Department Of Psychiatry And Psychology, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Suicide is the most terrible outcome of bipolar disorders (BD). It impacts families and healthcare professionals deeply. Family history of suicide (FHS) is one of its main risk factors, whereas lithium treatment and absence of substance use disorders (SUD) are two of its few modifiable protective factors.

Objectives

To explore the relationship between FHS and clinical characteristics in BD. We hypothesized that FHS would be associated with less SUD, higher rates of lithium treatment and shorter duration of untreated illness (DUI).

Methods

Cross-sectional analysis of subjects with BD followed-up in a specialised outpatient unit (Barcelona, October’08-March’18). We described data with measures of frequency, central tendency and dispersion, and we used χ², Fisher’s test and t-tests for comparisons.

Results

The sample consisted of 83 subjects, 56.6% males, mean age 41.9 years (SD 12.7). 74.7% (n=62) had a diagnosis of BD-I and 25.3% (n=21) of BD-II. 11 subjects (13.3%) had FHS. Those with FHS did not show significant differences in sociodemographic data, DUI (58.5+/-60.4 vs 38.19+/-84.9 months, p=0.341), lithium use (72.7% vs 73.6%, p=0.95) or SUD (27.3% vs 23.6%, p=0.79). There were differences in terms of lifetime suicide attempts (54.5% vs 20.8%, p=0.026), family history of mental disorders (100% vs 69.4%, n=0.032).

Conclusions

Contrary to our hypothesis, FHS was not associated with the modifiable protective factors against suicide (namely, less SUD and more lithium prescription). Similarly, we did not find an association with earlier access to mental health services at symptom onset (DUP as proxy). Therefore, our results suggest FHS does not modify attitudes towards prevention.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
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.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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