Suicidal risks among 2826 Sardinian major affective disorder patients

Area of Science:

• Psychiatry
• Mood Disorders Research
• Suicidology

Background:

• Mood disorders, including bipolar disorder (BP) and major depressive disorder (MDD), are associated with significant suicide risk.
• Understanding the differential risk of suicidal behaviors across these diagnoses is crucial for targeted prevention.

Purpose of the Study:

• To estimate and compare the risks of suicidal ideation, attempts, and completed suicides in patients with BP-I, BP-II, and MDD.
• To identify associated risk factors for suicidal behaviors in these patient populations.

Main Methods:

• A 30-year longitudinal study of 2826 patients diagnosed with DSM-IV BP-I, BP-II, or MDD.
• Rates of suicidal ideation, attempts, and suicides were determined, along with associated risk factors, over an average of 11 years of illness.

Main Results:

• Suicide rates were higher in BP-II (0.16%/year) and BP-I (0.14%/year) than MDD (0.05%/year).
• Suicidal attempt rates were BP-I (1.52%/year) > BP-II (0.82%/year) > MDD (0.48%/year).
• Suicidal ideation was most prevalent in BP-II (42.7%) and MDD (33.8%) compared to BP-I (22.7%).
• Bipolar diagnosis, hospitalizations, and early illness onset independently predicted suicidal acts.
• Affective temperament, BP-II diagnosis, and higher depression scores predicted suicidal ideation.

Conclusions:

• Suicidal behaviors, including ideation and attempts, are more prevalent in outpatients with bipolar disorder compared to major depressive disorder.
• Early illness recognition and intervention are critical, especially for patients with bipolar disorder and early-onset depression.