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Do risk factors for suicidal behavior differ by affective disorder polarity?
J G Fiedorowicz1, A C Leon, M B Keller
1Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. jess-fiedorowicz@uiowa.edu
Psychological Medicine
|August 1, 2008
Summary
Mood polarity in affective disorders does not independently affect suicide risk. Common risk factors like hopelessness and substance abuse are key predictors, regardless of whether the disorder is depressive or bipolar.
Area of Science:
- Psychiatry and Mental Health Research
- Suicidology
- Epidemiology of Affective Disorders
Background:
- Suicide is a significant cause of mortality, closely linked to affective disorders.
- Understanding the role of mood polarity (depressive vs. bipolar) in suicide risk is crucial.
Purpose of the Study:
- To assess the influence of affective disorder polarity on subsequent suicidal behavior.
- To determine if suicide risk factors have differential effects based on mood polarity.
Main Methods:
- Prospective cohort study of 909 participants with major depressive and bipolar disorders (National Institute of Mental Health Collaborative Depression Study).
- Follow-up for up to 25 years, analyzing 4204 mood cycles.
- Mixed-effects, grouped-time survival analysis to evaluate risk factors for suicidal behavior (attempts or completions).
Main Results:
- No difference in prior suicide attempts based on polarity, though bipolar participants had more severe prior attempts.
- Age, hopelessness, and active substance abuse predicted suicidal behavior.
- Mood polarity did not independently predict suicidal behavior, and its influence did not alter the effects of other risk factors.
Conclusions:
- Bipolarity does not independently increase suicide risk or modify the impact of established risk factors in affective disorders.
- Suicide risk assessment in affective disorders can focus on common risk factors irrespective of mood polarity.
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