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Suicide Assessment and Prevention in Bipolar Disorder: How Current Evidence Can Inform Clinical Practice
Niloofar Izadi1, Rachel H B Mitchell1, Peter Giacobbe1
1Department of Psychiatry, Sunnybrook Health Sciences Centre, and Sunnybrook Research Institute, Toronto (all authors); Department of Psychiatry, University of Toronto, Toronto (Izadi, Mitchell, Giacobbe, Nestor, Steinberg, Sinyor, Schaffer).
Abstract:
Bipolar disorder is associated with a considerable risk of suicide, and this fact must be incorporated into management of all patients with the condition. This article highlights the importance of a more nuanced understanding of the factors associated with the increased risk of suicidal behavior in people diagnosed as having bipolar disorder and interventions that could mitigate it. Several sociodemographic, clinical, environmental, and other variables have been associated with suicide attempts or deaths in bipolar disorder. Youths with bipolar disorder are a particularly vulnerable group, and their trajectory of illness could be modified by early interventions. Several medications have been studied regarding their relationship to suicide risk in bipolar disorder, and interventional psychiatry is a newer area of research focus. Finally, community-based approaches can be incorporated into a comprehensive approach to suicide prevention. This article summarizes the current understanding of key variables that can help inform a clinical risk assessment of individuals and interventions that can be employed in suicide prevention in bipolar disorder.
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