Dalton E Jane, Cate-Carter Tasha D, Mundo Emanuela, Parikh Sagar V, Kennedy James L
Neurogenetics Section, Center for Addiction and Mental Health, University of Toronoto, Ontario, Canada.
Bipolar Disord. 2003 Feb;5(1):58-61. doi: 10.1034/j.1399-5618.2003.00017.x.
Bipolar disorder is associated with a high frequency of both completed suicides and suicide attempts. The primary aim of this study was to identify clinical predictors of suicide attempts in subjects with bipolar disorder.
We studied 336 subjects with a diagnosis of bipolar I, bipolar II, or schizoaffective disorder (bipolar type). The Structured Clinical Interview for DSM-IV (SCID-I) was administered and subsequently two expert psychiatrists established a diagnosis. Predictors of suicide attempts were examined in attempters and non-attempters.
The lifetime rate of suicide attempts for the entire sample was 25.6%. A lifetime co-morbid substance use disorder was a significant predictor of suicide attempts: bipolar subjects with co-morbid substance use disorders (SUD) had a 39.5% lifetime rate of attempted suicide, while those without had a 23.8% rate (odds ratio = 2.09, 95% CI = 1.03-4.21, chi2 = 4.33, df = 1, p = 0.037).
Lifetime co-morbid SUD were associated with a higher rate of suicide attempts in patients with bipolar disorder. This relationship may have a genetic origin and/or be explained by severity of illness and trait impulsivity.
双相情感障碍与较高的自杀既遂率和自杀未遂率相关。本研究的主要目的是确定双相情感障碍患者自杀未遂的临床预测因素。
我们研究了336例诊断为双相I型、双相II型或分裂情感性障碍（双相型）的患者。采用《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈（SCID-I）进行评估，随后由两位专家精神科医生确定诊断。对有自杀未遂史者和无自杀未遂史者的自杀未遂预测因素进行了检查。
整个样本的终身自杀未遂率为25.6%。终身共病物质使用障碍是自杀未遂的一个重要预测因素：患有共病物质使用障碍（SUD）的双相情感障碍患者的终身自杀未遂率为39.5%，而无共病物质使用障碍者的自杀未遂率为23.8%（优势比=2.09，95%置信区间=1.03-4.21，卡方=4.33，自由度=1，p=0.037）。
双相情感障碍患者终身共病SUD与较高的自杀未遂率相关。这种关系可能有遗传根源和/或可由疾病严重程度和特质冲动性来解释。
