Suicide in bipolar I disorder in Finland: psychological autopsy findings from the National Suicide Prevention Project in Finland.

Suicide mortality in bipolar disorders is high, but little is known about the conditions preceding these fatal acts. The Research phase of the National Suicide Prevention Project in Finland comprised a nationwide psychological autopsy study of suicides (N = 1397) in Finland in 1987-88. In a series of studies, all of the 31 suicides with bipolar I disorder were comprehensively investigated. These suicides usually occurred during a depressive phase, but many male victims also suffered from comorbid alcohol use disorders. Despite contact with psychiatric care, most subjects had not received adequate treatment nor adhered to it. In most cases, suicide occurred after a recent adverse life change. More than half had communicated their intent to next of kin or attending personnel before death.