Bipolar Disorder Research Program, Department of Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
Braz J Psychiatry. 2009 Sep;31(3):271-80. doi: 10.1590/s1516-44462009005000003. Epub 2009 Aug 7.
This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder.
Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation.
Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse.
Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.
本文综述了与双相情感障碍自杀行为相关的主要危险因素的证据。
对双相情感障碍、自杀行为和自杀意念的文献研究进行综述。
双相情感障碍与自杀意念和自杀企图密切相关。在临床样本中，14-59%的患者有自杀意念，25-56%的患者在一生中至少有一次自杀企图。大约 15%至 19%的双相情感障碍患者死于自杀。自杀行为的原因是多方面的、复杂的。一些强有力的自杀行为预测因素已经在文献中出现，如当前的情绪状态、抑郁的严重程度、焦虑、攻击性、敌意、绝望、与其他轴 I 和轴 II 障碍共病、混合状态的终生史以及身体或性虐待史。
双相情感障碍是与自杀尝试和自杀完成终身风险最高的精神疾病。因此，临床医生了解自杀行为的主要危险因素非常重要，以便选择更好的策略来应对这种复杂的行为。
