Goffin Kathryn C, Dell'Osso Bernardo, Miller Shefali, Wang Po W, Holtzman Jessica N, Hooshmand Farnaz, Ketter Terence A
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan, Italy.
J Psychiatr Res. 2016 May;76:94-100. doi: 10.1016/j.jpsychires.2016.02.006. Epub 2016 Feb 15.
Suicide attempts are common in patients with bipolar disorder (BD), and consistently associated with female gender and certain unfavorable BD illness characteristics. Findings vary, however, regarding effects of BD illness subtype and yet other illness characteristics upon prior suicide attempt rates. We explored the effects of demographics and BD illness characteristics upon prior suicide attempt rates in patients stratified by BD illness subtype (i.e., with bipolar I disorder (BDI) versus bipolar II disorder (BDII)).
Outpatients referred to the Stanford BD Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD Affective Disorders Evaluation. Rates of prior suicide attempt were compared in patients with and without diverse demographic and BD illness characteristics stratified by BD subtype.
Among 494 BD outpatients (mean ± SD age 35.6 ± 13.1 years; 58.3% female; 48.6% BDI, 51.4% BDII), overall prior suicide attempt rates in were similar in BDI versus BDII patients, but approximately twice as high in BDI (but not BDII) patients with compared to without lifetime eating disorder, and in BDII (but not BDI) patients with compared to without childhood BD onset. In contrast, current threshold-level suicidal ideation and lifetime alcohol use disorder robustly but less asymmetrically increased prior suicide attempt risk across BD subtypes.
American tertiary bipolar disorder clinic referral sample, cross-sectional design.
Further studies are needed to assess the extent to which varying clinical characteristics of samples of patients with BDI and BDII could yield varying prior suicide attempt rates in patients with BDI versus BDII.
自杀未遂在双相情感障碍（BD）患者中很常见，并且一直与女性性别以及某些不利的BD疾病特征相关。然而，关于BD疾病亚型以及其他疾病特征对既往自杀未遂率的影响，研究结果存在差异。我们探讨了人口统计学和BD疾病特征对按BD疾病亚型分层（即双相I型障碍（BDI）与双相II型障碍（BDII））的患者既往自杀未遂率的影响。
对2000年至2011年转诊至斯坦福BD诊所的门诊患者进行双相情感障碍评估的系统治疗强化项目评估。比较了按BD亚型分层的具有不同人口统计学和BD疾病特征的患者与无这些特征的患者的既往自杀未遂率。
在494名BD门诊患者中（平均±标准差年龄35.6±13.1岁；58.3%为女性；48.6%为BDI，51.4%为BDII），BDI患者和BDII患者的总体既往自杀未遂率相似，但有终生饮食障碍的BDI患者（而非BDII患者）的自杀未遂率约为无终生饮食障碍患者的两倍，有儿童期BD发病的BDII患者（而非BDI患者）的自杀未遂率约为无儿童期BD发病患者的两倍。相比之下，当前阈值水平的自杀意念和终生酒精使用障碍在各BD亚型中均显著增加既往自杀未遂风险，但差异不那么明显。
美国三级双相情感障碍诊所转诊样本，横断面设计。
需要进一步研究以评估BDI和BDII患者样本的不同临床特征在多大程度上可能导致BDI患者与BDII患者的既往自杀未遂率不同。
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