1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca' Granda Policlinico,Milan,Italy.
2Department of Psychiatry and Behavioral Sciences,Bipolar Disorders Clinic,Stanford Medical School,Stanford University,California,USA.
CNS Spectr. 2018 Aug;23(4):271-277. doi: 10.1017/S1092852917000384. Epub 2017 Jun 20.
IntroductionBipolar disorder (BD) is a chronic, highly disabling condition associated with psychiatric/medical comorbidity and substantive morbidity, mortality, and suicide risks. In prior reports, varying parameters have been associated with suicide risk.
To evaluate sociodemographic and clinical variables characterizing Italian individuals with BD with versus without prior suicide attempt (PSA).
A sample of 362 Italian patients categorized as BD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) was assessed and divided in 2 subgroups: with and without PSA. Sociodemographic and clinical variables were compared between prior attempters and non-attempters using corrected multivariate analysis of variance (MANOVA).
More than one-fourth of BD patients (26.2%) had a PSA, with approximately one-third (31%) of these having>1 PSA. Depressive polarity at onset, higher number of psychiatric hospitalizations, comorbid alcohol abuse, comorbid eating disorders, and psychiatric poly-comorbidity were significantly more frequent (p<.05) in patients with versus without PSA. Additionally, treatment with lithium, polypharmacotherapy (≥4 current drugs) and previous psychosocial rehabilitation were significantly more often present in patients with versus without PSA.
We found several clinical variables associated with PSA in BD patients. Even though these retrospective findings did not address causality, they could be clinically relevant to better understanding suicidal behavior in BD and adopting proper strategies to prevent suicide in higher risk patients.
介绍双相情感障碍（BD）是一种慢性、高度致残的疾病，与精神科/医学共病以及实质性发病率、死亡率和自杀风险有关。在之前的报告中，不同的参数与自杀风险相关。
评估与意大利双相情感障碍患者有或无既往自杀未遂（PSA）相关的社会人口学和临床变量。
根据《精神障碍诊断与统计手册》第四版修订版（DSM-IV-TR），对 362 名意大利患者进行了评估，并将其分为有和无 PSA 两个亚组。使用校正多元方差分析（MANOVA）比较既往尝试者和非尝试者之间的社会人口学和临床变量。
超过四分之一（26.2%）的双相情感障碍患者有 PSA，其中约三分之一（31%）有>1 次 PSA。发病时的抑郁极性、更多的精神科住院次数、共病酒精滥用、共病饮食障碍和精神科多共病在有 PSA 和无 PSA 的患者中明显更常见（p<.05）。此外，锂治疗、多药治疗（≥4 种当前药物）和既往心理社会康复在有 PSA 和无 PSA 的患者中明显更常见。
我们发现了一些与 BD 患者 PSA 相关的临床变量。尽管这些回顾性发现没有解决因果关系，但它们可能与更好地理解 BD 中的自杀行为和采取适当策略预防高危患者自杀具有临床相关性。
