Department of Psychiatry and Psychology, Mayo Clinic, Generose 2A, 200 First Street SW, Rochester, MN 55905, USA.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
J Affect Disord. 2018 Jan 1;225:489-494. doi: 10.1016/j.jad.2017.08.076. Epub 2017 Aug 30.
To compare the relative influence (RI) of individual predictors for lifetime attempted suicide between adults with bipolar I (BDBD-I) and bipolar II disorder (BDBD-II).
We conducted an analysis of data from 1465 enrollees in the Mayo Clinic Bipolar Disorder Biobank. Demographic and clinical variables and history of attempted suicide were ascertained using standardized questionnaires. Height and weight were assessed to determine body mass index (BMI); obesity was defined as BMI ≥30kg/m. The frequencies of these variables were compared between persons with and without self-reported lifetime suicide attempts both overall, and within BD-I and BD-II subgroups. Gradient boosting machine (GBM) models were used to quantify the RI of study variables on the risk of lifetime attempted suicide.
Nearly one-third of patients reported having a lifetime suicide attempt. Attempted suicide rates were higher in patients with BD-I than BD-II, but absolute differences were small. Lifetime attempted suicide was associated with female sex, BD-I subtype, psychiatric and substance use comorbidities, binge eating behavior, lifetime history of rapid cycling, other indicators of adverse illness course, and early age of bipolar illness onset in the entire cohort. Differences in the rank-ordering of RI for predictors of attempted suicide between BD-I and BD-II patients were modest. Rapid cycling was a strong risk factor for attempted suicide, particularly in men with BD-I.
Actively psychotic or suicidal patients needing psychiatric hospitalization were initially excluded, but were approached after these acute psychiatric problems resolved.
The prevalence of lifetime attempted suicide was significantly higher in BD-I than BD-II in this large, cross-sectional cohort. Predictors of attempted suicide were similar in BD-I and BD-II subgroups.
比较单相躁狂症（BDBD-I）和双相 II 型障碍（BDBD-II）患者一生中尝试自杀的个体预测因素的相对影响（RI）。
我们对梅奥诊所双相情感障碍生物库的 1465 名参与者的数据进行了分析。使用标准化问卷确定人口统计学和临床变量以及自杀未遂史。通过评估身高和体重来确定体重指数（BMI）；BMI≥30kg/m 定义为肥胖。比较了报告有或无终生自杀未遂史的个体之间这些变量的频率，包括总体情况，以及在 BD-I 和 BD-II 亚组内的情况。使用梯度提升机（GBM）模型来量化研究变量对终生尝试自杀风险的 RI。
近三分之一的患者报告有过一生中的自杀未遂。BD-I 患者的自杀未遂率高于 BD-II 患者，但绝对差异较小。一生中尝试自杀与女性、BD-I 亚型、精神和物质使用共病、暴食行为、快速循环史、其他不良疾病过程指标以及双相情感障碍发病的早期年龄有关在整个队列中。BD-I 和 BD-II 患者尝试自杀预测因素的 RI 排序差异不大。快速循环是自杀未遂的一个强烈危险因素，尤其是在男性 BD-I 患者中。
最初排除了正在经历精神病或自杀风险需要住院治疗的活动期患者，但在这些急性精神问题解决后对他们进行了接触。
在这个大型横断面队列中，BD-I 一生中尝试自杀的比例明显高于 BD-II。BD-I 和 BD-II 亚组中自杀未遂的预测因素相似。
