Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Eur Arch Psychiatry Clin Neurosci. 2022 Apr;272(3):359-370. doi: 10.1007/s00406-021-01343-y. Epub 2021 Oct 15.
The purpose of the present study was to detect demographic and clinical factors associated with lifetime suicide attempts in Bipolar Disorder (BD). A total of 1673 bipolar patients from different psychiatric departments were compared according to the lifetime presence of suicide attempts on demographic/clinical variables. Owing to the large number of variables statistically related to the dependent variable (presence of suicide attempts) at the univariate analyses, preliminary multiple logistic regression analyses were realized. A final multivariable logistic regression was then performed, considering the presence of lifetime suicide attempts as the dependent variable and statistically significant demographic/clinical characteristics as independent variables. The final multivariable logistic regression analysis showed that an earlier age at first contact with psychiatric services (odds ratio [OR] = 0.97, p < 0.01), the presence of psychotic symptoms (OR = 1.56, p < 0.01) or hospitalizations (OR = 1.73, p < 0.01) in the last year, the attribution of symptoms to a psychiatric disorder (no versus yes: OR = 0.71, partly versus yes OR = 0.60, p < 0.01), and the administration of psychoeducation in the last year (OR = 1.49, p < 0.01) were all factors associated with lifetime suicide attempts in patients affected by BD. In addition, female patients resulted to have an increased association with life-long suicidal behavior compared to males (OR: 1.02, p < 0.01). Several clinical factors showed complex associations with lifetime suicide attempts in bipolar patients. These patients, therefore, require strict clinical monitoring for their predisposition to a less symptom stabilization. Future research will have to investigate the best management strategies to improve the prognosis of bipolar subjects presenting suicidal behavior.
本研究旨在检测与双相情感障碍(BD)患者一生中自杀尝试相关的人口统计学和临床因素。根据一生中是否存在自杀尝试,比较了来自不同精神科部门的 1673 名双相情感障碍患者的人口统计学/临床变量。由于单变量分析中与因变量(自杀尝试的发生)相关的变量数量众多,因此首先进行了初步的多元逻辑回归分析。然后,考虑到一生中自杀尝试的发生作为因变量,具有统计学意义的人口统计学/临床特征作为自变量,进行最终的多变量逻辑回归分析。最终的多变量逻辑回归分析表明,首次接触精神科服务的年龄较早(比值比[OR] = 0.97,p < 0.01)、过去一年存在精神病症状(OR = 1.56,p < 0.01)或住院治疗(OR = 1.73,p < 0.01)、将症状归因于精神障碍(无与是:OR = 0.71,部分与是 OR = 0.60,p < 0.01),以及过去一年接受心理教育(OR = 1.49,p < 0.01),这些都是与 BD 患者一生中自杀尝试相关的因素。此外,与男性相比,女性患者一生中自杀行为的相关性更高(OR:1.02,p < 0.01)。几项临床因素与双相情感障碍患者一生中的自杀尝试存在复杂的关联。因此,这些患者需要严格的临床监测,以预防其病情不稳定。未来的研究将不得不调查最佳的管理策略,以改善有自杀行为的双相情感障碍患者的预后。