Lage Renata Reis, de Assis da Silva Rafael, Tancini Marcelo Baggi, Nardi Antonio Egidio, Mograbi Daniel C, Cheniaux Elie
Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Av. Venceslau Brás, 71, fundos, CEP 22290-140, Rio de Janeiro, RJ, Brazil.
Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil.
Psychiatr Q. 2022 Jun;93(2):453-461. doi: 10.1007/s11126-021-09965-0. Epub 2021 Oct 19.
Bipolar disorder (BD) has the highest risk of suicide among all mental disorders. Thus, identifying factors related to suicidal ideation is essential for a better assessment of the risk of suicide in BD.
To analyze the relationship between suicidal ideation and clinical and sociodemographic characteristics in BD patients.
This is a cross-sectional study that included eighty individuals with BD. Information regarding sociodemographic data and history of attempted suicide were collected, and the Hamilton Depression Scale, Young Mania Rating Scale, Positive And Negative Syndrome Scale/positive symptom subscale, Clinical Global Impressions Scale for use in bipolar illness, Insight Scale for Affective Disorders, and Barratt Impulsiveness Scale were administered. The presence and severity of suicidal ideation were assessed using the Beck Scale for Suicidal Ideation.
All regression models significantly predicted suicidal ideation. In the model that had the lowest AIC score and the highest cross-validity, the severity of depressive and of manic symptoms (standardized β = 0.49, p < 0.001; standardized β = 0.42, p = 0.007), the insight level (standardized β = - 0.38, p = 0.012) and previous suicide attempt (standardized β = 0.20, p = 0.036) acted as predictors of suicidal ideation, while degree of impulsivity (β standardized = 0.13, p = 0.229) and educational level (standardized β = - 0.16, p = 0.108) did not give a significant contribution.
According to our results, more severe depression and mania symptoms, higher level of insight and a history of suicide attempt indicate the occurrence of suicidal ideation in BD.
双相情感障碍（BD）在所有精神障碍中自杀风险最高。因此，识别与自杀意念相关的因素对于更好地评估BD患者的自杀风险至关重要。
分析BD患者自杀意念与临床及社会人口学特征之间的关系。
这是一项横断面研究，纳入了80例BD患者。收集了社会人口学数据和自杀未遂史的信息，并使用汉密尔顿抑郁量表、杨氏躁狂评定量表、阳性和阴性症状量表/阳性症状分量表、双相情感障碍临床总体印象量表、情感障碍自知力量表和巴拉特冲动性量表进行评估。使用贝克自杀意念量表评估自杀意念的存在和严重程度。
所有回归模型均能显著预测自杀意念。在AIC得分最低且交叉效度最高的模型中，抑郁和躁狂症状的严重程度（标准化β = 0.49，p < 0.001；标准化β = 0.42，p = 0.007）、自知力水平（标准化β = -0.38，p = 0.012）和既往自杀未遂（标准化β = 0.20，p = 0.036）是自杀意念的预测因素，而冲动性程度（标准化β = 0.13，p = 0.229）和教育水平（标准化β = -0.16，p = 0.108）没有显著贡献。
根据我们的研究结果，更严重的抑郁和躁狂症状、更高的自知力水平以及自杀未遂史表明BD患者会出现自杀意念。
