Suicide and bipolar disorder
Bipolar disorders are common illnesses with markedly elevated premature mortality, but they remain frequently under-referred, under-diagnosed, and under-treated. Suicide is the cause of death in up to 15% of patients with bipolar disorders, and about half of them make at least one suicide attempt in their lifetime. The suicide rate of (untreated) bipolar patients is 25 times higher than the same rate in the general population. Suicidal behaviour in bipolar patients occurs almost exclusively during severe major depressive episodes, and less frequently in mixed affective episodes or in dysphoric mania. In contrast, suicidal behaviour occurs very rarely during euphoric mania, hypomania, or euthymia, suggesting that suicidal behaviour in bipolar patients is a state- and severity-dependent phenomenon. However, because the majority of bipolar patients never commit (and up to 50% of them never attempt) suicide, risk factors other than bipolar disorder itself also play a significant contributory role. This chapter summarises the clinically most relevant suicide risk and protective factors in bipolar disorders, and touches briefly on the most effective suicide prevention strategies.
KeywordsBipolar Disorder Suicide Attempt Bipolar Patient Bipolar Spectrum Disorder Suicide Risk Factor
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