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. 2022 Apr;272(3):359-370.
doi: 10.1007/s00406-021-01343-y. Epub 2021 Oct 15.

Factors associated with lifetime suicide attempts in bipolar disorder: results from an Italian nationwide study

Massimiliano Buoli  1   2 , Bruno Mario Cesana  3 , Simone Bolognesi  4 , Andrea Fagiolini  4 , Umberto Albert  5 , Gabriele Di Salvo  6 , Giuseppe Maina  6 , Andrea de Bartolomeis  7 , Maurizio Pompili  8 , Claudia Palumbo  9 , Emi Bondi  9 , Luca Steardo Jr  10 , Pasquale De Fazio  10 , Mario Amore  11 , Mario Altamura  12 , Antonello Bellomo  12 , Alessandro Bertolino  13 , Marco Di Nicola  14   15 , Guido Di Sciascio  16 , Andrea Fiorillo  17 , Emilio Sacchetti  18   19 , Gabriele Sani  14   15 , Alberto Siracusano  20   21 , Giorgio Di Lorenzo  20   21 , Alfonso Tortorella  22 , A Carlo Altamura  23   24 , Bernardo Dell'Osso  25   26   27 ; ISBD Italian Chapter Epidemiologic Group
Affiliations

Factors associated with lifetime suicide attempts in bipolar disorder: results from an Italian nationwide study

Massimiliano Buoli et al. Eur Arch Psychiatry Clin Neurosci. 2022 Apr.

Abstract

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.

Keywords: Bipolar Disorder (BD); Clinical features; Outcome; Suicidal attempts.

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Conflict of interest statement

The authors have not conflicts of interest to disclose in relation to the present article.

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