Current Psychiatry Reports

, Volume 10, Issue 1, pp 66–72 | Cite as

Bipolar disorder and suicide: Research synthesis and clinical translation

  • Roger S. McIntyre
  • David J. Muzina
  • David E. Kemp
  • Diana Blank
  • Hanna O. Woldeyohannes
  • Jodi Lofchy
  • Joanna K. Soczynska
  • Suman Banik
  • Jakub Z. Konarski
Article

Abstract

Attempted suicide and suicide are prevalent in individuals with bipolar disorder (BD). Extant evidence indicates that history of suicide attempts, percentage of time spent in a depressed state, and hostility are factors associated with suicide attempts and completed suicide. Childhood adversity (eg, sexual and physical abuse) is emerging as a risk factor for suicide attempts in adults with BD. The pertinacity of medical comorbidity (eg, obesity, metabolic syndrome) in the bipolar population is further underscored by its preliminary association with suicidality. Biomarkers such as cerebrospinal fluid monoamine metabolite levels may be predictive of suicide attempts and lethality in BD. Compelling evidence supports an antisuicide effect of long-term lithium prophylaxis; lithium’s salutary effect is mediated primarily by reduced lethality of suicidal acts. Conventional unimodal antidepressants may engender or exacerbate suicidality in susceptible individuals with BD. A nascent database suggests that adjunctive psychosocial interventions may further reduce suicide risk in bipolar individuals.

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Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  • Roger S. McIntyre
    • 1
  • David J. Muzina
  • David E. Kemp
  • Diana Blank
  • Hanna O. Woldeyohannes
  • Jodi Lofchy
  • Joanna K. Soczynska
  • Suman Banik
  • Jakub Z. Konarski
  1. 1.Department of Psychiatry and PharmacologyUniversity of Toronto, Mood Disorders Psychopharmacology Unit, University Health NetworkTorontoCanada

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