Correlation Between Insight Level and Suicidal Behavior/Ideation in Bipolar Depression


Suicide is a relatively common outcome along the course of bipolar disorder. Studies have shown a positive correlation between ideation or attempts of suicide and higher insight in schizophrenic patients. Nevertheless there are still few studies that evaluate the relationship between suicide and insight in mood disorders. Evaluate the relationship between insight and suicidal ideation or behavior in bipolar depression. A group of 165 bipolar patients were followed up along 1 year. Each patient’s mood was assessed in every consultation according to DSM-IV-TR criteria. Suicidal ideation and behavior were prospectively assessed through item 3 of HAM-D whenever a major depressive episode was diagnosed. Insight was evaluated through the Insight Scale for Affective Disorders. A history of suicidal attempts was associated with worse insight in 60 patients with one episode of bipolar depression. The difference remained even when the supposed effect of depression over insight was controlled. No correlation between current suicidal ideation and insight level was found though. Our results suggest that a history of suicide attempts may correlate with higher impairment of insight in bipolar depression. No relationship was found between current suicidal ideation and insight.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES.

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Correspondence to Rafael de Assis da Silva.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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de Assis da Silva, R., Mograbi, D.C., Bifano, J. et al. Correlation Between Insight Level and Suicidal Behavior/Ideation in Bipolar Depression. Psychiatr Q 88, 47–53 (2017).

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  • Insight
  • Suicide
  • Bipolar depression