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Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy pp 47–56Cite as

Suicide and bipolar disorder

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Part of the Milestones in Drug Therapy book series (MDT)

Abstract

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.

Keywords

  • Bipolar Disorder
  • Suicide Attempt
  • Bipolar Patient
  • Bipolar Spectrum Disorder
  • Suicide Risk Factor

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Author information

Authors and Affiliations

  1. Department of Clinical and Theoretical Mental Health, and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Kútvülgyi Clinical Centre, Kútvülgyi út 4, 1125, Budapest, Hungary

    Zoltán Rihmer

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  1. Zoltán Rihmer
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Editors and Affiliations

  1. Mood Disorders Research Unit Laboratory of Molecular Pathophysiology, National Institute of Mental Health Mark O. Hatfield Clinical Research Center, Unit 7SE Rm. 7-3445 10 Center Drive, Bethesda, Maryland, 20892, USA

    Carlos A. Zarate

  2. Laboratory of Molecular Pathophysiology, National Institute of Mental Health Porter Neuroscience Research Center, Building 35, Room 1C-917 36 Convent Drive, MSC 3711, Bethesda, Maryland, 20892, USA

    Husseini K. Manji

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Rihmer, Z. (2009). Suicide and bipolar disorder. In: Zarate, C.A., Manji, H.K. (eds) Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy. Milestones in Drug Therapy. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8567-5_4

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