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Clinical correlates of suicidality and self-injurious behaviour among Canadian adolescents with bipolar disorder

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Abstract

There is high risk of suicidality in bipolar disorder (BD), particularly in early onset cases. The literature regarding correlates and putative predictors of suicide attempts (SA), non-suicidal self-injury (NSSI) and suicidal ideation (SI) among youth with BD remains sparse. Participants included 197 adolescents with BD, divided into 4 groups: SA (with or without NSSI), NSSI (with or without SI), SI only, and comparison group (CG; no SA/NSSI/SI). Diagnoses, treatment, and suicidality measures were determined via semi-structured interviews, conducted between 2009 and 2017. Univariate analyses were followed by multinomial regression. Overall, 73.6% of participants had history of SA, NSSI, and/or SI. In comparison to CG, SA and NSSI were each associated with BD-II/-NOS (odds ratio [OR] = 15.99, p = 0.002; OR = 16.76, p = 0.003), female sex (OR = 6.89, p = 0.006; OR = 3.76, p = 0.02), and emotion dysregulation (OR = 1.10, p < 0.001; OR = 1.07, p = 0.004). NSSI and SI were each associated with most severe lifetime depression (OR = 1.10, p = 0.01; OR = 1.10, p = 0.01). SA and SI were associated with psychiatric hospitalization (OR = 19.45, p = 0.001; OR = 6.09, p = 0.03). SA was associated with poorer global functioning at most severe episode (OR = 0.88, p = 0.008). NSSI was associated with not living with both natural parents (OR = 0.22, p = 0.009). Study limitations include cross-sectional and retrospective design, stringent cut-offs for SA and NSSI, and recruitment from a tertiary clinical setting. Three quarters of adolescents with BD have had suicidality and/or self-injury. SA and NSSI were most similar to one another, and most different from CG, supporting the broader construct of self-harm. Future research should address the gap in knowledge regarding how sex differences and neurobiology are associated with the observed clinical differences.

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References

  1. Merikangas KR, Jin R, He J-P et al (2011) Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry 68:241–251. https://doi.org/10.1001/archgenpsychiatry.2011.12

    Article  Google Scholar 

  2. Van Meter A, Moreira ALR, Youngstrom E (2019) Updated meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry. https://doi.org/10.4088/JCP.18r12180

    Article  Google Scholar 

  3. Schaffer A, Isometsa ET, Tondo L et al (2015) International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disord 17:1–16. https://doi.org/10.1111/bdi.12271

    Article  Google Scholar 

  4. Chesney E, Goodwin GM, Fazel S (2014) Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. https://doi.org/10.1002/wps.20128

    Article  Google Scholar 

  5. Tondo L, Isacsson G, Baldessarini R (2003) Suicidal behaviour in bipolar disorder: risk and prevention. CNS Drugs 17:491–511. https://doi.org/10.2165/00023210-200317070-00003

    Article  CAS  Google Scholar 

  6. Crump C, Sundquist K, Winkleby MA, Sundquist J (2013) Comorbidities and mortality in bipolar disorder: a Swedish National Cohort Study. JAMA Psychiat 70:931–939. https://doi.org/10.1001/jamapsychiatry.2013.1394

    Article  Google Scholar 

  7. Dutta R, Boydell J, Kennedy N et al (2007) Suicide and other causes of mortality in bipolar disorder: a longitudinal study. Psychol Med 37:839–847. https://doi.org/10.1017/S0033291707000347

    Article  Google Scholar 

  8. Hayes JF, Miles J, Walters K et al (2015) A systematic review and meta-analysis of premature mortality in bipolar affective disorder. Acta Psychiatr Scand 131:417–425. https://doi.org/10.1111/acps.12408

    Article  CAS  Google Scholar 

  9. Judd LL, Schettler PJ, Akiskal HS et al (2003) Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol 6:127–137. https://doi.org/10.1017/S1461145703003341

    Article  Google Scholar 

  10. Pallaskorpi S, Suominen K, Ketokivi M et al (2015) Five-year outcome of bipolar I and II disorders: findings of the Jorvi Bipolar Study. Bipolar Disord 17:363–374. https://doi.org/10.1111/bdi.12291

    Article  Google Scholar 

  11. Schaffer A, Isometsa ET, Azorin J-M et al (2015) A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Aust N Z J Psychiatry 49:1006–1020. https://doi.org/10.1177/0004867415594428

    Article  Google Scholar 

  12. Gonda X, Pompili M, Serafini G et al (2012) Suicidal behavior in bipolar disorder: epidemiology, characteristics and major risk factors. J Affect Disord 143:16–26. https://doi.org/10.1016/j.jad.2012.04.041

    Article  Google Scholar 

  13. Isometsä E (2014) Suicidal behaviour in mood disorders—who, when, and why? Can J Psychiatry 59:120–130. https://doi.org/10.1177/070674371405900303

    Article  Google Scholar 

  14. Antypa N, Antonioli M, Serretti A (2013) Clinical, psychological and environmental predictors of prospective suicide events in patients with Bipolar Disorder. J Psychiatr Res 47:1800–1808. https://doi.org/10.1016/j.jpsychires.2013.08.005

    Article  Google Scholar 

  15. Schulze TG, Hedeker D, Zandi P et al (2006) What is familial about familial bipolar disorder? Resemblance among relatives across a broad spectrum of phenotypic characteristics. Arch Gen Psychiatry 63:1368–1376. https://doi.org/10.1001/archpsyc.63.12.1368

    Article  Google Scholar 

  16. Bobo WV, Na PJ, Geske JR et al (2018) The relative influence of individual risk factors for attempted suicide in patients with bipolar I versus bipolar II disorder. J Affect Disord 225:489–494. https://doi.org/10.1016/j.jad.2017.08.076

    Article  Google Scholar 

  17. McGrady A, Lynch D, Rapport D (2017) Psychosocial factors and comorbidity associated with suicide attempts: findings in patients with bipolar disorder. Psychopathology 50:171–174. https://doi.org/10.1159/000453272

    Article  Google Scholar 

  18. Perlis RH, Miyahara S, Marangell LB et al (2004) Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychiatry 55:875–881. https://doi.org/10.1016/j.biopsych.2004.01.022

    Article  Google Scholar 

  19. Merikangas KR, Cui L, Kattan G et al (2012) Mania with and without depression in a community sample of US adolescents. Arch Gen Psychiatry 69:943–951. https://doi.org/10.1001/archgenpsychiatry.2012.38

    Article  Google Scholar 

  20. Dickstein DP, Rich BA, Binstock AB et al (2005) Comorbid anxiety in phenotypes of pediatric bipolar disorder. J Child Adolesc Psychopharmacol 15:534–548. https://doi.org/10.1089/cap.2005.15.534

    Article  Google Scholar 

  21. Lewinsohn PM, Rohde P, Seeley JR (1994) Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychol 62:297–305. https://doi.org/10.1037/0022-006x.62.2.297

    Article  CAS  Google Scholar 

  22. Strober M, Schmidt-Lackner S, Freeman R et al (1995) Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up. J Am Acad Child Adolesc Psychiatry 34:724–731. https://doi.org/10.1097/00004583-199506000-00012

    Article  CAS  Google Scholar 

  23. Bhangoo RK, Dell ML, Towbin K et al (2003) Clinical correlates of episodicity in juvenile mania. J Child Adolesc Psychopharmacol 13:507–514. https://doi.org/10.1089/104454603322724896

    Article  Google Scholar 

  24. Lim K-S, Wong CH, McIntyre RS et al (2019) Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: a meta-analysis. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph16224581

    Article  Google Scholar 

  25. Hauser M, Galling B, Correll CU (2013) Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates, and targeted interventions. Bipolar Disord 15:507–523. https://doi.org/10.1111/bdi.12094

    Article  Google Scholar 

  26. Goldstein TR, Ha W, Axelson DA et al (2012) Predictors of prospectively examined suicide attempts among youth with bipolar disorder. Arch Gen Psychiatry. https://doi.org/10.1001/archgenpsychiatry.2012.650

    Article  Google Scholar 

  27. De Crescenzo F, Serra G, Maisto F et al (2017) Suicide attempts in juvenile bipolar versus major depressive disorders: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 56:825-831.e3. https://doi.org/10.1016/j.jaac.2017.07.783

    Article  Google Scholar 

  28. Brent DA, Perper JA, Moritz G et al (1993) Psychiatric risk factors for adolescent suicide: a case-control study. J Am Acad Child Adolesc Psychiatry 32:521–529. https://doi.org/10.1097/00004583-199305000-00006

    Article  CAS  Google Scholar 

  29. Goldstein TR (2009) Suicidality in pediatric bipolar disorder. Child Adolesc Psychiatr Clin N Am 18:339–352. https://doi.org/10.1016/j.chc.2008.11.005

    Article  Google Scholar 

  30. Halfon N, Labelle R, Cohen D et al (2013) Juvenile bipolar disorder and suicidality: a review of the last 10 years of literature. Eur Child Adolesc Psychiatry 22:139–151. https://doi.org/10.1007/s00787-012-0328-z

    Article  Google Scholar 

  31. Algorta GP, Youngstrom EA, Frazier TW et al (2011) Suicidality in pediatric bipolar disorder: predictor or outcome of family processes and mixed mood presentation? Bipolar Disord 13:76–86. https://doi.org/10.1111/j.1399-5618.2010.00886.x

    Article  Google Scholar 

  32. Bronisch T, Schwender L, Höfler M et al (2005) Mania, hypomania, and suicidality: findings from a prospective community study. Arch Suicide Res 9:267–278. https://doi.org/10.1080/13811110590929460

    Article  Google Scholar 

  33. Caetano SC, Olvera RL, Hunter K et al (2006) Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients. J Affect Disord 91:33–37. https://doi.org/10.1016/j.jad.2005.12.008

    Article  Google Scholar 

  34. Cardoso TA, Jansen K, Zeni CP et al (2017) Clinical outcomes in children and adolescents with bipolar disorder and substance use disorder comorbidity. J Clin Psychiatry 78:e230–e233. https://doi.org/10.4088/JCP.15m10293

    Article  Google Scholar 

  35. Dilsaver SC, Akiskal HS, Akiskal KK, Benazzi F (2006) Dose-response relationship between number of comorbid anxiety disorders in adolescent bipolar/unipolar disorders, and psychosis, suicidality, substance abuse and familiarity. J Affect Disord 96:249–258. https://doi.org/10.1016/j.jad.2006.07.008

    Article  Google Scholar 

  36. Friedman RC, Corn R, Hurt SW et al (1984) Family history of illness in the seriously suicidal adolescent: a life-cycle approach. Am J Orthopsychiatry 54:390–397

    Article  Google Scholar 

  37. Goldstein TR, Birmaher B, Axelson D et al (2005) History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk. Bipolar Disord 7:525–535. https://doi.org/10.1111/j.1399-5618.2005.00263.x

    Article  Google Scholar 

  38. Kochman FJ, Hantouche EG, Ferrari P et al (2005) Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder. J Affect Disord 85:181–189. https://doi.org/10.1016/j.jad.2003.09.009

    Article  CAS  Google Scholar 

  39. Dilsaver SC, Benazzi F, Rihmer Z et al (2005) Gender, suicidality and bipolar mixed states in adolescents. J Affect Disord 87:11–16. https://doi.org/10.1016/j.jad.2005.02.003

    Article  Google Scholar 

  40. Goldstein BI, Strober MA, Birmaher B et al (2008) Substance use disorders among adolescents with bipolar spectrum disorders. Bipolar Disord 10:469–478. https://doi.org/10.1111/j.1399-5618.2008.00584.x

    Article  Google Scholar 

  41. Lan WH, Bai YM, Hsu JW et al (2015) Comorbidity of ADHD and suicide attempts among adolescents and young adults with bipolar disorder: a nationwide longitudinal study. J Affect Disord 176:171–175. https://doi.org/10.1016/j.jad.2015.02.007

    Article  Google Scholar 

  42. Dilsaver SC, Benazzi F, Akiskal HS, Akiskal KK (2007) Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality. Bipolar Disord 9:649–655. https://doi.org/10.1111/j.1399-5618.2007.00396.x

    Article  Google Scholar 

  43. Miranda-Mendizabal A, Castellví P, Parés-Badell O et al (2019) Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health 64:265–283. https://doi.org/10.1007/s00038-018-1196-1

    Article  Google Scholar 

  44. Nock MK, Green JG, Hwang I et al (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiat 70:300–310. https://doi.org/10.1001/2013.jamapsychiatry.55

    Article  Google Scholar 

  45. Carballo JJ, Llorente C, Kehrmann L et al (2020) Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry 29:759–776. https://doi.org/10.1007/s00787-018-01270-9

    Article  CAS  Google Scholar 

  46. Geoffroy M-C, Orri M, Girard A et al (2020) Trajectories of suicide attempts from early adolescence to emerging adulthood: prospective 11-year follow-up of a Canadian cohort. Psychol Med. https://doi.org/10.1017/S0033291720000732

    Article  Google Scholar 

  47. Huang K-L, Wei H-T, Hsu J-W et al (2018) Risk of suicide attempts in adolescents and young adults with attention-deficit hyperactivity disorder: a nationwide longitudinal study. Br J Psychiatry 212:234–238. https://doi.org/10.1192/bjp.2018.8

    Article  Google Scholar 

  48. Kelleher I, Corcoran P, Keeley H et al (2013) Psychotic symptoms and population risk for suicide attempt: a prospective cohort study. JAMA Psychiat 70:940–948. https://doi.org/10.1001/jamapsychiatry.2013.140

    Article  Google Scholar 

  49. Miller AB, Esposito-Smythers C, Weismoore JT, Renshaw KD (2013) The relation between child maltreatment and adolescent suicidal behavior: a systematic review and critical examination of the literature. Clin Child Fam Psychol Rev 16:146–172. https://doi.org/10.1007/s10567-013-0131-5

    Article  Google Scholar 

  50. Santana GL, Coelho BM, Borges G et al (2015) The influence of parental psychopathology on offspring suicidal behavior across the lifespan. PLoS ONE 10:e0134970. https://doi.org/10.1371/journal.pone.0134970

    Article  CAS  Google Scholar 

  51. Posner K, Oquendo MA, Gould M et al (2007) Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants. Am J Psychiatry 164:1035–1043. https://doi.org/10.1176/ajp.2007.164.7.1035

    Article  Google Scholar 

  52. Silverman MM, Berman AL, Sanddal ND et al (2007) Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 2: suicide-related ideations, communications, and behaviors. Suicide Life Threat Behav 37:264–277. https://doi.org/10.1521/suli.2007.37.3.264

    Article  Google Scholar 

  53. Plener PL, Schumacher TS, Munz LM, Groschwitz RC (2015) The longitudinal course of non-suicidal self-injury and deliberate self-harm: a systematic review of the literature. Borderline Personal Disord Emot Dysregul 2:2. https://doi.org/10.1186/s40479-014-0024-3

    Article  Google Scholar 

  54. Chesin MS, Galfavy H, Sonmez CC et al (2017) Nonsuicidal self-injury is predictive of suicide attempts among individuals with mood disorders. Suicide Life-Threat Behav. https://doi.org/10.1111/sltb.12331

    Article  Google Scholar 

  55. MacPherson HA, Weinstein SM, West AE (2018) Non-suicidal self-injury in pediatric bipolar disorder: clinical correlates and impact on psychosocial treatment outcomes. J Abnorm Child Psychol 46:857–870. https://doi.org/10.1007/s10802-017-0331-4

    Article  Google Scholar 

  56. Kaufman J, Birmaher B, Brent D et al (1997) Schedule for affective disorders and schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988. https://doi.org/10.1097/00004583-199707000-00021

    Article  CAS  Google Scholar 

  57. Chambers WJ, Puig-Antich J, Hirsch M et al (1985) The assessment of affective disorders in children and adolescents by semistructured interview. Test–retest reliability of the schedule for affective disorders and schizophrenia for school-age children, present episode version. Arch Gen Psychiatry 42:696–702. https://doi.org/10.1001/archpsyc.1985.01790300064008

    Article  CAS  Google Scholar 

  58. Axelson D, Birmaher BJ, Brent D et al (2003) A preliminary study of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children mania rating scale for children and adolescents. J Child Adolesc Psychopharmacol 13:463–470. https://doi.org/10.1089/104454603322724850

    Article  Google Scholar 

  59. Birmaher B, Axelson D, Strober M et al (2006) Clinical course of children and adolescents with bipolar spectrum disorders. Arch Gen Psychiatry 63:175–183. https://doi.org/10.1001/archpsyc.63.2.175

    Article  Google Scholar 

  60. Keller MB, Lavori PW, Friedman B et al (1987) The longitudinal interval follow-up evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Arch Gen Psychiatry 44:540–548. https://doi.org/10.1001/archpsyc.1987.01800180050009

    Article  CAS  Google Scholar 

  61. Weissman MM, Wickramaratne P, Adams P et al (2000) Brief screening for family psychiatric history: the family history screen. Arch Gen Psychiatry 57:675–682. https://doi.org/10.1001/archpsyc.57.7.675

    Article  CAS  Google Scholar 

  62. Hollingshead A (1975) Four-factor index of socioeconomic status. Yale University, New Haven (Unpublished manuscript)

    Google Scholar 

  63. Shaffer D, Gould MS, Brasic J et al (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40:1228–1231. https://doi.org/10.1001/archpsyc.1983.01790100074010

    Article  CAS  Google Scholar 

  64. Rathus J, Miller A (1995) Life problems inventory. Montefiore Medical Center/Einstein College of Medicine, New York (Unpublished manuscript)

    Google Scholar 

  65. Gerson AC, Gerring JP, Freund L et al (1996) The Children’s Affective Lability Scale: a psychometric evaluation of reliability. Psychiatry Res 65:189–198

    Article  CAS  Google Scholar 

  66. Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B 57:289–300

    Google Scholar 

  67. IBM (2016) Statistical package for the social sciences (SPSS) Version 25. IBM Corp, Armonk

    Google Scholar 

  68. Esposito-Smythers C, Goldstein T, Birmaher B et al (2010) Clinical and psychosocial correlates of non-suicidal self-injury within a sample of children and adolescents with bipolar disorder. J Affect Disord 125:89–97. https://doi.org/10.1016/j.jad.2009.12.029

    Article  Google Scholar 

  69. Kozloff N, Cheung AH, Schaffer A et al (2010) Bipolar disorder among adolescents and young adults: results from an epidemiological sample. J Affect Disord 125:350–354. https://doi.org/10.1016/j.jad.2010.02.120

    Article  Google Scholar 

  70. Monto MA, McRee N, Deryck FS (2018) Nonsuicidal self-injury among a representative sample of US adolescents, 2015. Am J Public Health 108:1042–1048. https://doi.org/10.2105/AJPH.2018.304470

    Article  Google Scholar 

  71. McElroy SL, Crow S, Blom TJ et al (2016) Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder. J Affect Disord 191:216–221. https://doi.org/10.1016/j.jad.2015.11.010

    Article  Google Scholar 

  72. Katz D, Petersen T, Amado S et al (2020) An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder. J Affect Disord 266:49–56. https://doi.org/10.1016/j.jad.2020.01.091

    Article  Google Scholar 

  73. Swanson SA, Crow SJ, Le Grange D et al (2011) Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 68:714–723. https://doi.org/10.1001/archgenpsychiatry.2011.22

    Article  Google Scholar 

  74. Liu Z-Z, Chen H, Bo Q-G et al (2018) Psychological and behavioral characteristics of suicide attempts and non-suicidal self-injury in Chinese adolescents. J Affect Disord 226:287–293. https://doi.org/10.1016/j.jad.2017.10.010

    Article  Google Scholar 

  75. Zetterqvist M, Lundh L-G, Svedin CG (2013) A comparison of adolescents engaging in self-injurious behaviors with and without suicidal intent: self-reported experiences of adverse life events and trauma symptoms. J Youth Adolesc 42:1257–1272. https://doi.org/10.1007/s10964-012-9872-6

    Article  Google Scholar 

  76. Kostro K, Lerman JB, Attia E (2014) The current status of suicide and self-injury in eating disorders: a narrative review. J Eat Disord 2:19. https://doi.org/10.1186/s40337-014-0019-x

    Article  Google Scholar 

  77. Nock MK, Joiner TEJ, Gordon KH et al (2006) Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res 144:65–72. https://doi.org/10.1016/j.psychres.2006.05.010

    Article  Google Scholar 

  78. Ko A, Swampillai B, Timmins V et al (2014) Clinical characteristics associated with lithium use among adolescents with bipolar disorder. J Child Adolesc Psychopharmacol 24:382–389. https://doi.org/10.1089/cap.2013.0120

    Article  CAS  Google Scholar 

  79. Hafeman DM, Rooks B, Merranko J et al (2019) Lithium versus other mood-stabilizing medications in a longitudinal study of youth diagnosed with bipolar. J Am Acad Child Adolesc Psychiatry. https://doi.org/10.1016/j.jaac.2019.06.013

    Article  Google Scholar 

  80. Hayes JF, Pitman A, Marston L et al (2016) Self-harm, unintentional injury, and suicide in bipolar disorder during maintenance mood stabilizer treatment: a UK population-based electronic health records study. JAMA Psychiat 73:630–637. https://doi.org/10.1001/jamapsychiatry.2016.0432

    Article  Google Scholar 

  81. Goldstein BI, Birmaher B, Carlson GA et al (2017) The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: knowledge to date and directions for future research. Bipolar Disord 19:524–543. https://doi.org/10.1111/bdi.12556

    Article  Google Scholar 

  82. Smith KA, Cipriani A (2017) Lithium and suicide in mood disorders: Updated meta-review of the scientific literature. Bipolar Disord 19:575–586. https://doi.org/10.1111/bdi.12543

    Article  CAS  Google Scholar 

  83. Pacchiarotti I, Bond DJ, Baldessarini RJ et al (2013) The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders. Am J Psychiatry 170:1249–1262. https://doi.org/10.1176/appi.ajp.2013.13020185

    Article  Google Scholar 

  84. Bega S, Schaffer A, Goldstein B, Levitt A (2012) Differentiating between bipolar disorder types I and II: results from the national epidemiologic survey on alcohol and related conditions (NESARC). J Affect Disord 138:46–53. https://doi.org/10.1016/j.jad.2011.12.032

    Article  Google Scholar 

  85. Green E, Toma S, Collins J et al (2020) Similarities and differences across bipolar disorder subtypes among adolescents. J Child Adolesc Psychopharmacol 30:215–221. https://doi.org/10.1089/cap.2019.0031

    Article  Google Scholar 

  86. Arbuthnott AE, Lewis SP (2015) Parents of youth who self-injure: a review of the literature and implications for mental health professionals. Child Adolesc Psychiatry Ment Health 9:35. https://doi.org/10.1186/s13034-015-0066-3

    Article  Google Scholar 

  87. Goldstein TR, Fersch-Podrat RK, Rivera M et al (2015) Dialectical behavior therapy for adolescents with bipolar disorder: results from a pilot randomized trial. J Child Adolesc Psychopharmacol 25:140–149. https://doi.org/10.1089/cap.2013.0145

    Article  Google Scholar 

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Acknowledgements

We would like to thank all staff, study participants and families for their time and contributions to this study. This study was supported in part by philanthropic donations to Sunnybrook from the Great Gulf Foundation and the Michael Albert Garron Foundation.

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Authors and Affiliations

  1. Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada

    Diana Khoubaeva, Mikaela Dimick, Vanessa H. Timmins & Benjamin I. Goldstein

  2. Department of Pharmacology, University of Toronto, Toronto, ON, Canada

    Mikaela Dimick & Benjamin I. Goldstein

  3. Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Lisa M. Fiksenbaum

  4. Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Rachel H. B. Mitchell, Ayal Schaffer & Mark Sinyor

  5. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Rachel H. B. Mitchell, Ayal Schaffer, Mark Sinyor & Benjamin I. Goldstein

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  1. Diana Khoubaeva
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Correspondence to Benjamin I. Goldstein.

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Dr. Goldstein acknowledges research grant support from Brain Canada, Canadian Institutes of Health Research, Heart and Stroke Foundation, National Institute of Mental Health, and the Departments of Psychiatry at the University of Toronto and Sunnybrook Health Sciences Centre. Dr. Schaffer is a member of advisory board/speakers bureau for Lundbeck, Janssen, and Otsuka/Bristol Myers Squibb. Dr. Sinyor declares that he has received in-kind assistance from Google Canada in developing a website to deliver a free youth health literacy curriculum. All other authors have no potential or actual conflicts of interest to declare.

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Khoubaeva, D., Dimick, M., Timmins, V.H. et al. Clinical correlates of suicidality and self-injurious behaviour among Canadian adolescents with bipolar disorder. Eur Child Adolesc Psychiatry 32, 41–51 (2023). https://doi.org/10.1007/s00787-021-01803-9

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  • DOI: https://doi.org/10.1007/s00787-021-01803-9

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