Skip to main content

Advertisement

Log in

Suicide risk factors in children and adolescents with bipolar disorder

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Suicidal behavior in children and adolescents with bipolar disorder is a major public health problem that remains understudied. Most research on suicidal behavior in bipolar disorder has been conducted in older adolescents and adults and is limited by retrospective design. Although preliminary research suggests that the early onset of bipolar disorder is associated with increased suicide risk, few studies have prospectively examined the effects of prior suicidal behavior, clinical course, comorbid psychiatric disorders, familial suicidality, and psychosocial factors on suicidal behavior in bipolar youths. More systematic research is needed to better understand suicidal behavior in bipolar children and adolescents. Increased knowledge of the risk factors that contribute to suicidal behavior should lead to better prevention and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Anderson RN, Smith BL: Deaths: leading causes for 2002. Natl Vital Stat Rep 2005, 53: 13–19.

    Google Scholar 

  2. Gould MS, Greenberg T, Velting DM, et al.: Youth suicide risk and preventive interventions: a review of the last 10 years. J Am Acad Child Adolesc Psychiatry 2003, 42: 386–405.

    PubMed  Google Scholar 

  3. Gould MS, King R, Greenwald S, et al.: Psychopathology associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry 1998, 37: 915–923.

    Article  PubMed  CAS  Google Scholar 

  4. Harris EC, Barraclough B: Suicide as an outcome for mental disorders. Br J Psychiatry 1997, 170: 205–228.

    Article  PubMed  CAS  Google Scholar 

  5. Craney JL, Geller B: A prepubertal and early adolescent bipolar disorder-I phenotype: review of phenomenology and longitudinal course. Bipolar Disord 2003, 5: 243–256.

    Article  PubMed  Google Scholar 

  6. Faedda GL, Baldessarini RJ, Glovinsky IP, et al.: Pediatric bipolar disorder: phenomenology and course of illness. Bipolar Disord 2004, 6: 305–313.

    Article  PubMed  Google Scholar 

  7. Dilsaver SC, Benazzi F, Akiskal HS: Mixed states: the most common outpatient presentation of bipolar depressed adolescents? Psychopathology 2005, 38: 268–272.

    Article  PubMed  Google Scholar 

  8. Strober M, Schmidt-Lackner S, Freeman R, et al.: Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up. J Am Acad Child Adolesc Psychiatry 1995, 34: 724–731.

    Article  PubMed  CAS  Google Scholar 

  9. Bhangoo RK, Dell ML, Towbin K, et al.: Clinical correlates of episodicity in juvenile mania. J Child Adolesc Psychopharmacol 2003, 13: 507–514.

    Article  PubMed  Google Scholar 

  10. Lewinsohn PM, Klein DN, Seeley JR: Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. J Am Acad Child Adolesc Psychiatry 1995, 34: 454–463.

    PubMed  CAS  Google Scholar 

  11. Chen YW, Dilsaver SC: Lifetime rates of suicide attempts among subjects with bipolar and unipolar disorders relative to subjects with other Axis I disorders. Biol Psychiatry 1996, 39: 896–899.

    Article  PubMed  CAS  Google Scholar 

  12. Kessler RC, Borges G, Walters EE: Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Study. Arch Gen Psychiatry 1999, 56: 617–626.

    Article  PubMed  CAS  Google Scholar 

  13. Valtonen H, Suominen K, Mantere O, et al.: Suicidal ideation and attempts in bipolar I and II disorders. J Clin Psychiatry 2005, 66: 1456–1462.

    PubMed  Google Scholar 

  14. Dalton EJ, Cate-Carter TD, Mundo E, et al.: Suicide risk in bipolar patients: the role of co-morbid substance use disorders. Bipolar Disord 2003, 5: 58–61.

    Article  PubMed  Google Scholar 

  15. Brent DA, Perper JA, Goldstein CE, et al.: Risk factors for adolescent suicide. Arch Gen Psychiatry 1988, 45: 581–588.

    PubMed  CAS  Google Scholar 

  16. Shaffer D, Gould MS, Fisher P, et al.: Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry 1996, 53: 339–348.

    PubMed  CAS  Google Scholar 

  17. Tsai SY, Lee JC, Chen CC: Characteristics and psychosocial problems of patients with bipolar disorder at high risk for suicide attempt. J Affect Disord 1999, 52: 145–152.

    Article  PubMed  CAS  Google Scholar 

  18. López P, Mosquera F, de Leon J, et al.: Suicide attempts in bipolar disorder. J Clin Psychiatry 2001, 62: 963–966.

    PubMed  Google Scholar 

  19. Leverich GS, Altshuler LL, Frye MA, et al.: Factors associated with suicide attempts in 648 patients with bipolar disorder in the Stanley Foundation Bipolar Network. J Clin Psychiatry 2003, 64: 506–515.

    PubMed  Google Scholar 

  20. Perlis RH, Miyahara S, Marangell LB, et al.: 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 2004, 55: 875–881.

    Article  PubMed  Google Scholar 

  21. Hawton K, Sutton L, Haw C, et al.: Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. J Clin Psychiatry 2005, 66: 693–704.

    Article  PubMed  Google Scholar 

  22. Marangell LB, Bauer MS, Dennehy EB, et al.: Prospective predictors of suicide and suicide attempts in 1,556 patients with bipolar disorder followed for up to 2 years. Bipolar Disord 2006, 8: 566–575.

    Article  PubMed  Google Scholar 

  23. Tondo L, Baldessarini RJ, Hennen J, et al.: Suicide attempts in major affective disorder patients with comorbid substance abuse disorders. J Clin Psychiatry 1999, 60(Suppl 2): 63–69.

    Google Scholar 

  24. Dilsaver SC, Chen YW, Swann AC, et al.: Suicidality, panic disorder and psychosis in bipolar depression, depressivemania and pure mania. Psychiatry Res 1997, 73: 47–56.

    Article  PubMed  CAS  Google Scholar 

  25. Strakowski SM, McElroy SL, Keck PE, et al.: Suicidality among patients with mixed and manic bipolar disorder. Am J Psychiatry 1996, 153: 674–676.

    PubMed  CAS  Google Scholar 

  26. Judd LL, Akiskal HS, Schettler PJ, et al.: The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 2002, 59: 530–537.

    Article  PubMed  Google Scholar 

  27. Post RM, Denicoff KD, Leverich GS, et al.: Morbidity in 258 bipolar outpatients followed for 1 year with daily prospective ratings on the NIMH Life Chart Method. J Clin Psychiatry 2003, 64: 680–690.

    Article  PubMed  Google Scholar 

  28. Oquendo MA, Waternaux C, Brodsky B, et al.: Suicidal behavior in bipolar disorder: clinical characteristics of attempters and nonattempters. J Affect Disord 2000, 59: 107–117.

    Article  PubMed  CAS  Google Scholar 

  29. Geller B, Tillman R, Craney JL, et al.: Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. Arch Gen Psychiatry 2004, 61: 459–467.

    Article  PubMed  Google Scholar 

  30. Birmaher B, Axelson D, Strober M, et al.: Clinical course of children and adolescents with bipolar spectrum disorders. Arch Gen Psychiatry 2006, 63: 175–183.

    Article  PubMed  Google Scholar 

  31. Goldstein TR, Birmaher B, Axelson D, et al.: History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk. Bipolar Disord 2005, 7: 525–535.

    Article  PubMed  Google Scholar 

  32. Perugi G, Micheli C, Akiskal HS, et al.: Polarity of the first episode, clinical characteristics, and course of manic depressive illness: a systematic retrospective investigation of 320 bipolar I patients. Compr Psychiatry 2000, 41: 13–18.

    Article  PubMed  CAS  Google Scholar 

  33. Daban C, Colom F, Sanchez-Moreno, et al.: Clinical correlates of first-episode polarity in bipolar disorder. Compr Psychiatry 2006, 47: 433–437.

    Article  PubMed  Google Scholar 

  34. Coryell W, Solomon D, Turvey C, et al.: The long-term course of rapid-cycling bipolar disorder. Arch Gen Psychiatry 2003, 60: 914–920.

    Article  PubMed  Google Scholar 

  35. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  36. MacKinnon DF, Zandi PP, Gershon E, et al.: Rapid switching of mood in families with multiple cases of bipolar disorder. Arch Gen Psychiatry 2003, 60: 921–928.

    Article  PubMed  Google Scholar 

  37. Marttunen MJ, Aro HM, Henriksson MM, et al.: Mental disorders in adolescent suicide. Arch Gen Psychiatry 1991, 48: 834–839.

    PubMed  CAS  Google Scholar 

  38. Feinman JA, Dunner DL: The effect of alcohol and substance abuse on the course of bipolar affective disorder. J Affect Disord 1996, 37: 43–49.

    Article  PubMed  CAS  Google Scholar 

  39. Oquendo MA, Galfalvy H, Russo S, et al.: Prospective study of clinical predictors of suicidal acts after a major depressive episode in patients with major depression or bipolar disorder. Am J Psychiatry 2004, 161: 1433–1441.

    Article  PubMed  Google Scholar 

  40. Tsai SY, Kuo CJ, Chen CC, Lee HC: Risk factors for completed suicide in bipolar disorder. J Clin Psychiatry 2002, 63: 469–476.

    PubMed  Google Scholar 

  41. Brent DA, Oquendo M, Birmaher B, et al.: Familial pathways to early-onset suicide attempt. Arch Gen Psychiatry 2002, 59: 801–807.

    Article  PubMed  Google Scholar 

  42. Gould MS, Fisher P, Parides M, et al.: Psychosocial risk factors of child and adolescent completed suicide. Arch Gen Psychiatry 1996, 53: 1155–1162.

    PubMed  CAS  Google Scholar 

  43. Rucklidge JJ: Psychosocial functioning of adolescents with and without paediatric bipolar disorder. J Affect Disord 2006, 91: 181–188.

    Article  PubMed  Google Scholar 

  44. Leverich GS, McElroy SL, Suppes T, et al.: Early physical and sexual abuse associated with an adverse course of bipolar illness. Biol Psychiatry 2002, 51: 288–297.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth B. Weller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jolin, E.M., Weller, E.B. & Weller, R.A. Suicide risk factors in children and adolescents with bipolar disorder. Curr Psychiatry Rep 9, 122–128 (2007). https://doi.org/10.1007/s11920-007-0081-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-007-0081-z

Keywords

Navigation