Suicidality in pediatric bipolar disorder ‘needs urgent attention’
medwireNews: Suicidality in children with bipolar disorder is common but underinvestigated, suggest meta-analysis findings.
Christoph Correll (The Zucker Hillside Hospital, Glen Oaks, New York, USA) and team found an overall lifetime rate of 57.4% for suicide ideation and 21.3% for suicide attempts. In prospective studies, the average incidence rates were 17.1% and 14.7%, respectively.
"These prevalences in youth with a mean age of 14.4 years are staggering, highlighting the importance of early illness identification and adequate psychosocial and pharmacologic treatment, as well as specific assessment for suicide risk and general and indicated preventive actions," the authors write in Bipolar Disorders.
Yet these data were drawn from just 14 available studies. "This limited availability of research is in strong contrast to the prevalence and relevance of suicidality in children and adolescents," says the team.
Just two of the studies reported variables associated with suicide ideation, which included being younger, Caucasian, and having a narrowly defined bipolar disorder phenotype. Ten studies reported variables associated with suicide attempts; these included being female, older, having a younger age at bipolar disorder onset, severe illness, and comorbid illnesses.
But the study authors note that just two studies looked at more than one risk factor that could potentially direct preventive measures, and there were no studies assessing risk factors for completed suicide.
Given the high rates of suicide ideation and attempts found, "the relative dearth of studies focusing on this important illness aspect is concerning," they say.
The team found just one study that tested a preventive intervention, although the intervention in question (an adapted dialectic behavioral therapy program) reportedly reduced suicide ideation and attempts at 1 year.
"While these are data from a very preliminary pilot study, they provide the basis for larger randomized trials that are urgently needed in this population at high risk and with high need for help," say Correll et al.
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By Eleanor McDermid, Senior medwireNews Reporter