Suicide risk for sleepless bipolar patients
medwireNews: Researchers have identified predictors of suicide attempts in patients with mood disorders, including chronic insomnia during the 6 months preceding the attempt.
"Chronic insomnia is also of significance in the context of residual symptoms during partial remission periods, observed in patients with recurring affective disorders," write Joanna Pawlak (Poznan University of Medical Sciences, Poland) and team in General Hospital Psychiatry.
"Early diagnosis and the proper, effective treatment of bipolar affective disorders are perhaps the most effective steps in reducing the risk of suicide in patients with [bipolar disorder]."
The study included 597 patients, of whom 391 had bipolar I disorder, 104 had bipolar II disorder, and 102 had unipolar depression. Of these patients, 367 were women and 230 were men, and 41.1% of women and 32.6% of men attempted suicide. Pawlak et al note that more men than women complete suicide, but their findings support others suggesting that more women actually attempt it.
Besides insomnia, inappropriate guilt during depressive episodes and a family history of psychiatric illness, affective disorders, and substance abuse and/or dependence were associated with an increased risk for suicide attempts. The size of the risk increases ranged from 1.59-fold for guilt during depressive episodes to 20.17-fold for insomnia, although the latter had a very wide 95% confidence interval.
A younger age at onset of the mood disorder also predicted suicide attempts, but only in patients with unipolar disorder.
However, the majority of patients were young when they attempted suicide. In bipolar disorder patients the highest frequency (14.8%) of suicide attempts was among patients aged 20-24 years, and there was a large peak in attempts within the first year after diagnosis. Suicide attempts among patients with unipolar depression peaked at a slightly older age (23.1%; 35-39 years), and there was no obvious relationship with the time of diagnosis.
"This study confirms the observations made by other authors: young adults are predisposed to suicide attempts," say the researchers.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Eleanor McDermid, Senior medwireNews Reporter