%0 Journal Article
%T Attempted suicide in people with co-occurring bipolar and substance use disorders: systematic review and meta-analysis
%J Journal of affective disorders
%D 2014
%A Carrà, Giuseppe
%A Bartoli, Francesco
%A Crocamo, Cristina
%A Brady, Kathleen T.
%A Clerici, Massimo
%V 167C
%N 
%P 125-135
%X BACKGROUND: Both individuals with bipolar (BD) and those with alcohol (AUD) and other substance (SUD) use disorders are likely to attempt suicide. Comorbidity of BD and AUD/SUD may increase the likelihood of suicide attempts. We conducted a meta-analysis to estimate the association of comorbid AUD/SUD and suicide attempts in subjects with BD in the literature to date. <br><br>METHODS: Electronic databases through January 2013 were searched. Studies reporting rates of suicide attempts in people with co-occurring BD and AUD/SUD were retrieved. Comorbid AUD and SUD and suicide attempts rates as well as demographic, clinical, and methodological variables were extracted from each publication or obtained directly from its authors. <br><br>RESULTS: Twenty-nine of 222 studies assessed for eligibility met the inclusion criteria, comprising a total of 31,294 individuals with BD, of whom 6308 (20.1%) had documented suicide attempts. There were consistent findings across the studies included. As compared to controls, subjects with BD and comorbid AUD/SUD were more likely to attempt suicide. The cross-sectional association estimates showed random-effects pooled crude ORs of 1.96 (95% CI=1.56-2.47; p<0.01), 1.72 (95% CI=1.52-1.95; p<0.01), and 1.77 (95% CI=1.49-2.10; p<0.01), for combined AUD/SUD, AUD, and SUD. There was no publication bias and sensitivity analyses based on the highest quality studies confirmed core results. LIMITATIONS: The effects of the number and the type of suicide attempts could not be investigated due to insufficient information. <br><br>CONCLUSIONS: Comorbid AUD and SUD in individuals with BD are significantly associated with suicide attempts. Individuals with this comorbidity should be targeted for intensive suicide prevention efforts.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0165-0327
%U http://dx.doi.org/10.1016/j.jad.2014.05.066