TY  - JOUR
PY  - 2012//
TI  - Predictors of prospectively examined suicide attempts among youth with bipolar disorder: predictors of suicide attempts
JO  - Archives of general psychiatry
A1  - Goldstein, Tina R.
A1  - Ha, Wonho
A1  - Axelson, David A.
A1  - Goldstein, Benjamin I.
A1  - Liao, Fangzi
A1  - Gill, Mary Kay
A1  - Ryan, Neal D.
A1  - Yen, Shirley
A1  - Hunt, Jeffrey
A1  - Hower, Heather M.
A1  - Keller, Martin
A1  - Strober, Michael
A1  - Birmaher, Boris
SP  - 1113
EP  - 1122
VL  - 69
IS  - 11
N2  - CONTEXT Individuals with early onset of bipolar disorder are at high risk for suicide. Yet, no study to date has examined factors associated with prospective risk for suicide attempts among youth with bipolar disorder. OBJECTIVE To examine past, intake, and follow-up predictors of prospectively observed suicide attempts among youth with bipolar disorder. DESIGN We interviewed subjects, on average, every 9 months over a mean of 5 years using the Longitudinal Interval Follow-up Evaluation. SETTING Outpatient and inpatient units at 3 university centers. PARTICIPANTS A total of 413 youths (mean [SD] age, 12.6 [3.3] years) who received a diagnosis of bipolar I disorder (n = 244), bipolar II disorder (n = 28), or bipolar disorder not otherwise specified (n = 141). MAIN OUTCOME MEASURES Suicide attempt over prospective follow-up and past, intake, and follow-up predictors of suicide attempts. RESULTS Of the 413 youths with bipolar disorder, 76 (18%) made at least 1 suicide attempt within 5 years of study intake; of these, 31 (8% of the entire sample and 41% of attempters) made multiple attempts. Girls had higher rates of attempts than did boys, but rates were similar for bipolar subtypes. The most potent past and intake predictors of prospectively examined suicide attempts included severity of depressive episode at study intake and family history of depression. Follow-up data were aggregated over 8-week intervals; greater number of weeks spent with threshold depression, substance use disorder, and mixed mood symptoms and greater number of weeks spent receiving outpatient psychosocial services in the preceding 8-week period predicted greater likelihood of a suicide attempt. CONCLUSIONS Early-onset bipolar disorder is associated with high rates of suicide attempts. Factors such as intake depressive severity and family history of depression should be considered in the assessment of suicide risk among youth with bipolar disorder. Persistent depression, mixed presentations, and active substance use disorder signal imminent risk for suicidal behavior in this population.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-990X
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2012.650
ID  - ref1
ER  -