TY  - JOUR
PY  - 2021//
TI  - Predictors of suicidal ideation and preparatory behaviors in individuals with bipolar disorder: the contribution of chronobiological dysrhythmicity and its association with hopelessness
JO  - Journal of clinical psychiatry
A1  - Palagini, Laura
A1  - Miniati, Mario
A1  - Caruso, Danila
A1  - Cappelli, Andrea
A1  - Massa, Lucia
A1  - Pardini, Francesco
A1  - Petrucci, Alessandra
A1  - Romeo, Francesca
A1  - Salarpi, Gianluca
A1  - Etain, Bruno
A1  - Geoffroy, Pierre
SP  - m13371
EP  - m13371
VL  - 82
IS  - 2
N2  - OBJECTIVE: To examine the role of chronobiological dysrhythmicity in suicidal ideation and behaviors and its relation with hopelessness. <br><br>METHODS: One hundred twenty-seven patients (77 females, mean age of 47.4 ± 12.5 years) with a major depressive episode and bipolar disorder (BD) type I or II (according to Structured Clinical Interview for DSM-5 assessment) were recruited in 2019 and assessed for depressive and manic symptoms (Beck Depression Inventory-II, Young Mania Rating Scale) and with the Biological Rhythms Interview of Assessment in Neuropsychiatry, Beck Hopelessness Scale, and Scale for Suicide Ideation. Univariate regression and mediation analyses were performed. <br><br>RESULTS: Forty-one patients (32.3%) showed clinically significant suicidal ideation and were more frequently affected by BD type I (P =.029) with mixed features (P =.022). Compared to nonsuicidal individuals, they had significantly more depressive symptoms (P =.019), higher emotional component of hopelessness (P =.037), and higher dysrhythmicity of sleep (P =.009), activities (P =.048), and social life (P =.019). Passive and active suicidal ideation and suicidal plans were best predicted by dysrhythmicity of sleep and social life. Dysrhythmicity of sleep and social life mediated the direct effect of depressive symptoms on passive and active suicidal ideation and also of active ideation on suicidal plans. The emotional component of hopelessness was related to dysrhythmicity of social life and mediated its effect on suicidal plans (P =.010). <br><br>CONCLUSIONS: Chronobiological alterations directly contributed to passive and active suicidal ideation and to suicidal preparation, with a key role of dysrhythmicity of sleep, activities, and social life. Chronobiological alterations also impacted the emotional component of hopelessness, hence indirectly contributing to suicidal ideations and plans. These findings call for the systematic screening of these dysrhythmicity dimensions when considering suicidal risk in individuals with BD.<p />  <p>Language: en</p>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/10.4088/JCP.20m13371
ID  - ref1
ER  -