Hopelessness and suicidal risk in bipolar disorder. A study in clinically nonsyndromal patients |
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Authors: | Francisco J Acosta Dulcinea Vega Luz Torralba Santiago Navarro Yolanda Ramallo-Fariña Dolores Fiuza José L Hernández Samuel G Siris |
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Institution: | 1. Mental Health Research Program, Service of Mental Health, General Health Care Programs Direction, Canary Health Service, Gran Canaria, Spain;2. Telde Mental Health Unit, Insular University Hospital of Gran Canaria, Gran Canaria, Spain;3. El Puerto Mental Health Unit, Service of Psychiatry, University Hospital of Gran Canaria Dr Negrín, Gran Canaria, Spain;4. La Feria Mental Health Unit, Service of Psychiatry, University Hospital of Gran Canaria Dr Negrín, Gran Canaria, Spain;5. The Canary Islands Foundation for Health Research, FUNCIS, Canary Islands, and CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain;6. Research Unit, University Hospital of Gran Canaria Dr Negrín, Gran Canaria, Spain;g Psychiatry Department, The Zucker-Hillside Hospital of the North Shore Long Island Jewish Health System, Glen Oaks, NY;h Hofstra/North Shore/LIJ School of Medicine, Hempstead, NY;i Albert Einstein College of Medicine, Bronx, NY |
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Abstract: | ObjectiveAttempted suicide and death due to suicide are not uncommon among patients with bipolar disorder. Although some risk factors for suicidality in bipolar patients have been identified, little is known about hopelessness and other possible trait or diathesis-related factors. Consequently, the objective of this study was to investigate variables associated with suicidal risk in clinically nonsyndromal bipolar patients.MethodsA sample of 102 outpatients with a diagnosis of bipolar disorder according to International Classification of Diseases, 10th Revision criteria during nonsyndromal stage were evaluated. On the basis of suicidal history, patients were divided into suicide attempt, suicidal ideation, and nonsuicidal groups. Sociodemographic, clinical, and psychopathological variables were assessed.ResultsAs compared with the nonsuicidal group, female sex, combined psychopharmacologic treatment, and hopelessness were independently associated with suicide attempt. Hopelessness and insight into having a mental disorder were independently associated with history of suicidal ideation.ConclusionsPatients with bipolar disorder and suicidal history are characterized by the presence of hopelessness, which probably confers greater vulnerability for suicidal behavior in the presence of stress factors. This identification of the risk profile for suicidal behavior in nonsyndromal bipolar patients adds complementary information to risk factors established for suicidality during acute phases of the disease, allows for differentiated preventive and treatment approaches of patients at risk, and suggests psychotherapy as an advisable intervention in this group of patients. |
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