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Clinical and dimensional characteristics of euthymic bipolar patients with or without suicidal behavior

Published online by Cambridge University Press:  05 October 2011

C. Parmentier ,
B. Etain ,
L. Yon ,
H. Misson ,
F. Mathieu ,
M. Lajnef ,
B. Cochet ,
A. Raust ,
J.-P. Kahn  and
O. Wajsbrot-Elgrabli
...Show all authors
C. Parmentier*
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France
B. Etain
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France Fondation Fondamental, 94000Créteil, France
L. Yon
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France
H. Misson
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France
F. Mathieu
Affiliation:
Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France Fondation Fondamental, 94000Créteil, France
M. Lajnef
Affiliation:
Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France
B. Cochet
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France
A. Raust
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France
J.-P. Kahn
Affiliation:
Fondation Fondamental, 94000Créteil, France Service de psychiatrie et psychologie clinique, hôpitaux de Brabois, CHU de Nancy, 54500Vandœuvre-Les-Nancy, France
O. Wajsbrot-Elgrabli
Affiliation:
Service de psychiatrie et psychologie clinique, hôpitaux de Brabois, CHU de Nancy, 54500Vandœuvre-Les-Nancy, France
R. Cohen
Affiliation:
Service de psychiatrie et psychologie clinique, hôpitaux de Brabois, CHU de Nancy, 54500Vandœuvre-Les-Nancy, France
C. Henry
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France Université Paris-Est, faculté de médecine, IFR10, 94000Créteil, France Fondation Fondamental, 94000Créteil, France
M. Leboyer
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France Université Paris-Est, faculté de médecine, IFR10, 94000Créteil, France Fondation Fondamental, 94000Créteil, France
F. Bellivier
Affiliation:
AP–HP, groupe Henri-Mondor-Albert-Chenevier, pôle de psychiatrie, 94000Créteil, France Inserm, unité 955, IMRB, équipe de psychiatrie génétique, 94000Créteil, France Université Paris-Est, faculté de médecine, IFR10, 94000Créteil, France Fondation Fondamental, 94000Créteil, France
*
*Corresponding author. E-mail address:claire.sanz-parmentier@hmn.aphp.fr (C. Parmentier).
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Abstract

Background

The clinical and dimensional features associated with suicidal behaviour in bipolar patients during euthymic states are not well characterised.

Methods

In a sample of 652 euthymic bipolar patients, we assessed clinical features with the Diagnostic Interview for Genetics Studies (DIGS) and dimensional characteristics with questionnaires measuring impulsivity/hostility and affective lability/intensity. Bipolar patients with and without suicidal behaviour were compared for these clinical and dimensional variables.

Results

Of the 652 subjects, 42.9% had experienced at least one suicide attempt. Lifetime history of suicidal behaviour was associated with being a woman, a history of head injury, tobacco misuse and indicators of severity of bipolar disorder including early age at onset, high number of depressive episodes, positive history of rapid cycling, alcohol misuse and social phobia. Indirect hostility and irritability were dimensional characteristics associated with suicidal behaviour in bipolar patients, whereas impulsivity and affective lability/intensity were not associated with suicidal behaviour.

Limitations

This study had a retrospective design with no replication sample.

Conclusions

Bipolar patients with earlier onset, mood instability (large number of depressive episodes, rapid cycling) and/or particular addictive and anxiety comorbid disorders might be at high risk of suicidal behaviour. In addition, hostility dimensions (indirect hostility and irritability), may be trait components associated with suicidal behaviour in euthymic bipolar patients.

Keywords

Bipolar disorderSuicidal behaviourSeverity of illnessComorbid disordersPsychological dimensionsHostility
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 8 , November 2012 , pp. 570 - 576
Copyright
Copyright © European Psychiatric Association 2012

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