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Self-injurious behaviour in patients with bipolar disorder and attention deficit hyperactivity disorder after central stimulant start– a retrospective study based on the lisie cohort

Published online by Cambridge University Press:  13 August 2021

L. Öhlund ,
M. Ott ,
R. Lundqvist ,
M. Sandlund ,
E. Salander Renberg  and
U. Werneke
L. Öhlund*
Affiliation:
Sunderby Research Unit, Department Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, Sweden
M. Ott
Affiliation:
Department Of Public Health And Clinical Medicine, Division Of Medicine, Umeå University, Umeå, Sweden
R. Lundqvist
Affiliation:
Sunderby Research Unit, Department Of Public Health And Clinical Medicine, Umeå University, Umeå, Sweden
M. Sandlund
Affiliation:
Department Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, Sweden
E. Salander Renberg
Affiliation:
Department Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, Sweden
U. Werneke
Affiliation:
Sunderby Research Unit, Department Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, Sweden
*
*Corresponding author.

Abstract

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Introduction

Currently, our understanding remains limited of how co-occurring bipolar disorder and attention deficit hyperactivity disorder (ADHD) should be treated.

Objectives

To evaluate the impact of central stimulant treatment on self-injurious behaviour in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD.

Methods

Retrospective cohort study (LiSIE) into effects and side-effects of lithium as compared to other mood stabilisers. Here, using a mirror-image design, we compared suicide attempts and non-suicidal self-injury events within 6 months and 2 years before and after central stimulant treatment start.

Results

Of 1564 eligible patients, 206 patients met inclusion criteria; having a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD at first central stimulant initiation. In these, suicide attempts and non-suicidal self-injury events decreased significantly within both 6 months (p = 0.004) and 2 years (p = 0.028) after central stimulant start. After multiple adjustments, this effect was preserved 2 years after central stimulant start (OR 0.63, 95% CI; 0.40 – 0.98, p = 0.041).

Conclusions

Central stimulant treatment may reduce the risk of self-injurious behavior in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD. However, to reduce the risk of manic switches, concomitant mood stabilising treatment remains warranted.

Disclosure

Michael Ott has been a scientific advisory board member of Astra Zeneca Sweden, Ursula Werneke has received funding for educational activities on behalf of Norrbotten Region (Masterclass Psychiatry Programme 2014–2018 and EAPM 2016, Luleå, Sweden): Astra

Keywords

attention deficit disorder with hyperactivitycentral nervous system stimulantsself-injurious behaviourbipolar disorder
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S79 - S80
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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