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Risk factors for suicide in bipolar disorder: a cohort study of 12 850 patients

Journal article
Authors Caroline Hansson
Erik Joas
Erik Pålsson
K. Hawton
B. Runeson
Mikael Landén
Published in Acta Psychiatrica Scandinavica
Volume 138
Issue 5
Pages 456-463
ISSN 0001-690X
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 456-463
Language en
Links dx.doi.org/10.1111/acps.12946
Keywords bipolar disorder, suicide, risk factors, international society, task-force, sweden, mortality, deaths, trends, Psychiatry
Subject categories Psychiatry

Abstract

ObjectiveMethodBipolar disorder carries a high risk of suicide. Identification of risk factors is important. The aim of this study was to study risk factors for suicide in a large cohort of men and women with bipolar disorder. A prospective cohort study using clinical data from the Swedish National Quality Register for Bipolar Affective Disorder (BipolaR). The outcome variable was suicide captured in the Cause of Death Register between 2004 and 2014. Hazard ratios (HR) were calculated using Cox proportional hazards models. ResultsConclusionsOf 12 850 persons (4844 men and 8006 women) with bipolar disorder, 90 (55 men and 35 women) died by suicide during the follow-up period (between 1 and 10 years). Male sex (HR 2.56), living alone (HR 2.45), previous suicide attempts (HR 4.10), comorbid psychiatric disorder (HR 2.64), recent affective episodes (HR 2.39), criminal conviction (HR 4.43), psychiatric inpatient care (HR 2.79), and involuntary commitment (HR 3.50) were significant risk factors for suicide. Several of the statistically significant risk factors for suicide in bipolar disorder differed between men and women. Risk factors for suicide in bipolar disorder include factors associated with suicide in general, but also diagnosis-specific factors.

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