ArticleBipolar disorders2017
Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5-year follow-up study.
Article in Bipolar disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04569448 (Low-Dose Adjunctive Brexpiprazole in the Treatment of Bipolar I Depression), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Low-Dose Adjunctive Brexpiprazole in the Treatment of Bipolar I Depression: An Open-Label Study
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Suicides in Mood Disorders in Psychiatric Settings in Nordic National Register-Based Studies.Frontiers in psychiatry · 2020Pooled it
- Lithium for acute mania.The Cochrane database of systematic reviews · 2019Pooled it
- Diagnosis-Specific Clinical and Longitudinal Predictors of Suicide Attempts in Early-Onset Mood Disorders.Psychiatry investigation · 2026Article
- The role of predominant polarity in older age bipolar disorder.International journal of bipolar disorders · 2025Article
- The influence of depressive and manic symptoms on suicidal ideation in mixed mood states.International journal of bipolar disorders · 2025Article
- Lithium and its effects: does dose matter?International journal of bipolar disorders · 2024Review
- Latent Profile Analysis of Suicidal Ideation in Chinese Individuals with Bipolar Disorder.Behavioral sciences (Basel, Switzerland) · 2024Article
- NRX-101 (D-cycloserine plus lurasidone) vs. lurasidone for the maintenance of initial stabilization after ketamine in patients with severe bipolar depression with acute suicidal ideation and behavior: a randomized prospective phase 2 trial.International journal of bipolar disorders · 2023Article
- Risks and benefits of psilocybin use in people with bipolar disorder: An international web-based survey on experiences of 'magic mushroom' consumption.Journal of psychopharmacology (Oxford, England) · 2023Article
- Factors associated with lifetime suicide attempts in bipolar disorder: results from an Italian nationwide study.European archives of psychiatry and clinical neuroscience · 2022Article
- Comparison of Patterns of Non-suicidal Self-Injury and Emotion Dysregulation Across Mood Disorder Subtypes.Frontiers in psychiatry · 2022Article
- Factors of suicidal behavior among inpatients with major depressive disorder: A retrospective case series.Frontiers in psychiatry · 2022Article
- Suicidal Ideation and Insomnia in Bipolar Disorders: Idéation suicidaire et insomnie dans les troubles bipolaires.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2020Article
- Study of Risk Factors Associated with Suicide Attempt in Patients with Bipolar Disorder Type I.Journal of neurosciences in rural practice · 2020Article
- Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?Frontiers in psychiatry · 2020Article
- Borderline Personality Disorder With Depression Confers Significant Risk of Suicidal Behavior in Mood Disorder Patients-A Comparative Study.Frontiers in psychiatry · 2020Article
- Suicidal and non-suicidal self-injurious behaviour in patients with bipolar disorder and comorbid attention deficit hyperactivity disorder after initiation of central stimulant treatment: a mirror-image study based on the LiSIE retrospective cohort.Therapeutic advances in psychopharmacology · 2020Article
- Article
- Suicide Risk in Bipolar Disorder: A Brief Review.Medicina (Kaunas, Lithuania) · 2019Review
- Identification and initial validation of empirically derived bipolar symptom states from a large longitudinal dataset: an application of hidden Markov modeling to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.Psychological medicine · 2019Article
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Authors and funding
8 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFew long-term studies on bipolar disorder (BD) have investigated the incidence and risk factors of suicide attempts (SAs) specifically related to illness phases. We examined the incidence of SAs during different phases of BD in a long-term prospective cohort of bipolar I (BD-I) and bipolar II (BD-II) patients, and risk factors specifically for SAs during major depressive episodes (MDEs).
methodsIn the Jorvi Bipolar Study (JoBS), 191 BD-I and BD-II patients were followed using life-chart methodology. Prospective information on SAs of 177 patients (92.7%) during different illness phases was available up to 5 years. The incidence of SAs and their predictors were investigated using logistic and Poisson regression models. Analyses of risk factors for SAs occurring during MDEs were conducted using two-level random-intercept logistic regression models.
resultsDuring the 5 years of follow-up, 90 SAs per 718 patient-years occurred. The incidence was highest, over 120-fold higher than in euthymia, during mixed states (765/1000 person-years; 95% confidence interval [CI] 461-1269 person-years), and also very high in MDEs, almost 60-fold higher than in euthymia (354/1000 person-years; 95% CI 277-451 person-years). For risk of SAs during MDEs, the duration of MDEs, severity of depression, and cluster C personality disorders were significant predictors.
conclusionsWe confirmed in this long-term study that the highest incidences of SAs occur in mixed and major depressive illness phases. The variations in incidence rates between euthymia and illness phases were remarkably large, suggesting that the question "when" rather than "who" may be more relevant for suicide risk in BD. However, risk during MDEs is likely also influenced by personality factors.
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