ArticleBipolar disorders2020
Symptom trajectories in the months before and after a suicide attempt in individuals with bipolar disorder: A STEP-BD study.
Article in Bipolar disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Calm after the storm? Clinical phenotypes and risk markers in suicidal patients: data from a liaison-consultation psychiatric setting.Frontiers in psychiatry · 2026Article
- Staging of suicidality in bipolar disorder: Findings from the FACE-BD cohort (FondaMental Advanced Centers of Expertise for Bipolar Disorders).European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Clinical indicators of the suicide crisis and response to ketamine.Journal of affective disorders · 2025Article
- Functional Abnormality of the Reward System in Depressed Adolescents and Young Adults with and without Suicidal Behavior.Brain topography · 2024Article
- Clinical and electrophysiological correlates of hopelessness in the context of suicide riskEuropean neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2024Article
- The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study.International journal of bipolar disorders · 2022Article
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Authors and funding
8 authors.
Funding
Abstract
objectivesThe suicide crisis is a relatively short-lived psychiatric emergency, with transient symptoms that ebb and flow around the suicide attempt. Understanding the dynamic processes of symptoms before and after suicide attempt may aid future prevention efforts.
methodsData were drawn from the NIMH STEP-BD study, which followed 4,360 patients with bipolar disorder; a subset attempted suicide during the trial (245/4100 or 5.97% of the sample eligible for analysis). This analysis focused on change in suicidal ideation (SI) in the 120 days before and 120 days after suicide attempt; similar analyses were conducted for other depressive symptoms. Generalized linear mixed models with a two-piece linear function of time corresponding to pre- and post-suicide attempt trends were used.
resultsSI ratings from 216 individuals were analyzed (n = 1,231 total; n = 395 pre-attempt, n = 126 circa-attempt, n = 710 post-attempt) and compared to data from a matched sample of 648 non-attempters. SI worsened in the 120 days pre-attempt but improved afterwards, reaching non-attempter levels by 90 days post-attempt. A similar pattern was found for other depressive symptoms, including depressed mood, loss of interest, guilt, and self-esteem. Pre/post differences in tension/activating symptoms of depression-anxiety, agitation, and irritability-were less pronounced and more time-limited.
conclusionsThe suicide crisis is dynamic, and the days before and after suicide attempt may be particularly critical. The findings extend previous research on proximal symptoms of suicide and underscore that some SI and affective/cognitive symptoms of depression can remain elevated up to 90 days post-attempt in individuals with bipolar disorder.
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