Suicide and self-harm

How is suicide and self-harm relevant to people with bioplar disorder?

Rates of suicide and self-harm are higher in people with a mental disorder than in people without a mental disorder.

What is the evidence for suicide and self-harm in people with bipolar disorder?

Rates of suicide attempts in people with bipolar disorder

Moderate to high quality evidence suggests the overall prevalence rate of suicide attempts is around 30%, and the yearly incidence rate is around 4%.

In children and adolescents with bipolar disorder

Moderate to high quality evidence suggests the risk of suicide attempts is higher in children and adolescents with bipolar disorder than in children and adolescents with major depression. Moderate quality evidence suggests suicide ideation is more prevalent than suicide attempts (~50% vs. ~25%). The only significant predictors of suicide attempts in children and adolescents were having bipolar I disorder rather than bipolar II disorder, and having a concurrent diagnosis of attention deficit hyperactivity disorder.

In adults with bipolar disorder

Moderate quality evidence suggests a large increased risk of suicide completion in psychiatric hospital patients who were assessed as being at high risk of suicide. A history of suicidal behaviour and depressive symptoms or affective disorder was included in the majority of the high-risk models.

Increased risk of suicide attempts was associated with; anxiety disorders or being female (both high quality evidence, small effects), concurrent cluster B personality disorders (moderate to high quality evidence, medium-sized effect), a younger age at bipolar onset (<18yrs, moderate to high quality evidence, small effect), depressive polarity of first illness episode (moderate quality evidence, large effect), displaying risky decision making (moderate quality evidence, medium-sized effect), and depressive episode predominance, concurrent substance use disorders, and having a family history of suicide (all moderate quality evidence, small effects).

Increased risk of suicide completion was associated with; having a family history of suicide (moderate to high quality evidence, medium-sized effect), male gender (moderate quality evidence, small effect), or being incarcerated (moderate quality evidence, medium-sized effect).

April 2019

Last updated at: 4:23 am, 8th April 2019
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Fact Sheet Technical Commentary

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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.