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Functional impairment and previous suicide attempts in bipolar disorder

Published online by Cambridge University Press:  24 June 2014

Adriane R. Rosa ,
Carolina Franco ,
Anabel Martínez-Aran ,
Jose Sánchez-Moreno ,
Manel Salamero ,
M. Valenti ,
Rafael Tabarés-Seisdedos ,
Ana González-Pinto ,
Flávio Kapczinski  and
Eduard Vieta
Adriane R. Rosa
Affiliation:
Bípolar Disorders Program, Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos, Porto Alegre, RS, Brazil Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain
Carolina Franco
Affiliation:
Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain Department of Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
Anabel Martínez-Aran
Affiliation:
Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain
Jose Sánchez-Moreno
Affiliation:
Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain Department of Psychiatry, Universidad Autonoma de Madrid Hospital, Universitario de la Princesa, CIBERSAM, Madrid, Spain
Manel Salamero
Affiliation:
Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain
M. Valenti
Affiliation:
Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain
Rafael Tabarés-Seisdedos
Affiliation:
Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Spain
Ana González-Pinto
Affiliation:
Department of Psychiatry, Santiago Apostol Hospital, Osakidetza Mental Health System, CIBERSAM, Vitoria, Spain
Flávio Kapczinski
Affiliation:
Bípolar Disorders Program, Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos, Porto Alegre, RS, Brazil
Eduard Vieta*
Affiliation:
Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, Villarroel, Barcelona, Spain
*
Eduard Vieta, Bipolar Disorders Program, Clinical Institute of Neuroscience, University Clinic Hospital of Barcelona, Villarroel 170, 08036-Barcelona, Spain. Tel: +34932275401; Fax: +34932279876; E-mail: evieta@clinic.ub.es
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Abstract

Objective:

The aim of the present study was to assess the association between previous suicide attempts and functional impairment among euthymic patients with bipolar disorder (BD).

Methods:

Seventy-one Diagnostic Statistical Manual IV (DSM-IV) patients with BD and 61 healthy volunteers were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. Patients with (n = 36, 50.7%) and without (n = 35, 49.3%) previous suicide attempts were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID-P). Previous suicide attempts were carefully investigated by means of patient and caregiver interview and by a standard structured interview from the protocol of our BD Program. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment.

Results:

Euthymic patients with previous suicide attempts showed functional impairment, particularly in occupational (F = 30.39; p = 0.001) and cognitive functioning (F = 18.43; p = 0.001). In addition, family history of psychiatric illness (χ2: 6.49; degrees of freedom (df) = 2;132; p = 0.010), family history of affective disorders (χ2 = 5.57; p = 0.017), psychotic symptoms (χ2 = 5.88; p = 0.014) and axis II comorbidity were associated with previous suicide attempts (χ2 = 5.16; p = 0.021).

Conclusion:

Bipolar patients with previous suicide attempts had lower overall functioning than patients who did not attempt suicide. Previous suicide attempts were particularly associated with the occupational and cognitive domains of functioning.

Keywords

bipolar disordercognitionfunctioningoccupational functioningsuicide attempts
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 20 , Issue 6 , December 2008 , pp. 300 - 306
Copyright
Copyright © 2008 Blackwell Munksgaard

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References

Goodwin, FK, Jamison, KR. Manic-depressive illness. New York: Oxford University Press, 1990. Google Scholar
Hawton, K, Sutton, L, Haw, C, Sinclair, J, Harriss, L. Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. J Clin Psychiatry 2005;66:693–704. CrossRefGoogle ScholarPubMed
Valtonen, H, Suominen, K, Mantere, O, Leppämäki, S, Arvilommi, P, Isometsä, ET. Suicidal ideation and attempts in bipolar I and II disorders. J Clin Psychiatry 2005;66:1456–1462. CrossRefGoogle ScholarPubMed
Baldessarini, RJ, Pompili, M, Tondo, L. Suicide in bipolar disorder: risks and management. CNS Spectr 2006;11:465–471. CrossRefGoogle ScholarPubMed
Dilsaver, SC, Chen, YW, Swann, AC, Shoaib, AM, Krajewski, KJ. Suicidality in patients with pure and depressive mania. Am J Psychiatry 1994;151:1312–1315. Google ScholarPubMed
Goldberg, JF, Garno, JL, Portera, L, Leon, AC, Kocsis, JH, Whiteside, JE. Correlates of suicidal ideation in dysphoric mania. J Affect Disord 1999;56:75–81. CrossRefGoogle ScholarPubMed
Leverich, GS, Altshuler, LL, Frye, MAet al. Factors associated with suicide attempts in 648 patients with bipolar disorder in the Stanley Foundation Bipolar Network. J Clin Psychiatry 2003;64:506–515. CrossRefGoogle ScholarPubMed
Oquendo, MA, Waternaux, C, Brodsky, Bet al. Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters. J Affect Disord 2000;59:107–117. CrossRefGoogle ScholarPubMed
Chaudhury, SR, Grunebaum, MF, Galfalvy, HCet al. Does first episode polarity predict risk for suicide attempt in bipolar disorder? J Affect Disord 2007;104:245–250. CrossRefGoogle ScholarPubMed
Strakowski, SM, McElroy, SL, Keck, PE Jr, West, SA. Suicidality among patients with mixed and manic bipolar disorder. Am J Psychiatry 1996;153:674–676. Google ScholarPubMed
Gonzalez-Pinto, A, Mosquera, F, Alonso, Met al. Suicidal risk in bipolar I disorder patients and adherence to long-term lithium treatment. Bipolar Disord 2006;8(5 Pt 2):618–624. CrossRefGoogle ScholarPubMed
Berk, M. The place of placebo? The ethics of placebo-controlled trials in bipolar disorder. Acta Neuropsychiatrica 2007;19:74–75. CrossRefGoogle ScholarPubMed
Murray, CJ, Lopez, AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997;349:1436–1442. CrossRefGoogle ScholarPubMed
Depp, CA, Davis, CE, Mittal, D, Patterson, TL, Jeste, DV. Health-related quality of life and functioning of middle-aged and elderly adults with bipolar disorder. J Clin Psychiatry 2006;67:215–221. CrossRefGoogle ScholarPubMed
Suppes, T, Leverich, GS, Keck, PEet al. The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. J Affect Disord 2001;67:45–59. CrossRefGoogle ScholarPubMed
Zarate, CA Jr, Tohen, M, Land, M, Cavanagh, S. Functional impairment and cognition in bipolar disorder. Psychiatr Q 2000;71:309–329. CrossRefGoogle ScholarPubMed
Tohen, M, Hennen, J, Zarate, CM Jret al. Two-year syndromal and functional recovery in 219 cases of first-episode major affective disorder with psychotic features. Am J Psychiatry 2000;157:220–228. CrossRefGoogle ScholarPubMed
Zanarini, MC, Frankenburg, FR, Hennen, J, Reich, DB, Silk, KR. Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years. J Personal Disord 2005;19:19–29. CrossRefGoogle ScholarPubMed
Hajek, T, Slaney, C, Garnham, J, Ruzickova, M, Passmore, M, Alda, M. Clinical correlates of current level of functioning in primary care-treated bipolar patients. Bipolar Disord 2005;7:286–291. CrossRefGoogle ScholarPubMed
Harkavy-Friedman, JM, Keilp, JG, Grunebaum, MFet al. BPII suicide attempters distinct neuropsychologically? J Affect Disord 2006;94:255–259. CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Vieta, E, Reinares, Met al. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161:262–270. CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Guía del usuario para la entrevista clínica estructurada para los trastornos del eje I del DSM-IV®: SCID-I. Elsevier-Masson, 1999. Google Scholar
First, MB, Gibbon, M, Smith, BL, Spitzer, RL, Williams, JBW. Guía del usuario para la entrevista clínica estructurada para los trastornos de la personalidad del eje II del DSM-IV®: SCID-I. Elsevier-Masson, 1999. Google Scholar
Bobes, J, Bulbena, A, Luque, A, Dal-Ré, R, Ballesteros, J, Ibarra, N; Grupo de Validacion en Espanol de Escalas Psicometricas. [A comparative psychometric study of the Spanish versions with 6, 17, and 21 items of the Hamilton Depression Rating Scale]. Med Clin (Barc) 2003;120:693–700 (Spanish).CrossRefGoogle Scholar
Colom, F, Vieta, E, Martínez-Arán, Aet al. Spanish version of a scale for the assessment of mania: validity and reliability of the Young Mania Rating Scale]. Med Clin (Barc) 2002;119:366–371. CrossRefGoogle ScholarPubMed
Vieta, E, Colom, F, Corbella, Bet al. Clinical correlates of psychiatric comorbidity in bipolar I patients. Bipolar Disord 2001;3:253–258. CrossRefGoogle ScholarPubMed
Rosa, AR, Sánchez-Moreno, J, Martínez-Aran, Aet al. Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemol Ment Health 2007;3:5. CrossRefGoogle ScholarPubMed
Caetano, SC, Kaur, S, Brambilla, Pet al. Smaller cingulate volumes in unipolar depressed patients. Biol Psychiatry 2006;59:702–706. CrossRefGoogle ScholarPubMed
González-Pinto, A, Aldama, A, González, C, Mosquera, F, Arrasate, M, Vieta, E. Predictors of suicide in first-episode affective and nonaffective psychotic inpatients: five-year follow-up of patients from a catchment area in Vitoria, Spain. J Clin Psychiatry 2007;68:242–247. CrossRefGoogle ScholarPubMed
Galfalvy, H, Oquendo, MA, Carballo, JJet al. Clinical predictors of suicidal acts after major depression in bipolar disorder: a prospective study. Bipolar Disord 2006;8(5 Pt 2):586–595. CrossRefGoogle ScholarPubMed
Sanchez, LE, Le, LT. Suicide in mood disorders. Depress Anxiety 2001;14:177–182. CrossRefGoogle ScholarPubMed
Slama, F, Bellivier, F, Henry, Cet al. Bipolar patients with suicidal behavior: toward the identification of a clinical subgroup. J Clin Psychiatry 2004;65:1035–1039. CrossRefGoogle ScholarPubMed
Vieta, E, Benabarre, A, Colom, Fet al. Suicidal behavior in bipolar I and bipolar II disorder. J Nerv Ment Dis 1997;185:407–409. CrossRefGoogle ScholarPubMed
Vieta, E, Nieto, E, Gastó, C, Cirera, E. Serious suicide attempts in affective patients. J Affect Disord 1992;24:147–152. CrossRefGoogle ScholarPubMed
Vieta, E, Colom, F, Martínez-Arán, A, Benabarre, A, Reinares, M, Gastó, C. Bipolar II disorder and comorbidity. Compr Psychiatry 2000;41:339–343. CrossRefGoogle ScholarPubMed
Colom, F, Vieta, E, Martínez-Arán, A, Reinares, M, Benabarre, A, Gastó, C. Clinical factors associated with treatment noncompliance in euthymic bipolar patients. J Clin Psychiatry 2000;61:549–555. CrossRefGoogle ScholarPubMed
Dunayevich, E, Sax, KW, Keck, PE Jret al. Twelve-month outcome in bipolar patients with and without personality disorders. J Clin Psychiatry 2000;61:134–139. Erratum in J Clin Psychiatry 2000;61:529. CrossRefGoogle ScholarPubMed
Kay, JH, Altshuler, LL, Ventura, J, Mintz, J. Impact of axis II comorbidity on the course of bipolar illness in men: a retrospective chart review. Bipolar Disord 2002;4:237–242. CrossRefGoogle ScholarPubMed
Uçok, A, Karaveli, D, Kundakçi, T, Yazici, O. Comorbidity of personality disorders with bipolar mood disorders. Compr Psychiatry 1998;39:72–74. CrossRefGoogle ScholarPubMed
Cheour, M, Tabbene, K, Khiari, G, Douki, S. [Influence of personality disorder on the course of manic-depressive illness]. Encephale 1999;25:73–76. Google ScholarPubMed
Brieger, P, Ehrt, U, Marneros, A. Frequency of comorbid personality disorders in bipolar and unipolar affective disorders. Compr Psychiatry 2003;44:28–34. CrossRefGoogle ScholarPubMed
Garno, JL, Goldberg, JF, Ramirez, PM, Ritzler, BA. Bipolar disorder with comorbid cluster B personality disorder features: impact on suicidality. J Clin Psychiatry 2005;66:339–345. CrossRefGoogle ScholarPubMed
Colom, F, Vieta, E. Treatment adherence in bipolar disorders. Clin Approach Bipolar Disord 2002;1:49–56. Google Scholar
López, P, Mosquera, F, De León, Jet al. Suicide attempts in bipolar patients. J Clin Psychiatry 2001;62:963–966. CrossRefGoogle ScholarPubMed
Virkkunen, M, Goldman, D, Nielsen, DA, Linnoila, M. Low brain serotonin turnover rate (low CSF 5-HIAA) and impulsive violence. J Psychiatry Neurosci 1995;20:271–275. Google ScholarPubMed
Martinez-Aran, A, Vieta, E, Torrent, Cet al. Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord 2007;9:103–113. CrossRefGoogle ScholarPubMed
Torrent, C, Martínez-Arán, A, Amann, Bet al. Cognitive impairment in schizoaffective disorder: a comparison with non-psychotic bipolar and healthy subjects. Acta Psychiatr Scand 2007;116:453–460. CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Vieta, E, Colom, Fet al. Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disord 2004;6:224–232. CrossRefGoogle ScholarPubMed
Oquendo, MA, Galfalvy, H, Russo, Set al. Prospective study of clinical predictors of suicidal acts after a major depressive episode in patients with major depressive disorder or bipolar disorder. Am J Psychiatry 2004;161:1433–1441. CrossRefGoogle ScholarPubMed
Valtonen, HM, Suominen, K, Mantere, O, Leppämäki, S, Arvilommi, P, Isometsä, ET. Prospective study of risk factors for attempted suicide among patients with bipolar disorder. Bipolar Disord 2006;8(5 Pt 2):576–585. CrossRefGoogle ScholarPubMed
Valtonen, HM, Suominen, K, Mantere, O, Leppämäki, S, Arvilommi, P, Isometsä, E. Suicidal behaviour during different phases of bipolar disorder. J Affect Disord 2007;97:101–107. CrossRefGoogle ScholarPubMed