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Suicide in bipolar disorder in a national English sample, 1996–2009: frequency, trends and characteristics

Published online by Cambridge University Press:  19 March 2013

C. Clements ,
R. Morriss ,
S. Jones ,
S. Peters ,
C. Roberts  and
N. Kapur
C. Clements*
Affiliation:
Centre for Mental Health and Risk, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
R. Morriss
Affiliation:
Institute of Mental Health, The University of Nottingham, UK
S. Jones
Affiliation:
Spectrum Centre for Mental Health Research, School of Health and Medicine, Lancaster University
S. Peters
Affiliation:
School of Psychological Science, The University of Manchester, UK
C. Roberts
Affiliation:
Institute of Population Health, The University of Manchester, UK
N. Kapur
Affiliation:
Centre for Mental Health and Risk, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
*
*Address for correspondence: C. Clements, Centre for Mental Health and Risk, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK. (Email: caroline.v.clements@manchester.ac.uk)
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Abstract

Background

Bipolar disorder (BD) has been reported to be associated with high risk of suicide. We aimed to investigate the frequency and characteristics of suicide in people with BD in a national sample.

Method

Suicide in BD in England from 1996 to 2009 was explored using descriptive statistics on data collected by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI). Suicide cases with a primary diagnosis of BD were compared to suicide cases with any other primary diagnosis.

Results

During the study period 1489 individuals with BD died by suicide, an average of 116 cases/year. Compared to other primary diagnosis suicides, those with BD were more likely to be female, more than 5 years post-diagnosis, current/recent in-patients, to have more than five in-patient admissions, and to have depressive symptoms. In BD suicides the most common co-morbid diagnoses were personality disorder and alcohol dependence. Approximately 40% were not prescribed mood stabilizers at the time of death. More than 60% of BD suicides were in contact with services the week prior to suicide but were assessed as low risk.

Conclusions

Given the high rate of suicide in BD and the low estimates of risk, it is important that health professionals can accurately identify patients most likely to experience poor outcomes. Factors such as alcohol dependence/misuse, personality disorder, depressive illness and current/recent in-patient admission could characterize a high-risk group. Future studies need to operationalize clinically useful indicators of suicide risk in BD.

Keywords

Bipolar disordermood disorderssuicide
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 12 , December 2013 , pp. 2593 - 2602
Copyright
Copyright © Cambridge University Press 2013 

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