Suicide rates in mania with depressive symptoms

Among the broad range of posters on display – in electronic format at IRPB for the first time – was an interesting study examining suicidality in bipolar I patients who are manic with episodes of concurrent depressive symptoms.

The poster, presented by Emmanuelle Weiller and Jonas Eberhard. was a naturalistic study: an online patient self-assessments of adult patients with bipolar I disorder, collated by 184 psychiatrists from eight countries. Of the 1035 patients who took part, 348 met the DSM-5 criteria for ‘mixed features specifier’ (≥3 depressive symptoms) during their most recent manic episode.

 

The importance of anxiety, irritability and agitation

 

Of the 48% of patients who met the criteria of severe anxiety, irritability and agitation (a score ≥4 on a 7-point scale) significantly more patients in this group had a risk of suicide vs. those with mild anxiety, irritability and agitation (no scores or one symptom with a score ≥4). Suicidal ideation was also significantly more frequent in the severe anxiety, irritability and agitation group vs. those in the mild group (72% vs. 48%; p<0.0001). The study helps highlight the added risk of suicide posed by this subgroup of bipolar I patients.

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