Abstract
Background: Suicide is often associated with depression in patients suffering from bipolar disorder (BD) and less is known about its relation to mania. Available data suggest that patients in the manic phase of BD may be at risk of suicide. Aim: We characterized suicide attempts in a cohort of patients with BD in manic and mixed phases. Method: We focused on the scope, rate, and characteristics of suicide attempts among BD patients during manic or mixed states. Associations between suicide as well as clinical and sociodemographic variables were analyzed using computerized medical chart data from 209 adult inpatients diagnosed (DSM-IV) as experiencing manic and mixed BD episodes. Results: The rate of recent suicide attempts among BD inpatients with manic and mixed episodes was 10.5%. Married patients had a decreased rate of suicide attempts. Comorbid alcohol or substance abuse were correlated with an increased risk of suicide attempts. Presence of suicidal ideation increased suicide risk while older age was linked to a decrease in the rate of suicide attempts. Limitations: The retrospective design of the study and overrepresentation of the clinical severity of BD were limitations. Conclusion: The rate of suicide attempts in the manic and mixed phases of BD is substantial and calls for raising awareness among psychiatrists.