Abstract：
BACKGROUND:Suicide is a major risk for those with bipolar disorder, a risk amplified by comorbid substance abuse in some, but not all, previous studies. To further explore the relationships of substance abuse, suicide, and bipolarity as they present in clinical practice, we analyzed standardized clinical data from a large acute psychiatric inpatient service. METHODS:Standardized clinical evaluations of 7819 patients with diagnoses of bipolar depression (n=990), bipolar mania (n=948), unipolar depressive episode (n=3626), or schizophrenia-schizoaffective disorders (n=2255) were analyzed to evaluate the relationship between current substance-use problems, substance-induced symptoms, and a current suicide crisis, as well as lifetime suicide attempts, with logistic regressions adjusting for age, gender, and ethnicity. RESULTS:Across the combined groups, current substance-use problems were significantly associated with a lifetime suicide attempt (odds ratios [ORs] 1.6-2.5) and to a lesser degree to the admission suicide crisis (ORs 1-2.2). Among bipolar (depressed/manic) patients, but not other diagnostic groups, those with both current substance-use problems and substance-induced symptoms had even higher rates of a recent suicide crisis (ORs 1.5-3.1) and of a lifetime attempt (ORs 2.5-3.4). CONCLUSIONS:In bipolar patients, substance use disorder doubled and substance use disorder plus substance-induced symptoms tripled the suicidal risk. Implications for future research are discussed.
journal_name
Biol Psychiatryjournal_title
Biological psychiatryauthors
Comtois KA,Russo JE,Roy-Byrne P,Ries RKdoi
10.1016/j.biopsych.2004.10.003subject
Has Abstractpub_date
2004-11-15 00:00:00pages
757-63issue
10eissn
0006-3223issn
1873-2402pii
S0006-3223(04)01062-5journal_volume
56pub_type
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journal_title：Biological psychiatry
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journal_title：Biological psychiatry
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journal_title：Biological psychiatry
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pub_type： 杂志文章
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pub_type： 杂志文章
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journal_title：Biological psychiatry
pub_type： 杂志文章,meta分析
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