Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder
Autor: | Mauricio Tohen, Terence A. Ketter, Louisa G. Sylvia, Melvin G. McInnis, Richard C. Shelton, Trine Madsen, Joseph R. Calabrese, Keming Gao, Susan L. McElroy, Andrew A. Nierenberg, Edward S. Friedman, Charles L. Bowden, Ida Behrendt-Møller, Ole Köhler-Forsberg, Madhukar H. Trivedi, Thilo Deckersbach, Noreen A. Reilly-Harrington, Michael E. Thase, William V. Bobo |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
Male Risk medicine.medical_specialty Future studies Bipolar Disorder Suicide Attempted Lithium Suicidal Ideation 03 medical and health sciences Quetiapine Fumarate 0302 clinical medicine Pharmacotherapy Outpatients medicine Journal Article Mixture modelling Humans Bipolar disorder Health risk Psychiatry Suicidal ideation Depression (differential diagnoses) Psychotropic Drugs Middle Aged medicine.disease 030227 psychiatry Psychiatry and Mental health Clinical Psychology Suicide Quetiapine Female medicine.symptom Psychology 030217 neurology & neurosurgery Clinical psychology medicine.drug Antipsychotic Agents |
Zdroj: | Köhler-Forsberg, O, Madsen, T, Behrendt-Møller, I, Sylvia, L, Bowden, C L, Gao, K, Bobo, W V, Trivedi, M H, Calabrese, J R, Thase, M, Shelton, R C, McInnis, M, Tohen, M, Ketter, T A, Friedman, E S, Deckersbach, T, McElroy, S L, Reilly-Harrington, N A & Nierenberg, A A 2017, ' Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder ', Journal of Affective Disorders, vol. 223, pp. 146-152 . https://doi.org/10.1016/j.jad.2017.07.038 |
Popis: | INTRODUCTION: Suicidal ideation occurs frequently among individuals with bipolar disorder; however, its course and persistence over time remains unclear. We aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder.METHODS: The Bipolar CHOICE study randomized 482 outpatients with bipolar disorder to 6 months of lithium- or quetiapine-based treatment including other psychotropic medications as clinically indicated. Participants were asked at 9 visits about suicidal ideation using the Concise Health Risk Tracking scale. We performed latent Growth Mixture Modelling analysis to empirically identify trajectories of suicidal ideation. Multinomial logistic regression analyses were applied to estimate associations between trajectories and potential predictors.RESULTS: We identified four distinct trajectories. The Moderate-Stable group represented 11.1% and was characterized by constant suicidal ideation. The Moderate-Unstable group included 2.9% with persistent thoughts about suicide with a more fluctuating course. The third (Persistent-low, 20.8%) and fourth group (Persistent-very-low, 65.1%) were characterized by low levels of suicidal ideation. Higher depression scores and previous suicide attempts (non-significant trend) predicted membership of the Moderate-Stable group, whereas randomized treatment did not.LIMITATIONS: No specific treatments against suicidal ideation were included and suicidal thoughts may persist for several years.CONCLUSION: More than one in ten adult outpatients with bipolar disorder had moderately increased suicidal ideation throughout 6 months of pharmacotherapy. The identified predictors may help clinicians to identify those with additional need for treatment against suicidal thoughts and future studies need to investigate whether targeted treatment (pharmacological and non-pharmacological) may improve the course of persistent suicidal ideation. |
Databáze: | OpenAIRE |
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