Patients with bipolar disorder are at high risk for suicide, with estimates suggesting that between 25% and 60% of those with bipolar disorder will attempt suicide at some point in their lifetime. Given the magnitude of this risk, our ability to better identify those patients at increased risk for suicide is vital. A recent study carried out by researchers at the Dauten Family Center for Bipolar Treatment Innovation at Massachusetts General Hospital looks at how comorbid post-traumatic stress disorder (PTSD) affects risk for suicide.
In this study, Katz and colleagues analyzed baseline data collected from the Clinical and Health Outcomes Initiative in Comparative Effectiveness for bipolar disorder study (Bipolar CHOICE), which is a 6-month, pharmacological comparative effectiveness trial in individuals with bipolar disorder.
In a total of 482 individuals with bipolar disorder (male/female, type I or II), hierarchical multiple regression analysis was used to assess whether comorbid PTSD was associated with increased suicidal ideation. Suicidal ideation was identified using the Concise Health Risk Tracking Scale (CHRT).
All participants with comorbid PTSD (N = 58) reported current suicidal ideation and were more likely to have had a previous suicide attempt (p<.001) compared to those without PTSD. It is important to note, however, that suicidal ideation was also reported in the majority of patients without PTSD (83%). While comorbid PTSD was associated with a generalized tendency toward suicidality, it did not predict active suicidal ideation.
While this was a relatively small study, the findings are consistent with other studies which have demonstrated that comorbid PTSD may be an independent risk factor for suicide attempt in individuals with major depression. Given that PTSD comorbidity may increase risk for suicide, careful screening for PTSD should be carried out in patients with bipolar disorder.
Read More:
Katz D, Petersen T, Amado S, Kuperberg M, Dufour S, Rakhilin M, Hall NE, Kinrys G, Desrosiers A, Deckersbach T, Sylvia L, Nierenberg AA. An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder. J Affect Disord. 2020 Apr 1;266:49-56.
