Suicidality in bipolar disorder

Abstract:

Attempted and completed suicide is a frequent and most serious consequence of bipolar disorder (BD). In the last decade, a considerable progress has been made in the investigation of risk factors associated with suicidal tendencies. Evidence indicates that family and personal history of suicidal behaviour, childhood abuse, polarity of the first episode and comorbidity are the factors associated with attempted and completed suicide. Abnormal values of particular biological parameters, such as cholesterol and serotonin, may be associated with suicidal behaviour of individuals with BD. When administered as monotherapy, antidepressants (especially conventional ones) can exacerbate suicidal tendencies in susceptible individuals with BD. A large body of evidence shows that a long-term lithium prophylaxis has antisuicide effect. 

Key words:
antidepressive agents, biological markers, bipolar disorder, drug therapy, suicide, risk factors