Created By: Mariela Dagio
Suicide attempts: differences between unipolar and bipolar patients and among groups with different lethality risk.
Psichiatrico di Diagnosi e Cura, Dipartimento di Salute Mentale,
Ospedale Santo Spirito, Via Prisciano 26, 00136 Rome, Italy.
present naturalistic study aimed to distinguish between suicide
attempts (SAs) of bipolar and unipolar patients, and among SAs
characterized by different lethality risk.
records of 2395 consecutive admissions to our psychiatric intensive care
unit (PICU) were assessed for presence of suicide attempt (SA). Cases
of SA were rated for symptom severity with the brief psychiatric rating
scale (BPRS), the scale for the assessment of positive symptoms (SAPS),
the scale for the assessment of negative symptoms (SANS), the mini
mental state examination (MMSE), the global assessment of functioning
scale (GAF) and the clinical global impression (CGI). An original
questionnaire was administered to explore clinical aspects related with
 Among 2395 admissions, 80
(3.3%) had attempted suicide. Fifty-three cases (66.2%) suffered from a
mood episode, including 22 (27.5%) with unipolar depression and 31
(38.7%) with bipolar depression (types I and II combined) or mixed
state, while 27 (33.8%) cases received other diagnoses. Forty-eight
(60%) cases had attempted suicide prior to the index episode. Ten cases
(12.5%) had a relative who attempted or committed suicide. Thirty-nine
cases (48.7%) described their SA as impulsive. Twenty cases (25.0%)
reported alcohol ingestion before SA. In comparison with women, men used
more violent methods. Cases characterized by a non-lethal risk SA had
higher BPRS psychotic cluster and SAPS scores than cases with either low
or high lethal risk SA. Bipolar cases were over-represented in the high
lethality risk group. BPRS anxiety-depressive cluster score was higher
in unipolar than in bipolar cases.
sample may not be representative of all patients with SA. The
questionnaire has not been standardized for use in psychiatric
The higher proportion of high
lethal risk SA in bipolar cases suggests that the risk of completed
suicide is higher in bipolar disorder than in unipolar depression. The
risk of lethality in SA was not associated with the intensity of
symptoms of anxiety and depression.
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