Atypical depression linked to suicide risk in bipolar patients

MedWire News: Atypical depression is associated with an increased risk of suicide attempts in patients with bipolar disorder, say researchers in findings that may help identify bipolar disorder patients who are at risk of taking their own lives.

Atypical depression is a subtype of depression in which a patient’s mood can improve in response to actual or potentially positive events, unlike the ‘unreactive’ nature of conventional depression. Patients with atypical depression may also overeat, sleep too much, experience leaden feelings in arms or legs and have a long-standing pattern of sensitivity to interpersonal rejection.

Dr Eduard Vieta, from the University of Barcelona in Spain, and team explain that although up to 50% of bipolar disorder patients may attempt suicide in their lifetime, and such patients are more likely to have a lifetime history of suicide than patients with other psychiatric disorders, there has been little investigation of factors linked to suicide attempts among such patients.

To address this, the team assessed 390 patients with bipolar disorder who were aged an average of 42 years, with an average age at bipolar disorder onset of 27 years.

In all, 29% of the patients had attempted suicide at least once.

The researchers found that patients who had attempted suicide were nearly four times more likely to have depression with atypical features than those with no suicide attempts.

Other factors associated with an increased risk of suicide attempts included a family history of suicide, the presence of a personality disorder and depression as the initial mood episode.

Dr Vieta and team conclude in the journal Acta Psychiatrica Scandinavica: “These findings should encourage clinicians to systematically check for the previously mentioned factors, in order to detect and treat individuals at risk for suicide attempt as early as possible.”

They add: “To deal with the main complication of bipolar disorder, high priority must be given not only to the provision of health support, but also to the development of specific preventative programmes.”