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- Title
Clinical correlates of suicidality and self-injurious behaviour among Canadian adolescents with bipolar disorder.
- Authors
Khoubaeva, Diana; Dimick, Mikaela; Timmins, Vanessa H.; Fiksenbaum, Lisa M.; Mitchell, Rachel H. B.; Schaffer, Ayal; Sinyor, Mark; Goldstein, Benjamin I.
- Abstract
There is high risk of suicidality in bipolar disorder (BD), particularly in early onset cases. The literature regarding correlates and putative predictors of suicide attempts (SA), non-suicidal self-injury (NSSI) and suicidal ideation (SI) among youth with BD remains sparse. Participants included 197 adolescents with BD, divided into 4 groups: SA (with or without NSSI), NSSI (with or without SI), SI only, and comparison group (CG; no SA/NSSI/SI). Diagnoses, treatment, and suicidality measures were determined via semi-structured interviews, conducted between 2009 and 2017. Univariate analyses were followed by multinomial regression. Overall, 73.6% of participants had history of SA, NSSI, and/or SI. In comparison to CG, SA and NSSI were each associated with BD-II/-NOS (odds ratio [OR] = 15.99, p = 0.002; OR = 16.76, p = 0.003), female sex (OR = 6.89, p = 0.006; OR = 3.76, p = 0.02), and emotion dysregulation (OR = 1.10, p < 0.001; OR = 1.07, p = 0.004). NSSI and SI were each associated with most severe lifetime depression (OR = 1.10, p = 0.01; OR = 1.10, p = 0.01). SA and SI were associated with psychiatric hospitalization (OR = 19.45, p = 0.001; OR = 6.09, p = 0.03). SA was associated with poorer global functioning at most severe episode (OR = 0.88, p = 0.008). NSSI was associated with not living with both natural parents (OR = 0.22, p = 0.009). Study limitations include cross-sectional and retrospective design, stringent cut-offs for SA and NSSI, and recruitment from a tertiary clinical setting. Three quarters of adolescents with BD have had suicidality and/or self-injury. SA and NSSI were most similar to one another, and most different from CG, supporting the broader construct of self-harm. Future research should address the gap in knowledge regarding how sex differences and neurobiology are associated with the observed clinical differences.
- Subjects
CANADA; RISK factors of self-injurious behavior; STATISTICS; CROSS-sectional method; RESEARCH methodology; MULTIPLE regression analysis; RETROSPECTIVE studies; INTERVIEWING; TERTIARY care; SUICIDAL ideation; RISK assessment; SEX distribution; DESCRIPTIVE statistics; MENTAL depression; HOSPITAL care; ODDS ratio; EMOTION regulation; BIPOLAR disorder; MENTAL illness; ADOLESCENCE
- Publication
European Child & Adolescent Psychiatry, 2023, Vol 32, Issue 1, p41
- ISSN
1018-8827
- Publication type
Article
- DOI
10.1007/s00787-021-01803-9