Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I

de Abreu, Lena Nabuco; Nery, Fabiano G.; Harkavy-Friedman, Jill M.; de Almeida, Karla Matias; Gomes, Bernardo Carramao; Oquendo, Maria A.; Lafer, Beny

doi:10.1016/j.comppsych.2011.03.003

« Previous Next »Comprehensive Psychiatry
Volume 53, Issue 2 , Pages 125-129, February 2012

Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I

Lena Nabuco de Abreu
- Bipolar Disorder Research Program, Department of Psychiatry, University Sao Paulo, Medical School, Sao Paulo, Brazil
- Corresponding author. Tel.: +55 11 30697928; fax: +55 11 30697928.
Fabiano G. Nery
- Bipolar Disorder Research Program, Department of Psychiatry, University Sao Paulo, Medical School, Sao Paulo, Brazil
Jill M. Harkavy-Friedman
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
Karla Matias de Almeida
- Bipolar Disorder Research Program, Department of Psychiatry, University Sao Paulo, Medical School, Sao Paulo, Brazil
Bernardo Carramao Gomes
- Bipolar Disorder Research Program, Department of Psychiatry, University Sao Paulo, Medical School, Sao Paulo, Brazil
Maria A. Oquendo
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University Sao Paulo, Medical School, Sao Paulo, Brazil

published online 09 May 2011.

Abstract

Background

The association between suicidal behavior and quality of life (QoL) in bipolar disorder (BD) is poorly understood. Worse QoL has been associated with suicide attempts and suicidal ideation in schizophrenic patients, but this relationship has not been investigated in BD. This study tested whether a history of suicide attempts was associated with poor QoL in a well-characterized sample of patients with BD, as has been observed in other psychiatric disorders and in the general population.

Methods

One hundred eight patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD type I (44 with previous suicide attempts, 64 without previous suicide attempts) were studied. Quality of life was assessed using the World Health Organization's Quality of Life Instrument–Short Version. Depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale–17 items and the Young Mania Rating Scale.

Results

Patients with BD and previous suicide attempts had significantly lower scores in all the 4 domains of the World Health Organization's Quality of Life Instrument–Short Version scale than did patients with BD but no previous suicide attempts (physical domain P = .001; psychological domain P < .0001; social domain P = .001, and environmental domain P = .039). In the euthymic subgroup (n = 70), patients with previous suicide attempts had significantly lower scores only in the psychological and social domains (P = .020 and P = .004).

Limitations

This was a cross-sectional study, and no causal associations can be assumed.

Conclusions

Patients with BD and a history of previous suicide attempts seem to have a worse QoL than did patients who never attempted suicide. Poorer QoL might be a marker of poor copying skills and inadequate social support and be a risk factor for suicidal behavior in BD. Alternatively, poorer QoL and suicidal behavior might be different expressions of more severe BD.