OBJECTIVE: Pediatric bipolar disorder (PBD) is associated with poor outcomes, including suicidal ideation (SI) and suicide attempt (SA). However, frequencies and risk factors of SI/SA and targeted intervention trials for SI/SA in PBD have not been reviewed systematically. METHODS: We conducted a systematic PubMed review, searching for articles reporting on prevalences/incidences, correlates and intervention studies targeting SI/SA in PBD. Weighted means were calculated, followed by an exploratory meta-regression of SI and SA correlates. RESULTS: Fourteen studies (n = 1595), in which 52.1% of patients were male and the mean age was 14.4 years, reported data on SI/SA prevalence (N = 13, n = 1508) and/or correlates (N = 10, n = 1348) in PBD. Weighted mean prevalences were: past SI = 57.4%, past SA = 21.3%, current SI = 50.4%, and current SA = 25.5%; incidences (mean 42 months of follow-up) were: SI = 14.6% and SA = 14.7%. Regarding significant correlates, SI (N = 3) was associated with a higher percentage of Caucasian race, narrow (as opposed to broad) PBD phenotype, younger age, and higher quality of life than SA. Significant correlates of SA (N = 10) included female sex, older age, earlier illness onset, more severe/episodic PBD, mixed episodes, comorbid disorders, past self-injurious behavior/SI/SA, physical/sexual abuse, parental depression, family history of suicidality, and poor family functioning. Race, socioeconomic status, living situation, and life events were not clearly associated with SA. In a meta-regression analysis, bipolar I disorder and comorbid attention-deficit hyperactivity disorder were significantly associated with SA. Only one open label study targeting the reduction of SI/SA in PBD was identified. CONCLUSIONS: SI and SA are very common but under-investigated in PBD. Exploration of predictors and protective factors is imperative for the establishment of effective preventive and intervention strategies, which are urgently needed.
OBJECTIVE:Pediatric bipolar disorder (PBD) is associated with poor outcomes, including suicidal ideation (SI) and suicide attempt (SA). However, frequencies and risk factors of SI/SA and targeted intervention trials for SI/SA in PBD have not been reviewed systematically. METHODS: We conducted a systematic PubMed review, searching for articles reporting on prevalences/incidences, correlates and intervention studies targeting SI/SA in PBD. Weighted means were calculated, followed by an exploratory meta-regression of SI and SA correlates. RESULTS: Fourteen studies (n = 1595), in which 52.1% of patients were male and the mean age was 14.4 years, reported data on SI/SA prevalence (N = 13, n = 1508) and/or correlates (N = 10, n = 1348) in PBD. Weighted mean prevalences were: past SI = 57.4%, past SA = 21.3%, current SI = 50.4%, and current SA = 25.5%; incidences (mean 42 months of follow-up) were: SI = 14.6% and SA = 14.7%. Regarding significant correlates, SI (N = 3) was associated with a higher percentage of Caucasian race, narrow (as opposed to broad) PBD phenotype, younger age, and higher quality of life than SA. Significant correlates of SA (N = 10) included female sex, older age, earlier illness onset, more severe/episodic PBD, mixed episodes, comorbid disorders, past self-injurious behavior/SI/SA, physical/sexual abuse, parental depression, family history of suicidality, and poor family functioning. Race, socioeconomic status, living situation, and life events were not clearly associated with SA. In a meta-regression analysis, bipolar I disorder and comorbid attention-deficit hyperactivity disorder were significantly associated with SA. Only one open label study targeting the reduction of SI/SA in PBD was identified. CONCLUSIONS: SI and SA are very common but under-investigated in PBD. Exploration of predictors and protective factors is imperative for the establishment of effective preventive and intervention strategies, which are urgently needed.
Authors: Augustine Osman; Peter M Gutierrez; Francisco X Barrios; Courtney L Bagge; Beverly A Kopper; Sena Linden Journal: J Clin Psychol Date: 2005-04
Authors: Tina R Goldstein; Wonho Ha; David A Axelson; Benjamin I Goldstein; Fangzi Liao; Mary Kay Gill; Neal D Ryan; Shirley Yen; Jeffrey Hunt; Heather Hower; Martin Keller; Michael Strober; Boris Birmaher Journal: Arch Gen Psychiatry Date: 2012-11
Authors: Matthew K Nock; Jennifer Greif Green; Irving Hwang; Katie A McLaughlin; Nancy A Sampson; Alan M Zaslavsky; Ronald C Kessler Journal: JAMA Psychiatry Date: 2013-03 Impact factor: 21.596
Authors: Kathleen Ries Merikangas; Lihong Cui; G Kattan; Gabrielle A Carlson; Eric A Youngstrom; Jules Angst Journal: Arch Gen Psychiatry Date: 2012-09
Authors: Ian H Stanley; Melanie A Hom; Joan L Luby; Paramjit T Joshi; Karen D Wagner; Graham J Emslie; John T Walkup; David A Axelson; Thomas E Joiner Journal: J Psychiatr Res Date: 2017-07-29 Impact factor: 4.791
Authors: Diana Khoubaeva; Mikaela Dimick; Vanessa H Timmins; Lisa M Fiksenbaum; Rachel H B Mitchell; Ayal Schaffer; Mark Sinyor; Benjamin I Goldstein Journal: Eur Child Adolesc Psychiatry Date: 2021-05-24 Impact factor: 4.785
Authors: Ayal Schaffer; Erkki T Isometsä; Jean-Michel Azorin; Frederick Cassidy; Tina Goldstein; Zoltán Rihmer; Mark Sinyor; Leonardo Tondo; Doris H Moreno; Gustavo Turecki; Catherine Reis; Lars Vedel Kessing; Kyooseob Ha; Abraham Weizman; Annette Beautrais; Yuan-Hwa Chou; Nancy Diazgranados; Anthony J Levitt; Carlos A Zarate; Lakshmi Yatham Journal: Aust N Z J Psychiatry Date: 2015-07-14 Impact factor: 5.744
Authors: Ayal Schaffer; Erkki T Isometsä; Leonardo Tondo; Doris H Moreno; Mark Sinyor; Lars Vedel Kessing; Gustavo Turecki; Abraham Weizman; Jean-Michel Azorin; Kyooseob Ha; Catherine Reis; Frederick Cassidy; Tina Goldstein; Zoltán Rihmer; Annette Beautrais; Yuan-Hwa Chou; Nancy Diazgranados; Anthony J Levitt; Carlos A Zarate; Lakshmi Yatham Journal: Aust N Z J Psychiatry Date: 2015-07-16 Impact factor: 5.744
Authors: Craig Jeffrey Robb Sewall; Tina R Goldstein; Rachel H Salk; John Merranko; Mary K Gill; Michael Strober; Martin B Keller; Danella Hafeman; Neal D Ryan; Shirley Yen; Heather Hower; Fangzi Liao; Boris Birmaher Journal: Arch Suicide Res Date: 2019-07-03