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Risk of suicidal behavior in patients with major depression and bipolar disorder: A systematic review and meta-analysis of registry-based studies
Centre for affective Disorders, Psychological Medicine, King's College London, United Kingdom; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.
Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Örebro University, University Library.ORCID iD: 0000-0001-5091-604X
United Arab Emirates University, Al Ain, United Arab Emirates.
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2024 (English)In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 159, article id 105594Article, review/survey (Refereed) Published
Abstract [en]

Suicide is a health priority and one of the most common causes of death in mood disorders. One of the limitations of this type of research is that studies often establish rates of suicide behaviors in mood disorders by using diverse comparison groups or simply monitoring cohort of patients over a time period. In this study registry-based systematic review, national registers were identified through searches in six academic databases, and information about the occurrence of suicide behaviors in mood disorders was systematically extracted. Odds ratios were subsequently calculated comparing rates of death by suicide in mood disorders in comparison with age and period matched rates of death by suicide in the general population obtained from country-wide national registers. The aim was to provide the most recent summary of epidemiological and clinical factors associated to suicide in mood disorders whilst calculating the likelihood of death by suicide in mood disorders in comparison with non-affected individuals according to national databases. The study follows the Preferred Reporting Guidelines for Systematic Reviews and Meta-analyses and was prespecify registered on Prospero (CRD42020186857). RESULTS: suggest that patients with mood disorders are at substantially increased risk of attempting and dying by suicide. Several epidemiological, clinical and social factors are reported to be associated with clinical populations at risk of suicide. Meta-analyses of completed deaths by suicide suggest that the likelihood for dying by suicide in mood disorders is 8.62 times higher in major depression and 8.66 times higher in bipolar disorder with higher number of untoward events in women compared to men in both conditions. The likelihood of dying by suicide in major depressive disorders is higher in the first year following discharge. Clinical guidelines might consider longer periods of monitoring following discharge from hospital. Overall, due to the higher risk of suicide in mood disorders, efforts should be made to increase detection and prevention whilst focusing on reducing risk in the most severe forms of illness with appropriate treatment to promote response and remission at the earliest convenience.

Place, publisher, year, edition, pages
Pergamon Press, 2024. Vol. 159, article id 105594
Keywords [en]
Suicide behaviors, bipolar disorder, major depression, mood disorders, national registries
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-111641DOI: 10.1016/j.neubiorev.2024.105594ISI: 001231771200001PubMedID: 38368970Scopus ID: 2-s2.0-85186518850OAI: oai:DiVA.org:oru-111641DiVA, id: diva2:1838890
Note

Financial support was provided by the Eunice L. Dwan Diabetes Research Endowment, Iacocca Foundation, Children with Diabetes Foundation, and the Winston and Maxine Wallin Islet Xenotransplant Fund.

Available from: 2024-02-19 Created: 2024-02-19 Last updated: 2024-06-11Bibliographically approved

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