@article{ref1,
title="Prevention of suicidal behavior in bipolar disorder",
journal="Bipolar disorders",
year="2020",
author="Tondo, Leonardo and Vazquez, Gustavo H. and Baldessarini, Ross J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Excess mortality is a critical hallmark of bipolar disorder (BD) due to co-occurring general medical disorders and especially from suicide. It is timely to review of the status of suicide in BD and to consider the possibility of limiting suicidal risk.   METHODS: We carried out a semi-systematic review of recent research reports pertaining to suicide in BD.   FINDINGS: Suicide risk in BD is greater than with most other psychiatric disorders. Suicide rates (per 100,000/year) are approximately 11 and 4 in the adult and juvenile general populations, but over 200 in adults, and 100 among juveniles diagnosed with BD. Suicide attempt rates with BD are at least 20-times higher than in the adult general population, and over 50-times higher among juveniles. Notable suicidal risk factors in BD include: previous suicidal acts, depression, mixed-agitated-dysphoric moods, rapid mood-shifts, impulsivity, and co-occurring substance abuse. Suicide-preventing therapeutics for BD remains severely underdeveloped. Evidence favoring lithium treatment is stronger than for other measures, though encouraging findings are emerging for other treatments.   CONCLUSIONS: Suicide is a leading clinical challenge for those caring for BD patients. Improved understanding of risk and protective factors combined with knowledge and close follow-up of BD patients should limit suicidal risk. Ethically appropriate and scientifically sound studies of plausible medicinal, physical, and psychosocial treatments aimed at suicide prevention specifically for BD patients are urgently needed.<p /> <p>Language: en</p>",
language="en",
issn="1398-5647",
doi="10.1111/bdi.13017",
url="http://dx.doi.org/10.1111/bdi.13017"
}