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Cited by 168Bipolar Disorder and TreatmentSuicide and Self-Harm StudiesPersonality Disorders and Psychopathology

Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates, and targeted interventions

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Hauser, Marta, Galling, Britta, Correll, Christoph U·2013·Bipolar Disorders
DOI 10.1111/bdi.12094PMC PMC3737391
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Abstract

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 C aucasian 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.

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  1. [1]Bridge JA Goldstein TR Brent DA Adolescent suicide and suicidal behavior J Child Psychol Psychiatry 2006 47 372 394 16492264
  2. [2]Stensland MD Zhu B Ascher-Svanum H Ball DE Costs associated with attempted suicide among individuals with bipolar disorder J Ment Health Policy Econ 2010 13 87 92 20919595
  3. [5]Grunbaum JA Kann L Kinchen SA Youth risk behavior surveillance - United States, 2001 MMWR Surveill Summ 2002 51 1 62 12102329
  4. [7]Goldstein TR Birmaher B Axelson D History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk Bipolar Disord 2005 7 525 535 16403178 PMC3679347
  5. [8]Goldstein TR Ha W Axelson DA Predictors of prospectively examined suicide attempts among youth with bipolar disorder Arch Gen Psychiatry 2012 69 1113 1122 22752079 PMC3600896
  6. [9]Suokas J Suominen K Isometsä E Ostamo A Lönnqvist J Long-term risk factors for suicide mortality after attempted suicide--findings of a 14-year follow-up study Acta Psychiatr Scand 2001 104 117 121 11473505
  7. [10]Suominen K Isometsä E Suokas J Haukka J Achte K Lönnqvist J Completed suicide after a suicide attempt: a 37-year follow-up study Am J Psychiatry 2004 161 562 563 14992984
  8. [11]Suominen K Isometsä E Ostamo A Lönnqvist J Level of suicidal intent predicts overall mortality and suicide after attempted suicide: a 12-year follow-up study BMC Psychiatry 2004 4 11 15099401 PMC415554
  9. [12]Foley DL Goldston DB Costello EJ Angold A Proximal psychiatric risk factors for suicidality in youth: the Great Smoky Mountains Study Arch Gen Psychiatry 2006 63 1017 1024 16953004
  10. [14]Fergusson DM Lynskey MT Suicide attempts and suicidal ideation in a birth cohort of 16-year-old New Zealanders J Am Acad Child Adolesc Psychiatry 1995 34 1308 1317 7592268
  11. [15]Kelly TM Cornelius JR Lynch KG Psychiatric and substance use disorders as risk factors for attempted suicide among adolescents: a case control study Suicide Life Threat Behav 2002 32 301 312 12374475
  12. [16]Brent DA Perper JA Moritz G Baugher M Schweers J Roth C Suicide in affectively ill adolescents: a case-control study J Affect Disord 1994 31 193 202 7963072
  13. [17]Brent DA Perper JA Goldstein CE Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients Arch Gen Psychiatry 1988 45 581 588 3377645
  14. [18]Brent DA Perper JA Moritz G Psychiatric risk factors for adolescent suicide: a case-control study J Am Acad Child Adolesc Psychiatry 1993 32 521 529 8496115
  15. [19]Posner K Oquendo MA Gould M Stanley B Davies M Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA's pediatric suicidal risk analysis of antidepressants Am J Psychiatry 2007 164 1035 1043 17606655 PMC3804920
  16. [20]O’Carroll PW Berman AL Maris RW Moscicki EK Tanney BL Silverman MM Beyond the Tower of Babel: A nomenclature for suicidology Suicide Life-Threatening Behav 1996 26 237 252 8897663
  17. [23]Osman A Downs WR Kopper BA The Reasons for Living Inventory for Adolescents (RFL-A): development and psychometric properties J Clin Psychol 1998 54 1063 1078 9840778
  18. [24]Osman A Gutierrez PM Barrios FX Bagge CL Kopper BA Linden S The Inventory of Suicide Orientation-30: further validation with adolescent psychiatric inpatients J Clin Psychol 2005 61 481 497 15503304
  19. [25]Baldessarini RJ Tondo L Suicide risk and treatments for patients with bipolar disorder JAMA 2003 290 1517 1519 13129995
  20. [26]Simon GE Hunkeler E Fireman B Lee JY Savarino J Risk of suicide attempt and suicide death in patients treated for bipolar disorder Bipolar Disord 2007 9 526 530 17680924
  21. [27]Perlis RH Miyahara S Marangell LB STEP-BD Investigators Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD) Biol Psychiatry 2004 55 875 881 15110730
  22. [28]Van Meter AR Moreira AL Youngstrom EA Meta-analysis of epidemiologic studies of pediatric bipolar disorder J Clin Psychiatry 2011 72 1250 1256 21672501
  23. [29]Moreno C Laje G Blanco C Jiang H Schmidt AB Olfson M National trends in the outpatient diagnosis and treatment of bipolar disorder in youth Arch Gen Psychiatry 2007 64 1032 1039 17768268
  24. [30]Blader JC Carlson GA Increased rates of bipolar disorder diagnoses among U.S child, adolescent, and adult inpatients, 1996–2004 Biol Psychiatry 2007 62 107 114 17306773 PMC2001259
  25. [31]Pompili M Innamorati M Rihmer Z Cyclothymic-depressive-anxious temperament pattern is related to suicide risk in 346 patients with major mood disorders J Affect Disord 2012 136 405 411 22177743
  26. [32]Gonda X Pompili M Serafini G Suicidal behavior in bipolar disorder: Epidemiology, characteristics and major risk factors J Affect Disord 2012 143 16 26 22763038
  27. [33]Masi G Perugi G Millepiedi S Developmental differences according to age at onset in juvenile bipolar disorder J Child Adolesc Psychopharmacol 2006 16 679 685 17201612
  28. [34]Geller B Zimerman B Williams M Diagnostic characteristics of 93 cases of a prepubertal and early adolescent bipolar disorder phenotype by gender, puberty and comorbid attention deficit hyperactivity disorder J Child Adolesc Psychopharmacol 2000 10 157 164 11052405
  29. [36]Leibenluft E Charney DS Towbin KE Defining clinical phenotypes of juvenile mania Am J Psychiatry 2003 160 430 437 12611821
  30. [37]Leibenluft E Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths Am J Psychiatry 2011 168 129 142 21123313 PMC3396206
  31. [38]McClellan J Kowatch R Findling RL Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder J Am Acad Child Adolesc Psychiatry 2007 46 107 125 17195735
  32. [39]Geller B Tillman R Craney JL Bolhofner K Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype Arch Gen Psychiatry 2004 61 459 467 15123490
  33. [40]Wozniak J Biederman J Kiely K Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children J Am Acad Child Adolesc Psychiatry 1995 34 867 876 7649957
  34. [41]Findling RL Gracious BL McNamara NK Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder Bipolar Disord 2001 3 202 210 11552959
  35. [42]Geller B Craney JL Bolhofner K Nickelsburg MJ Williams M Zimerman B Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar disorder phenotype Am J Psychiatry 2002 159 927 933 12042179
  36. [43]Althoff RR Rettew DC Faraone SV Boomsma DI Hudziak JJ Latent class analysis shows strong heritability of the child behavior checklist-juvenile bipolar phenotype Biol Psychiatry 2006 60 903 911 16650832
  37. [44]Kochman FJ Hantouche EG Ferrari P Lancrenon S Bayart D Akiskal HS Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder J Affect Disord 2005 85 181 189 15780688
  38. [45]Papolos D Hennen J Cockerham M Obsessive fears about harm to self or others and overt aggressive behaviors in youth diagnosed with juvenile-onset bipolar disorder J Affect Disord 2005 89 99 105 16194571
  39. [47]Axelson D Birmaher B Strober M Phenomenology of children and adolescents with bipolar spectrum disorders Arch Gen Psychiatry 2006 63 1139 1148 17015816
  40. [48]Lewinsohn PM Rohde P Seeley JR Psychosocial risk factors for future adolescent suicide attempts J Consult Clin Psychol 1994 62 297 305 8201067
  41. [49]Lewinsohn PM Seeley JR Klein DN Geller B DelBello MP Bipolar disorder in adolescents: epidemiology and suicidal behavior Bipolar Disorder in Childhood and Early Adolescence 2003 New York Guilford Press 7 24
  42. [50]Algorta GP Youngstrom EA Frazier TW Freeman AJ Youngstrom JK Findling RL Suicidality in pediatric bipolar disorder: predictor or outcome of family processes and mixed mood presentation? Bipolar Disord 2011 13 76 86 21320255 PMC3076793
  43. [51]Bhangoo RK Dell ML Towbin KE Clinical correlates of episodicity in juvenile mania J Child Adolesc Psychopharmacol 2003 13 507 514 14977463
  44. [52]Bronisch T Schwender L Höfler M Wittchen HU Lieb R Mania, hypomania, and suicidality: findings from a prospective community study Arch Suicide Res 2005 9 267 278 16020170
  45. [53]Craney JL Geller B A prepubertal and early adolescent bipolar disorder-I phenotype: review of phenomenology and longitudinal course Bipolar Disord 2003 5 243 256 12895202
  46. [54]Dickstein DP Rich BA Binstock AB Comorbid anxiety in phenotypes of pediatric bipolar disorder J Child Adolesc Psychopharmacol 2005 15 534 548 16190786
  47. [55]Dilsaver SC Benazzi F Rihmer Z Gender, suicidality, and bipolar mixed states in adolescents J Affect Disord 2005 87 11 16 15944138
  48. [56]Faedda GL Baldessarini RJ Glovinsky IP Austin NB Pediatric bipolar disorder: phenomenology and course of illness Bipolar Disord 2004 6 305 313 15225148
  49. [57]Friedman RC Corn R Hurt SW Fibel B Schulick J Swirsky S Family history of illness in the seriously suicidal adolescent: a life-cycle approach Am J Orthopsychiatry 1984 54 390 397 6465291
  50. [58]Kutcher SP Marton P Korenblum M Adolescent bipolar illness and personality disorder J Am Acad Child Adolesc Psychiatry 1990 29 355 358 2347830
  51. [59]Merikangas KR Cui L Kattan G Carlson GA Youngstrom EA Angst J Mania with and without depression in a community sample of US adolescents Arch Gen Psychiatry 2012 69 943 951 22566563 PMC11955849
  52. [60]Rucklidge JJ Psychosocial functioning of adolescents with and without paediatric bipolar disorder J Affect Disord 2006 91 181 188 16478633
  53. [61]Strober M Schmidt-Lackner S Freeman R Bower S Lampert C DeAntonio M Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up J Am Acad Child Adolesc Psychiatry 1995 34 724 731 7608045
  54. [62]Bottlender R Jäger M Strauss A Möller HJ Suicidality in bipolar compared to unipolar depressed inpatients Eur Arch Psychiatry Clin Neurosci 2000 250 257 261 11097169
  55. [63]Goldberg JF Garno JL Portera L Leon AC Kocsis JH Whiteside JE Correlates of suicidal ideation in dysphoric mania J Affect Disord 1999 56 75 81 10626783
  56. [64]Chen YW Dilsaver SC Lifetime rates of suicide attempts among subjects with bipolar and unipolar disorders relative to subjects with other Axis I disorders Biol Psychiatry 1996 39 896 899 8860192
  57. [65]Grunebaum MF Ramsay SR Galfalvy HC Correlates of suicide attempt history in bipolar disorder: a stress-diathesis perspective Bipolar Disord 2006 8 551 557 17042828
  58. [67]Baldessarini RJ Pompili M Tondo L Suicide in bipolar disorder: Risks and management CNS Spectr 2006 11 465 471 16816785
  59. [69]Valtonen HM Suominen K Mantere O Leppämäki S Arvilommi P Isometsä ET Prospective study of risk factors for attempted suicide among patients with bipolar disorder Bipolar Disord 2006 8 576 585 17042831
  60. [70]Angst J Angst F Gerber-Werder R Gamma A Suicide in 406 mood-disorder patients with and without long-term medication: a 40 to 44 years' follow-up Arch Suicide Res 2005 9 279 300 16020171
  61. [71]Valtonen H Suominen K Mantere O Leppämäki S Arvilommi P Isometsä ET Suicidal ideation and attempts in bipolar I and II disorders J Clin Psychiatry 2005 66 1456 1462 16420084
  62. [72]Valtonen HM Suominen K Haukka J Differences in incidence of suicide attempts during phases of bipolar I and II disorders Bipolar Disord 2008 10 588 596 18657243
  63. [73]Abreu LN Lafer B Baca-Garcia E Oquendo MA Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician Revista Brasileira de Psiquiatria 2009 31 271 280 19787156
  64. [74]Hawton K Sutton L Haw C Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors J Clin Psychiatry 2005 66 693 704 15960561
  65. [75]Moor S Crowe M Luty S Carter J Joyce PR Effects of comorbidity and early age of onset in young people with Bipolar Disorder on self harming behaviour and suicide attempts J Affect Disord 2012 136 1212 1215 22085804
  66. [76]Angst J The bipolar spectrum Br J Psychiatry 2007 190 189 191 17329735

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Authors
Hauser, M., Galling, B., & Correll, C. U.
Affiliations
  • Feinstein Institute for Medical Research (US)
  • University Medical Center Hamburg-Eppendorf (DE)
  • Albert Einstein College of Medicine (US)
Corresponding author
Correll, Christoph U
ORCID
Venue
Bipolar Disorders
Publisher
Wiley
Published
2013-07-05
Volume
15
Issue
5
Pages
507-523
ISSN
  • 1398-5647 (ISSN-L)
  • 1399-5618
DOI
10.1111/bdi.12094
PMC
PMC3737391
OpenAlex
W1980708245
Cited by
168
References
6
Citations by year
2026: 7 · 2025: 10 · 2024: 13 · 2023: 13 · 2022: 10 · 2021: 17 · 2020: 13 · 2019: 16 · 2018: 8 · 2017: 13 · 2016: 17 · 2015: 22 · 2014: 7 · 2013: 1
FWCI
2.14
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Bipolar Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (P30MH090590)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
pediatric bipolar disorder, suicidal ideation, suicide attempts, prevalence, incidence, risk factors, bipolar I disorder, mixed states, self-harm, parental depression, family functioning, suicide prevention interventions, quality of life
MeSH terms
Adolescent, Bipolar Disorder, Child, Female, Humans, Male, Suicide, Attempted, Incidence, Prevalence, Databases, Factual, Suicidal Ideation

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