Table 2.
Study and sample characteristics
| Study | Design/setting | Na | Age, years [range]a |
Sex (% males)/racea |
Diagnosis and clinical state (%)a |
Age of onset, yearsa |
Comorbidities and trauma (%)a |
Family historya | Suicide measure | Suicidality (%)a |
|---|---|---|---|---|---|---|---|---|---|---|
| Algorta et al. 2011 (50) |
CS Outpatients with mental illness (n = 828) |
138 | 11.2 [5–18] |
55.8 NR |
BD-I: 19.6 BD-II: 13.0 (mixed features: 76% BD- I/BD-II) BD-NOS: 32.6 Cyclothymic d/o: 34.7 |
NR | NR | NR | K-SADS-P/K- SADS |
Past: SI: 17.4, SA: 9.4 Current: SI: 44.9, SA: 6.5 |
| Axelson et al. 2006 (47)b |
CS (COBY) Inpatients + outpatients |
438 | 12.7 [7–18] |
53.2 White: 81.7 |
BD-I: 58.2 BD-II: 6.8 BD-NOS: 34.9 C-GAS: 54.6 K-SADS-MRS: 22.9 K-SADS-DEP: 14.8 PSY: 27.6 |
9.3 | ADHD: 59.5 MDD: 52.7 ANX: 39.7 ODD: 38.5 CD: 12.8 SUD: 8.9 PD: 5.4 |
MDD: 68.0 Mania: 32.2 SUD: 57.8 Schizophrenia: 1.1 Suicidality: (SA: 29.7, SC: 4.7) |
K-SADS-P/K- SADS |
Axelson (2006): Past: SI: 76.2, SA : 30.7 Goldstein (2005): Past: SA: 32 (lethality: very high = 11, moderate = 16) |
| Goldstein et al. 2012 (8) |
LT (COBY) Inpatients + outpatients (follow-up: 5 years) |
413 | 12.6 [7–17] |
53 White: 82 |
BD-I: 59.1 BD-II: 6.8 BD-NOS: 34.1 MS: 26.9 PSY: 22.3 Hopelessness: 87.5 |
NR | ADHD: 59.3 ANX: 39.2 CD: 11.9 SUD: 8.5 PD: 5.3 ODD: 3.9 Trauma (sexual or physical): 19.6 |
DEP: 82.1 SUD: 69 Mania/hypomania: 50.8 SA: 40.7 |
K-SADS-P/K- SADS |
Past: SI: 75.1, SA: 29.5 Prospective: SA after 5 years follow-up: 18.0(≥ 2 SAs: 8) |
| Bhangoo et al. 2003 (51) |
CS Outpatients (ascertained via web survey) |
87 | EPI: 11.2 CHR: 11.1 [6–17] |
EPI: 86 CHR: 84 NR |
EPI: 39 CHR: 61 |
EPI: 6.1 CHR: 6.3 |
ADHD: EPI = 77, CHR = 67 ODD: EPI = 65, CHR = 81 CD: EPI = 22, CHR = 33 |
NR | NR | NR |
| Bronisch et al. 2005 (52) |
LT Community sample (n = 3,021) (mean follow-up: 42 months) |
96 | NR [14–24] |
NR/NR | Mania: 42.7 Hypomania: 56.3 |
NR | NR | NR | M-CIDId |
Mania Past: SI: 46.9, SA: 14.6 Prospective: SI: 17.1, SA: 2.4 Hypomania Past: SI: 31.3, SA: 7.3 Prospective: SI: 12.7, SA: 3.6 |
| Craney and Geller 2003 (53) |
LT Outpatients |
93 | 10.9 [7–16] |
61.3 White: 89.3 |
BD-I: 100 Psychosis: 60.2 Mixed mania: 54.8 Rapid cycling: 77.4 |
6.8 | ADHD: 87.1 ODD/CD: 78.1 |
NR | NR | Suicidality (follow-up duration not specified): 24.7 |
| Dickstein et al. 2005 (54) | CS Outpatients |
31 | BD: 12.7 [NR] |
58.1 NR |
BD-I: 77.4 BD-II: 22.6 |
BD: 10.3 ED: 5.6 |
ANX: 77.4 ADHD: 67.7 ODD: 38.7 PSY (lifetime): 25.8 CD: 3.2 |
NR | Clinical interview |
Past: SI: 93.5, SA: 64.5 |
| Dilsaver et al. 2005 (55) |
CS MDE outpatients (n = 247) |
82 | NR [12–17] |
37.2 NR |
BD-I/BD-II: NR Mixed states: 82 |
NR | NR | NR | Clinical interview |
Current: SI: 67.1, SA: 57.1 |
| Faedda et al. 2004 (56) |
LT, CS Private mood disorder clinic (mean follow- up: 18 months) |
82 | 10.6 [3–17] |
65.9 NR |
BD-I: 52.4 BD-II: 40.2 Cyclothymia: 7.3 PSY: 31.7 |
9.6 | OCD: 26.8 ANX: 23.2 LD: 15.9 ADHD: 11.0 ED: 4.9 SUD: 3.7 Tourette’s: 3.7 |
Mood d/o or SUD: 90.2 |
Questionnaire + semi-structured interview |
Current: SI: 30.0 |
| Friedman et al. 1984 (57) |
CS, DEP Inpatients (n =34) |
8 | NR [NR] |
NR/NR | NR | NR | NR | NR | SADS |
Past: SA: 37.5 Current: SI: 37.5 |
| Kutcher et al. 1990 (58) |
CS Euthymic inpatients + outpatients |
22 | 17.5 [NR] |
55 NR |
Euthymic: 100 Personality d/o: 35 |
16.4 | Personality d/o: 35 |
NR | NR | Past: SA: 15 |
| Lewinsohn et al. 1994 (48)c Lewinsohn et al. 2003 (49)c |
CS, LT Community sample (n = 1709) (T1 = 0, T2 = 12 months, T3 = age 24 years) |
18 | 16 [14–18] at study intake |
33.3 White: 91.1 |
BD-I: 11.1 BD-II: 61.1 Cyclothymia: 27.8 PSY: 5.5 GAF: 76.3 Follow-up T3 -GAF: 75.6 |
11.8 | ANX: 33.3 SUD: 22.2 ADHD: 11.1 OCD: 11.1 CD: 5.6 |
MDD: 43.3 SUD: 34.9 (alcohol), 27.9 (other) Personality d/o: 11.5 (antisocial), borderline (7.7) BD: 3.9 |
K-SADS |
Past year: SI: 72.2, SA: 44.4 (≥ 2 SAs: 38.9) T3 follow-up SA: 5.9 |
| Merikangas et al. 2012 (59) |
CS Community sample (n = 10,123) |
408 | 15.2 [13–18] |
40.9 White: 52.4 |
BD-I and BD-II + MDD: 60.3 BD-I mania only: 39.7 |
NR | ANX: 64.5 SUD: 32.4 CD: 28.9 ADHD: 12.2 ED: 10.5 ≥ 2 d/o: 49.0 |
Mania: 60.2 MDD: 41.9 |
Clinical interview |
Past: SA: BD-I and BD-II + MDD: 21.9 BD-I mania only: 7.4 Weighted mean:13.7 |
| Rucklidge 2006 (60) |
CS Outpatients and healthy controls (n = 39) |
24 | 15.7 [13–17] |
41.7 White: 87.5 |
BD-I: 37.5 BD-II: 25.0 BD-NOS: 37.5 GAF: 54.5 CBCL-parent: 71.5 YSR-youth: 61.9 TRF-teacher: 64.7 |
Post puberty |
ODD: 45.8 CD: 25.0 MDD: 25.0 ADHD: 20.8 SP: 20.8 PTSD: 16.7 SUD: 4.2 Trauma: 54.2 |
NR | K-SADS |
Past: SI: 62.5 Current: SI: 29.2 |
| Strober et al. 1995 (61) |
LT Inpatientsv (follow-up: 5 years) |
54 | 16 [13–17] |
48.1 NR |
Manic: 37.0 Depressed: 25.9 Mixed: 22.2 Cycling: 18.5 PSY: 27.7 |
NR | ADHD: 14.8 ANX: 13.0 Dysthymia: 11.1 SUD: 9.3 CD: 5.6 |
NR |
Medical attention needed (no further details) |
5-year follow-up: 20% ≥ 1 SA |
|
Totals and weighted means across 14 studies |
CS: (N = 8) LT: (N = 4) CS + LT: (N = 2 Community sample: (N = 5) Outpatients: (N = 6) Inpatients: (N = 3)Inpatients + outpatients: (N = 2) |
1595 | 14.4 [3–18] |
52.1 White: 70.5 |
BD-I: 54.6 BD-NOS: 22.3 BD-II: 17.1 Cyclothymia: 6.4 Mixed state: 62.1 PSY: 28.3 |
8.1 (N = 7) | ANX: 66.0 DEP (in BP- NOS): 46.9 ODD: 44.8 ADHD: 44.2 Personality d/o: 35.0 CD: 33.8 PSY (lifetime): 25.8 OCD: 24.0 SUD: 18.0 LD: 15.9 ED: 9.6 Tourette’s: 3.7 Trauma (N = 2): 54.2 (sexual: 29.2, physical: 20.8, sexual or physical: 19.6, emotional: 8.3, neglect: 4.2) |
MDD: 55.2 BD/mania: 44.9 SUD: 31.2 Personality d/o: 11.5 (antisocial), borderline: 7.7 Schizophrenia: 1.1 Suicidality (N = 1): SA: 29.7, SC: 4.7 |
K-SADS (N = 5) Semi-structured clinical interview: (N = 4) NR: (N = 3) M-CIDI: (N = 1) Medical attention needed: (N = 1) |
SI: N = 10 SA: N = 11 Past: SI (N = 7): 57.4 SA (N = 8): 21.3 Current: SI (N = 4): 50.4 SA (N = 2): 25.5 Prospective: SI (N = 1, 42 months): 14.6 SA (N = 4, mean: 42 months): 14.7 |
ADHD = attention-deficit hyperactivity disorder; ANX = anxiety disorder; BD = bipolar disorder; BD-I = bipolar I disorder; BD-II = bipolar II disorder; BD-NOS = bipolar disorder not otherwise specified; CBCL = Child Behavior Checklist; CBQ = Child Bipolar Questionnaire; CD = conduct disorder; C-GAS = Child Global Assessment Scale; CHR = chronic; COBY = Course and Outcome of Bipolar Illness in Youth; CS = cross-sectional study; DEP = depression; d/o = disorder; ED = eating disorder; EPI = episodic; K-SADS (P)=Kiddie-Schedule for Affective Disorders and Schizophrenia (Present Episode Version); LD = learning disorder; LT = longitudinal study; M-CIDI = Munich-Composite International Diagnostic Interview; MDD = major depressive disorder; MDE = major depressive episode; MRS = Mania Rating Scale (KSADS); MS = mixed state; NR = not reported; OAS #11 = Overt Aggression Scale, item #11 (self-harm); OCD = obsessive compulsive disorder; ODD = oppositional defiant disorder; PD = panic disorder; PTSD = posttraumatic stress disorder; PSY = psychosis; SA = suicide attempt; SB = suicidal behavior; SC = suicide completion; SD = standard deviation; SES = socioeconomic status, SI = suicidal ideation; SP = social phobia; SUD = substance use disorder; SXS = symptoms; TRF = Teacher Report Form; YSR = Youth Self-report.
Percentage based on the bipolar disorder (sub)group.
Goldstein et al. 2005 (7) (n = 405), prior sample.
Same sample.
Suicide measure: M-CIDI items for SI: (i) Has there ever been a period of two weeks or more where you thought a lot about death – either your own, someone else’s, or death in general?; (ii) Has there ever been a period of two weeks or more when you felt like you wanted to die?; (iii) Have you ever felt so low that you thought about committing suicide?; (iv) Have you ever made a plan as to how you might do it”. M-CIDI item for SA: Have you ever attempted suicide?.