Table 3.
Sociodemographic and bipolar disorder characteristics associated with suicide attempts and suicidal ideation in youth with pediatric bipolar disorder
| Study | Sociodemographic characteristics | Bipolar disorder characteristics | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Age | Sex | Race | SES | Living situation: with both parents |
Age of onset | BD subtype | Mixed episode |
Symptom/illness severity | |
| Cross-sectional studies | |||||||||
| Algorta et al. 2011 (50) |
SA older than SI and non-SI group (13.6 > 10.5 and > 11.0 years, p < 0.005) |
SA versus non-SA: females (r = 0.24, p < 0.01) |
SI versus non-SI: White > others (p <0.01) SA versus non- SA: Hispanic and African American > White (< 0.05) |
NR | NR | NR | SA: ns | SA > non-SA: mixed episode (p = 0.02) |
SA > non-SA: depression (CDRS-R) (p <0.005) SA = non-SA: mania (YMRS) |
| Bhangoo et al. 2003 (51) |
NR | NR | NR | NR | NR | NR | SA versus non-SA: episodic (47%) > chronic (15%), p = 0.001 |
NR | NR |
| Bronisch et al. 2005 (52) |
NR | NR | NR | NR | NR | NR |
CS: SI: mania = hypomania (OR = 2.4, CI: 0.8–6.4) CS: SA: mania = hypomania (OR = 3.3, CI :0.7–13.4) LT: SI: mania = hypomania (OR = 1.9, CI: 0.7–4.8) LT: SA: mania = hypomania (OR = 2.3, CI: 0.5–9.6) |
NR | NR |
| Dickstein et al. 2005 (54) |
NR | NR | NR | NR | NR | NR | SI versus non-SI: BD (93.5%) > EMDYS (56.3%), p = 0.002 SA versus non-SA: BD (64.5%) > EMDYS (6.3%), p = 0.0001 |
NR | NR |
| Dilsaver et al. 2005 (55) |
NR | SA versus non-SA: female > male (p < 0.001) SI versus non-SI: female > male (p = 0.004) |
NR | NR | NR | NR | NR | NR | NR |
| Friedman et al. 1984 (57) |
NR | NR | NR | NR | NR | SA earlier mania than non-SA: (11.0 versus 15.2 years, p < 0.05) |
NR | NR | NR |
| Goldstein et al. 2005 (7) Goldstein et al. 2012 (8) |
SA older than non-SA group (13.7 versus 12.3, p = 0.001) |
SA = non- SA (52% female versus 53% male, ns) |
SA = non-SA (85% versus 83% Caucasian, ns) |
SA = non-SA (3.5 versus 3.4, ns) |
SA = non-SA (40% versus 45%, ns) |
SA earlier illness onset than non-SA (35% versus 25%) |
SA > non-SA: BD-I > BD-NOS (p = 0.002) |
SA > non-SA: (38% versus 19%, p <0.001) |
SA > non-SA: Psychosis (44% versus 27%, p = 0.001 Hospitalization: 75% versus 45%, p <0.001 |
| Merikangas et al. 2012 (59) |
NR | NR | NR | NR | NR | NR | NR | SA = non-SA: Hypo/mania + MDD: 21.9 % MDD: 16.3% Only mania: 7.4% |
NR |
| Rucklidge 2006 (60) |
NR | NR | NR | NR | NR | NR | NR | NR | SA > non-SA: Hopelessness (p < 0.001) External locus of control (p <0.01) Low self-esteem (p < 0.05) More difficulties regulating anger (p < .05) |
| Longitudinal studies | |||||||||
| Bronisch et al. 2005 (52) |
NR | NR | NR | NR | NR | NR | SI: mania = hypomania (OR = 1.9, CI: 0.7–4.8) SA: mania = hypomania (OR = 2.3, CI: 0.5–9.6) |
NR | NR |
| Goldstein et al. 2005 (7) Goldstein et al. 2012 (8) |
SA = non- SA, ns |
SA versus non-SA: females (p = 0.03) |
SA = non-SA (85% versus 83% Caucasian, ns) |
NR | SA = non-SA (40% versus 45%, ns) |
NR | SA = non-SA (BD-I, II, NOS, ns) |
SA versus non-SA: (p = 0.18, ns) |
SA > non-SA: C-GAS past (p = 0.009) SA = non-SA: depression (p = 0.001); psychosis (ns) |
| Totals | SI: younger than SA (1/1 study, 100%) SA versus non-SA: older age (CS: 2/2 studies, 100%; LT: 1/1 study, 100%) |
SI: females (1/1 study, 100%) SA: females (3/4 studies, 75.0%) |
SI: Caucasian (1/1 study, 100%) SA: non- Caucasian (1/2 studies CS and 0/1 study, 0% LT) |
SA: no effect (1/1 study, 100%) |
SA: no effect both CS and LT (1/1 study, 100%) |
SA: earlier mania and illness onset (2/2 studies, 100%) |
SI: more severe subtype (1/2 studies, 50%), not LT (0/1 study, 0%) SA: more severe/episodic subtype (3/5 studies, 60.0%) CS; not LT (0/2 studies 0%) |
SA: mixed episode (2/3 studies, 66.7%) CS, not LT (1/1 study, 100%) |
SA: CS (all 1/1 study, 100%): depression, psychosis, hospitalization, hopelessness, external locus of control, low self- esteem, more difficulties regulating anger LT past functioning rating (1/1, 100%) |
BD = bipolar disorder; BD-I = bipolar I disorder; BD-NOS = bipolar disorder not otherwise specified; CDRS-R = Child Depression Rating Scale-Revised; C-GAS = Child Global Assessment Scale; CI = confidence interval; CS = cross-sectional; EMDYS = emotional dysregulation (broad bipolar phenotype with chronic irritability and without euphoria or grandiosity); LT = longitudinal; MDD = major depressive disorder; NR = not reported; ns = not significant; OR = odds ratio; SA = suicide attempt; SES = socioeconomic status; SI = suicidal ideation; YMRS = Young Mania Rating Scale.