MedWire News: Patients with bipolar II disorder are as likely as those with bipolar I disorder to attempt suicide, study findings show.

These findings highlight the need for treatment guidelines for the management of acute and long-term suicide risk to be directed at both patients with bipolar I and bipolar II disorders, say Danielle Novick and colleagues, from the University of Pittsburgh in Pennsylvania, USA.

Until now most treatment guidelines have directed the management of suicide risk at bipolar I disorder, which the researchers say is partly due to researchers and clinicians having viewed bipolar II disorder as a milder, less lethal condition compared with bipolar I disorder.

“This review provides evidence to the contrary,” they write in the journal Bipolar Disorders.

The researchers conducted a literature review of published reports on suicide attempts in individuals with bipolar I or bipolar II disorder.

They identified 24 reports that gave rates of suicide attempt in 1623 patients with bipolar II disorder and 21 that gave rates for 4899 patients with either bipolar I or bipolar II disorder patients.

Among the 24 reports, 18 had a retrospective design and three a prospective design, while the remaining three had descriptive designs.

Overall, 32.4% of bipolar II disorder patients studied retrospectively reported a lifetime history of suicide attempt, 19.8% prospectively studied reported suicide attempt, and 20.5% of first-time suicide attempters were diagnosed with bipolar II disorder.

The researchers describe this contribution of bipolar II disorder to suicide attempt as “considerable.”

Moreover, a meta-analysis of pooled findings for patients with bipolar I or bipolar II disorder showed that bipolar II disorder patients had a similar risk for suicide attempt as those with bipolar I disorder, at 32.4% and 36.3%, respectively.

“Individuals with bipolar II disorder are at marked risk for attempting suicide,” say Novick et al.

“This finding is particularly alarming considering the predictive role of suicide attempt for completed suicide and the use of violent and lethal methods among individuals with bipolar II disorder.”

The researchers conclude: “To reduce suicide-related morbidity and mortality, routine clinical care for bipolar II disorder must include ongoing risk assessment and interventions targeted at risk factors.”

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