From the Guidelines
People with bipolar disorder have a significantly higher suicide risk compared to the general population, with a likelihood of dying by suicide approximately 8.66 times higher than that of the general population, as reported in a recent meta-analysis 1. The suicide rate for individuals with bipolar disorder is significantly higher than that of the general population.
- Lifetime suicide risk for those with bipolar disorder is substantially increased, with some studies suggesting a risk 8-10 times higher than the general population 1.
- This elevated risk is particularly high during depressive episodes and mixed states where depressive symptoms occur alongside manic features.
- Factors that contribute to this increased risk include:
- Severity of depressive episodes
- Rapid cycling between mood states
- Comorbid substance use disorders
- Anxiety disorders
- Previous suicide attempts
- Comprehensive treatment with mood stabilizers like lithium (which has specific anti-suicidal properties), valproate, or lamotrigine, combined with psychotherapy, regular monitoring, and development of safety plans can significantly reduce this risk 1.
- Early intervention and continuous treatment adherence are crucial for suicide prevention in bipolar disorder.
- The risk is also higher early in the course of illness and during periods of transition in treatment, emphasizing the need for close monitoring and adjustment of treatment plans as necessary 1.
From the Research
Suicide Rate in Bipolar Disorder
The suicide rate in patients with bipolar disorder is significantly higher compared to the general population.
- Studies have shown that the suicide rate in bipolar disorder is approximately 60 times higher than the international population rate 2.
- Another study found that the suicide rate in bipolar disorder is around 20-30 times higher than that of the general population 3.
- The estimated 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 bipolar disorder 4.
Comparison of Suicide Rates
The comparison of suicide rates between bipolar disorder patients and the general population is as follows:
- A study estimated that 25% to 50% of patients with bipolar disorder will attempt suicide at least once over their lifetime, and that 8% to 19% will complete suicide 5.
- Another study found that up to 20% of untreated bipolar disorder subjects end their life by suicide, and 20-60% of them attempt suicide at least once in their lifetime 6.
Risk Factors
Several risk factors are associated with an increased risk of suicide in bipolar disorder, including:
- Previous suicidal acts, depression, mixed-agitated-dysphoric moods, rapid mood-shifts, impulsivity, and co-occurring substance abuse 4.
- Younger age of onset of the illness, history of past suicidal behavior, family history of suicide acts, comorbid borderline personality disorder, and substance use disorders 5.
- Male gender, living alone, divorced, no children, Caucasian, younger age (< 35 years), elderly age (> 75 years), unemployment, and a personal history of suicide attempt and family history of suicide attempt or suicide completion 3.