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Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms : A naturalistic study

Eberhard, Jonas LU and Weiller, Emmanuelle (2016) In Neuropsychiatric Disease and Treatment 12. p.2265-2271
Abstract

Purpose: Patients with a bipolar I disorder (BD-I) manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), criteria for "with mixed features" have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA) symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study. Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 "with mixed features" specifier, the severity of AIA symptoms, the frequency and... (More)

Purpose: Patients with a bipolar I disorder (BD-I) manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), criteria for "with mixed features" have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA) symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study. Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 "with mixed features" specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts. Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6%) met the criteria for the DSM-5 "with mixed features" specifier (three or more depressive symptoms). These patients were further stratified according to the severity of their AIA symptoms: "mild AIA" (zero or one AIA symptom above a severity threshold; 105 patients) or "severe AIA" (all three AIA symptoms above a severity threshold; 167 patients). A greater incidence of suicidal ideation was observed in the severe AIA group (71.9%) than in the mild AIA group (47.6%). Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P,0.05) and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively). Conclusion: The high risk of suicide among BD-I mania patients with depressive symptoms is further increased when they experience severe AIA symptoms. Recognizing AIA symptoms in BD-I mania could provide a means of identifying patients with depressive symptoms, as well as those who may be suicidal, thereby allowing for appropriate, tailored treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bipolar i disorder, DSM-5, Mania with depressive symptoms, Mixed features, Suicide
in
Neuropsychiatric Disease and Treatment
volume
12
pages
2265 - 2271
publisher
Dove Press
external identifiers
  • Scopus:84987703605
ISSN
1176-6328
DOI
10.2147/NDT.S111094
language
English
LU publication?
yes
id
2c2cf845-eeee-4538-9ae2-ed759ea922dd
date added to LUP
2016-10-06 10:10:11
date last changed
2016-10-07 03:00:02
@misc{2c2cf845-eeee-4538-9ae2-ed759ea922dd,
  abstract     = {<p>Purpose: Patients with a bipolar I disorder (BD-I) manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), criteria for "with mixed features" have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA) symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study. Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 "with mixed features" specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts. Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6%) met the criteria for the DSM-5 "with mixed features" specifier (three or more depressive symptoms). These patients were further stratified according to the severity of their AIA symptoms: "mild AIA" (zero or one AIA symptom above a severity threshold; 105 patients) or "severe AIA" (all three AIA symptoms above a severity threshold; 167 patients). A greater incidence of suicidal ideation was observed in the severe AIA group (71.9%) than in the mild AIA group (47.6%). Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P,0.05) and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively). Conclusion: The high risk of suicide among BD-I mania patients with depressive symptoms is further increased when they experience severe AIA symptoms. Recognizing AIA symptoms in BD-I mania could provide a means of identifying patients with depressive symptoms, as well as those who may be suicidal, thereby allowing for appropriate, tailored treatment.</p>},
  author       = {Eberhard, Jonas and Weiller, Emmanuelle},
  issn         = {1176-6328},
  keyword      = {Bipolar i disorder,DSM-5,Mania with depressive symptoms,Mixed features,Suicide},
  language     = {eng},
  month        = {08},
  pages        = {2265--2271},
  publisher    = {ARRAY(0xa0b3a70)},
  series       = {Neuropsychiatric Disease and Treatment},
  title        = {Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms : A naturalistic study},
  url          = {http://dx.doi.org/10.2147/NDT.S111094},
  volume       = {12},
  year         = {2016},
}