Prevalence and clinical correlates of lifetime suicide attempts in 2114 patients with bipolar disorder: Findings from a multi-center Asian consortium study

Background Bipolar disorder (BD), a psychiatric condition with significant illness burden, is associated with high suicide risk. To date, there are relatively fewer studies examining clinical factors including psychotropic drug use and dosing associated with suicide attempts in patients with BD, especially within Asia. Methods We conducted a cross-sectional survey across 13 Asian sites on both outpatients and inpatients with BD to examine the prevalence of lifetime suicide attempts and clinical correlates, such as demographic features, treatment setting, and illness characteristics (including illness course, psychotropic drug use and dose). Univariate analysis was performed to identify factors associated with lifetime suicide attempts, and multivariable logistic regression analysis was performed to control for confounders. Results A total of 2114 patients with BD (47.7% male, mean age 42.4 ± 15.2 years) were surveyed, with lifetime suicide attempt rate of 17.2%. Univariate analysis found that lifetime suicide attempts were associated with demographic (younger age, females), illness features (depressed and mixed illness phases, recurrent illness course, depression at illness onset, lifetime rapid cycling), and treatment factors (ECT in past year, antidepressant prescription). Multivariable logistic regression showed that factors associated with lifetime suicide attempt included inpatient status, depressive and mixed phases of BD, presence of rapid cycling in the past year and depression at illness onset. Conclusions Our study noted a significant lifetime suicide attempt rate in BD patients across Asian sites and identified germane clinical factors. This allows for better identification and monitoring of relevant BD patients, allowing for optimisation of care for these individuals.