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Hauser, Marta; Galling, Britta; Correll, Christoph U

Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates, and targeted interventions

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  • Medientyp: E-Artikel
  • Titel: Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates, and targeted interventions
  • Beteiligte: Hauser, Marta; Galling, Britta; Correll, Christoph U
  • Erschienen: Wiley, 2013
  • Erschienen in: Bipolar Disorders, 15 (2013) 5, Seite 507-523
  • Sprache: Englisch
  • DOI: 10.1111/bdi.12094
  • ISSN: 1398-5647; 1399-5618
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Objective</jats:title><jats:p>Pediatric bipolar disorder (<jats:styled-content style="fixed-case">PBD</jats:styled-content>) is associated with poor outcomes, including suicidal ideation (<jats:styled-content style="fixed-case">SI</jats:styled-content>) and suicide attempt (<jats:styled-content style="fixed-case">SA</jats:styled-content>). However, frequencies and risk factors of <jats:styled-content style="fixed-case">SI</jats:styled-content>/<jats:styled-content style="fixed-case">SA</jats:styled-content> and targeted intervention trials for <jats:styled-content style="fixed-case">SI</jats:styled-content>/<jats:styled-content style="fixed-case">SA</jats:styled-content> in <jats:styled-content style="fixed-case">PBD</jats:styled-content> have not been reviewed systematically.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a systematic PubMed review, searching for articles reporting on prevalences/incidences, correlates and intervention studies targeting <jats:styled-content style="fixed-case">SI</jats:styled-content>/<jats:styled-content style="fixed-case">SA</jats:styled-content> in <jats:styled-content style="fixed-case">PBD</jats:styled-content>. Weighted means were calculated, followed by an exploratory meta‐regression of <jats:styled-content style="fixed-case">SI</jats:styled-content> and <jats:styled-content style="fixed-case">SA</jats:styled-content> correlates.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Fourteen studies (n = 1595), in which 52.1% of patients were male and the mean age was 14.4 years, reported data on <jats:styled-content style="fixed-case">SI</jats:styled-content>/<jats:styled-content style="fixed-case">SA</jats:styled-content> prevalence (N = 13, n = 1508) and/or correlates (N = 10, n = 1348) in <jats:styled-content style="fixed-case">PBD</jats:styled-content>. Weighted mean prevalences were: past <jats:styled-content style="fixed-case">SI</jats:styled-content> = 57.4%, past <jats:styled-content style="fixed-case">SA</jats:styled-content> = 21.3%, current <jats:styled-content style="fixed-case">SI</jats:styled-content> = 50.4%, and current <jats:styled-content style="fixed-case">SA</jats:styled-content> = 25.5%; incidences (mean 42 months of follow‐up) were: <jats:styled-content style="fixed-case">SI</jats:styled-content> = 14.6% and <jats:styled-content style="fixed-case">SA</jats:styled-content> = 14.7%. Regarding significant correlates, <jats:styled-content style="fixed-case">SI</jats:styled-content> (N = 3) was associated with a higher percentage of <jats:styled-content style="fixed-case">C</jats:styled-content>aucasian race, narrow (as opposed to broad) <jats:styled-content style="fixed-case">PBD</jats:styled-content> phenotype, younger age, and <jats:italic>higher quality of life than <jats:styled-content style="fixed-case">SA</jats:styled-content></jats:italic>. Significant correlates of <jats:styled-content style="fixed-case">SA</jats:styled-content> (N = 10) included female sex, older age, earlier illness onset, more severe/episodic <jats:styled-content style="fixed-case">PBD</jats:styled-content>, mixed episodes, comorbid disorders, past self‐injurious behavior/<jats:styled-content style="fixed-case">SI</jats:styled-content>/<jats:styled-content style="fixed-case">SA</jats:styled-content>, physical/sexual abuse, parental depression, family history of suicidality, and poor family functioning. Race, socioeconomic status, living situation, and life events were not clearly associated with <jats:styled-content style="fixed-case">SA</jats:styled-content>. In a meta‐regression analysis, bipolar I disorder and comorbid attention‐deficit hyperactivity disorder were significantly associated with <jats:styled-content style="fixed-case">SA</jats:styled-content>. Only one open label study targeting the reduction of <jats:styled-content style="fixed-case">SI</jats:styled-content>/<jats:styled-content style="fixed-case">SA</jats:styled-content> in <jats:styled-content style="fixed-case">PBD</jats:styled-content> was identified.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p><jats:styled-content style="fixed-case">SI</jats:styled-content> and <jats:styled-content style="fixed-case">SA</jats:styled-content> are very common but under‐investigated in <jats:styled-content style="fixed-case">PBD</jats:styled-content>. Exploration of predictors and protective factors is imperative for the establishment of effective preventive and intervention strategies, which are urgently needed.</jats:p></jats:sec>