Suicide Attempts in Patients With Bipolar I Disorder During Acute and Maintenance Phases of Intensive Treatment With Pharmacotherapy and Adjunctive Psychotherapy

• DOI: 10.1176/appi.ajp.159.7.1160
• Publication Date: 2002-10-11T18:30:25Z
• Authors: Paola Rucci; Ellen Frank; Bryan Kostelnik; Andrea Fagiolini; Alan G. Mallinger; Holly A. Swartz; Michael E. Thase; Lori Siegel; Dorothy Wilson; David J. Kupfer
• Keywords: Pharmacotherapy; Maintenance therapy

OBJECTIVE: Lifetime rates of suicide attempts among patients with bipolar I disorder were compared to during a 2-year period intensive treatment pharmacotherapy and one two adjunctive psychosocial interventions. METHOD: Subjects entered the study an acute mood episode. treated primarily lithium either psychotherapy specific disorder, which included help in regularizing daily routines, or nonspecific, clinical management involving regular visits empathic clinicians. Data on prior obtained retrospectively from interviews NIMH-Life-Chart method. trial collected systematically throughout protocol. RESULTS: The rate was 1.05 per 100 person-months before trial. Patients experienced threefold reduction phase (until patient achieved stabilization, defined by completion 4 weeks had mean score ≤7 17-item Hamilton Depression Rating Scale Bech-Rafaelsen Mania Scale) 17.5-fold maintenance treatment. Poisson loglinear regression analysis modeling relationship between observed three protocol stages (pretreatment, acute, maintenance) showed that reductions significant phases, pretreatment phase. No more entering attempted CONCLUSIONS: A program maximally supportive environment can significantly reduce suicidal behavior high-risk disorder.