Suicidality in bipolar affective disorder the nature of impulsivity and impulse control disorders - a cross sectional controlled study
Thangavelu, Karthik Morriss, Richard K. Howard, Richard C.
Thangavelu, Karthik
Morriss, Richard K.
Howard, Richard C.
Abstract
Patients with bipolar disorder have a higher risk of committing suicide(15-20%) Poor impulse control might be the mechanism by which suicidality may become manifest in bipolar disorder. Aims: To determine the nature of poor impulse control and suicidal behaviour. To understand the relationship between poor impulse control,co-morbid diagnosis and suicidal behaviour in patients with bipolar disorder. Method: A cross sectional study was carried out in 40 patients with bipolar disorder. Clinical parameters were established using semi-structured interview, co-morbid diagnosis and impulse control disorders using SCID. All completed impulsivity questionnaire (UPPS) and Suicidal behaviour questionnaire (SBQ). ANOVA and Pearsons correlation was performed. Results: There was high degree of co-morbidity (55 % anxiety, 30% substance use, 13% personality disorder and 47 % impulse control disorder). 45% did not have a past history of self harm, 40% had history of less severe self harm and 15%had near fatal self harm history.The sample mean showed significant difference compared to population mean ( P< 0.05) with marked difference noted for near fatal self harm group (P< 0.01) indicating that patients with bipolar disorder might have a high degree of trait impulsivity.The three items on impulsivity scale-lack of premeditation, urgency and lack of perseverance correlated significantly (P< 0.01) with the future likelihood of dying. Conclusion: This study supports the view that there is a high degree of suicidal behaviour in bipolar disorder.15% of the sample had past history of near-fatal self harm.High scores of trait impulsivity in sample are akin to scores for patients with borderline personality and addiction. There is a clear correlation between impulsivity scores and future risk of completed suicide.
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Date
2012
Type
Conference Proceeding
Subject
Bipolar disorder, Suicide
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Citation
Thangavelu, K., Morriss, R. K. & Howard, R. C. (2012). Suicidality in bipolar affective disorder the nature of impulsivity and impulse control disorders - a cross sectional controlled study. In: Fiorillo, A., Frangou, S. & Heun, R., (Eds.) 20th European Congress of Psychiatry, 3-6 March 2012 Prague, Czech Republic. Paris: European Psychiatry, p.1.