Atypical depression is associated with suicide attempt in bipolar disorder

Suicidal behaviour is a major complication ofbipolar disorder. Between 30% and 50% of bipolarpatients may attempt suicide in their lifetime (1, 2).Previous studies have reported a higher odds ratiofor lifetime history of suicide in bipolar patients incomparison with patients with any other psychiat-ric disorder (2–5). Although recent investigationshave described sustained reductions of death bysuicide (6), suicide-related morbidity in terms ofmedical consequences, impairment of quality of lifeSa´nchez-Gistau V, Colom F, Mane´A, Romero S, Sugranyes G, Vieta E.Atypical depression is associated with suicide attempt in bipolardisorder.Objective: There is a dearth of research focusing on factors associatedwith suicide attempts. High rates of atypical depression have beenreported in studies including unipolar and bipolar II patients. In thisstudy, the association between suicide attempt and atypical depression,in addition to other major risk factors, was evaluated in 390 bipolar Iand II out-patients.Method: Variables were defined according to DSM-IV criteria, andassessed with a Structured Interview for DSM-IV (axis I and II).History of suicide attempt was obtained through interviews withpatients and relatives. Attempters and non-attempters were comparedusing univariate and multivariate analysis.Results: Attempters showed significantly higher rates of atypicaldepression, family history of completed suicide, depression at indexepisode and cluster B personality disorder.Conclusion: Our results highlight the relevance of atypical depressionin bipolar disorder. A more accurate identification of potentialattempters may contribute to the development of effective preventivetreatment strategies.