The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study
Abstract Background This study sought to examine the association between prospective suicidal behavior and variability, intensity, and persistence of suicidal ideation (SI) in bipolar disorder (BD). Methods Data were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-07-01
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| Series: | International Journal of Bipolar Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40345-022-00263-7 |
| _version_ | 1811328825332596736 |
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| author | Bartholt Bloomfield-Clagett Dede K. Greenstein Carlos A. Zarate Elizabeth D. Ballard |
| author_facet | Bartholt Bloomfield-Clagett Dede K. Greenstein Carlos A. Zarate Elizabeth D. Ballard |
| author_sort | Bartholt Bloomfield-Clagett |
| collection | DOAJ |
| description | Abstract Background This study sought to examine the association between prospective suicidal behavior and variability, intensity, and persistence of suicidal ideation (SI) in bipolar disorder (BD). Methods Data were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a naturalistic study of 4360 outpatients 15 years or older with BD. In separate models, logistic regressions with suicidal behavior (first attempt or death by suicide) as the outcome variable and SI variability (fluctuating levels of SI over time, measured as ordinal dispersion of SI score), intensity (median SI score over time in study), or persistence (number of visits with reported SI) as the explanatory variables were used to examine the relationship between SI characteristics and odds of future suicidal behavior events. Results After adjusting for possible confounders, the odds of prospective suicidal behavior were 1.2 times greater per 10% increase in SI variability. SI persistence was not associated with suicidal behavior. For SI intensity, a median SI score of ‘rare/fleeting’ or ‘several days’ of SI was not associated with suicidal behavior, but the odds of prospective suicidal behavior were nearly five times greater for participants with the highest observed median SI intensity score of ‘nearly every day’. Conclusions The findings suggest that, in BD participants, monitoring SI variability may be clinically useful for assessing suicide risk. |
| first_indexed | 2024-04-13T15:31:50Z |
| format | Article |
| id | doaj.art-243b0d7f682d456e8a875091cd59329c |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-04-13T15:31:50Z |
| publishDate | 2022-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-243b0d7f682d456e8a875091cd59329c2022-12-22T02:41:21ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112022-07-011011810.1186/s40345-022-00263-7The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) studyBartholt Bloomfield-Clagett0Dede K. Greenstein1Carlos A. Zarate2Elizabeth D. Ballard3Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of HealthExperimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of HealthExperimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of HealthExperimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of HealthAbstract Background This study sought to examine the association between prospective suicidal behavior and variability, intensity, and persistence of suicidal ideation (SI) in bipolar disorder (BD). Methods Data were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a naturalistic study of 4360 outpatients 15 years or older with BD. In separate models, logistic regressions with suicidal behavior (first attempt or death by suicide) as the outcome variable and SI variability (fluctuating levels of SI over time, measured as ordinal dispersion of SI score), intensity (median SI score over time in study), or persistence (number of visits with reported SI) as the explanatory variables were used to examine the relationship between SI characteristics and odds of future suicidal behavior events. Results After adjusting for possible confounders, the odds of prospective suicidal behavior were 1.2 times greater per 10% increase in SI variability. SI persistence was not associated with suicidal behavior. For SI intensity, a median SI score of ‘rare/fleeting’ or ‘several days’ of SI was not associated with suicidal behavior, but the odds of prospective suicidal behavior were nearly five times greater for participants with the highest observed median SI intensity score of ‘nearly every day’. Conclusions The findings suggest that, in BD participants, monitoring SI variability may be clinically useful for assessing suicide risk.https://doi.org/10.1186/s40345-022-00263-7SuicideSuicidal ideationBipolar disorderAffective instability |
| spellingShingle | Bartholt Bloomfield-Clagett Dede K. Greenstein Carlos A. Zarate Elizabeth D. Ballard The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study International Journal of Bipolar Disorders Suicide Suicidal ideation Bipolar disorder Affective instability |
| title | The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study |
| title_full | The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study |
| title_fullStr | The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study |
| title_full_unstemmed | The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study |
| title_short | The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study |
| title_sort | association between variability intensity and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder step bd study |
| topic | Suicide Suicidal ideation Bipolar disorder Affective instability |
| url | https://doi.org/10.1186/s40345-022-00263-7 |
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