Substance use Disorders and Suicide Attempts in Bipolar Subtypes

The authors studied previous suicidal behaviour in adults with a major depressive episode in context of bipolar disorder type I or bipolar disorder type II, with & without history of substance use disorders. Substance use disorders were associated with suicide attempt in bipolar disorder-I but not bipolar disorder-II, an effect not attributable to sample size differences. The higher suicide attempt rate associated with alcoholism in bipolar disorder-I was mostly explained by higher aggression scores. The attempt rate associated with other drug disorders in bipolar disorder-I was collectively explained by higher impulsivity, hostility, & aggression scores. The presence of both alcohol & drug use disorders increased odds of a history of suicide attempt in a multiplicative fashion. (73 refs.)