Suicidal Risk in Bipolar I Disorder Patients and Adherence to Long-Term Lithium Treatment

The association of suicidal acts with adherence to long-term lithium maintenance treatment & other potential risk factors was examined in 72 bipolar I patients followed up prospectively for up to 10 years at a mood disorders research centre in Spain. The observed rates of suicide were 0.143, & of attempts, 2.01%/year, with a 5.2-fold greater risk among patients consistently rated poorly versus highly adherent to lithium prophylaxis. In multivariate analysis, suicidal risk was associated with previous suicidality, poor treatment adherence, more depressive episodes, & younger age. Findings indicate that treatment adherence is a potentially modifiable factor contributing to antisuicidal benefits. (48 refs.)