Suicide Risk in Bipolar Patients: the Role of Co-Morbid Substance use Disorders

336 subjects with a diagnosis of bipolar I, bipolar II, or schizoaffective disorder (bipolar type) were studied. The Structured Clinical Interview for DSM-OV was administered & subsequently two expert psychiatrists established a diagnosis. Predictors of suicide attempts were examined in attempters & non-attempters. The lifetime rate of suicide attempts for the entire sample was 25.6%. A lifetime co-morbid substance use disorder was a significant predictor of suicide attempts. Bipolar subjects with co-morbid substance use disorders had a 39.5% lifetime rate of attempted suicide while those without had a 23.8% rate. This relationship may have a genetic origin &/or be explained by severity of illness & trait impulsivity. (15 refs.)