The effect of emotional dysregulation and impulsivity on suicidality in patients with bipolar disorder

Background: We aimed to evaluate the effect of emotional dysregulation and impulsivity on suicidality in patients with bipolar disorder by comparing patients with bipolar disorder with healthy individuals. Subjects and methods: The study included 85 patients (59 women, 26 men) with bipolar disorder and education and age matched 65 (44 women, 21 men) healthy volunteers. The patient group was separated into 3 different groups if they have a suicide attempt history, or have suicidal ideation without attempt, or have neither suicide attempt nor ideation. Sociodemographic Form, The Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale (BIS-11),  Scale for Suicidal Ideation, Suicide Behaviors Questionnaire scales were applied to the participants. Results: Patients with bipolar disorder (n=85) had significantly higher scores for emotion dysregulation and impulsivity than the healthy controls (p<0.001, p<0.001). The scores of DERS, BIS-11, Suicidal ideation, and Suicide behavior  scores were significantly correlated. DERS Total and BIS Total scores of bipolar patients with suicide attempts were significantly higher than bipolar patients with suicidal ideation and bipolar patients with neither attempt nor ideation.  According to the hierarchical regression analysis, strategies, clarity, and non-planning impulsiveness were found as the predictors of suicidal ideation in bipolar patients. Conclusions: Suicidal behavior has a significant relationship between emotional dysregulation and impulsivity in patients with BD. Clinicians must carefully evaluate emotional dysregulation and impulsivity among this population to  develop treatment strategies in suicide prevention.