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Child Psychiatrist /Adult Psychiatrist

Suicide and Other Deaths From Unnatural Causes in Bipolar Disorder


A poster at the 2024 American Psychiatric Association (APA) Annual Meeting discussed the results of a recent meta-analysis that investigated the risk of premature mortality, particularly due to unnatural causes like suicide, among individuals with bipolar disorder compared with the general population.

Bipolar Disorder

According to the poster’s researchers, there is an association between bipolar disorder and premature mortality. Individuals with bipolar disorder face heightened susceptibility to unnatural deaths, predominantly through suicide, alongside other unnatural causes such as homicide and accidents. The study discussed in the poster undertook a meta-analysis of current research findings concerning these unnatural causes, with a specific focus on suicide in bipolar disorder.

Following PRISMA guidelines, the study researchers retrieved relevant data from multiple databases including PubMed, Embase, Web of Science, and PsycINFO. A total of 25 studies on suicide and 17 studies on unnatural causes were included in the analysis, which encompassed 180,210 individuals with bipolar disorder for suicide and 349,744 individuals with bipolar disorder for unnatural causes.

The standardized mortality ratio (SMR) for suicide and unnatural causes was higher in individuals with bipolar disorder compared with the general population. Specifically, the relative risk (RR) for suicide was 11.69, with higher SMR observed in women (17.53) compared with men (14.02). Similarly, the SMR for unnatural causes was 7.29, with higher RR observed in females (9.33) compared with males (6.69). Meta-regression analysis showed no significant influence on results, and publication bias was not observed.

According to the researchers, the study emphasizes the urgent need for suicide prevention efforts, particularly among individuals with bipolar disorder, as suicide remains a leading cause of preventable death in this population. These findings also underscore the importance of addressing suicide risk factors at both the individual and the population levels through clinical interventions and public health policies.

“As supported by the data collected, in agreement with previous literature, bipolar disorder subjects presented elevated mortality from unnatural causes—suicide being the most concerning, as it is the leading cause of preventable death,” the researchers concluded. “Our findings lead to an understanding that an effort to prevent suicide is necessary mainly in high-risk bipolar disorder. Clinicians (individual level) and public health policies (populational level) should address risk factors for suicide.”

Note: This article originally appeared on Psychiatric Times

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