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Symptom trajectories in the months before and after a suicide attempt in individuals with bipolar disorder: A STEP-BD study

Bipolar Disorders Dec 14, 2019

Ballard ED, Farmer CA, Shovestul B, et al. - Given that the suicide crisis is a comparatively short-lived psychiatric emergency, with temporary symptoms that ebb and flow around the suicide attempt, researchers sought to determine the dynamic processes of symptoms before and after suicide attempt as these may support future prevention efforts. Among 4,360 patients with bipolar disorder from the NIMH STEP-BD study, they identified a subset that attempted suicide during the trial. They assessed suicidal ideation (SI) ratings from 216 individuals (n = 1,231 total; n = 395 preattempt, n = 126 circa-attempt, n = 710 postattempt) and compared these to data from a matched sample of 648 non-attempters. During the 120 days preattempt, they observed worsening of SI, however, it improved afterward, touching non-attempter levels by 90 days postattempt. They discovered a similar pattern for other depressive symptoms, including depressed mood, loss of interest, guilt, and self-esteem. The findings highlight that individuals with bipolar disorder continue to exhibit elevated some SI and affective/cognitive symptoms of depression up to 90 days postattempt.
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