Prospective studies of suicidal behavior in major depressive and bipolar disorders: what is the evidence for predictive risk factors?

OBJECTIVE

Prospective studies over the past 30 years have identified an array of predictive indicators for suicidal acts in mood disorders. However, prediction of suicidal behavior remains an elusive goal. This paper reviewed evidence from prospective studies for clinical factors that elevate risk of suicidal acts in that group.

METHOD: English language prospective studies of suicidal behavior in major depressive and bipolar disorders were examined.

RESULTS

The predictors with the best support were a past history of suicidal behavior and the presence of refractory or recurrent depressions. For other risk factors, there was either not enough data to consider them robust or findings were contradictory.

CONCLUSION

Future studies must not only be comprehensive in their inclusion of potentially contributing factors, but must also address their relative importance towards the goal of developing predictive models and enhance suicide prevention efforts.