Association of recurrent suicidal ideation with nonremission from acute mixed mania.

OBJECTIVE

The authors' goal was to examine suicidality in relation to acute symptom remission in inpatients with mixed and pure bipolar disorder.

METHOD: Using chart review of 184 adult inpatients with bipolar I disorder, the authors assessed patients' past and current suicidality, other psychopathology, treatment, and remission.

RESULTS

Past, current, and recurrent suicidality were significantly more common among patients with mixed mania than among those with pure mania. The probability of remission declined by 49% for every suicide attempt made before the index manic episode. Mixed mania, multiple previous hospitalizations, and previous suicide attempts were significantly associated with current suicidality.

CONCLUSIONS

Suicidality is linked with mixed manic states and may be a clinical marker for recurrent dysphoric mania. Multiple suicide attempts are associated with nonremission from mixed manic episodes.