vendredi 27 février 2015

RECHERCHE INTERNATIONALE Identification du risque de suicidaire dans le trouble bipolaire

Commentaires sur l'étude Schaffer A, Isometsä ET, Tondo L et al. International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disord 

 Identification of suicide risk in bipolar disorder
Jorge Lopez-Castroman1,2, Philippe Courtet1,3, Enrique Baca-Garcia2,4 and Maria A Oquendo4,*
dans Bipolar Disorders Volume 17, Issue 1, pages 22–23, February 2015

Author Information

1 Department of Emergency Psychiatry, CHRU Montpellier, Montpellier, France
2
IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain3University of Montpellier 1, Montpellier, France
4 Department of Psychiatry, New York State Psychiatric Institute and Columbia  University, New York, NY, USA*
Corresponding author:
  Maria A. Oquendo, M.D.  Department of Psychiatry  Columbia University New York State Psychiatric Unit #88  1051 Riverside Drive, Box #42
New York, NY 10032 USA  Fax: 212-543-6017  E-mail: mao4@columbia.edu

L'étude commentée
International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder
Ayal Schaffer1,*, Erkki T Isometsä2,  Leonardo Tondo3,4,  Doris H Moreno5, Gustavo Turecki6,  Catherine Reis1,  Frederick Cassidy7,  Mark Sinyor1,  Jean-Michel Azorin8,  Lars Vedel Kessing9,  Kyooseob Ha10,  Tina Goldstein11,  Abraham Weizman12,
Annette Beautrais13,  Yuan-Hwa Chou14,  Nancy Diazgranados15,  Anthony J Levitt1,  Carlos A Zarate Jr16,  Zoltán Rihmer17 and Lakshmi N Yatham18
Dans Bipolar Disorders  Volume 17, Issue 1, pages 1–16, February 2015
Author Information
1 Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Toronto, ON, Canada 
2 Department of Psychiatry, University of Helsinki, Helsinki, Finland
3 Lucio Bini Center, Cagliari, Italy
4 Harvard Medical School, McLean Hospital, Boston, MA, USA
5 Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
6 Departments of Psychiatry, Human Genetics, and Neurology & Neurosurgery, McGill University, Montreal, QC, Canada
7 Department of Psychiatry and Behavioural Sciences, Duke University, Durham, NC, USA
8 Department of Psychiatry, University of Aix-Marseille II, Marseille, France
9 Faculty of Health Sciences, University of Copenhagen, Psychiatric Center Copenhagen Department, Copenhagen, Denmark
10 Department of Psychiatry, Seoul National University, Bundang Hospital, Seoul, Korea
11 Department of Child and Adolescent Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
12 Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
13 Department of Emergency Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
14 Department of Psychiatry, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan
15 National Institute of Alcohol Abuse and Alcoholism
16 National Institute of Mental Health, Bethesda, MD, USA
17 Department of Clinical and Theoretical Mental Health and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary
18 Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
* Corresponding author:  Ayal Schaffer, M.D., F.R.C.P.C.  Mood and Anxiety Disorders Program Department of Psychiatry  Sunnybrook Health Sciences Centre  2075 Bayview Avenue, Room FG 52 Toronto, ON  Canada M4N 3M5  Fax: 416-480-4613  E-mail: ayal.schaffer@sunnybrook.ca

1.      Partial findings were presented during the symposia at the 16th Annual Conference of the International Society for Bipolar Disorders, Seoul, South Korea, 18–21 March 2014.
Objectives
Bipolar disorder is associated with a high risk of suicide attempts and suicide death. The main objective of the present study was to identify and quantify the demographic and clinical correlates of attempted and completed suicide in people with bipolar disorder.
Methods
Within the framework of the International Society for Bipolar Disorders Task Force on Suicide, a systematic review of articles published since 1980, characterized by the key terms bipolar disorder and ‘suicide attempts’ or ‘suicide’, was conducted, and data extracted for analysis from all eligible articles. Demographic and clinical variables for which ≥ 3 studies with usable data were available were meta-analyzed using fixed or random-effects models for association with suicide attempts and suicide deaths. There was considerable heterogeneity in the methods employed by the included studies.
Results  Variables significantly associated with suicide attempts were: female gender, younger age at illness onset, depressive polarity of first illness episode, depressive polarity of current or most recent episode, comorbid anxiety disorder, any comorbid substance use disorder, alcohol use disorder, any illicit substance use, comorbid cluster B/borderline personality disorder, and first-degree family history of suicide. Suicide deaths were significantly associated with male gender and first-degree family history of suicide.
Conclusions  This paper reports on the presence and magnitude of the correlates of suicide attempts and suicide deaths in bipolar disorder. These findings do not address causation, and the heterogeneity of data sources should limit the direct clinical ranking of correlates. Our results nonetheless support the notion of incorporating diagnosis-specific data in the development of models of understanding suicide in bipolar disorder.

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