Abstract : Background: Bipolar
disorder (BD) is a chronic, lifelong condition, associated with
increased risk of obesity, cognitive impairment, and suicidal behaviors.
Abdominal obesity and a higher risk of violent suicide attempt (SA)
seem to be shared correlates with older age, BD, and male sex until
middle age when menopause-related female body changes occur. This study
aimed at assessing the role of abdominal obesity and cognition in the
violent SA burden of individuals with BD.
Methods: From the well-defined nationwide cohort FACE-BD (FondaMental
Advanced center of Expertise for Bipolar Disorders), we extracted data
on 619 euthymic BD patients that were 50 years or older at inclusion.
Cross-sectional clinical, cognitive, and metabolic assessments were
performed. SA history was based on self-report.
Results: Violent SA, in contrast to non-violent and no SA, was
associated with higher waist circumference, abdominal obesity and poorer
California Verbal Learning Test short-delay free recall (CVLT-SDFR)
(ANOVA, p < .001, p = .014, and p = .006). Waist circumference and
abdominal obesity were associated with violent SA history independently
of sex, BD type and anxiety disorder (Exp(B) 1.02, CI 1.00-1.05, p =
.018; Exp(B) 2.16, CI 1.00-4.64, p = .009, accordingly). In an
exploratory model, waist circumference and CVLT-SDFR performance
mediated the association between male sex and violent SA.
Limitations: Cross-sectional design and retrospective reporting.
Conclusions: Violent SA history was associated with abdominal obesity
and poorer verbal memory in older age BD patients. These factors were
interlinked and might mediate the association between male sex and
violent SA.
Soumis le : mardi 12 octobre 2021 -