Suicide and Bipolar Disorder

Suicide, which is both a stereotypic yet highly individualized act, is a common endpoint formany patients with severe psychiatric illness. The mood disorders (depression and bipolar manic-depression)are by far the most common psychiatric conditions associated with suicide. At least 25%to 50% of patients with bipolar disorder also attempt suicide at least once. With the exception of lithium—which is the most demonstrably effective treatment against suicide—remarkably little is knownabout specific contributions of mood-altering treatments to minimizing mortality rates in persons withmajor mood disorders in general and bipolar depression in particular. Suicide is usually a manifestationof severe psychiatric distress that is often associated with a diagnosable and treatable form of depressionor other mental illness. In a clinical setting, an assessment of suicidal risk must precede anyattempt to treat psychiatric illness.