Study Shows High Rate of Suicidal Ideation among Veterans with Bipolar Disorder
Bipolar disorder is a debilitating, chronic mental illness and, of all psychiatric conditions, is among the strongest risk factors for suicide; bipolar disorder also is linked to increased rates of suicide attempts and suicidal ideation. This naturalistic cohort study examined the impact of current mood and patient perceptions of therapeutic relationships on suicidal ideation in 432 Veterans at one large, urban VA mental health clinic. Investigators examined the impact of patient- and treatment-related factors on suicidal ideation within the two weeks prior to study recruitment, including: current mood (depressed, manic or mixed), patient perceptions of therapeutic relationships (i.e., shared decision-making), suicidal ideation, demographics, hazardous drinking, other mental health symptoms, overall level of functioning, and medication adherence.
Results show that, overall, some suicidal ideation within the past two weeks was reported in 49% of the Veterans. Approximately 32% of the Veterans reported suicidal ideation for several days, 9% reported suicidal ideation more than half of the days, and 8% reported experiencing it nearly every day. Elevated rates of suicidal ideation were found in Veterans who reported drug use, poorer mental health status, and poorer general functioning. After accounting for current mood state and other risk factors, even minimal increases in the extent to which Veterans perceived their therapeutic relationship as collaborative were associated with a reduction in the risk of suicidal ideation. Authors suggest that successful management of suicidal ideation involves a focus on improving symptoms, as well as establishing a collaborative therapeutic relationship.
Ilgen M, Czyz E, Welsh D, Zeber J, Bauer M, and Kilbourne A. A collaborative therapeutic relationship and risk of suicidal ideation in patients with bipolar disorder. Journal of Affective Disorders May 2009;115(1-2):246-251.
This study was funded by HSR&D. Drs. Ilgen and Kilbourne and Ms. Welsh are part of HSR&D’s Center for Clinical Management Research and VA’s National Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI.