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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. Am J Psychiatry 1998; 155: 1753-1755

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