TY - JOUR
T1 - Mood, Dimensional Personality, and Suicidality in a Longitudinal Sample of Patients with Bipolar Disorder and Controls
AU - Kamali, Masoud
AU - Saunders, Erika F.H.
AU - Assari, Shervin
AU - Ryan, Kelly A.
AU - Marshall, David F.
AU - McInnis, Melvin G.
N1 - Funding Information:
This study utilizes a subset (N?=?650) of the Prechter Longitudinal Study of Bipolar Disorder at the University of Michigan (McInnis et?al.,) who were enrolled between October of 2004 and December of 2010. The study was approved by the Institutional Review Board of the University of Michigan Medical School (IRBMED). We included only those with a diagnosis of bipolar type I disorder (BP; N?=?151) and unaffected controls (HC; N?=?119) who had completed measures of childhood trauma and had a mood measurement within 30?days of the personality assessment (mean difference?=?0.59?days, SD 5.67?days). All participants were evaluated utilizing the Diagnostic Interview for Genetic Studies (DIGS) (Nurnberger et?al.,). Mood state was determined at baseline using the Hamilton Rating Scale for Depression, 17 item (HAMD-17) (Hamilton,) and the Young Mania Rating Scale (YMRS) (Young, Biggs, Ziegler, & Meyer,). Euthymia was defined as both a HAMD-17 and YMRS <8. History of abuse and neglect was obtained through the Childhood Trauma Questionnaire (CTQ) (Bernstein & Fink,), a self-report questionnaire designed to assess five types of negative childhood experiences including emotional neglect, emotional abuse, physical neglect, physical abuse, and sexual abuse. Each item is rated on a 1?5 scale, ranging from never true when you were growing up to very often true when you were growing up. Scores ranged from 5 to 25 for each type of negative childhood experience. The CTQ has demonstrated test?retest reliabilities ranging from.79 to.86 over an average of four months as well as internal consistency reliability coefficients ranging from a median of.66 to a median of.92 across samples (Bernstein & Fink,).
Publisher Copyright:
© 2018 The American Association of Suicidology
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objective: To evaluate the effects of mood and anxiety symptoms in relation to personality dimensions and clinical features such as trauma and substance use on suicidal behaviors in a longitudinal sample of individuals with bipolar illness (BP) and healthy controls (HC). Methods: Mood, personality, and clinical features were assessed in 151 individuals with BP I and 119 HC. Clinical data were collected at baseline and at 2-year follow-up. Personality traits were measured using the NEO PI-R. Results: In bivariate analyses, personality measures were significantly different between BP and HC, and between BP based on suicide attempt history. However, in regression analyses, baseline measures of depression, mania, anxiety, trauma, education, and age of BP onset correlated with personality domains, while a history of suicide attempts did not. Logistic regressions showed that prospective depression or mania, and a pattern of mixed mood features and chronicity of illness, along with two Neuroticism facet scores (N4—Self-Consciousness and N6—Vulnerability) were predictive of suicide ideation (SI) in the 2-year follow-up period. Conclusions: While dimensions of personality, trauma, and substance use clearly correlated with suicidal behaviors in BP, in multivariate models emerging mood symptoms were the most robust predictors of suicidality. These results reinforce the importance and attributable role of mood and anxiety symptoms in evaluating suicidal risk.
AB - Objective: To evaluate the effects of mood and anxiety symptoms in relation to personality dimensions and clinical features such as trauma and substance use on suicidal behaviors in a longitudinal sample of individuals with bipolar illness (BP) and healthy controls (HC). Methods: Mood, personality, and clinical features were assessed in 151 individuals with BP I and 119 HC. Clinical data were collected at baseline and at 2-year follow-up. Personality traits were measured using the NEO PI-R. Results: In bivariate analyses, personality measures were significantly different between BP and HC, and between BP based on suicide attempt history. However, in regression analyses, baseline measures of depression, mania, anxiety, trauma, education, and age of BP onset correlated with personality domains, while a history of suicide attempts did not. Logistic regressions showed that prospective depression or mania, and a pattern of mixed mood features and chronicity of illness, along with two Neuroticism facet scores (N4—Self-Consciousness and N6—Vulnerability) were predictive of suicide ideation (SI) in the 2-year follow-up period. Conclusions: While dimensions of personality, trauma, and substance use clearly correlated with suicidal behaviors in BP, in multivariate models emerging mood symptoms were the most robust predictors of suicidality. These results reinforce the importance and attributable role of mood and anxiety symptoms in evaluating suicidal risk.
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U2 - 10.1111/sltb.12529
DO - 10.1111/sltb.12529
M3 - Article
C2 - 30450613
AN - SCOPUS:85056757159
VL - 49
SP - 1360
EP - 1378
JO - Suicide and Life-Threatening Behavior
JF - Suicide and Life-Threatening Behavior
SN - 0363-0234
IS - 5
ER -