Lifetime rhythmicity and mania as correlates of suicidal ideation and attempts in mood disorders.

BACKGROUND The aim of this study is to establish to what degree variation in lifetime experience of rhythmicity and manic-hypomanic features correlates with suicidality in individuals with mood disorders and other major psychiatric diagnoses and in a comparison group of controls. METHOD Suicidal ideation and attempts were investigated in a clinical sample, including 77 patients with schizophrenia, 60 with borderline personality disorder, 61 with bipolar disorder, 88 with unipolar depression, and 57 with panic disorder, and in a comparison group of 102 controls. Using information derived from the diagnostic interview and a self-report assessment of mood spectrum symptoms, subjects were assigned to 3 categories according to the maximum level of suicidality achieved in the lifetime (none, ideation/plans, and suicide attempts). The association of categorical and continuous variables with suicidality levels was investigated using multinomial logistic regression models. RESULTS Suicidal ideation and plans were more common in unipolar depression (50%) and bipolar disorder (42.4%) than in borderline personality disorder (30%), whereas the reverse was true for suicidal attempts. In each of the study groups, the number and the type of mood spectrum items endorsed, including depressive and manic-hypomanic items and rhythmicity and vegetative symptoms, were associated with increased levels of suicidality. CONCLUSIONS Our results suggest that the assessment of lifetime rhythmicity and manic-hypomanic features may be clinically useful to identify potential suicide attempters in high-risk groups.