Veterans with Bipolar Disorder Are at High Risk of Suicide

Researchers at the Department of Veterans Affairs (VA) Healthcare System and the University of Michigan, Ann Arbor, carried out a study on the suicide risks of veterans diagnosed with a psychiatric illness, and concluded that men with bipolar disorder and women with substance abuse disorders have a particularly high risk of committing suicide.

The study was carried out by Mark A. Ilgen, PhD, and colleagues at the Department of VA Healthcare System and the University of Michigan, Ann Arbor, who looked for a link between psychiatric disorders and suicide risks, among over 3 million veterans who received care at a VA facility in 1999, and were alive at the beginning of 2000.

The researchers got psychiatric diagnoses from the treatment records of 1998 and 1999, and they tracked deaths by suicide for the following seven years.

During this period, there were 7,684 veterans who committed suicide and a little less than half of them, had at least one psychiatric diagnosis – depression, schizophrenia, bipolar disorder, substance use disorders, PTSD or other anxiety disorders, all of which were associated with a high risk of suicide.

The authors say that “in men, the risk of suicide was greatest for those with bipolar disorder, followed by depression, substance use disorders, schizophrenia, other anxiety disorders and PTSD.

“In women, the greatest risk of suicide was found in those with substance use disorders, followed by bipolar disorder, schizophrenia, depression, PTSD and other anxiety disorder.”

Bipolar disorder, which was the least common diagnosis, proved to be the more strongly linked to suicide risk.

9% of those who committed suicide suffered from bipolar disorder, and “this makes bipolar disorder particularly appropriate for targeted intervention efforts or attempts to improve medication adherence,” wrote the authors.

90 to 98 percent of people who generally commit suicide, have at least one psychiatric disorder – “prior research has consistently found associations between psychiatric conditions (e.g., depression, bipolar disorder, post-traumatic stress disorder [PTSD], schizophrenia and alcohol and/or drug use disorders) and risk of fatal and non-fatal suicide attempts.”

Still, establishing a strong connection between individual psychiatric conditions and suicide risk has not been easy, also because of the low numbers of suicides in many research studies.

The researchers say that “in all likelihood, many individuals with psychiatric disorders who were at risk for suicide were not identified by the treatment system.

“This could be owing to stigma, which may have made individuals less likely to report their mental health symptoms to physicians, an effect that could be more pronounced among men with military experience.

“These findings highlight the importance of improved identification, diagnosis and treatment of psychiatric diagnoses (particular bipolar disorder, depression, substance use disorders and schizophrenia) of all health care system users.”

This research is published in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.