Bipolar Patients at High Risk for Self-Harm Recurrence

Up to 60% of patients diagnosed with bipolar disorder (PBD) cause harm to themselves at least once throughout their lifetimes, and at least 5% of them commit suicide. Nevertheless, few prospective studies have examined self-harm in BPD patients specifically.

A team of researchers from the United Kingdom recently set out to describe BPD patients who presented to a hospital following self-harm and examine their propensity to repeat such behaviors. In a study that appeared in the October 2014 issue of the Journal of Affective Disorders, they postulated that describing the characteristics of this high-risk group might inform clinical practice and expand pharmacists’ knowledge of suicide prevention.

In comparing 103 bipolar subjects to 515 non-bipolar controls, the researchers found 58% of BPD patients self-harmed versus 25% of controls. In addition, patients with BPD were more likely to repeat self-harm than controls. The methods of self-harm included self-poisoning with drugs (84%), self-poisoning with other substances (2%), and self-injury (14%).

BPD patients who self-harmed and who were suicidal were significantly more likely to be female. They were also more likely to report previous self-harm, unemployment, contact with psychiatric services, and sleep disturbance.

In the control group, those who self-harmed were more likely to be current alcohol users, have a suicide plan, and report relationship problems. The authors found this surprising, as they noted that alcohol and substance abuse is quite common among BPD patients.

The researchers reported that their findings are limited by the fact that all cases involved self-harm that was serious enough to present to hospital emergency departments, and such cases may be medically different from less serious forms of self-harm.