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Higher Risk of Suicide in Bipolar Patients Who Abuse Alcohol

Alcohol, especially in a person with bipolar disorder, may increase the risk of suicide.

New research released this week suggests bipolar patients who abuse or are dependent on alcohol are more likely to attempt suicide than bipolar patients who abstain.

Dr. Maria A. Oquendo from the Department of Psychiatry at Columbia University in New York, and her colleagues, found that the odds of attempting suicide in bipolar patients are more than doubled if the individual either abuses or is dependent on alcohol.

Bipolar disorder, a mood disorder affecting more than five million Americans. It is characterized by alternating periods of depression and mania or hypomania (a milder form of mania). Up to 20 percent of individuals with bipolar illness commit suicide.  Alcohol is also known to increase one’s risk of suicide by more than 50 percent and, according to some studies, 25 percent of substance abusers commit suicide.

Oquendo and her colleagues used data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)  to identify 1,643 individuals with bipolar disorder from the 43,093 surveyed.  The NESARC is a large survey of the general population which includes questions about many areas related to substance use and mental health.

The records of the 1,643 individuals with bipolar disorder were assessed for any lifetime evidence of alcohol abuse, any history of suicide attempt, and any history of suicidal thinking.

Oquendo found that 54 percent of the individuals with bipolar disorder also reported alcohol abuse.  The odds of a suicide attempt were higher (odds ratio 2.25) in the bipolar patients who abused alcohol than in those who did not.

The authors also found that the bipolar patients who abused alcohol were more likely to also use tobacco or to abuse other substances.  Neither tobacco nor other substance abuse appeared to have an affect on suicide risk in this study.

The authors also noted that although the individuals in the study had more than one mental health issue, and had more risky suicidal behaviors, they did not receive any additional psychiatric treatment.

“Given the high disease burden suffered by these individuals and the increased risk for morbidity and mortality when bipolar disorder and alcohol use disorder are comorbid, targeting them for treatment is a public health imperative,” according to Oquendo.

Oquendo’s results are published in the July issue of the Journal of Clinical Psychiatry.

Source:  Journal of Clinical Psychiatry

Higher Risk of Suicide in Bipolar Patients Who Abuse Alcohol

Jessica Ward Jones, MD, MPH

APA Reference
Jones, J. (2019). Higher Risk of Suicide in Bipolar Patients Who Abuse Alcohol. Psych Central. Retrieved on October 31, 2020, from
Scientifically Reviewed
Last updated: 18 Mar 2019 (Originally: 23 Jul 2010)
Last reviewed: By a member of our scientific advisory board on 18 Mar 2019
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