Abstract
Objective: To evaluate the risk of association between suicidal behaviors and comorbid anxiety disorders in adolescents with bipolar depression. Methods: We conducted a cross-sectional study using the nationwide inpatient sample (NIS) from the United States. This study included 9720 adolescent inpatients with bipolar depression and further grouped by co-diagnosis of anxiety disorders. Logistic regression analysis was used to evaluate the odds ratio (OR) of suicidal behaviors due to comorbid anxiety after controlling demographic confounders and psychiatric comorbidities. Results: Out of total inpatients, 34.8% (n = 3385) had comorbid anxiety disorders with a predominance in females (70.3%) and White patients (67.7%). About 54.1% of inpatients with comorbid anxiety had suicidal behaviors versus 44.6% in the non-anxiety cohort (p < 0.001). Comorbid anxiety disorders were associated with 1.35 times higher odds (95% CI 1.23–1.47, p < 0.001) for suicidal behaviors. Conclusion: Suicidal behaviors are significantly prevalent in bipolar depression adolescents with comorbid anxiety disorders. Anxiety disorders are an independent risk factor in bipolar depression that increase the risk of suicidal behaviors by 35%. This necessitates careful assessment and management of comorbid anxiety disorders in bipolar youth to mitigate suicidality.
Highlights
Bipolar disorder (BP) is a psychiatric condition that causes irregular changes in mood, motivation, levels of activity, attention, and the ability to perform everyday tasks [1]
Suicidal behaviors are significantly prevalent in bipolar depression adolescents with comorbid anxiety disorders
Bipolar depression inpatients with comorbid anxiety was most prevalent in White patients (67.7%) followed by Hispanic (16.3%) and Black patients (11.2%), and there was statistically no significant difference when compared with the non-anxiety cohort
Summary
Bipolar disorder (BP) is a psychiatric condition that causes irregular changes in mood, motivation, levels of activity, attention, and the ability to perform everyday tasks [1]. BP is a recurring familial disorder that occurs in 1–3% of adolescents. Most adolescents with BP experienced a depressive episode as the onset mood phase with the mean age of onset at 11.75 years. Suicidal behaviors are high among patients with BP as about 25% to 50% adults with BP had at least one lifetime suicide attempt and eight to 19% of died from suicide [4]. About 20% to 65% of adults with an initial BP experience in childhood and those with an early onset of disease are at greater risk for suicidal behaviors [4]. The prevalence of current and past suicidal ideation in pediatric BP are 50%
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