Bipolar disorders are quite prevalent but frequently underdiagnosed and undertreated. The early recognition and appropriate treatment is particularly important, since out of all psychiatric illnesses, (untreated) bipolar disorders carry the highest risk of both attempted and completed suicide. Studies show that suicidal behaviour in patients with bipolar disorders is state and severity dependent; that means that suicidality markedly decreases or vanishes after clinical recovery. However, since the majority of mood disorder patients never commit suicide and more than half of them never attempt suicide, special clinical characteristics of the disorder as well as some familial and psychosocial factors should also play a contributory role. Considering the clinically explorable suicide risk factors in patients with bipolar disorders (family and/or personal history of suicidal behaviour, early onset, severe depressive episode/hopelessness, agitated/mixed depression, bipolar II diagnosis, rapid cycling, comorbid Axis I and Axis II disorders, adverse life situations, lack of social and medical support, cyclothymic temperament, impulsive aggressive personality features, etc.), there is a good chance that suicidal behaviour is predictable. There is also much evidence that (successful) acute and long-term pharmacotherapy of bipolar patients reduces the risk of attempted and completed suicide by more than 80 percent, even in this high-risk population. Recent studies also show that supplementary psychosocial interventions (psychoeducation, and targeted psychotherapies) further improve the results.
Keywords: bipolar disorders, suicidal behaviour, suicide prevention, antidepressants, mood stabilizers, suicide risk factors, psychosocial interventions