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Prevalence and correlates of suicide attempts in juvenile bipolar and major depressive disorders

Published online by Cambridge University Press:  26 August 2025

L. Ciampoli
Affiliation:
Child Neuropsychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
R. Abregú Crespo
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
E. Rodriguez Toscano
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
M. Ayora Rodriguez
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
R. Panadero Gómez
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
C. Ordás Díaz
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
A. Sánchez Cámara
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
L. Sevilla Cermeño
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
C. Llorente Sarabia
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
C. Moreno Ruiz*
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
*
*Corresponding author.

Abstract

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Introduction

Major depressive disorders (MDD) and bipolar disorders (BD) are strongly associated with suicide attempts in youth. However, little is known regarding the differences in prevalence and clinical-related features of suicide attempts between these two disorders.

Objectives

The study aimed to examine the prevalence of suicide attempts and related factors in children and adolescents with major mood disorders and compare clinical features between BD and MDD patients who attempted suicide.

Methods

A cross-sectional study was conducted at the Child and Adolescent Psychiatry Department of the Institute of Psychiatry and Mental Health Gregorio Marañón. Patients with diagnosis of major mood disorder were included. All patients were evaluated with K-SADS, CGI (Clinical Global Impression), HDRS (Hamilton Depression Rating scale), YMRS (Young Mania Rating Scale), Conners Rating Scale and CGAS (Children’s Global Assessment Scale). Bivariate analysis was conducted to compare patients with and without suicide attempts and BD versus MDD attempters. Subsequently, a multivariate analysis was performed to assess the combined influence of suicide attempts related factors.

Results

The sample included 145 patients (58 males, 87 females) aged 7 to 17 years (mean 15.15), with diagnosis of BD (55.2%) and MDD (44.8%). The prevalence of suicide attempts for MDD and BD were 58.5 % and 28.8 %, respectively (p< 0.001). 56,5 % of BD attempters reported medically serious suicide attempts versus 28.9% of MDD (p=0.03). 61 patients with suicide attempts were compared to 84 patients without suicide attempts. Suicide attempts were associated with female sex (p<0.001), internalizing disorders (p= 0.003), hopelessness (p=0.001), higher punctuation on HDRS score (p=0.03), suicidal ideation (p<0.001) and NSSI (p<0.001). In the multivariate analysis, it was found that female sex (p<0.001), suicidal ideation (p<0.001) and hopelessness (p=0.048) were independently related to suicide attempts. Comparing suicide attempters with BD versus MDD, BD patients showed higher impulsivity (p=0.04) and a more alcohol use proportion (p=0.04) than MDD patients.

Conclusions

Female sex, suicidal ideation and hopelessness are strongly related to suicide attempts in youth with major mood disorder. The findings revealed some differences between BD and MDD for patients with suicide attempts and accentuate the need for early identification of BD and accurate differentiation between BD and MDD in children and adolescents, to treat them adequately and minimize suicidal behaviors.

Disclosure of Interest

None Declared

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Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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