A Clinical Exploratory Study Of Suicide Risk In Patients With Bipolar Disorder Accompanied By Psychotic Symptoms

Objective Bipolar disorder is a serious mental illness that is characterized by recurrent episodes of emotional ups and downs or mixed presence.Due to missed diagnosis,misdiagnosis,and non-standardized treatment,patients may receive inappropriate treatment or receive standardized treatment for many years after the onset of the disease.At the same time,due to the recurrent characteristics of bipolar disorder,patients are repeatedly and chronically tortured by the disease,and some patients will suffer from suicidal behaviors.In the classification of mental and behavioral disorders,Bipolar disorder,current episode manic with psychotic symptoms and Bipolar disorder,current episode severe depression with psychotic symptoms are two diagnostic entries in the mood disorder spectrum.Due to the existence of psychotic symptoms,the disease may have a more serious impact on patients with BD,and in this part of the patient population,the possibility of suicidal behavior may be higher.Are there any factors such as: gender,age of onset,duration of disease,substance abuse,compliance with previous treatment,negative perceptions,frequency of disease onset,etc.may be bipolar disorder with psychotic symptoms Patients have an effect on suicidal behavior.For individuals,mental illness has a high disability rate.At the same time,the average life expectancy of mental illness patients such as suicide and accident is shorter than that of the normal population.As far as society is concerned,people with mental illness also put a heavy burden on the family.In order to better identify this type of bipolar patients with high risk of suicidal behaviors and psychotic symptoms,early intervention or treatment to reduce the risk of suicidal behaviors,this study intends to The clinical characteristics of suicidal behavior in patients with BD are studied to provide evidence for more targeted treatment.Methods A retrospective analysis of the "bipolar affective disorder" in the ICD-10 mental and behavioral disorder diagnostic criteria confirmed by a tertiary physician during the rounds of hospitalization at the Seventh People’s Hospital of Dalian from 2013 to 2018,is currently agitation with psychotic symptoms "Manic seizures" or "bipolar disorder,currently a major depressive episode with psychotic symptoms" 143 patients with medical history,including: suicidal behavior,age of onset,duration of disease,gender,marital status,smoking history,Drinking history,other substance use history,family history of mental illness,family suicide history,previous treatment interruption or no treatment,suicidal ideation,seasonal correlation,bipolar manic episodes with psychotic symptoms,with psychotic symptoms The number of bipolar depression episodes and so on.They are divided into suicidal group and non-suicidal group based on the presence or absence of suicidal behavior.Mann-Whitney U test was used for measurement data that did not obey the normal distribution,and Chi-square test was used for categorical variables for univariate clinical feature analysis.If 1≤T <5,use continuous calibration Chi-square test;T <1,use Fisher exact test.Unconditional multivariate logistic regression analysis of two-category response variables was used to analyze statistically significant variables to obtain independent risk factors for suicidal behavior in BD-P patients.Results The results of this study indicate that positive family history of mental illness,the existence of suicidal ideation,bipolar mania with psychotic symptoms,and the number of depressive episodes of depression are risk factors for suicidal behavior.Multivariate logistic regression analysis showed that two factors were risk factors for suicidal behaviors in BD patients with psychotic symptoms: the existence of suicidal ideation(OR = 27.527,95% CI: 5.041-150.320),and positive family history of mental illness(OR = 4.544,95% CI1.522-13.564).Factors such as duration of disease,seasonality,substance use,and marital status are not risk factors for suicide.Conclusion The study found that the relevant risk factors for suicidal behaviors in BD-P patients were: the existence of suicidal ideation,a positive family history of mental illness,the number of manic episodes with psychotic symptoms,and the number of severe depressive episodes with psychotic symptoms.The existence of suicidal ideation and positive family history of mental illness are independent risk factors for suicidal behaviors in BD patients with psychotic symptoms.Therefore,more targeted prevention and treatment measures are particularly important.