Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients

Sheila C. Caetano, Rene L. Olvera, Kristina Hunter, John P Hatch, Pablo Najt, Charles L Bowden, Steven Pliszka, Jair C. Soares

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Background: Psychosis in pediatric mood disorder patients may be related to suicidal ideation. Bipolar (BP) adolescents are at high risk of completed suicide. We examined whether pediatric BP patients with psychosis have a higher prevalence of suicidality than non-psychotic BP patients. Based on previous findings in adult BP patients, we predicted that pediatric BP patients with psychotic symptoms would have higher prevalence of suicidality, higher occurrence of lifetime psychiatric hospitalizations and worse current Global Assessment of Functioning Scale (GAF) scores compared to non-psychotic BP patients. Methods: We studied 43 BP children and adolescents (mean age ± S.D = 11.2 ± 2.8 y, range = 8-17) who did (n = 17) or did not have (n = 26) a lifetime history of psychotic symptoms. Indicators of suicidality (thoughts of death and suicidal ideation, plans, and attempts), psychiatric diagnoses, psychotic symptoms, psychiatric hospitalizations and GAF scores were assessed with the K-SADS-PL interview. Limitations: Small sample size, cross-sectional study and exclusion of substance abuse comorbidity. Results: Pediatric BP patients with a lifetime history of psychotic symptoms compared to BP patients without psychosis were more likely to have thoughts of death (100% versus 69.2%, p = 0.01), suicidal ideation (94.1% versus 42.3%, p = 0.001) and suicidal plans (64.7% versus 15.4%, p = 0.002). Occurrence of psychiatric hospitalization was higher in psychotic BP patients compared to non-psychotic BP patients (82.4% versus 46.2%, p = 0.018). Conclusions: Psychotic symptoms in pediatric BP patients are associated with suicidal ideation and plans, and psychiatric hospitalizations. Psychotic symptoms are a risk factor for suicidality amongst pediatric BP patients.

Original languageEnglish (US)
Pages (from-to)33-37
Number of pages5
JournalJournal of Affective Disorders
Issue number1
StatePublished - Mar 2006


  • Adolescents
  • Bipolar disorder
  • Children
  • Hospitalization
  • Psychosis
  • Suicide

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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