Suicide risk and prevention in bipolar disorder

Bipolar disorders are prevalent and severe illnesses that are associated with a high risk of suicide. Patients with bipolar disorder who have had prior suicide attempts are at a substantially higher risk for future suicidality, even after controlling for other risk factors. Despite the magnitude of this problem, there is a paucity of controlled prospective data to guide clinical care, most likely due to the difficulties inherent in such studies. The most robust literature supports the use of lithium as a suicide-protective agent in bipolar disorder, but a definitive controlled study in a generalizable population is warranted. As in other areas of psychiatry, a careful assessment of the individual patient risk is of paramount importance.