Suicidal risk in bipolar affective disorder taking into account its comorbidity with alcohol addiction

High risk of suicide in people with bipolar affective disorder and alcohol addiction has been demonstrated in numerous studies. Comorbid course of these disorders further increases the vulnerability of patients to suicidal thoughts and suicide attempts. Aim: to study the effect of comorbid alcohol addiction on the risk of suicidal behavior in patients with bipolar affective disorder. Material and methods. Two groups of patients were examined in a psychiatric hospital with subsequent comparison. The group of patients with bipolar affective disorder and comorbid alcohol addiction – 43 people aged 35 [24.0; 45.0] and the group of patients with bipolar affective disorder without comorbid alcohol addiction – 60 people aged 38 [24.0; 51.0]. The groups were comparable in age and gender (p> 0.05). Research methods: clinical-psychopathological, clinical-follow-up, psychometric, statistical. Various aspects of suicidal behavior in patients of the examined groups were assessed using the SBQR suicidal behavior questionnaire. The level of social functioning and quality of life of patients was determined using the SASS questionnaire. Results. In patients with comorbid bipolar affective disorder and alcohol dependence, compared with "isolated" bipolar affective disorder, a more frequent occurrence of suicide attempts in the anamnesis (44.2% versus 25.0%) and higher scores of the SBQ-R scale (13 [10; 14] and 7 [4; 9], respectively) (p<0.05) were revealed. Correlation analysis of the relationship SBQ-R scores with clinical and dynamic indicators of bipolar affective disorder and demographic characteristics showed: in both groups, the risk of suicidal behavior decreases with increasing age of patients (p<0.05), with "isolated" bipolar affective disorder, more unfavorable SBQ-R scores are associated with male gender, shorter duration of affective disorder and younger age at onset of bipolar affective disorder (p<0.05). Similar correlations were not revealed in the group of bipolar affective disorder with comorbid alcohol addiction. Evaluation of the relationships between the SASS and SBQR scales showed that in both study groups, the severity of suicidal behavior scores correlates with difficulties arising in relationships with other people. Conclusions. Patients with comorbid bipolar affective disorder and alcohol addiction show more severe rates of suicidal behavior compared to patients with "isolated" bipolar affective disorder.