Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder

Mary E. Duffy; Anna R. Gai; Megan L. Rogers; Thomas E. Joiner; Joan L. Luby; Paramjit T. Joshi; Karen D. Wagner; Graham J. Emslie; John Timothy Walkup; David Axelson

doi:10.1111/bdi.12789

Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder

Mary E. Duffy^*, Anna R. Gai, Megan L. Rogers, Thomas E. Joiner, Joan L. Luby, Paramjit T. Joshi, Karen D. Wagner, Graham J. Emslie, John Timothy Walkup, David Axelson

^*Corresponding author for this work

Psychiatry and Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Objectives: The purpose of this study was to explore associations between specific types of hallucinations and delusions and suicidal ideation in a sample of children and adolescents with bipolar I disorder. Methods: Participants (N = 379) were children and adolescents aged 6-15 years (M = 10.2, SD = 2.7) with DSM-IV diagnoses of bipolar I disorder, mixed or manic phase. The study sample was 53.8% female and primarily White (73.6% White, 17.9% Black, and 8.5% Other). Presence and nature of psychotic symptoms, suicidal ideation, and functioning level were assessed through clinician-administered measures. A series of logistic regressions was performed to assess the contribution of each subtype of psychotic symptom to the presence of suicidal ideation above and beyond age, sex, socio-economic status, age at bipolar disorder onset, and global level of functioning. Results: Hallucinations overall, delusions of guilt, and number of different psychotic symptom types were uniquely associated with increased odds of suicidal ideation after accounting for covariates. Other forms of delusions (eg, grandiose) and specific types of hallucinations (eg, auditory) were not significantly uniquely associated with the presence of suicidal ideation. Conclusions: Findings of this study suggest the presence of hallucinations as a whole, delusions of guilt specifically, and having multiple concurrent types of psychotic symptoms are associated with the presence of suicidal ideation in children and adolescents with bipolar I disorder. Psychotic symptom subtypes, as opposed to psychosis as a whole, are an under-examined, potentially important, area for consideration regarding suicidal ideation in pediatric bipolar I disorder.

Original language	English (US)
Pages (from-to)	342-349
Number of pages	8
Journal	Bipolar Disorders
Volume	21
Issue number	4
DOIs	https://doi.org/10.1111/bdi.12789
State	Published - Jun 2019

Funding

Funding information The Treatment of Early Age Mania (TEAM) study was supported by National Institute of Mental Health grants U01 MH064846, U01 MH064850, U01 MH064851, U01 MH064868, U01 MH064869, U01 MH064887, U01 MH064911, and R01 MH051481. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, NIH, or NIMH. The current project was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH-16-2-0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This material is also based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding sources had no role in the conduct of the research or preparation of the manuscript. The authors gratefully acknowledge the pivotal contributions of Barbara Geller, M.D., of Washington University, in designing and overseeing the TEAM study from its inception through to its publication. The Treatment of Early Age Mania (TEAM) study was supported by National Institute of Mental Health grants U01 MH064846, U01 MH064850, U01 MH064851, U01 MH064868, U01 MH064869, U01 MH064887, U01 MH064911, and R01 MH051481. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, NIH, or NIMH. The current project was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH‐16‐2‐0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This material is also based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding

Keywords

adolescent
bipolar disorder
child
delusions
hallucinations
psychotic symptoms
suicidal ideation

ASJC Scopus subject areas

Psychiatry and Mental health
Biological Psychiatry

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/bdi.12789

Cite this

@article{dedb3a2cb6f84f799a51d89a0bab6c72,

title = "Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder",

abstract = "Objectives: The purpose of this study was to explore associations between specific types of hallucinations and delusions and suicidal ideation in a sample of children and adolescents with bipolar I disorder. Methods: Participants (N = 379) were children and adolescents aged 6-15 years (M = 10.2, SD = 2.7) with DSM-IV diagnoses of bipolar I disorder, mixed or manic phase. The study sample was 53.8% female and primarily White (73.6% White, 17.9% Black, and 8.5% Other). Presence and nature of psychotic symptoms, suicidal ideation, and functioning level were assessed through clinician-administered measures. A series of logistic regressions was performed to assess the contribution of each subtype of psychotic symptom to the presence of suicidal ideation above and beyond age, sex, socio-economic status, age at bipolar disorder onset, and global level of functioning. Results: Hallucinations overall, delusions of guilt, and number of different psychotic symptom types were uniquely associated with increased odds of suicidal ideation after accounting for covariates. Other forms of delusions (eg, grandiose) and specific types of hallucinations (eg, auditory) were not significantly uniquely associated with the presence of suicidal ideation. Conclusions: Findings of this study suggest the presence of hallucinations as a whole, delusions of guilt specifically, and having multiple concurrent types of psychotic symptoms are associated with the presence of suicidal ideation in children and adolescents with bipolar I disorder. Psychotic symptom subtypes, as opposed to psychosis as a whole, are an under-examined, potentially important, area for consideration regarding suicidal ideation in pediatric bipolar I disorder.",

keywords = "adolescent, bipolar disorder, child, delusions, hallucinations, psychotic symptoms, suicidal ideation",

author = "Duffy, {Mary E.} and Gai, {Anna R.} and Rogers, {Megan L.} and Joiner, {Thomas E.} and Luby, {Joan L.} and Joshi, {Paramjit T.} and Wagner, {Karen D.} and Emslie, {Graham J.} and Walkup, {John Timothy} and David Axelson",

note = "Funding Information: Funding information The Treatment of Early Age Mania (TEAM) study was supported by National Institute of Mental Health grants U01 MH064846, U01 MH064850, U01 MH064851, U01 MH064868, U01 MH064869, U01 MH064887, U01 MH064911, and R01 MH051481. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, NIH, or NIMH. The current project was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH-16-2-0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This material is also based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding sources had no role in the conduct of the research or preparation of the manuscript. The authors gratefully acknowledge the pivotal contributions of Barbara Geller, M.D., of Washington University, in designing and overseeing the TEAM study from its inception through to its publication. Funding Information: The Treatment of Early Age Mania (TEAM) study was supported by National Institute of Mental Health grants U01 MH064846, U01 MH064850, U01 MH064851, U01 MH064868, U01 MH064869, U01 MH064887, U01 MH064911, and R01 MH051481. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, NIH, or NIMH. The current project was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH‐16‐2‐0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This material is also based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

year = "2019",

month = jun,

doi = "10.1111/bdi.12789",

language = "English (US)",

volume = "21",

pages = "342--349",

journal = "Bipolar Disorders",

issn = "1398-5647",

publisher = "Blackwell Munksgaard",

number = "4",

}

TY - JOUR

T1 - Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder

AU - Duffy, Mary E.

AU - Gai, Anna R.

AU - Rogers, Megan L.

AU - Joiner, Thomas E.

AU - Luby, Joan L.

AU - Joshi, Paramjit T.

AU - Wagner, Karen D.

AU - Emslie, Graham J.

AU - Walkup, John Timothy

AU - Axelson, David

N1 - Funding Information: Funding information The Treatment of Early Age Mania (TEAM) study was supported by National Institute of Mental Health grants U01 MH064846, U01 MH064850, U01 MH064851, U01 MH064868, U01 MH064869, U01 MH064887, U01 MH064911, and R01 MH051481. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, NIH, or NIMH. The current project was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH-16-2-0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This material is also based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding sources had no role in the conduct of the research or preparation of the manuscript. The authors gratefully acknowledge the pivotal contributions of Barbara Geller, M.D., of Washington University, in designing and overseeing the TEAM study from its inception through to its publication. Funding Information: The Treatment of Early Age Mania (TEAM) study was supported by National Institute of Mental Health grants U01 MH064846, U01 MH064850, U01 MH064851, U01 MH064868, U01 MH064869, U01 MH064887, U01 MH064911, and R01 MH051481. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, NIH, or NIMH. The current project was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH‐16‐2‐0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This material is also based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding Publisher Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

PY - 2019/6

Y1 - 2019/6

N2 - Objectives: The purpose of this study was to explore associations between specific types of hallucinations and delusions and suicidal ideation in a sample of children and adolescents with bipolar I disorder. Methods: Participants (N = 379) were children and adolescents aged 6-15 years (M = 10.2, SD = 2.7) with DSM-IV diagnoses of bipolar I disorder, mixed or manic phase. The study sample was 53.8% female and primarily White (73.6% White, 17.9% Black, and 8.5% Other). Presence and nature of psychotic symptoms, suicidal ideation, and functioning level were assessed through clinician-administered measures. A series of logistic regressions was performed to assess the contribution of each subtype of psychotic symptom to the presence of suicidal ideation above and beyond age, sex, socio-economic status, age at bipolar disorder onset, and global level of functioning. Results: Hallucinations overall, delusions of guilt, and number of different psychotic symptom types were uniquely associated with increased odds of suicidal ideation after accounting for covariates. Other forms of delusions (eg, grandiose) and specific types of hallucinations (eg, auditory) were not significantly uniquely associated with the presence of suicidal ideation. Conclusions: Findings of this study suggest the presence of hallucinations as a whole, delusions of guilt specifically, and having multiple concurrent types of psychotic symptoms are associated with the presence of suicidal ideation in children and adolescents with bipolar I disorder. Psychotic symptom subtypes, as opposed to psychosis as a whole, are an under-examined, potentially important, area for consideration regarding suicidal ideation in pediatric bipolar I disorder.

AB - Objectives: The purpose of this study was to explore associations between specific types of hallucinations and delusions and suicidal ideation in a sample of children and adolescents with bipolar I disorder. Methods: Participants (N = 379) were children and adolescents aged 6-15 years (M = 10.2, SD = 2.7) with DSM-IV diagnoses of bipolar I disorder, mixed or manic phase. The study sample was 53.8% female and primarily White (73.6% White, 17.9% Black, and 8.5% Other). Presence and nature of psychotic symptoms, suicidal ideation, and functioning level were assessed through clinician-administered measures. A series of logistic regressions was performed to assess the contribution of each subtype of psychotic symptom to the presence of suicidal ideation above and beyond age, sex, socio-economic status, age at bipolar disorder onset, and global level of functioning. Results: Hallucinations overall, delusions of guilt, and number of different psychotic symptom types were uniquely associated with increased odds of suicidal ideation after accounting for covariates. Other forms of delusions (eg, grandiose) and specific types of hallucinations (eg, auditory) were not significantly uniquely associated with the presence of suicidal ideation. Conclusions: Findings of this study suggest the presence of hallucinations as a whole, delusions of guilt specifically, and having multiple concurrent types of psychotic symptoms are associated with the presence of suicidal ideation in children and adolescents with bipolar I disorder. Psychotic symptom subtypes, as opposed to psychosis as a whole, are an under-examined, potentially important, area for consideration regarding suicidal ideation in pediatric bipolar I disorder.

KW - adolescent

KW - bipolar disorder

KW - child

KW - delusions

KW - hallucinations

KW - psychotic symptoms

KW - suicidal ideation

UR - http://www.scopus.com/inward/record.url?scp=85065645978&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065645978&partnerID=8YFLogxK

U2 - 10.1111/bdi.12789

DO - 10.1111/bdi.12789

M3 - Article

C2 - 31025487

AN - SCOPUS:85065645978

SN - 1398-5647

VL - 21

SP - 342

EP - 349

JO - Bipolar Disorders

JF - Bipolar Disorders

IS - 4

ER -

Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this