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

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalBipolar Disorders
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Suicidal Ideation
Bipolar Disorder
Delusions
Hallucinations
Guilt
Diagnostic and Statistical Manual of Mental Disorders
Psychotic Disorders
Logistic Models
Economics
Pediatrics

Keywords

  • adolescent
  • bipolar disorder
  • child
  • delusions
  • hallucinations
  • psychotic symptoms
  • suicidal ideation

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Duffy, M. E., Gai, A. R., Rogers, M. L., Joiner, T. E., Luby, J. L., Joshi, P. T., ... Axelson, D. (2019). Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder. Bipolar Disorders. https://doi.org/10.1111/bdi.12789
Duffy, Mary E. ; Gai, Anna R. ; Rogers, Megan L. ; Joiner, Thomas E. ; Luby, Joan L. ; Joshi, Paramjit T. ; Wagner, Karen D. ; Emslie, Graham J. ; Walkup, John Timothy ; Axelson, David. / Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder. In: Bipolar Disorders. 2019.
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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.",
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Duffy, ME, Gai, AR, Rogers, ML, Joiner, TE, Luby, JL, Joshi, PT, Wagner, KD, Emslie, GJ, Walkup, JT & Axelson, D 2019, 'Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder', Bipolar Disorders. https://doi.org/10.1111/bdi.12789

Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder. / Duffy, Mary E.; Gai, Anna R.; Rogers, Megan L.; Joiner, Thomas E.; Luby, Joan L.; Joshi, Paramjit T.; Wagner, Karen D.; Emslie, Graham J.; Walkup, John Timothy; Axelson, David.

In: Bipolar Disorders, 01.01.2019.

Research output: Contribution to journalArticle

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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

PY - 2019/1/1

Y1 - 2019/1/1

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.

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KW - suicidal ideation

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