The risk of suicidal behavior in depression in the structure of bipolar disorder complicated by plant cannabinoid addiction
https://doi.org/10.31549/2542-1174-2022-6-3-7-14
Abstract
I n t r o d u c t i o n . According to clinical observations, depressive states in the structure of bipolar disorder (BD) are observed in 23.8% of the examined patients. Most studies show that compared with the general population, the standardized mortality rate in patients is about 30%; BD patients account for 1.4% of total deaths.
A i m . To assess the risk of suicidal behavior in depression in the structure of BD complicated by plant cannabinoid addiction.
M a t e r i a l s a n d m e t h o d s . For this research, 58 patients with diagnosed BD associated with the syndrome of cannabinoid addiction were selected – the main group (mean age 34 ± 4 years). The control group consisted of 100 individuals with BD without associated pathology (mean age 32 ± 3 years). The duration of the disease in both groups ranged from 1 to 5 years. The following methods and scales were used in the study: clinical method – mental status assessment, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the SAD PERSONS Scale – a scale for suicide risk assessment.
R e s u l t s . The study showed that the risk of suicidal behavior in depression in the structure of BD complicated by plant cannabinoid addiction increases significantly, which is confirmed by the results of assessment using psychometric scales (after 6 months since the beginning of the study in the main group, a high risk of suicide was diagnosed in 8% of cases, after 12 months – in 11%, very high risk – in 4% of cases). The deterioration of the mental state was confirmed by the frequency and longer duration of hospitalizations in a psychiatric hospital: in the main group, the average duration of hospitalization in a psychiatric hospital after 6 months since the beginning of the study was about 5.3 ± 2 months (67% (p < 0.005)), after 12 months – about 5.9 ± 1 months (72% (p < 0.005)). In the treatment of this category of patients, high drug resistance was noted (73–86% (p < 0.05)).
C o n c l u s i o n . The use of plant cannabinoids increases the risk of suicidal behavior. Depression in the structure of BD associated with plant cannabinoid addiction was characterized by resistance to therapy. An increase in anxiety levels led to compulsive suicide attempts which is a key risk factor for completed suicide.
About the Authors
I. Yu. KlimovaRussian Federation
Irina Yu. Klimova – Assistant, Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Novosibirsk State Medical University.
Novosibirsk.
SPIN-code: 5189-8069
A. A. Ovchinnikov
Russian Federation
Anatoliy A. Ovchinnikov – Dr. Sci. (Med.), Professor, Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Novosibirsk State Medical University.
Novosibirsk.
SPIN-code: 2228-5923
References
1. Neznanov N.G., Rukavishnikov G.V., Kaysanov E.D., Zhilyaeva T.V., Mazo G.E. New approach to mental disorders systematic: starting point or point of view? V.M. Bekhterev Review of Psychiatry and Medical Psychology. 2020;3:3–10. DOI: 10.31363/2313-7053-2020-3-3-10. (In Russ.)
2. Petrova N.N., Ashenbrenner Yu.V. Bipolar disorder type I and patients’ psychosocial functioning. Social and Clinical Psychiatry. 2018;28(1):10–14. (In Russ.)
3. Potanin S.S., Morozova M.A. Is the prescription of antidepressants for bipolar depression justified from the point of view of evidence-based medicine? Psykhiatriya. 2020;18(2):51–60. DOI: 10.30629/2618-6667-2020-18-2-51-60. (In Russ.)
4. Baez S., Pinasco C., Roca M. et al. Brain structural correlates of executive and social cognition profiles in behavioral variant frontotemporal dementia and elderly bipolar disorder. Neuropsychologia. 2019;126:159–169. DOI: 10.1016/j.neuropsychologia.2017.02.012.
5. Chakroun M., Zgueb Y., Khaled D.B. et al. What are the characteristics of patients with bipolar disorder type I who attempt suicide? Pan Afr. Med. J. 2020;37:116. (In French)
6. Bardenshteyn L.M., Osipova N.N., Slavgorodskiy Ya.M. et al. The bipolar affective disorder type II //. Rossiiskii meditsinskii zhurnal (Medical Journal of the Russian Federation, Russian journal). 2018;24(3):157–162. DOI: 10.18821/0869-2106-2018-24-3-157-162. (In Russ.)
7. Vasileva S.N., Simutkin G.G., Schastnyy E.D., Ivanova S.A., Bokhan N.A. Suicidal behavior of patients suffering from bipolar affective disorder and comorbid mental diseases // Suicidology. 2018;9(3):86–92. DOI: 10.32878/suiciderus.18-09-03(32)-86-92. (In Russ.)
8. Zakharova K.V., Avedisova A.S., Samotaeva I.S., Arkusha I.A., Luzin R.V. Influence of apathy on late-life depression // Neurology Bulletin. 2018;50(4):88–89. (In Russ.)
9. Kolyagin V.V. (2015). Bipolar Affective Disorder. Guide for Doctors: In 2 parts. Irkutsk. Pt. 2. 48 p. (In Russ.)
10. Bauer I.E., Soares J.C., Selek S., Meyer T.D. The link between refractoriness and neuroprogression in treatment-resistant bipolar disorder. Mod. Trends Pharmacopsychiatry. 2017;31:10–26. DOI: 10.1159/000470803.
11. Mosolov S.N. (2008). Bipolar Disorder: Diagnosis and Therapy. Moscow: MEDpress-inform, 384 p. (In Russ.)
12. Dols A., Beekman A. Older age bipolar disorder. Psychiatric Clin. North Amer. 2018;41(1):95–110. DOI: 10.1016/j.psc.2017.10.008.
13. Eyler L.T., Aebi M.E., Daly R.E. et al. Understanding aging in bipolar disorder by integrating archival clinical research datasets. Am. J. Geriatr. Psychiatry. 2019;27(10):1122–1134. DOI: 10.1016/j. jagp.2019.04.003.
14. Goldstein B.I., Baune B.T., Bond D.J. et al. Call to action regarding the vascular-bipolar link: A report from the Vascular Task Force of the International Society for Bipolar Disorders. Bipolar Disord. 2020;22(5):440–460. DOI: 10.1111/bdi.12921.
15. Karabulut S., Taçdemir İ, Akcan U. et al. Inflammation and neurodegeneration in patients with early-stage- and chronic bipolar disorder. Türk Psikiyatri Derg. 2019;30(2):75–81. (In Turkish)
16. Sajatovic M., Eyler L.T., Rej S. et al. The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project: Understanding older-age bipolar disorder by combining multiple datasets. Bipolar Disord. 2019;21(7):642–649. DOI: 10.1111/bdi.12795.
17. Smilowitz S., Afftab A., Aebi M. et al. Age-related differences in medication adherence, symptoms, and stigma in poorly adherent adults with bipolar disorder. J. Geriatr. Psychiatry and Neurol. 2020;33(5):250–255. DOI: 10.1177/0891988719874116.
18. Young R.C., Mulsant B.H., Sajatovic M. et al. GERI-BD: a randomized double-blind controlled trial of lithium and divalproex in the treatment of mania in older patients with bipolar disorder. Am. J. Psychiatry. 2017;174(11):1086–1093.
Review
For citations:
Klimova I.Yu., Ovchinnikov A.A. The risk of suicidal behavior in depression in the structure of bipolar disorder complicated by plant cannabinoid addiction. Journal of Siberian Medical Sciences. 2022;(3):7-14. https://doi.org/10.31549/2542-1174-2022-6-3-7-14

























