Interpersonal Relationships and Suicidal Ideation in Youth with Bipolar Disorder

Abstract

This study examines how relationship quality in family and peer domains are associated with suicidal ideation (SI) in youth with bipolar disorder (BP). We assessed 404 Course and Outcome of Bipolar Youth study participants for psychiatric disorders and SI at intake and for family/peer relationships the month after intake. Multivariate logistic regression examined associations between relationships and SI, controlling for significant covariates. There were 144 youth (36%) who reported SI at intake; bivariate analyses indicated they had significantly worse family/peer relationships. Multivariate analyses showed that family/peer relationships were associated with current SI, controlling for significant covariates. Results support associations between poor relationships and SI in BP youth, regardless of current mood symptom severity. Clinicians should assess relationships when completing risk assessments with BP youth.

Keywords:

• suicidal ideation
• interpersonal relations
• bipolar disorder
• youth

DISCLOSURE STATEMENT

Sewall, Salk, and Liao do not have any conflicts of interest to report.

Additional information

Funding

Goldstein receives grant support from the National Institute of Mental Health (NIMH), the American Foundation for Suicide Prevention, the Brain and Behavior Foundation, the University of Pittsburgh Clinical and Translational Science Institute, and royalties from Guilford Press. Birmaher receives grant support from NIMH, and royalties for publications from Random House, Inc., UpToDate, and Lippencott Williams and Wilkins. Strober receives grant support from NIMH, and support from the Resnick Endowed Chair in Eating Disorders at UCLA. Merranko receives grant support from NIMH. Keller receives grant support from NIMH. Hafeman receives grant support from the NIMH and the Klingenstein Third Generation Foundation. Ryan receives grant support from NIMH. Gill receives grant support from NIMH. Hower receives grant support from the NIMH, and honoraria from the Department of Defense. Yen receives grant support from NIMH and is a consultant at Janssen Research and Development, LLC.

Notes on contributors

Craig Jeffrey Robb Sewall

Craig Jeffrey Robb Sewall, School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA.

Tina R. Goldstein

Tina R. Goldstein, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA.

Rachel H. Salk

Rachel H. Salk, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.

John Merranko

John Merranko, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA.

Mary K. Gill

Mary K. Gill, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA.

Michael Strober

Michael Strober, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, LA, USA; David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Martin B. Keller

Martin B. Keller, Bradley Hospital, East Providence, RI, USA.

Danella Hafeman

Danella Hafeman, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA

Neal D. Ryan

Neal D. Ryan, University of Pittsburgh, School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA.

Shirley Yen

Shirley Yen, Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA.

Heather Hower

Heather Hower, Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, State Providence, RI, USA.

Fangzi Liao

Fangzi Liao, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA.

Boris Birmaher

Boris Birmaher, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA.