Comparison of anxiety in patients of bipolar disorder with and without suicidal behaviour.

Introduction: Suicidal behaviour is common in bipolar disorder. This is especially true in anxious patients or comorbid anxiety disorder. The effect of subsyndromal anxiety in this group of patients in India needs to be assessed. This study was undertaken to assess comorbid anxiety in patients of bipolar disorder with and without suicidal behavior and to study the relationship of co-morbid anxiety with suicidal behavior in patients with bipolar disorder. Material & Method: 60 bipolar disorder patients in remission coming to the Central Institute of Psychiatry diagnosed as per DSM IV-TR (American Psychiatric Association, 2000) criteria, 30 with suicidal ideation and 30 without suicidal ideation were taken in the study. Co-morbid conditions other than anxiety were ruled out. They were further assessed on Hamilton Rating Scale for Anxiety. Results: The suicidal group was significantly more depressed than the Non-suicidal group with p < 0.001. Statistically significant positive correlation was found between General Somatic Symptoms (Muscular) item and duration of illness (r=0.481, p<0.01). Statistically significant positive correlation were found between the item anxious (r=0.380, p<0.05) and BSI scores. Statistically significant positive correlation were found between the item tension (r=0.435, p<0.05) and BSI scores. Statistically significant positive correlation was found between depressed mood (r=0.368, p< 0.05) and age of onset. Statistically significant positive correlation was found between General Somatic Symptoms (Muscular) (r=0.434, p< 0.05) and age of onset. Conclusions: Suicidal patients were significantly more depressed than the non suicidal patients. Within the suicidal group it was noted that patients who were more anxious and had more tension had higher scores on the suicidal ideation scale. These two items may be taken as indicators of higher suicidal tendencies in patients of bipolar disorders. Also, somatic symptoms were related to duration of illness. Within the Non-suicidal group, age of onset was related to depressed mood and somatic symptoms.