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Altitude is a risk factor for completed suicide in bipolar disorder.

Authors
  • Huber, Rebekah S1
  • Coon, Hilary2
  • Kim, Namkug3
  • Renshaw, Perry F4
  • Kondo, Douglas G4
  • 1 The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States. Electronic address: [email protected] , (United States)
  • 2 The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States. , (United States)
  • 3 The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea. , (North Korea)
  • 4 The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; VISN 19 Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Medical Center, Salt Lake City, UT, United States. , (United States)
Type
Published Article
Journal
Medical hypotheses
Publication Date
Mar 01, 2014
Volume
82
Issue
3
Pages
377–381
Identifiers
DOI: 10.1016/j.mehy.2014.01.006
PMID: 24495565
Source
Medline
License
Unknown

Abstract

Bipolar disorder (BD) is a severe brain disease that is associated with a significant risk for suicide. Recent studies indicate that altitude of residence significantly affects overall rate of completed suicide, and is associated with a higher incidence of depressive symptoms. Bipolar disorder has shown to be linked to mitochondrial dysfunction that may increase the severity of episodes. The present study used existing data sets to explore the hypothesis that altitude has a greater effect of suicide in BD, compared with other mental illnesses. The study utilized data extracted from the National Violent Death Reporting System (NVDRS), a surveillance system designed by the Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC). Data were available for 16 states for the years 2005-2008, representing a total of 35,725 completed suicides in 922 U.S. counties. Random coefficient and logistic regression models in the SAS PROC MIXED procedure were used to estimate the effect of altitude on decedent's mental health diagnosis. Altitude was a significant, independent predictor of the altitude at which suicides occurred (F=8.28, p=0.004 and Wald chi-square=21.67, p<0.0001). Least squares means of altitude, independent of other variables, indicated that individuals with BD committed suicide at the greatest mean altitude. Moreover, the mean altitude at which suicides occurred in BD was significantly higher than in decedents whose mental health diagnosis was major depressive disorder (MDD), schizophrenia, or anxiety disorder. Identifying diagnosis-specific risk factors such as altitude may aid suicide prevention efforts, and provide important information for improving the clinical management of BD.

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