Is religiosity a protective factor against suicidal behavior in bipolar I outpatients?

• Published in: Journal of affective disorders 2015-11, Vol.186, p.156-161
• Main Authors: Caribé, André C, Studart, Paula, Bezerra-Filho, Severino, Brietzke, Elisa, Nunes Noto, Mariane, Vianna-Sulzbach, Mireia, Kapczinski, Flavio, Silva Neves, Fernando, Correa, Humberto, Miranda-Scippa, Ângela
• Format: Article
• Language: English
• Subjects: Adult; Bipolar disorder; Bipolar Disorder - psychology; Brazil; Comorbidity; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Outpatients - psychology; Protective Factors; Psychiatry; Religion and Psychology; Religiosity; Spirituality; Suicidal behavior; Suicidality; Suicide; Suicide attempt; Suicide, Attempted - prevention & control; Suicide, Attempted - psychology; Surveys and Questionnaires
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2015.07.024

Abstract Background Several risk factors have been associated with suicidal behavior (SB) in bipolar disorder (BD), but little is known regarding possible protective factors. Religiosity has been related to favorable outcomes in mental health and to a reduction in the risk of SB, although the relation between BD, religiosity and SB remains under-investigated. The objective of this study was to evaluate the association between religiosity and SB in euthymic bipolar I outpatients. Method In this study, 164 outpatients with BD type I with and without a history of suicide attempts were assessed and compared using a questionnaire to collect clinical and sociodemographic characteristics, the Structured Clinical Interview for DSM-IV, the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Duke Religious Index, and the Barratt Impulsivity Scale. Results The suicide attempters (SA) group had more psychiatric comorbidity ( p =0.007), more rapid cycling ( p =0.004), higher levels of impulsivity in all domains ( p =0.000), and less religious affiliation ( p =0.006) compared with the non-SA group. In the multivariate analysis, after controlling for covariates, non-organizational religious activities (OR, 0.66; 95% CI, 0.50–0.86) and intrinsic religiosity (OR, 0.70; 95% CI, 0.60–0.81) were associated with less SB. Limitations A small sample size, the cross-sectional design that precluded the possibility of assessing cause and effect relationships, and the infeasibility of determining the time lapse between the last suicide attempt and the period when the patients were evaluated. Conclusion Non-organizational religious activities and intrinsic religiosity dimensions exert a protective effect against SB in bipolar I outpatients, even when controlling for variables that may affect the outcome in question.