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Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder.

Title: Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder.
Name(s): Stanley, Ian H, author
Hom, Melanie A, author
Luby, Joan L, author
Joshi, Paramjit T, author
Wagner, Karen D, author
Emslie, Graham J, author
Walkup, John T, author
Axelson, David A, author
Joiner, Thomas E, author
Type of Resource: text
Genre: Journal Article
Date Issued: 2017-12-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6-15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH-U-KSADS and the CDRS-R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed.
Identifier: FSU_pmch_28777984 (IID), 10.1016/j.jpsychires.2017.07.027 (DOI), PMC5653415 (PMCID), 28777984 (RID), 28777984 (EID), S0022-3956(17)30625-8 (PII)
Keywords: Bipolar disorder, Nightmares, Sleep disturbances, Suicide risk, Youth
Grant Number: U01 MH064868, R01 MH051481, U01 MH064846, U01 MH064911, U01 MH064869, U01 MH064851, U01 MH064887, U01 MH064850
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at
Subject(s): Adolescent
Bipolar Disorder/epidemiology
Sleep Arousal Disorders/epidemiology
Sleep Wake Disorders/epidemiology
Suicide/statistics & numerical data
Persistent Link to This Record:
Host Institution: FSU
Is Part Of: Journal of psychiatric research.
Issue: vol. 95

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Stanley, I. H., Hom, M. A., Luby, J. L., Joshi, P. T., Wagner, K. D., Emslie, G. J., … Joiner, T. E. (2017). Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder. Journal Of Psychiatric Research. Retrieved from