Is there an association between suicide attempt and delay of initiation of mood stabilizers in bipolar I disorder?

Background is known about the extent to which delay of initiation of mood-stabilizing treatment may influence outcomes in bipolar patients (BP). In this study, our aim was to investigate the association between delay of mood stabilizer treatment in bipolar patients and lifetime history of suicide attempts. ecutive sample of 268 bipolar I outpatients from two teaching hospitals in Brazil was recruited. The assessment included a socio-demographic history form, a clinical interview regarding clinical variables and the Structured Clinical Interview for DSM-IV. Participants were divided into three groups: BP that initiated the first mood stabilizer in the same year of the first episode of the disease (FMS ≤ 1), between 1 and 5 years after the first episode of the disease (1 < FMS ≤ 5), and after 5 years after the first episode of BD (FMS > 5). s an time from the first episode until the first mood stabilizer medication was 8.6 years (SD 9.8 years). The FMS > 5 group, showed a higher lifetime prevalence of suicide attempts than the other two groups (PR = 1.75, 95% CI: 1.24–2.47), p = 0.001. These results remained significant after adjusting for potential confounders, (PR = 1.82, 95% CI: 1.29–2.60), p = 0.001. tions tudy evaluated patients retrospectively and does not permit a cause-effect relationship. sion esent study supports the importance of early diagnosis and early intervention for BP in order to limit the potentially lethal impact of the disease.