Suicide Attempts in Juvenile Bipolar Versus Major Depressive Disorders: Systematic Review and Meta-Analysis

Stefano Vicari, Giulia Serra, Mai Uchida, Hilary Woodworth, Maria Pia Casini, Ross J. Baldessarini

Research output: Contribution to journalArticle

13 Citations (Scopus)


OBJECTIVE: Suicide attempts are prevalent in association with major mood disorders, and risk is greater with bipolar disorder (BD) than major depressive disorder (MDD) in adults. There may be similar relationships in juvenile mood disorders, but the evidence has not been compiled systematically and quantitatively. METHOD: We searched for reports of studies comparing rates of suicide attempts in children or adolescents diagnosed with BD or MDD, and applied random-effects meta-analysis. RESULTS: In 6 reports from 1995 to 2017, with 2,303 participants diagnosed with mood disorder from the United States and South Korea, aged 3 to 18 years, rates of suicide attempts differed significantly by diagnosis: BD (31.5%) > MDD (20.5%) > hypomania or mania-only (8.49%). Risk of suicide attempts differed (BD > MDD) highly significantly by meta-analysis (odds ratio [OR] = 1.71, CI = 1.33-2.20, p < .0001), and was very similar if a study with attempts and suicidal ideation was excluded (OR = 1.64, CI = 1.26-2.15, p < .0001). CONCLUSION: Risk of suicide attempts in juvenile mood disorder patients ranked: BD > MDD >> hypomania or mania-only >> juvenile general population.
Original languageEnglish
Pages (from-to)825-831
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Publication statusPublished - 2017


  • affective
  • bipolar
  • depression
  • meta-analysis
  • suicide attempt


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