Pilot sample of very early onset bipolar disorder in a military population moderates the association of negative life events and non-fatal suicide attempt

Objectives: To examine the moderating effects of very early onset diagnostic status (≤ 13 years) upon the association between life events and non-fatal suicide attempt. Methods: Measures of negative life events, suicidal ideation and current suicide attempt were administered to 298 military-based young adults at entry to treatment for suicidality. Current and lifetime diagnoses were assigned using the Diagnostic Interview Schedule. The predictive ability of negative life events for non-fatal suicide attempt was examined separately for the total sample and for those with retrospectively determined histories of very early onset bipolar disorder (VEOBPD; n = 16), very early onset major depressive disorder (VEOMDD; n = 21) and very early onset anxiety disorder (VEOANX; n = 53). Results: Negative life events and suicide attempt were significantly and positively associated among those with no history of VEOBPD (OR = 1.30, 95% CI = 1.02-1.65, p \u3c 0.05), including those with VEOMDD and VEOANX. Consistent with expectation, VEOBPD moderated the association between negative life events and suicide attempt (OR = 0.88, 95% CI = 0.78-0.99, p \u3c 0.05), such that negative life events were non-significantly and negatively associated with the presence of a suicide attempt (OR = 0.21, 95% CI = 0.04-1.02, p = 0.09) among patients with a history of VEOBPD. Conclusions: Despite similar rates of suicide attempt among all diagnostic groups, life stress did not contribute to attempt among those with VEOBPD. These findings are consistent with the severity and chronicity of VEOBPD. Potential explanations of these findings include a scarring effect on coping skills and increased sensitization to life stress. © 2006 Blackwell Munksgaard