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Suicidality and Its Association With Insight and Neurocognition in Taiwanese Patients With Bipolar I Disorder in Remission

Yen, Cheng-Fang MD, PhD*†; Cheng, Chung-Ping PhD; Ko, Chih-Hung MD†§; Yen, Ju-Yu MD†§∥; Huang, Chi-Fen BS*; Chen, Cheng-Sheng MD*†§

The Journal of Nervous and Mental Disease: June 2008 - Volume 196 - Issue 6 - p 462-467
doi: 10.1097/NMD.0b013e3181775a3d
Original Article

The aims of this study were to examine the relationships between suicidality, insight, and neurocognition in patients with bipolar I disorder who were in a remitted state. Using the Violence and Suicide Assessment Scale, we evaluated 96 patients with bipolar I disorder in remission to determine their suicidal ideations and attempts over the previous year. We also evaluated their level of insight by using the Schedule of Assessment of Insight (SAI) and its expanded version (SAI-E), as well as their neurocognitive function by a series of neurocognitive function tests. Insight and neurocognitive functions of bipolar subjects who had and who had no suicidal ideations or attempts over the previous year were compared. The results indicated that the remitted bipolar subjects who had suicidal ideations or attempts over the previous year had higher insight scores on all 3 SAI dimensions and on the SAI-E compared with those who had no suicidal ideations or attempts. However, no difference in any neurocognitive function was found between the 2 groups of remitted bipolar subjects. The results of this study suggest clinicians need to be particularly alert to the potential for suicide in bipolar patients with a high level of insight.

*Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University; †Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; ‡Department of Psychology and Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan; §Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University; and ∥Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Supported by grant NSC 91-2413-H-037-005 and grant NSC 92-2413-H-037-010 awarded by the National Science Council, Taiwan (ROC).

Send reprint requests to Cheng-Sheng Chen, MD, Department of Psychiatry, Kaohsiung Medical University, No. 100, Tzyou 1st Rd, Kaohsiung 807, Taiwan. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.