Información del artículo
Abstract
Bipolar disorder is associated with high risk for suicidal behavior. Lack of adherence to treatment is one factor that may be partly responsible for this common complication. We searched MEDLINE with the combination of the key words “compliance” or “adherence” with “suicide” and “bipolar”, limited to English language papers published between 1990 and July 2008.We evaluate the existent literature studying the influence of treatment adherence on suicidality among these patients. Our findings show a limited number of studies addressing this issue, mostly conducted with patients enrolled in lithium clinics. Results suggest an association between non-adherence and an increased risk of suicidal behavior among bipolar patients. Whether non-adherence leads to increase risk of suicidality due to specific properties of interventions such as lithium treatment or simply is secondary to mood stabilization is still an open question.
Keywords:
Suicide
Compliance
Comorbidity
Lithium
Resumen
El trastorno bipolar conlleva un riesgo elevado de conductas suicidas. La falta de cumplimiento terapéutico es uno de los factores que, en parte, puede ser la causa de esta complicación frecuente. Realizamos una búsqueda en MEDLINE con la combinación de las palabras clave “compliance” o “adherence” con “suicide” y “bipolar”, y limitada a los artículos publicados en inglés entre 1990 y julio de 2008. Hemos evaluado la literatura médica existente en la que se ha estudiado la influencia del cumplimiento terapéutico en las tendencias suicidas en estos pacientes. Nuestros resultados muestran un número limitado de estudios en los que se ha abordado esta cuestión, la mayoría de ellos llevados a cabo en pacientes registrados en clínicas en que se usa el litio. Los datos obtenidos indican una relación entre la falta de adherencia y el aumento de riesgo de conducta suicida en los pacientes bipolares. Continúa estando sin resolver la cuestión de si la falta de adherencia conduce a un aumento del riesgo de tendencias suicidas a causa de las propiedades específicas de intervenciones como el tratamiento con litio o ello es simplemente secundario a la estabilización del estado de ánimo.
Palabras clave:
Suicidio
Cumplimiento
Comorbilidad
Litio
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