{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:20:45Z","timestamp":1789438845536,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T00:00:00Z","timestamp":1443484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CD13\/0149"],"award-info":[{"award-number":["CD13\/0149"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2015,11]]},"abstract":"\n Objectives<\/jats:title>\n \n The Bipolar Disorders: Improving Diagnosis, Guidance, and Education (\n BRIDGE<\/jats:styled-content>\n \u2010\n II<\/jats:styled-content>\n \u2010Mix) study aimed to estimate the frequency of mixed states in patients with a major depressive episode (\n MDE<\/jats:styled-content>\n ) according to different definitions and to compare their clinical validity, looking into specific features such as suicidality.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 2,811 subjects were enrolled in this multicenter cross\u2010sectional study. Psychiatric symptoms, and sociodemographic and clinical variables were collected. The analysis compared the characteristics of patients with\n MDE<\/jats:styled-content>\n with (\n MDE<\/jats:styled-content>\n \u2010\n SA<\/jats:styled-content>\n group) and without (\n MDE<\/jats:styled-content>\n \u2010\n NSA<\/jats:styled-content>\n ) a history of suicide attempts.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The history of suicide attempts was registered in 628 patients (22.34%). In the\n MDE<\/jats:styled-content>\n \u2010\n SA<\/jats:styled-content>\n group, women (72.5%, p = 0.028), (hypo)mania in first\u2010degree relatives (20.5%, p < 0.0001), psychotic features (15.1%, p < 0.0001), and atypical features (9.2%, p = 0.009) were more prevalent.\n MDE<\/jats:styled-content>\n \u2010\n SA<\/jats:styled-content>\n patients\u2019 previous responses to treatment with antidepressants included more (hypo)manic switches [odds ratio (\n OR<\/jats:styled-content>\n ) = 1.97, 95% confidence interval (\n CI<\/jats:styled-content>\n ): 1.58\u20132.44, p < 0.0001], treatment resistance (\n OR<\/jats:styled-content>\n = 2.07, 95%\n CI<\/jats:styled-content>\n : 1.72\u20132.49, p < 0.0001), mood lability (\n OR<\/jats:styled-content>\n = 1.98, 95%\n CI<\/jats:styled-content>\n : 1.65\u20132.39, p < 0.0001), and irritability (\n OR<\/jats:styled-content>\n = 1.80, 95%\n CI<\/jats:styled-content>\n : 1.48\u20132.17, p < 0.0001). Multivariate analysis evidenced that risky behavior, psychomotor agitation and impulsivity, and borderline personality and substance use disorders were the variables most frequently associated with previous suicide attempts. In the\n MDE<\/jats:styled-content>\n \u2010\n SA<\/jats:styled-content>\n group, 75 patients (11.9%) fulfilled Diagnostic and Statistical Manual (DSM)\u20105 criteria for\n MDE<\/jats:styled-content>\n with mixed features, and 250 patients (39.8%) fulfilled research\u2010based diagnostic criteria for a mixed depressive episode.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Important differences between\n MDE<\/jats:styled-content>\n \u2010\n SA<\/jats:styled-content>\n and\n MDE<\/jats:styled-content>\n \u2010NSA patients have emerged. Early identification of symptoms such as risky behavior, psychomotor agitation, and impulsivity in patients with\n MDE<\/jats:styled-content>\n , and treatment of mixed depressive states could represent a major step in suicide prevention.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bdi.12338","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T01:36:51Z","timestamp":1443490611000},"page":"795-803","source":"Crossref","is-referenced-by-count":89,"title":["Suicide attempts in major depressive episode: evidence from the\n BRIDGE<\/scp>\n \u2010\n II<\/scp>\n \u2010Mix study"],"prefix":"10.1111","volume":"17","author":[{"given":"Dina","family":"Popovic","sequence":"first","affiliation":[{"name":"Barcelona Bipolar Disorders Program Hospital Clinic University of Barcelona IDIBAPS CIBERSAM Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Vieta","sequence":"additional","affiliation":[{"name":"Barcelona Bipolar Disorders Program Hospital Clinic University of Barcelona IDIBAPS CIBERSAM Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Michel","family":"Azorin","sequence":"additional","affiliation":[{"name":"H\u00f4pital Sainte\u2010Marguerite Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules","family":"Angst","sequence":"additional","affiliation":[{"name":"Psychiatric Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles L","family":"Bowden","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center San Antonio TX 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