{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:44:15Z","timestamp":1787496255695,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to compare suicide deaths in those with or without bipolar disorder\u00a0(BD), taking into particular consideration the degree to which treatment at the time of death, according to toxicology data, reflects evidence\u2010based pharmacotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Coroner data were coded for all verified suicide deaths in the City of Toronto, Canada (1998\u20132020). Suicide decedents with BD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009340) were compared to the non\u2010BD group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094948) on demographic, clinical, and suicide\u2010related variables. In a subsample of decedents, the presence and\/or lethality of medications or substances at the time of death was identified from toxicology data and compared between groups and across time (two 11.5\u2009year epochs). Data were analyzed using univariate analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Several noteworthy demographic, clinical, and suicide\u2010specific differences between BD and non\u2010BD suicide groups emerged. Antidepressants (48.9%) and benzodiazepines (46.7%) were the most commonly present medications among people with BD, at a proportion similar to the non\u2010BD group. There was a significant decrease in the presence of mood stabilizers across time (33.3% vs. 13.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), and lithium was present in only 5.8% of decedents with BD. Opioids (22.1%) and antipsychotics (22.1%) were the most common substances detected in lethal amounts in the BD group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings of this study suggest that a substantial proportion of people with BD who die by suicide are not receiving first\u2010line treatments at the time of death. While causality cannot be established, further exploration of pharmacotherapy at the time of death would ideally link to living controls to address issues of risk and lethality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70061","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T05:30:12Z","timestamp":1756791012000},"page":"527-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Suicide Deaths in People With Bipolar Disorder: Characteristics and Treatments at Time of Death"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-5042","authenticated-orcid":false,"given":"Ayal","family":"Schaffer","sequence":"first","affiliation":[{"name":"Department of Psychiatry Sunnybrook Health Sciences Centre  Toronto Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto 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