Suicidal ideation and attempts in adolescents are closely associated to bipolar disorders (BD). Growing evidence also suggests that high functioning autism spectrum disorders (HF-ASD) are at increased risk for suicidal ideation and behaviors. Although BD and HF-ASD are frequently comorbid, no studies explored suicidality in these individuals. This exploratory study addressed this issue in a clinical group of inpatient adolescents referred to a psychiatric emergency unit. Seventeen adolescents with BD and HF-ASD and severe suicidal ideation or attempts (BD-ASD-S), were compared to 17 adolescents with BD and HF-ASD without suicidal ideation or attempts (BD-ASD-noS), and to 18 adolescents with BD and suicidal ideation or attempts without ASD (BD-noASD-S), using a structured assessment methodology. Individuals with BD-ASD-S had a higher intelligence quotient, more severe clinical impairment, more lethality in suicide attempts, more internalizing symptoms, less impulsiveness, and lower social competence. Severity of ASD traits in individuals and parents did not correlate with suicidal risk. Some dimensions of resilience were protective in terms of repulsion by life and attraction to death. Main limitations are the small sample size, the lack of a control group of typically developing adolescents. However, a better understanding of the specificities of bipolar HF-ASD individuals with suicidality may improve prevention and treatment strategies.

中文翻译：

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具有功能性自闭症谱系障碍和共病双相障碍的转诊青少年的自杀意念和自杀尝试：一项初步研究

青少年的自杀意念和尝试与双相情感障碍（BD）密切相关。越来越多的证据还表明，高功能自闭症谱系障碍（HF-ASD）的自杀意念和行为风险增加。尽管BD和HF-ASD经常并存，但尚无研究探讨这些人的自杀倾向。这项探索性研究在被称为精神科急诊科的住院青少年临床组中解决了这个问题。将17例BD和HF-ASD且有严重自杀意念或未遂（BD-ASD-S）的青少年与17例BD和HF-ASD的未自杀意念或未尝试（BD-ASD-noS）的青少年以及18例青少年进行了比较使用结构化评估方法进行BD和自杀意念或没有ASD的尝试（BD-noASD-S）。患有BD-ASD-S的个体的智商更高，临床损伤更严重，自杀未遂的致死率更高，内在症状更多，冲动更少，社交能力更低。个体和父母的ASD特征严重程度与自杀风险无关。弹性的某些方面在生命排斥和死亡吸引力方面具有保护作用。主要局限性是样本量小，缺乏通常发育中的青少年的对照组。但是，更好地了解具有自杀倾向的双相HF-ASD患者的特异性可能会改善预防和治疗策略。个体和父母的ASD特征严重程度与自杀风险无关。弹性的某些方面在生命排斥和死亡吸引力方面具有保护作用。主要局限性是样本量小，缺乏通常发育中的青少年的对照组。但是，更好地了解具有自杀倾向的双相HF-ASD患者的特异性可能会改善预防和治疗策略。个体和父母的ASD特征严重程度与自杀风险无关。弹性的某些方面在生命排斥和死亡吸引力方面具有保护作用。主要局限性是样本量小，缺乏通常发育中的青少年的对照组。但是，更好地了解具有自杀倾向的双相HF-ASD患者的特异性可能会改善预防和治疗策略。