Patients with bipolar disorder have a higher risk of committing suicide(15-20%) Poor impulse control might be the mechanism by which suicidality may become manifest in bipolar disorder.

To determine the nature of poor impulse control and suicidal behaviour.

To understand the relationship between poor impulse control,co-morbid diagnosis and suicidal behaviour in patients with bipolar disorder.

A cross sectional study was carried out in 40 patients with bipolar disorder. Clinical parameters were established using semi-structured interview, co-morbid diagnosis and impulse control disorders using SCID. All completed impulsivity questionnaire (UPPS) and Suicidal behaviour questionnaire (SBQ). ANOVA and Pearsons correlation was performed.

There was high degree of co-morbidity (55% anxiety, 30% substance use, 13% personality disorder and 47% impulse control disorder). 45% did not have a past history of self harm, 40% had history of less severe self harm and 15%had near fatal self harm history.The sample mean showed significant difference compared to population mean (P<0.05) with marked difference noted for near fatal self harm group (P<0.01) indicating that patients with bipolar disorder might have a high degree of trait impulsivity.The three items on impulsivity scale-lack of premeditation, urgency and lack of perseverance correlated significantly (P<0.01) with the future likelihood of dying.

This study supports the view that there is a high degree of suicidal behaviour in bipolar disorder.15% of the sample had past history of near-fatal self harm.High scores of trait impulsivity in sample are akin to scores for patients with borderline personality and addiction. There is a clear correlation between impulsivity scores and future risk of completed suicide.