All searching had been done on an electronically. Of the search criteria one hundred and seventy reports were found. For the article to be relevant to the study it had to follow clinical assessments at baseline and follows the patient for 6 months, the report must be of a person with bipolar or Major Depressive disorder in adults, and must report on complete, attempted or suicidal ideation. Studies were not included if they involved treatment, epidemiologic or community based. 24 of the studies met the conditions to be included in the report. This is due to a small number of reports that address the predictive factors of suicidal ideation. This caused inadequate information to conduct a misanalysis. Instead a narrative synthesis was performed to recognize the major factors of suicidal behavior from the literature they reviewed. They look at both suicide attempters and suicide victims. The term suicidal behavior is used in the review to asses when risk factors predict both acts. There was some issue of agreement on what constituted suicidal …show more content…
The Jorvi Bipolar Study is a joint project, the department of mental health and alcohol research of the national public health institute, Helsinki, and the department of psychiatry, Jorvi Hospital, Helsinki University hospital, Espoo, Finland. Patients were screened for bipolar disorder then requested if they would take part in a longitudinal study to study the multiple phases of bipolar disorder. 177 patients agreed to the study. Almost 59% of participants, out of 177, had depressive episodes or phases. It was noted that there where varying levels of suicidal ideation and attempt at different phases of Bipolar disorder. Only 32 (18%) attempted suicide during the study period. There ascertained that there is a possibility of four phases of bipolar disorder. The first being depressive phase in which varied hopelessness, anxiety, and degree of depression (subjective and objective) have an effect on varying degree of suicidal ideation. Hopelessness, anxiety and depression. Mixed and depressive mixed phase also had significant levels of suicidal ideation, however, it was noticed in the mixed phase hopelessness levels correlated with increased suicidal ideation. It was found that the hypomanic/manic phase had no attempts at suicidal attempts It was found that hopelessness affected suicidal behavior during the depressive phase. People of