(PS9-B36) Perceived Loneliness and Social Support in Bipolar Disorder: Relation to Suicidal Ideation and Attempts

The rate of suicide in bipolar disorder (BD) is 20-30 times greater than in the general population and is among the highest across all psychiatric conditions. Identifying modifiable variables related to suicidal thoughts and behaviors (STBs) in BD may inform prevention strategies. Connection with others is a modifiable variable found to relate to STBs in the general population, but the relationship has been studied to a lesser extent in BD and existing findings have been equivocal. Many studies have reported an increase in loneliness since the start of the COVID-19 pandemic owing to social distancing guidelines and resulting shifts in norms related to the workplace and social interaction. Thus, social connection may be a particularly important variable to target when seeking to reduce STBs. The aim of this study was to explore how perceived levels of connection relate to STBs in those with BD in order to inform prevention and intervention strategies.The sample consisted of participants with BD (N = 75) and healthy controls (N = 47) aged 18-68. The majority of the sample was white (77.9%) with a mean age of 42.3 years. All participants completed clinical interviews: the Hamilton Depression Rating Scale (HAM-D) assessed depression severity and presence of current suicidal ideation, and the Structured Clinical Interview for DSM-5 (SCID-5) assessed number of lifetime suicide attempts. Participants also completed self-report measures of subjective feelings of trait-level loneliness (UCLA Loneliness Scale) and social support (Interpersonal Support Evaluation List). Logistic and linear regressions were conducted to explore relationships between STBs (lifetime suicide attempts and presence of current suicidal ideation) and indicators of social connection (loneliness and social support). Results indicated that BD participants perceived their levels of loneliness (F (1,116) = 40.037, p < .001) and social support (F (1,113) = 33.153, p < .001) as significantly worse than healthy controls. In BD, perceived social support was significantly related to both ever having attempted suicide (p = .038) and number of lifetime suicide attempts (p = .034). Interestingly, perceived loneliness (p = .029), but not perceived social support, was significantly associated with the presence of current suicidal ideation per the HAM-D. These results are limited by the cross-sectional study design and modest sample size, and future research evaluating the longitudinal relationship between social connection and STBs in a larger sample is warranted. Nonetheless, findings expand the evidence-base supporting a relationship between perceived social connection and STBs in BD and suggest potential nuance to this association. Specifically, whereas high loneliness may be more heavily linked to thoughts of suicide, low social support may be more heavily linked to suicide attempt. Findings also build support for social connection as a fruitful treatment target for suicide prevention in this population.