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.