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Bipolar Affective Disorder and Dissociation

A Potentially Lethal Combination

The Nexus Unit, Newcastle, Australia, The Bipolar Program, Newcastle, Australia, Tanya.Hanstock@ hnehealth.nsw.gov.au.

In isolation, bipolar disorder and dissociation can place adolescents at risk of self-harm or suicide. However, when these are combined, they place an adolescent at serious risk of self-harming behavior or suicide completion. It appears from the scarcity in the literature to be rare for adolescents to have the combination of bipolar disorder and dissociation. This article outlines the case of an older adolescent girl with a comorbid combination. This case study highlights how the comorbidity of bipolar disorder and dissociation increases a patient's lethality risk and how both disorders may contribute to the volatile destabilization of the other. Risk management strategies are proposed in relation to the assessment of risk and preparedness for discharge from inpatient facilities.

Key Words: adolescents • bipolar disorder • children • comorbidity • dissociation

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