Comorbidities and Mortality in Bipolar Disorder A Swedish National Cohort Study
Casey Crump,Kristina Sundquist,Kristina Sundquist,Marilyn A. Winkleby,Jan Sundquist,Jan Sundquist +5 more
TLDR
Patients with bipolar disorder had increased mortality from cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), influenza or pneumonia, unintentional injuries, and suicide for both women and men and cancer for women only.Abstract:
Importance Bipolar disorder is associated with premature mortality, but the specific causes and underlying pathways are unclear. Objective To examine the physical health effects of bipolar disorder using outpatient and inpatient data for a national population. Design, Setting, and Participants National cohort study of 6 587 036 Swedish adults, including 6618 with bipolar disorder. Main Outcomes and Measures Physical comorbidities diagnosed in any outpatient or inpatient setting nationwide and mortality (January 1, 2003, through December 31, 2009). Results Women and men with bipolar disorder died 9.0 and 8.5 years earlier on average than the rest of the population, respectively. All-cause mortality was increased 2-fold among women (adjusted hazard ratio [aHR], 2.34; 95% CI, 2.16-2.53) and men (aHR, 2.03; 95% CI, 1.85-2.23) with bipolar disorder, compared with the rest of the population. Patients with bipolar disorder had increased mortality from cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), influenza or pneumonia, unintentional injuries, and suicide for both women and men and cancer for women only. Suicide risk was 10-fold among women (aHR, 10.37; 95% CI, 7.36-14.60) and 8-fold among men (aHR, 8.09; 95% CI, 5.98-10.95) with bipolar disorder, compared with the rest of the population. Substance use disorders contributed only modestly to these findings. The association between bipolar disorder and mortality from chronic diseases (ischemic heart disease, diabetes, COPD, or cancer) was weaker among persons with a prior diagnosis of these conditions (aHR, 1.40; 95% CI, 1.26-1.56) than among those without a prior diagnosis (aHR, 2.38; 95% CI, 1.95-2.90; P interaction = .01). Conclusions and Relevance In this large national cohort study, patients with bipolar disorder died prematurely from multiple causes, including cardiovascular disease, diabetes, COPD, influenza or pneumonia, unintentional injuries, and suicide. However, chronic disease mortality among those with more timely medical diagnosis approached that of the general population, suggesting that better provision of primary medical care may effectively reduce premature mortality among persons with bipolar disorder.read more
Citations
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Areas of controversy in neuroprogression in bipolar disorder.
Ives Cavalcante Passos,Benson Mwangi,Eduard Vieta,Michael Berk,Michael Berk,Flávio Kapczinski +5 more
TL;DR: Clinical features and biological underpinnings related to neuroprogression in bipolar disorder (BD) and areas of controversy and future research in the field are discussed.
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The theory of bipolar disorder as an illness of accelerated aging: implications for clinical care and research.
Lucas B. Rizzo,Leonardo Gazzi Costa,Rodrigo B. Mansur,Walter Swardfager,Sintia Iole Belangero,Rodrigo Grassi-Oliveira,Roger S. McIntyre,Moisés Evandro Bauer,Elisa Brietzke +8 more
TL;DR: How the understanding of aging and senescence can contribute to the search for new and promising molecular targets to explain and ameliorate neuroprogression in bipolar disorder is discussed.
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Disruption in the Blood-Brain Barrier: The Missing Link between Brain and Body Inflammation in Bipolar Disorder?
TL;DR: This work proposes a novel model wherein transient or persistent disruption of BBB integrity is associated with decreased CNS protection and increased permeability of proinflammatory substances from the peripheral blood into the brain.
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Bipolar disorder prevalence: a systematic review and meta-analysis of the literature.
Adauto Silva Clemente,Breno S. Diniz,Rodrigo Nicolato,Flávio Kapczinski,Jair C. Soares,Josélia Oliveira Araújo Firmo,Erico Castro-Costa +6 more
TL;DR: It is confirmed that estimates of BD type 1 and type 2 prevalence are low in the general population and the increase in prevalence from DSM- III and DSM-III-R to DSM-IV may reflect different factors, such as minor changes in diagnostic operationalization, use of different assessment instruments, or even a genuine increase in the prevalence of BD.
Journal ArticleDOI
The economic burden of bipolar I disorder in the United States in 2015
TL;DR: Besides direct healthcare costs, BDI was associated with substantial direct non-healthcare and indirect costs and more effective treatments and practices are needed to optimize therapeutic strategies and contain direct and indirect Costs.
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