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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Substance use disorders in adolescent and young adult relatives of probands with bipolar disorder: What drives the increased risk?
Leslie A. Hulvershorn,Jennifer King,Patrick O. Monahan,Holly C. Wilcox,Philip B. Mitchell,Janice M. Fullerton,Howard J. Edenberg,Gloria Roberts,Masoud Kamali,Masoud Kamali,Anne L. Glowinski,Neera Ghaziuddin,Melvin G. McInnis,Priya A. Iyer-Eimerbrink,John I. Nurnberger +14 more
TL;DR: In this article, the authors found that adults with bipolar disorder have higher rates of substance use disorders compared to the general population, as well as factors which drive those rates, are not as well-characterized.
Journal ArticleDOI
Clinical correlates of suicidality and self-injurious behaviour among Canadian adolescents with bipolar disorder.
Diana Khoubaeva,Mikaela Dimick,Mikaela Dimick,Vanessa Timmins,Lisa Fiksenbaum,Rachel H.B. Mitchell,Rachel H.B. Mitchell,Ayal Schaffer,Ayal Schaffer,Mark Sinyor,Mark Sinyor,Benjamin I. Goldstein,Benjamin I. Goldstein +12 more
TL;DR: In this paper, the authors found that 73.6% of adolescents with bipolar disorder had history of suicide attempts, NSSI, and/or self-injury, and SI was associated with poorer global functioning at most severe episode.
Dissertation
Mortality, substance use disorder and cardiovascular health care in persons with severe mental illness
TL;DR: The increased mortality in patients with schizophrenia and/or substance use disorder corresponded to more than 10,000 premature deaths, which constituted 84% of all deaths in the cohort, and the persistent mortality gap highlights the importance of securing systematic screening and PLOS ONE.
Journal ArticleDOI
Impact of a Web-Based Psychiatric Assessment on the Mental Health and Well-Being of Individuals Presenting With Depressive Symptoms: Longitudinal Observational Study.
Dan-Mircea Mirea,Nayra A Martin-Key,Giles Barton-Owen,Tony Olmert,Jason D. Cooper,Sung Yeon Sarah Han,Lynn P. Farrag,Emily K. Bell,Lauren V. Friend,Pawel Eljasz,Daniel Cowell,Jakub Tomasik,Sabine Bahn +12 more
TL;DR: The results suggest that completing a web-based mental health assessment and receiving personalized psychoeducation are associated with subjective mental health improvements, facilitated by increased self-awareness and subsequent use of self-help interventions.
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Simulation enhanced interprofessional education with nurse practitioner and medical students for patients with bipolar disorder: Facilitators and barriers in teamwork
TL;DR: It is recommended that integrating this type of longitudinal Sim-IPE sessions into curricula of all health professions education can improve successful learning of teamwork in psychiatric care.
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