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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Dysregulation of glucose metabolism since young adulthood increases the risk of cardiovascular diseases in patients with bipolar disorder
TL;DR: It is suggested that glucose dysregulation across the adult age span is the major metabolic risk contributing to CVDs in patients with BD, and Clinicians have to notice the serum fasting glucose levels of BD patients since young adulthood.
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Appraisal of physical health guidelines for severe mental illness
TL;DR: Most guidelines scored poorly when rated by the AGREE II Instrument, but these guidelines may still be useful in assisting evidence-based clinical practice and the methodological rigour of future guidelines can be improved by ensuring the AGree II domains are addressed during the development phase.
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Personality disorders as predictors for the conversion from major depressive disorder to bipolar disorder: A prospective cohort study
Gisele Bartz de Ávila,B. B. Montezano,Luciano Dias de Mattos Souza,Taiane de Azevedo Cardoso,Ricardo Azevedo da Silva,Thaíse Campos Mondin,Fernanda Pedrotti Moreira,Karen Jansen +7 more
TL;DR: In this article , a prospective cohort study conducted in two waves was conducted to assess whether personality traits in individuals with major depressive disorder (MDD) can predict the conversion to bipolar disorder (BD).
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The clinical and cost effectiveness of adapted dialectical behaviour therapy (DBT) for bipolar mood instability in primary care (ThrIVe-B programme): a feasibility study.
Kim Wright,Alyson Dodd,Fiona C Warren,Antonieta Medina-Lara,Rod S Taylor,Steven Jones,Christabel Owens,Mahmood Javaid,Barney Dunn,Julie E Harvey,Alexandra Newbold,Thomas R. Lynch +11 more
TL;DR: This feasibility study is a phase II evaluation of a dialectical behavioural therapy-informed approach (Therapy for Inter-episode mood Variability in Bipolar) to examine the feasibility and acceptability of a future definitive trial evaluating the clinical and cost effectiveness of the ThrIVe-B programme.
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Bipolar disorder and medical comorbidities: A Portuguese population-based observational retrospective study (2008–2015)
TL;DR: In this article , the authors used the Charlson Comorbidity Index (CCI) to assess the prevalence of medical comorbidities among hospitalization episodes with a primary Bipolar Disorder diagnosis, and to analyze its association with hospitalization outcomes.
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