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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Metabolic Comorbidity and Physical Health Implications for Bipolar Disorder: An Update
TL;DR: Co-occurrence of obesity or type 2 diabetes mellitus and bipolar disorder has been suggested to contribute to cognitive dysfunction, a core feature of bipolar disorder and a principal mediator of functional disability, highlighting the clinical releva...
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Treating Bipolar Disorder in Primary Care: Diagnosis, Pharmacology, and Management
Heather Huang,Nicholas J Nissen,Christopher T Lim,Jessica L. Gören,Margaret Spottswood,Hsiang-Ning Huang +5 more
TL;DR: In this article , the authors provide primary care providers with an evidence-based approach to the screening, diagnosis, and pharmacological management of bipolar disorder, and guidance for helping patients connect with higher levels of specialty psychiatric care when clinically indicated.
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Physical Health Impairment and Exercise as Medicine in Severe Mental Disorders: A Narrative Review
TL;DR: In this paper , the authors review and critically appraise the evidence based on key physiological factors relating to aerobic endurance and skeletal muscle strength; implications for physical function and health; and effects of training interventions with different intensities evaluated in individuals with severe mental disorders.
Book ChapterDOI
Innate Immune Response and Psychotic Disorders
Jaana Suvisaari,Outi Mantere +1 more
TL;DR: The evidence linking innate immune responses to the developmental process leading to psychotic disorders has been reviewed and indicates that people with first-episode psychosis and with chronic psychotic disorders seem to have both proinflammatory activation of the innate immune system and an activation of T cells of the adaptive immune system.
Journal ArticleDOI
Psychiatric symptoms and mortality in older adults with major psychiatric disorders: results from a multicenter study
Margaux Chene,Marina Sánchez-Rico,Carlos Blanco,Rachel Pascal De Raykeer,Cécile Hanon,Frédéric Limosin,Nicolas Hoertel,Jean Adès,C Alezrah,Isabelle Amado,Gilles Amar,O. Andrei,D. Arbault,G. Archambault,G. Aurifeuille,Sarah Barrière,Céline Béra-Potelle,Yvonne Blumenstock,H. Bardou,M. Bareil-Guerin,P. Barrau,C. Barrouillet,Emilie Baup,Nadine Bazin,Béatrice Beaufils,Jalel Ben Ayed,Michel Benoit,A K Benyacoub,T. Bichet,F. Blanadet,Olivier Blanc,J. Blanc-Comiti,Didier Boussiron,A. Bouysse,A Brochard,O. Brochart,B. Bucheron,Maria R. Cabot,Vincent Camus,J.-M. Chabannes,V. Charlot,Thomas Charpeaud,C. Clad-Mor,Col James Combes,M. Comisu,Sylvaine Cordier,F. Costi,J. Courcelles,M. Creixell,H. Cuche,Christine Cuervo-Lombard,A. Dammak,David Rin,J. B. Denis,Hélène Denizot,A. Deperthuis,E. Diers,S. Dirami,D. Donneau,P. Dreano,Caroline Dubertret,E. Duprat,D. Duthoit,C. Fernandez,P. Fonfrede,Nelly Freitas,P. Gasnier,J Gauillard,F. Getten,Fabien Gierski,F. Godart,Raphaël Gourevitch,Aude Grassin Delyle,J. Gremion,Hélène Gres,Veronique Griner,Christophe Guerin-Langlois,C. Guggiari,Olivier Guillin,H. Hadaoui,Emmanuel Haffen,Sadeq Haouzir,Cyril Hazif-Thomas,Anne Héron,B. Hubsch,Isabelle Jalenques,Dominique Januel,Arthur Kaladjian,J. Karnycheff,Oussama Kebir,Marie-Odile Krebs,Christine Lajugie,Marion Leboyer,Pierre Legrand,Michel Lejoyeux,Vincent Lemaire,Eve Leroy,D Lévy-Chavagnat,Antoine Leydier,C. Liling,Pierre-Michel Llorca,P. Loeffel,Patrice Louville,Stéphane Lucas Navarro,N. Mages,M. Mahi,Odile Maillet,Aude Manetti,Catherine Martelli,Pascal Martin,M. Masson,I. Maurs-Ferrer,Joëlle Mauvieux,S. Mazmanian,E. Mechin,Lila Mekaoui,M. Meniai,A Metton,Amine Mihoubi,Mary Miron,G. Mora,Valérie Niro Adès,Philippe Nubukpo,C. Omnes,S. V. Papin,Pierre Paris,Christine Passerieux,Jérôme Pellerin,Julie Perlbarg,S. Perron,A. Petit,François Petitjean,Christophe Portefaix,D. Pringuey,Andrei Radtchenko,H. Rahiou,Delphine Raucher-Chéné,A. Rauzy,L. Reinheimer,Michel Renard,Margaux René,Charles-Edouard Rengade,Paul Reynaud,Didier Robin,C. Rodrigues,A. Rollet,Fabien Rondepierre,B. Rousselot,S. Rubingher,Ghassen Saba,J. Salvarelli,Jean-Claude Samuelian,C. Scemama-Ammar,F. Schurhoff,Jean-Pierre Schuster,Daniel Sechter,B. Segalas,T. Seguret,Anne-Sophie Seigneurie,A. Semmak,Frédéric Slama,Sophie Taisne,M. Taleb,Jean-Louis Terra,D. Thefenne,Eric Tran,R. Tourtauchaux,M.N. Vacheron,Pierre Vandel,V. Vanhoucke,E. Venet,Hélène Verdoux,A. Viala,Gilles Vidon,M. Vitre,J. Vurpas,C. Wagermez,Michel Walter,Liova Yon,Xavier Zendjidjian +179 more
TL;DR: It is found that all psychiatric symptoms were associated with increased mortality, and that their effect on the 5-year mortality were exerted mostly through a general psychopathology dimension.
References
More filters
Journal ArticleDOI
Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study
TL;DR: The three leading contributors to the burden of disease are communicable and perinatal disorders affecting children, and the substantial burdens of neuropsychiatric disorders and injuries are under-recognised.
Journal ArticleDOI
External review and validation of the Swedish national inpatient register
Jonas F. Ludvigsson,Jonas F. Ludvigsson,Eva Andersson,Anders Ekbom,Maria Feychting,Jeong-Lim Kim,Christina Reuterwall,Mona Heurgren,Petra Otterblad Olausson +8 more
TL;DR: The validity of the Swedish IPR is high for many but not all diagnoses, but for certain research areas the use of other health registers, such as the Swedish Cancer Register, may be more suitable.
Journal ArticleDOI
Suicide as an outcome for mental disorders. A meta-analysis.
E C Harris,B Barraclough +1 more
TL;DR: Almost all mental disorders have an increased risk of suicide excepting mental retardation and dementia, which is highest for functional and lowest for organic disorders with substance misuse disorders lying between.
Journal ArticleDOI
Antipsychotic-Induced Weight Gain: A Comprehensive Research Synthesis
David B. Allison,Janet L. Mentore,Moonseong Heo,L.P. Chandler,Joseph C. Cappelleri,Ming C. Infante,Peter J. Weiden +6 more
TL;DR: Among the newer antipsychotic agents, clozapine appears to have the greatest potential to induce weight gain, and ziprasidone the least, and the differences among newer agents may affect compliance with medication and health risk.
Journal ArticleDOI
Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication
Kathleen R. Merikangas,Hagop S. Akiskal,Jules Angst,Paul E. Greenberg,Robert M. A. Hirschfeld,Maria Petukhova,Ronald C. Kessler +6 more
TL;DR: This study presents the first prevalence estimates of the BPD spectrum in a probability sample of the United States, and finds subthreshold BPD is common, clinically significant, and underdetected in treatment settings.
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