Sixfold Higher Mortality Due to External Causes Seen With Bipolar Disorder

83 percent of deaths due to external causes were excess, while 51 percent of deaths due to somatic causes were excess
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THURSDAY, July 20, 2023 (HealthDay News) -- Among individuals with a diagnosis of bipolar disorder (BD), external causes of death contribute more to the mortality gap than somatic causes, according to a study published online July 18 in BMJ Mental Health.

Tapio Paljärvi, Ph.D., from Niuvanniemi Hospital in Kuopio, Finland, and colleagues conducted a nationwide cohort study involving individuals with and without a diagnosis of BD, aged 15 to 64 years, during 2004 to 2018. Using mortality rates in the Finnish general population without BD as weights, standardized mortality ratios (SMRs) were calculated.

The researchers found that 7 percent of the included 47,018 individuals with BD died during follow-up. Individuals with BD had sixfold and twofold higher mortality due to external causes and somatic causes, respectively (SMRs, 6.01 and 2.06, respectively). Eighty-three percent of the deaths due to external causes were excess deaths, while 51 percent of the deaths due to somatic causes were excess. Of the potential years of life lost in excess, about twice the number were due to external versus somatic causes. More excess mortality was contributed by alcohol-related causes than deaths due to cardiovascular disease.

"This calls for a re-evaluation of the current emphasis on preventing somatic mortality to reduce the mortality gap between BD and the general population," the authors write. "A balanced consideration between therapeutic response, potential serious long-term somatic side effects of different medicines and risk of cause-specific premature mortality is needed, especially in younger persons."

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