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Bipolar Disorder Increases Mortality Risk More Than Smoking
A diagnosis of bipolar disorder increased the risk of premature death more than smoking or being older than 60 years, according to study results published in Psychiatry Research.
“Bipolar disorder has long been seen as a risk factor for mortality, but always through a lens of other common causes of death,” said lead and corresponding author Anastasia Yocum, PhD, of the University of Michigan, Ann Arbor, Michigan. “We wanted to look at it by itself in comparison with conditions and lifestyle behaviors that are also linked to higher rates of premature death.”
Related: Vitamin B6 Plus Lithium Helps Ease Mania Symptoms in Patients With Bipolar Disorder
Researchers compared observational data for 1128 participants from the Prechter Longitudinal Study of Bipolar Disorder (PLS-BD). The analysis included 847 people with bipolar disorder and 281 control subjects without the condition. Since the study launched in 2006, 56 participants have died: 54 were people with bipolar disorder, and 2 were control subjects.
In the PLS-BD cohort, a diagnosis of bipolar disorder increased the risk of death over a 10-year period by 6 times, according to the study. In comparison, participants who smoked or were older than 60 years were more than twice as likely to die than people who never smoked or were younger than 60, regardless of whether or not they had bipolar disorder.
Among participants with bipolar disorder, smoking and higher depression symptom scores were both associated with double the risk of death. On the other hand, mania symptoms, anxiety symptoms, and medication use patterns were not associated with risk of death.
For replication analyses, the study tapped anonymous patient data for 10,735 patients with bipolar disorder and 7826 control subjects without a psychiatric diagnosis from University of Michigan Health (U-M Health) clinics.
In the U-M Health cohort, a diagnosis of bipolar disorder increased the risk of death 4 times over the study period, researchers reported. The sole factor associated with a higher risk of death was high blood pressure: hypertension increased the risk of death 5 times whether or not a patient had bipolar disorder. Smoking increased the risk of death 2 times, and age older than 60 years 3 times, regardless of bipolar disorder status.
Among U-M Health patients with bipolar disorder, hypertension was again associated with a 5-fold, and smoking with a nearly 2-fold, risk of death, the study found.
“To our major surprise, in both samples we found that having bipolar disorder is far more of a risk for premature death than smoking,” said researcher Melvin McInnis, MD, a professor of psychiatry at the U-M Medical School.
“Over the years there have been all kinds of programs that have been implemented for smoking prevention and cardiovascular disease awareness,” he added, “but never a campaign on that scale for mental health.”
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