Bipolar disorder is a health condition that makes people experience big mood changes.
People with this disorder are six times more likely to die earlier than expected because of things like accidents, violence, or suicide, according to a study published in the BMJ Mental Health journal.
These individuals also have a two times higher chance of dying from physical causes, with alcohol playing a big part.
There’s a long history of reports showing people with bipolar disorder, from many countries, have a higher chance of dying early. But it’s not very clear what exactly causes this or how much physical illness contributes to this risk.
The Study and its Findings
A team of researchers from Finland decided to look deeper into this. They used national health and social insurance records to track the health of all 15–64-year-olds diagnosed with bipolar disorder from 2004 to 2018.
They checked the number of deaths in people with bipolar disorder during about eight years of tracking. They compared this to the number of deaths expected in the general Finnish population.
They kept an eye on 47,018 people with bipolar disorder who were about 38 years old on average when the study started. Over half of them (57%) were women.
In total, 3,300 (7%) of them died during the study period. This was compared with 141,536 people in the general population.
So, people with bipolar disorder had a six times higher risk of dying from external causes and a two times higher risk of dying from physical causes.
Their average age at death was 50; most of these deaths (65%; 2,137) were among men. The cause of death was physical in 61% (2,027) and external in 39% (1,273).
Among those who died from physical illness, the top cause was alcohol at 29% (595).
Heart disease and stroke came next at 27% (552), then cancer at 22% (442), respiratory disease at 4% (78), diabetes at 2% (41), and behavioral disorders linked with other drug misuse at 1% (23). The remaining 15% (296) were due to other causes.
Among the 595 deaths related to alcohol, liver disease caused nearly half (48%). Accidental alcohol poisoning caused 28%, and alcohol addiction caused 10%.
Most of the deaths from external causes were suicides (58%, 740). Nearly half of these suicides (48%) happened because of an overdose of mental health medication, including drugs used to treat bipolar disorder.
The Bigger Picture: Excess Deaths
Overall, nearly two-thirds (64%, 2,104) of the deaths were ‘excess deaths’. These are deaths that are higher than what we would expect for people of the same age and sex. These deaths can be directly linked to bipolar disorder.
Out of the deaths caused by physical illness, 51% (1,043) were excess deaths. Among the deaths from external causes, 83% (1,061) were excess deaths.
The most common reasons for excess deaths from physical illness were alcohol-related (40%), heart disease (26%), or cancer (10%).
Most excess deaths from external causes were suicides (61%). This is about eight times higher than in the general population.
The Researchers’ Suggestions
Considering that external causes seem to play a bigger role in excess deaths among people with bipolar disorder, the researchers suggest changing the current treatment focus.
Instead of mainly trying to prevent physical illness, they suggest a more balanced approach.
This includes considering the therapeutic response, possible long-term side effects of different drugs, and the risk of early death, especially in younger people.
They recommend focusing on preventing drug misuse, which could likely lower the number of deaths from both external and physical causes.
They also highlight the importance of preventing suicide and raising awareness about the risk of overdose and other poisonings.
If you care about mental health, please read studies about 6 foods you can eat to improve mental health and B vitamins could help prevent depression and anxiety.
The study was published in BMJ Mental Health.
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