People with bipolar disorder, which is characterized by extreme mood swings, are 6 times more likely to die prematurely from external causes such as accidents, violence and suicide than people without the condition, according to a study published in BMJ Mental Health.
Finnish researchers used nationwide health and social insurance registries to identify and track the health status of all people aged 15 to 64 with bipolar disorder between 2004 and 2018. They calculated the ratio of the number of deaths observed over 8 years of follow-up among persons diagnosed with bipolar disorder to the expected number of deaths in the Finnish population as a whole. The scientists tracked the results of 47,018 people with bipolar disorder who were on average 38 years old at the start of the follow-up period, more than half (57%) were women.
In total, 3,300 (7%) of them died during the follow-up compared to 141,536 people in the general population, which corresponds to a 6-fold increase in the risk of death from external causes and a 2-fold increase in the risk of death from somatic causes. The median age of patients with bipolar disorder at death was 50 years, and almost two-thirds of these deaths occurred in men.
Most of the excess deaths from medical diseases were due to either alcohol-related causes (40%), which is 3 times higher than in the general population, cardiovascular disease (26%) or cancer (10%). Of the additional deaths from external causes, 61% (651) were due to suicide, which is about 8 times higher than in the general population.
Given that external causes appear to play a larger role than physical illness in excess mortality among people with bipolar disorder, the current therapeutic focus on preventing medical illness should be reconsidered, the researchers say.