Being bipolar significantly raises risk of premature death: study

By Mark Waghorn via SWNS

Bipolar disorder raises the risk of premature death more than six-fold, according to new research.

People with severe depression - characterized by extreme mood swings - are dramatically more likely to die through accidents, violence or suicide, say scientists.

They are also twice as likely to die from physical causes - with alcohol a major contributing factor.

Famous sufferers who have highlighted their condition include comedian Stephen Fry and singer Demi Lovato as well as actors Mel Gibson and Carrie Fisher.

Dr. Tapio Paljarvi, a lead author of the study of Niuvanniemi Hospital, Kuopio, Finland, said: "Improved interventions aimed at reducing the risk of death due to external causes, and alcohol abuse should be developed to prevent premature excess mortality associated with bipolar disorder."

Bipolar is among the world's biggest health problems with case numbers soaring in recent years - especially among young adults.

It has led to an increase in suicides. Medical expenses have risen to $326 billion annually in the United States alone.

Bipolar is a severe mental health condition - leading to manic highs and depressive lows. The majority of patients experience alternating episodes.

It affects 1.3 million in the UK - one in fifty people. Up to five percent of us are on the bipolar spectrum.

Almost as many live with it as cancer. It is more than twice as common as dementia, epilepsy, autism and rheumatoid arthritis.

Dr. Paljarvi said: "Our results showed that the excess risk of death due to external causes was substantial in all age groups.

"A key implication of the high number of excess deaths due to suicide is the need for personalized approaches to prediction and prevention."

Simple scalable models have been developed and validated in people with bipolar disorders that can assist with risk prediction.

Dr. Paljarvi added: "If this can be linked to effective interventions aimed at suicide prevention, such as safety planning, this may have a role in reducing the mortality gap further.

"Similar prediction models could be developed for premature mortality from other causes as well.

"For example, well-calibrated prediction models exist in cardiovascular medicine for low-base rate events, and these are used to inform treatment and prognosis."

His team drew on nationwide medical and social insurance registers to identify and track the health of all 15-64-year-olds with bipolar disorder between 2004 and 2018.

They calculated the ratio of the number of deaths observed over a given period - around eight years of monitoring - among those diagnosed with bipolar disorder.

They compared it to the number expected in the Finnish general population.

The researchers tracked the outcomes of 47,018 people with bipolar disorder. More than half - 57 percent - were women.

In all, 3,300 - 7 percent - of them died during the monitoring period compared with 141,536 people in the general population, equating to a six-fold higher risk of death from external causes and a twofold higher risk of death from somatic, or physical, causes.

Their average age at death was 50. Almost two-thirds of cases involved men. The cause of death was somatic in 61per cent (2,027) and external in 39 percent (1,273).

Among the former alcohol caused the most (29%) followed by cardiovascular disease (27 percent), cancer (22%), respiratory disease (4%), diabetes (2%) and behavioural disorders associated with other substance misuse (one per cent). The remaining 15 percent comprised various other causes.

Most of the latter were due to suicide (58%) nearly half of which were due to overdose with prescribed mental health meds, including those used to treat bipolar.

Dr. Paljarvi added: "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.

"Targeting preventive interventions for substance abuse will likely reduce the mortality gap both due to external causes and somatic causes. Suicide prevention remains a priority, and better awareness of the risk of overdose and other poisonings is warranted."

The study is in BMJ Mental Health.