Excess mortality and life-years lost in people with bipolar disorder: an 11-year population-based cohort study.

Autor:	Chan JKN; Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong., Wong CSM; Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong., Yung NCL; Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong., Chen EYH; Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong.; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong., Chang WC; Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong.; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong.
Jazyk:	angličtina
Zdroj:	Epidemiology and psychiatric sciences [Epidemiol Psychiatr Sci] 2021 May 28; Vol. 30, pp. e39. Date of Electronic Publication: 2021 May 28.
DOI:	10.1017/S2045796021000305
Abstrakt:	Aims: Bipolar disorder is associated with premature mortality, but evidence is mostly derived from Western countries. There has been no research evaluating shortened lifespan in bipolar disorder using life-years lost (LYLs), which is a recently developed mortality metric taking into account illness onset for life expectancy estimation. The current study aimed to examine the extent of premature mortality in bipolar disorder patients relative to the general population in Hong Kong (HK) in terms of standardised mortality ratio (SMR) and excess LYLs, and changes of mortality rate over time. Methods: This population-based cohort study investigated excess mortality in 12 556 bipolar disorder patients between 2008 and 2018, by estimating all-cause and cause-specific SMRs, and LYLs. Trends in annual SMRs over the 11-year study period were assessed. Study data were retrieved from a territory-wide medical-record database of HK public healthcare services. Results: Patients had higher all-cause [SMR: 2.60 (95% CI: 2.45-2.76)], natural-cause [SMR: 1.90 (95% CI: 1.76-2.05)] and unnatural-cause [SMR: 8.63 (95% CI: 7.34-10.03)] mortality rates than the general population. Respiratory diseases, cardiovascular diseases and cancers accounted for the majority of deaths. Men and women with bipolar disorder had 6.78 (95% CI: 6.00-7.84) years and 7.35 (95% CI: 6.75-8.06) years of excess LYLs, respectively. The overall mortality gap remained similar over time, albeit slightly improved in men with bipolar disorder. Conclusions: Bipolar disorder is associated with increased premature mortality and substantially reduced lifespan in a predominantly Chinese population, with excess deaths mainly attributed to natural causes. Persistent mortality gap underscores an urgent need for targeted interventions to improve physical health of patients with bipolar disorder.
Databáze:	MEDLINE
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