All-cause mortality risk increased in bipolar depression

By Mark Cowen, Senior medwireNews Reporter

Depressed patients with bipolar disorder are at significantly greater risk for all-cause mortality, suicide, and accidental death than patients with other types of depression (OTD), Taiwanese study results show.

Chau-Shoun Lee (Mackay Memorial Medical Center, Taipei) and colleagues also found that the risk for suicide was particularly high among depressed bipolar patients with comorbid cardiovascular disease (CVD).

"Given the etiology of bipolar depression, particularly in the presence of a comorbid condition, the early detection and treatment of CVD in bipolar depression patients and the implementation of suicide-prevention interventions for this population are strongly recommended," the researchers comment.

The team studied data from the Taiwanese National Health Insurance Dataset on 1542 patients with bipolar depression and 17,480 patients with OTD who were followed up from 1999-2004 until 2008.

The National Mortality Registry was used to identify all patients who died during the follow-up period, as well as their causes of death.

In total, 179 patients with bipolar depression and 1787 patients with OTD died over a mean follow-up period of 6.7 years.

After accounting for age, gender, the presence of comorbid condition and other variables, the team found that bipolar depression was associated with a significantly increased risk for all-cause mortality compared with OTD, at an adjusted hazard ratio (aHR) of 1.27.

Bipolar depression was also associated with a significantly increased risk for suicide and accidental death compared with OTD, at aHRs of 2.25 and 1.88, respectively.

The risk for suicide was even higher among bipolar depression patients with CVD compared with OTD patients with CVD, at an aHR of 3.76.

Lee and team summarize in the Journal of Psychiatric Research: "We found that bipolar depression [was] associated with an elevated risk for mortality, especially via suicide and accidents. Such higher mortality rates in bipolar depression patients were even more worrisome in those with comorbid CVD."

They add that "the differential mortality experiences of those with bipolar depression and OTD as seen in the current study could have important health policy implications."

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