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Cited by 107Bipolar Disorder and TreatmentSuicide and Self-Harm StudiesPersonality Disorders and Psychopathology

Suicide and other causes of mortality in bipolar disorder: a longitudinal study

DUTTA, RINA, BOYDELL, JANE, KENNEDY, NOEL, VAN OS, JIM, FEARON, PAUL, MURRAY, ROBIN M.·2007·Psychological Medicine
DOI 10.1017/s0033291707000347
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Abstract

Background. The high risk of suicide in bipolar disorder is well recognized, but may have been overestimated. There is conflicting evidence about deaths from other causes and little known about risk factors for suicide. We aimed to estimate suicide and mortality rates in a cohort of bipolar patients and to identify risk factors for suicide. Method. All patients who presented for the first time with a DSM-IV diagnosis of bipolar I disorder in a defined area of southeast London over a 35-year period (1965–1999) were identified. Mortality rates were compared with those of the 1991 England and Wales population, indirectly standardized for age and gender. Univariate and multivariate analyses were used to test potential risk factors for suicide. Results. Of the 239 patients in the cohort, 235 (98·3%) were traced. Forty-two died during the 4422 person-years of follow-up, eight from suicide. The standardized mortality ratio (SMR) for suicide was 9·77 [95% confidence interval (CI) 4·22–19·24], which, although significantly elevated compared to the general population, represented a lower case fatality than expected from previous literature. Deaths from all other causes were not excessive for the age groups studied in this cohort. Alcohol abuse [hazard ratio (HR) 6·81, 95% CI 1·69–27·36, p=0·007] and deterioration from pre-morbid level of functioning up to a year after onset (HR 5·20, 95% CI 1·24–21·89, p=0·024) were associated with increased risk of suicide. Conclusions. Suicide is significantly increased in unselected bipolar patients but actual case fatality is not as high as previously claimed. A history of alcohol abuse and deterioration in function predict suicide in bipolar disorder.

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  • In the population of bipolar spectrum disorders, deaths from cancer are not higher or only slightly elevated compared with the general population, despite the higher number of risk factors for cancer in this population.

    “In the population of bipolar spectrum disorders, deaths from cancer are not higher (8,288,416,417,454-456) or only slightly elevated (417,418,456) compared with the general population, despite the higher number of risk factors for cancer (such as obesity) in this population.”

    From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [454]

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Authors
DUTTA, R., BOYDELL, J., KENNEDY, N., VAN OS, J., FEARON, P., & MURRAY, R. M.
Affiliations
  • King's College London (GB)
  • St. Patrick's Hospital (IE)
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2007-03-12
Volume
37
Issue
6
Pages
839-847
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291707000347
OpenAlex
W2056116429
Cited by
107
References
15
Citations by year
2024: 2 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 12 · 2013: 12 · 2012: 5
FWCI
5.43
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
bipolar disorder, suicide, mortality, suicide risk factors, alcohol abuse, functional decline, standardized mortality ratio, bipolar I disorder, case fatality
MeSH terms
Adult, Aged, Bipolar Disorder, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netherlands, Suicide, Diagnostic and Statistical Manual of Mental Disorders

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