A systematic review and meta-analysis of premature mortality in bipolar affective disorder
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OBJECTIVE: To review and complete meta-analysis of studies estimating standardised mortality ratios (SMRs) in bipolar affective disorder (BPAD) for all-cause and cause-specific mortalities. METHOD: Cause-specific mortality was grouped into natural and unnatural causes. These subgroups were further divided into circulatory, respiratory, neoplastic and infectious causes, and suicide and other violent deaths. Summary SMRs were calculated using random-effects meta-analysis. Heterogeneity was examined via subgroup analysis and meta-regression. RESULTS: Systematic searching found 31 studies meeting inclusion criteria. Summary SMR for all-cause mortality = 2.05 (95% CI 1.89-2.23), but heterogeneity was high (I(2) = 96.2%). This heterogeneity could not be accounted for by date of publication, cohort size, mid-decade of data collection, population type or geographical region. Unnatural death summary SMR = 7.42 (95% CI 6.43-8.55) and natural death = 1.64 (95% CI 1.47-1.83). Specifically, suicide SMR = 14.44 (95% CI 12.43-16.78), other violent death SMR = 3.68 (95% CI 2.77-4.90), deaths from circulatory disease = 1.73 (95% CI 1.54-1.94), respiratory disease = 2.92 (95% CI 2.00-4.23), infection = 2.25 (95% CI 1.70-3.00) and neoplasm = 1.14 (95% CI 1.10-1.21). CONCLUSION: Despite considerable heterogeneity, all summary SMR estimates and a large majority of individual studies showed elevated mortality in BPAD compared to the general population. This was true for all causes of mortality studied.
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Since the turn of the millennium, strategies aimed at reducing the mortality gap between people with SMI and the general population have been implemented in the UK.
“Since the turn of the millennium, a number of strategies aimed at reducing the mortality gap between people with SMI and the general population have been implemented in the UK.10–17”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [17]
The Discussion (page unavailable) documents a mortality gap for people with bipolar disorder and mentions a smoking-cessation policy. It does not say that a number of strategies aimed at reducing the gap for people with serious mental illness were implemented in the UK since the turn of the millennium; it says the policy failed to address their needs. (LLM, conf=0.78)
Experimental — accuracy not yet measuredDepression predicts incident adult-onset asthma (RR = 1.43, 95% CI 1.28-1.61, p < 0.001).
“Depression predicted incident adult-onset asthma RR= 1.43 (95% CI, 1.28-1.61,P<0.001)”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [4]
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- Authors
- Hayes, J. F., Miles, J., Walters, K., King, M., & Osborn, D. P. J.
- Affiliations
- University College London (GB)
- Camden and Islington NHS Foundation Trust (GB)
- Corresponding author
- Hayes, J. F.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2015-03-03
- Volume
- 131
- Issue
- 6
- Pages
- 417-425
- ISSN
- 0001-690X (ISSN-L)
- PMC
- PMC4939858
- OpenAlex
- W2037091926
- Cited by
- 370
- References
- 52
- Citations by year
- 2026: 27 · 2025: 27 · 2024: 37 · 2023: 36 · 2022: 34 · 2021: 45 · 2020: 50 · 2019: 39 · 2018: 21 · 2017: 20 · 2016: 20 · 2015: 13
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Medical Research Council Population Health Scientist Fellowship (MR/K021362/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- bipolar disorder, premature mortality, standardized mortality ratio, all-cause mortality, suicide, violent death, circulatory diseases, respiratory diseases, infectious disease mortality, cause-specific mortality
- MeSH terms
- Age Factors, Bipolar Disorder, Cause of Death, Humans, Suicide, Mortality, Premature
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