Bipolar disorder linked to 6-fold higher risk of early death.

People with bipolar disorder—characterised by extreme mood swings—are 6 times more likely to die before their time from external causes, such as accidents, violence, and suicide, than those without the condition, finds research published in the open access journal BMJ Mental Health. And they are twice as likely to die from somatic (physical) causes, with alcohol a major contributing factor, the findings show.

The Finnish researchers therefore 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 tracked the outcomes of 47,018 people with bipolar disorder who were 38, on average, at the start of the monitoring period. More than half (57%) were women.

In all, 3300 (7%) of them died during the monitoring period compared with 141,536 people in the general population, equating to a 6-fold higher risk of death from external causes and a 2-fold higher risk of death from somatic causes.

Their average age at death was 50; almost two thirds (65%; 2137) of these deaths were among men. The cause of death was somatic in 61% (2027) and external in 39% (1273).

Of the excess deaths from external causes, 61% (651) were due to suicide, a proportion that is around 8 times higher than that of the general population.

Excess deaths from external causes were substantial in all age groups, but while most of the excess among 15–44 year olds was from external causes, external and somatic causes contributed in nearly equal numbers to this among 45–64 year olds.

Reference: Cause-specific excess mortality after first diagnosis of bipolar disorder: population-based cohort study, BMJ Mental Health, DOI 10.1136/bmjment-2023-300700