@article{ref1,
title="Cause-specific mortality and comorbid neurodevelopmental disorder in 167,515 patients with bipolar disorder: an entire population longitudinal study",
journal="Journal of affective disorders",
year="2024",
author="Cho, Wei-Min and Hsu, Tien-Wei and Cheng, Chih-Ming and Chang, Wen-Han and Tsai, Shih-Jen and Bai, Ya-Mei and Su, Tung-Ping and Chen, Tzeng-Ji and Chen, Mu-Hong and Liang, Chih-Sung",
volume="347",
number="",
pages="463-468",
abstract="OBJECTIVE: Studies addressing premature mortality in bipolar disorder (BD) patients are limited by small sample sizes. Herein, we used almost 99 % of the population of Taiwan to address this issue, and its association with comorbid neurodevelopmental disorders and severe BD.   METHODS: Between 2003 and 2017, we enrolled 167,515 individuals with BD and controls matched 1:4 for sex and birth year from the National Health Insurance Database linked to the Database of National Death Registry in Taiwan. Time-dependent Cox regression models were used to examine cause-specific mortality (all-cause, natural, and unnatural causes [accidents or suicide]).   RESULTS: With adjustments of sex, age, income, urbanization, and physical conditions, suicide was associated with the highest risk of mortality (reported as hazard ratio with 95 % confidence interval: 9.15; 8.53-9.81) among BD patients, followed by unnatural (4.94; 4.72-5.17), accidental (2.15; 1.99-2.32), and natural causes (1.02; 1.00-1.05). Comorbid attention-deficiency hyperactivity disorder did not contribute to the increased risk of cause-specific mortality; however, comorbid autism spectrum disorder (ASD) increased such risks, particularly for natural (3.00; 1.85-4.88) and accidental causes (7.47; 1.80-31.1). Cause-specific mortality revealed a linear trend with the frequency of psychiatric hospitalization (all, p for trend <0.001), and BD patients hospitalized twice or more each year had 34.63-fold increased risk of suicide mortality (26.03-46.07).   CONCLUSIONS: BD patients with a higher frequency of psychiatric hospitalization have the highest risk of suicide mortality, and comorbid ASD was associated with an increased risk of natural and accidental causes of mortality.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2023.12.007",
url="http://dx.doi.org/10.1016/j.jad.2023.12.007"
}