Objective

Mortality is increased in bipolar disorder due to both suicide and death by physical disorders, but it has never been investigated whether these mortalities translate into relatives to patients with bipolar disorder. The aim was to present the life expectancy and the overall mortality and mortality due to suicide and physical disorders among patients with bipolar disorder and their unaffected full siblings, respectively, compared with control individuals from the general population.

Methods

We used Danish nation-wide population-based longitudinal register linkage to identify 19.955 patients with bipolar disorder, their 13.923 siblings and 20 sex, age and calendar matched control individuals from the general population. Follow-up was from 1995 to 2017.

Results

Bipolar disorder was associated with a decreased life expectancy of 7.7 (95% CI: 7.4-8.1) years and increased mortality overall (hazard ratio (HR): 2.11 (95% CI: 2.04-2.18)) and due to suicide (HR: 18.23 (95% CI: 15.81-21.02) and physical disorders (HR: 2.01 (95% CI: 1.94-2.08). In contrast, siblings to patients with bipolar disorder who were unaffected by bipolar disorder did not have decreased life expectancy (0.45 (95% CI: -6.62-2.46)) or increased mortality overall (HR: 1.00 (95% CI: 0.88-1.14) or due to suicide (HR: 1.50 (95% CI: 0.95-2.36) or physical disorders (HR: 0.99 (95% CI: 0.87-1.34).

Conclusions

Increased mortality in bipolar disorder is mainly due to the impact of bipolar psychopathology and to a lesser degree to familial transmitted factors, highlighting the urgent need for preventive intervention studies in relation to suicide and physical disorders following onset of bipolar disorder.

中文翻译：

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一项关于双相情感障碍患者及其兄弟姐妹的预期寿命和特定死亡率的全国人口纵向研究

客观的

由于自杀和躯体疾病导致的死亡，双相情感障碍的死亡率增加，但从未研究过这些死亡率是否会转化为双相情感障碍患者的亲属。目的是分别展示双相情感障碍患者及其未受影响的兄弟姐妹与一般人群的对照个体的预期寿命和总体死亡率以及因自杀和身体疾病导致的死亡率。

方法

我们使用丹麦全国基于人口的纵向登记链接来确定 19.955 名双相情感障碍患者、他们的 13.923 名兄弟姐妹和 20 名来自一般人群的性别、年龄和日历匹配的对照个体。随访时间为1995年至2017年。

结果

双相情感障碍与预期寿命减少 7.7 (95% CI: 7.4-8.1) 年和总体死亡率增加有关（风险比 (HR): 2.11 (95% CI: 2.04-2.18)）和由于自杀（HR： 18.23 (95% CI: 15.81-21.02) 和躯体障碍 (HR: 2.01 (95% CI: 1.94-2.08)。相比之下，未受双相情感障碍影响的双相情感障碍患者的兄弟姐妹并没有减少预期寿命 (0.45 (95% CI: -6.62-2.46)) 或总体死亡率增加 (HR: 1.00 (95% CI: 0.88-1.14) 或由于自杀 (HR: 1.50 (95% CI: 0.95-2.36) 或身体疾病 (HR) : 0.99 (95% CI: 0.87-1.34)。

结论

双相情感障碍的死亡率增加主要是由于双相精神病理学的影响，在较小程度上受家族传播因素的影响，突出表明迫切需要对双相情感障碍发作后的自杀和身体障碍进行预防干预研究。