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All-Cause and Cause-Specific Mortality in Patients With Bipolar II Disorder.

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Area of Science:

  • Psychiatry and Mental Health
  • Epidemiology
  • Public Health

Background:

  • The long-term mortality risk associated with bipolar II disorder (BD-II) is not well-established, as previous studies often group it with bipolar I disorder (BD-I).
  • Distinguishing mortality outcomes between BD-II and BD-I is crucial for understanding the specific risks and needs of each patient group.

Purpose of the Study:

  • To investigate the association between BD-II and elevated all-cause and cause-specific mortality.
  • To compare mortality rates in individuals with BD-II against population controls, unaffected siblings, and individuals with BD-I.

Main Methods:

  • A population-based, retrospective cohort study utilizing Taiwan's National Health Insurance Database (2000-2022).
  • 11,427 individuals with BD-II were matched with 45,708 controls, and comparisons were made with unaffected siblings and a BD-I cohort.
  • Cox proportional hazards regression models were used to estimate adjusted hazard ratios (AHRs) for all-cause, natural-cause, and unnatural-cause mortality.

Main Results:

  • Individuals with BD-II exhibited significantly higher all-cause mortality (AHR, 1.62) compared to controls.
  • Increased mortality was observed for both natural causes (AHR, 1.37) and unnatural causes (AHR, 4.46), with suicide and unintentional injuries being predominant unnatural causes.
  • Within-family analyses and comparisons with BD-I confirmed elevated all-cause mortality in BD-II, with BD-II showing higher all-cause and natural-cause mortality than BD-I.

Conclusions:

  • Bipolar II disorder is associated with a substantial risk of premature mortality across multiple causes.
  • The elevated mortality risk in BD-II persists even after controlling for familial factors and when compared to BD-I.
  • These findings highlight the critical need for comprehensive psychiatric care and mortality risk management for individuals diagnosed with BD-II.