People with bipolar disorder 6 times likelier to die from suicide, accidents or violence: Study

People having bipolar disorder are 6 times more likely to die prematurely from external causes such as accidents, violence, and suicide than those not having the condition, according to new research published in BMJ Mental Health.

They are also twice as likely to die from physical illnesses such as heart and/or respiratory diseases, or cancer, with alcohol contributing majorly towards it, the Finnish population-based study found.

People with bipolar disorder are known to face a heightened risk of premature death, However, the drivers behind this, especially the role of physical illnesses, were unclear, which this study aimed to understand, researchers from Niuvanniemi Hospital, Finland, and other institutes from Sweden and the UK said.

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They tracked 47,018 people with bipolar disorder, with an average age of 38 years at the start of the monitoring period (2004-2018). Their data was picked from nationwide medical and social insurance registers. More than half of those identified (57 per cent) were women.

Overall, 3,300 (7 per cent) died over the monitoring period compared with 141,536 deaths in the general population excluding people having the condition, the researchers found and calculated the heightened risk of death to be 6 times due to external causes and 2 times from physical illnesses. Average age at death was 50 years and nearly two-thirds of the deaths were in men.

61 per cent of the 3,300 deaths (2027) were physically caused and 39 per cent (1273) were externally caused.

Of the physically caused deaths, alcohol was found to cause the most at 29 per cent, or 595 deaths. Of these, liver disease accounted for nearly half, followed by accidental alcohol poisoning and alcohol dependence.

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Remaining physically caused deaths were found to be caused by heart disease and stroke (27 per cent), cancer (22 per cent), respiratory disease (4 per cent), diabetes (2 per cent) and other causes (15-16 per cent).

Of the externally caused deaths, suicide caused the most (58 per cent). Of these, nearly half were caused by overdose of prescribed mental health medications, including those used for treating bipolar disorder.

"A balanced consideration between therapeutic response, potential serious long term somatic (physical) side effects of different medicines, and risk of cause-specific premature mortality is needed, especially in younger persons," the authors wrote in their paper.

"Targeting preventive interventions for substance abuse will likely reduce the mortality gap both due to external causes and somatic causes. Suicide prevention remains a priority, and better awareness of the risk of overdose and other poisonings is warranted," they said.