A retrospective analysis of risk and protective factors for natural death in bipolar disorder

Shang Ying Tsai, Chao Hsien Lee, Chian Jue Kuo, Chiao Chicy Chen

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Objective: Many of the prior mortality studies on bipolar disorder have emerged primarily from the larger health service groups, with a tendency to focus on suicide alone. This study examines personal and clinical characteristics of bipolar patients in Taiwan in order to identify the factors associated with early natural death. Method: Bipolar patients admitted to a psychiatric hospital in Taiwan between 1987 and 2002 were retrospectively followed through record linkage for cause of death. One living bipolar individual was matched to each deceased patient as a control subject for age, gender, and date of index admission. Clinical data and the results of laboratory examinations during the last period of hospitalization were obtained through a review of medical records. Results: In a total of 60 natural deaths, the principal cause was circulatory disease (33.3%). Conditional logistic regressions revealed that the variables most strongly associated with natural deaths were years of antipsychotic treatment prior to the last visit (95% CI for odds ratio [OR] = 0.77 to 0.98), serum alanine aminotransferase levels (95% CI for OR = 1.02 to 1.25), and leukocyte counts (95% CI for OR = 1.01 to 2.50). Years of lithium treatment (95% CI for OR = 0.74 to 0.97) may be substituted for antipsychotic treatment as a protective factor. Conclusions: Systemic inflammation and nonhepatic tissue damage during the acute phase of bipolar disorder may be risk factors for early natural death. Psychiatric treatment, including medication with antipsychotics or lithium, could be a factor in protecting against early natural death.

Original languageEnglish
Pages (from-to)1586-1591
Number of pages6
JournalJournal of Clinical Psychiatry
Volume66
Issue number12
Publication statusPublished - Dec 2005

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Bipolar Disorder
Odds Ratio
Antipsychotic Agents
Taiwan
Lithium
Cause of Death
Psychiatric Hospitals
Therapeutics
Alanine Transaminase
Leukocyte Count
Suicide
Health Services
Medical Records
Psychiatry
Hospitalization
Logistic Models
Inflammation
Mortality
Protective Factors
Serum

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

A retrospective analysis of risk and protective factors for natural death in bipolar disorder. / Tsai, Shang Ying; Lee, Chao Hsien; Kuo, Chian Jue; Chen, Chiao Chicy.

In: Journal of Clinical Psychiatry, Vol. 66, No. 12, 12.2005, p. 1586-1591.

Research output: Contribution to journalArticle

Tsai, Shang Ying ; Lee, Chao Hsien ; Kuo, Chian Jue ; Chen, Chiao Chicy. / A retrospective analysis of risk and protective factors for natural death in bipolar disorder. In: Journal of Clinical Psychiatry. 2005 ; Vol. 66, No. 12. pp. 1586-1591.
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