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Premature Mortality in Bipolar Disorder — Psychiatric Times

Wednesday, 16 March, 2022

Premature Mortality in Bipolar Disorder — Psychiatric Times

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CASE VIGNETTE
“Mr Brady” is a 52-year-old Caucasian male with a 12-year history of bipolar disorder with psychotic features. He has comorbid hypertension, hyperlipidemia, type 2 diabetes mellitus, chronic back pain, seizures, and a history of traumatic brain injury. He does not smoke or use alcohol or other illicit drugs. He has a history of 1 prior suicide attempt by overdose on prescription opioid medications approximately 10 years ago. His psychotropic medication regimen includes ziprasidone, prazosin, and alprazolam. He was previously unable to tolerate (separate) trials of lithium and valproic acid due to side effects. He sees a psychologist regularly for individual therapy. He was clinically stable, with euthymic mood and no psychiatric hospitalizations in the past 3 years. Three months after his last outpatient psychiatry follow-up appointment, Mr Brady died unexpectedly due to a myocardial infarction.
Bipolar disorder is associated with a two- to threefold increased risk of premature mortality, including not only suicide death, but also cardiovascular disease, respiratory disease, and cancer.1-3 Despite an increase in life expectancy in the general population, the mortality gap in bipolar disorder persists and may be increasing.4,5 Many previous studies investigated premature death in patients with bipolar disorder using mortality ratios, but an alternative approach is to estimate life expectancy and years of potential life lost (YPLL).
Life expectancy is the number of years an individual is expected to live based on estimates of the average age at death from a reference population. YPLL is the difference between the observed and the expected age at death. Several previous studies have measured YPLL in patients with bipolar disorder, but this evidence has not been systematically reviewed, which could inform on strategies to reduce preventable deaths in this population.
Read more at: https://www.psychiatrictimes.com/view/premature-mortality-in-bipolar-disorder

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