Psychosis complications such as schizophrenia and bipolar have been shown to lead to higher rates of physical illness, including diabetes, obesity, high blood pressure, and cardiovascular disease (CVD). Although some research has shown that people with these mental health challenges are more likely to die from suicide than from physical illnesses, new research suggests otherwise.
A study led by Jeanette Westman of the Department of Neurobiology, Care Sciences, and Society at the Center for Family Medicine at the Karolinska Institute in Sweden provides evidence that individuals with bipolar are twice as likely to die from CVD-related illnesses than from suicide.
Westman chose to focus on bipolar because there is less research on bipolar-related death than mortality from schizophrenia-related comorbidities. For her study, Westman analyzed data from a national study involving over 10 million Swedes that spanned a 20-year period. She found that over 17,000 of those individuals were diagnosed with bipolar and. In general, those with bipolar died almost a decade sooner than those without. She also found that of those deaths, 38% were attributed to CVD, while nearly 44% were from other somatic illnesses.
The study revealed that CVD led to 824 deaths, somatic conditions to 988, and yet a smaller number, 675 died from suicide. These findings directly contradict some existing research on suicide and psychosis. But Westman believes they are easily explained. She notes that many people with bipolar do not receive adequate screenings for CVD because they may be too young to be considered high-risk by clinicians.
However, bipolar can lead to increases in blood sugar, blood pressure, obesity, and cholesterol, all of which are risk factors for CVD. Surprisingly, even though the CVD mortality rate was twice as high in those with bipolar, their hospital admission rate was equal to CVD patients without bipolar. This also demonstrates the need for better monitoring and closer attention to CVD risk factors and improved treatment aimed at those with bipolar. Westman added, “Targeted interventions by effective collaboration between primary healthcare and psychiatric professionals would be crucial in the efforts to reduce excess CVD mortality in patients with bipolar disorder.”
Westman, J., Hällgren, J., Wahlbeck, K., et al. (2013). Cardiovascular mortality in bipolar disorder: A population-based cohort study in Sweden. BMJ Open 2013;3:e002373. doi:10.1136/bmjopen-2012-002373
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