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A systematic review and meta-analysis of premature mortality in bipolar affective disorder

Hayes, JF; Miles, J; Walters, K; King, M; Osborn, DP; (2015) A systematic review and meta-analysis of premature mortality in bipolar affective disorder. Acta Psychiatrica Scandinavica , 131 (6) pp. 417-425. 10.1111/acps.12408. Green open access

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Abstract

Objective To review and complete meta-analysis of studies estimating standardised mortality ratios (SMRs) in bipolar affective disorder (BPAD) for all-cause and cause-specific mortalities. Method Cause-specific mortality was grouped into natural and unnatural causes. These subgroups were further divided into circulatory, respiratory, neoplastic and infectious causes, and suicide and other violent deaths. Summary SMRs were calculated using random-effects meta-analysis. Heterogeneity was examined via subgroup analysis and meta-regression. Results Systematic searching found 31 studies meeting inclusion criteria. Summary SMR for all-cause mortality = 2.05 (95% CI 1.89–2.23), but heterogeneity was high (I2 = 96.2%). This heterogeneity could not be accounted for by date of publication, cohort size, mid-decade of data collection, population type or geographical region. Unnatural death summary SMR = 7.42 (95% CI 6.43–8.55) and natural death = 1.64 (95% CI 1.47–1.83). Specifically, suicide SMR = 14.44 (95% CI 12.43–16.78), other violent death SMR = 3.68 (95% CI 2.77–4.90), deaths from circulatory disease = 1.73 (95% CI 1.54–1.94), respiratory disease = 2.92 (95% CI 2.00–4.23), infection = 2.25 (95% CI 1.70–3.00) and neoplasm = 1.14 (95% CI 1.10–1.21). Conclusion Despite considerable heterogeneity, all summary SMR estimates and a large majority of individual studies showed elevated mortality in BPAD compared to the general population. This was true for all causes of mortality studied.

Type: Article
Title: A systematic review and meta-analysis of premature mortality in bipolar affective disorder
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/acps.12408
Publisher version: http://dx.doi.org/10.1111/acps.12408
Language: English
Additional information: © 2015 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: bipolar disorder, life expectancy, mortality
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1463331
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