Excess mortality in bipolar and unipolar disorder in Sweden
Excess mortality in bipolar and unipolar disorder in Sweden
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DOI：
10.1001/archpsyc.58.9.844
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发表时间：
2001-09-01
影响因子：
--
通讯作者：
Sparén, P
中科院分区：
文献类型：
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作者：
Ösby, U;Brandt, L;Sparén, P
背景：选定的双相和单极障碍患者群体因自杀和自然原因死亡的死亡率增加。然而，目前还没有对发病后随访的患者死亡率进行基于人群的研究。方法：从1973年至1995年瑞典所有被医院诊断为双相情感障碍（n = 15386）或单极情感障碍（n = 39182）的患者的住院登记中确定，并与国家死因登记相关联，以确定死亡日期和原因。按5岁年龄组和5年日历期计算总体和特定原因的标准化死亡率（SMRs）和超额死亡人数。结果：男性双相障碍患者自杀的smr为15.0，女性为22.4，单极障碍患者自杀的smr为20.9，女性为27.0。对于所有自然死亡原因，双相情感障碍男性和女性的smr分别为1.9和2.1，单相情感障碍患者的smr分别为1.5和1.6。就双相情感障碍而言，大多数超额死亡是自然原因，而就单极情感障碍而言，大多数超额死亡是非自然原因。在首次诊断后的头几年里，年轻患者自杀的SMR特别高。在研究期间，发现女性单极障碍患者自杀的SMR增加。结论：这项以人群为基础的研究表明，在医院接受治疗的患者中，双相和单相情感障碍患者自杀的smr增加。所有自然死亡原因的最低死亡率也有所增加，造成了大约一半的额外死亡。
Background: Selected groups of patients with bipolar and unipolar disorder have an increased mortality rate from suicide and natural causes of death. However, there has been no population-based study of mortality of patients followed up from the onset of the illness.Methods: All patients with a hospital diagnosis of bipolar (n = 15386) or unipolar (n = 39182) disorder in Sweden from 1973 to 1995 were identified from the inpatient register and linked with the national cause-of-death register to determine the date and cause of death. Overall and cause-specific standardized mortality ratios (SMRs) and numbers of excess deaths were calculated by 5-year age classes and 5-year calendar periods.Results: The SMRs for suicide were 15.0 for males and 22.4 for females with bipolar disorder, and 20.9 and 27.0, respectively, for unipolar disorder. For all natural causes of death, SMRs were 1.9 for males and 2.1 for females with bipolar disorder, and 1.5 and 1.6, respectively, for unipolar disorder. For bipolar disorder, most excess deaths were from natural causes, whereas for unipolar disorder, most excess deaths were from unnatural causes. The SMR for suicide was especially high for younger patients during the first years after the first diagnosis. Increasing SMR for suicide during the period of study was found for female patients with unipolar disorder.Conclusions: This population-based study of patients treated in the hospital documented increased SMRs for suicide in patients with bipolar and unipolar disorder. The SMR for all natural causes of death was also increased, causing about half the excess deaths.