Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan
Abstract Background Studies examining age-stratified risk factors for suicide among individuals with bipolar disorder in different stages of life are scant, possibly because of the insufficient number of suicide cases. Aim This study investigated suicide mortality rates and risk profiles of suic...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933825024514/type/journal_article |
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| author | Yueh-Pin Lin Wen-Yin Chen Chun-Hung Pan Sheng-Siang Su Shang-Ying Tsai Chiao-Chicy Chen Chian-Jue Kuo |
| author_facet | Yueh-Pin Lin Wen-Yin Chen Chun-Hung Pan Sheng-Siang Su Shang-Ying Tsai Chiao-Chicy Chen Chian-Jue Kuo |
| author_sort | Yueh-Pin Lin |
| collection | DOAJ |
| description |
Abstract
Background
Studies examining age-stratified risk factors for suicide among individuals with bipolar disorder in different stages of life are scant, possibly because of the insufficient number of suicide cases.
Aim
This study investigated suicide mortality rates and risk profiles of suicide mortality stratified by five age groups in individuals with bipolar disorder.
Methods
This study identified patients with a diagnosis of bipolar disorder between January 1, 2000, and December 31, 2021, from Taiwan’s National Health Insurance Research Database. The study population comprised 45,211 inpatients diagnosed with bipolar disorder, with 1,370 suicide cases during the study period. We calculated the standardized mortality ratio (SMR) of the bipolar cohort relative to the general population. In the age-stratified nested case–control study, risk set sampling was performed to match 1 suicide case with 10 living controls by age, sex, and the year of first diagnosis. The age-stratified risk associated with demographic characteristics, psychiatric and physical comorbidities was estimated using multivariable conditional logistic regression.
Results
The highest SMR (47.0) for suicide was observed in individuals with bipolar disorder aged <30 years. SMR decreased with age; patients aged >60 years had an SMR of 9.5. Among those younger than 40 years, a higher percentage of unemployment was noted among suicide cases than among controls. A significantly increased risk of the depressive phase of bipolar disorder was noted shortly before suicide mortality among patients with bipolar disorder in all age groups. Drug-induced and alcohol-induced mental disorders were associated with suicide and were highly prevalent in patients aged <30 years. Other forms of heart disease were identified in patients aged <40 years, and pneumonia was detected in the 50–59 years age group.
Conclusions
These findings aid the development of health-care intervention strategies for preventing suicide among patients with bipolar disorder in various stages of life.
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| format | Article |
| id | doaj-art-aa05c1f97e3f4a1cbb75fe9754a32e14 |
| institution | Kabale University |
| issn | 0924-9338 1778-3585 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj-art-aa05c1f97e3f4a1cbb75fe9754a32e142025-08-20T03:45:44ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.2451Risk profiles before suicide mortality in patients with bipolar disorder across the lifespanYueh-Pin Lin0https://orcid.org/0000-0002-2318-6835Wen-Yin Chen1https://orcid.org/0000-0001-8626-6472Chun-Hung Pan2https://orcid.org/0000-0002-8542-558XSheng-Siang Su3Shang-Ying Tsai4https://orcid.org/0000-0001-5662-0055Chiao-Chicy Chen5Chian-Jue Kuo6https://orcid.org/0000-0002-2773-1335Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan Department of Counseling Psychology, Chinese Culture University, Taipei, TaiwanTaipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanTaipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan Department of Psychology, National Chengchi University, Taipei, TaiwanTaipei City Psychiatric Center, Taipei City Hospital, Taipei, TaiwanPsychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanPsychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan Department of Psychiatry, Mackay Memorial Hospital, Taipei, TaiwanTaipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University Abstract Background Studies examining age-stratified risk factors for suicide among individuals with bipolar disorder in different stages of life are scant, possibly because of the insufficient number of suicide cases. Aim This study investigated suicide mortality rates and risk profiles of suicide mortality stratified by five age groups in individuals with bipolar disorder. Methods This study identified patients with a diagnosis of bipolar disorder between January 1, 2000, and December 31, 2021, from Taiwan’s National Health Insurance Research Database. The study population comprised 45,211 inpatients diagnosed with bipolar disorder, with 1,370 suicide cases during the study period. We calculated the standardized mortality ratio (SMR) of the bipolar cohort relative to the general population. In the age-stratified nested case–control study, risk set sampling was performed to match 1 suicide case with 10 living controls by age, sex, and the year of first diagnosis. The age-stratified risk associated with demographic characteristics, psychiatric and physical comorbidities was estimated using multivariable conditional logistic regression. Results The highest SMR (47.0) for suicide was observed in individuals with bipolar disorder aged <30 years. SMR decreased with age; patients aged >60 years had an SMR of 9.5. Among those younger than 40 years, a higher percentage of unemployment was noted among suicide cases than among controls. A significantly increased risk of the depressive phase of bipolar disorder was noted shortly before suicide mortality among patients with bipolar disorder in all age groups. Drug-induced and alcohol-induced mental disorders were associated with suicide and were highly prevalent in patients aged <30 years. Other forms of heart disease were identified in patients aged <40 years, and pneumonia was detected in the 50–59 years age group. Conclusions These findings aid the development of health-care intervention strategies for preventing suicide among patients with bipolar disorder in various stages of life. https://www.cambridge.org/core/product/identifier/S0924933825024514/type/journal_articlebipolar disorderlifespannested case–control studyrisk profilesuicide mortality |
| spellingShingle | Yueh-Pin Lin Wen-Yin Chen Chun-Hung Pan Sheng-Siang Su Shang-Ying Tsai Chiao-Chicy Chen Chian-Jue Kuo Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan European Psychiatry bipolar disorder lifespan nested case–control study risk profile suicide mortality |
| title | Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan |
| title_full | Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan |
| title_fullStr | Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan |
| title_full_unstemmed | Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan |
| title_short | Risk profiles before suicide mortality in patients with bipolar disorder across the lifespan |
| title_sort | risk profiles before suicide mortality in patients with bipolar disorder across the lifespan |
| topic | bipolar disorder lifespan nested case–control study risk profile suicide mortality |
| url | https://www.cambridge.org/core/product/identifier/S0924933825024514/type/journal_article |
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