Key result
Patients with bipolar disorder receive fewer or delayed medical interventions for severe somatic diseases compared to the general population, contributing to a shortened life expectancy of 10-20 years.
Why the study?
Somatic diseases shorten life expectancy by 10-20 years in patients with bipolar disorder, who have not benefitted from general population survival advances in prophylaxis, treatment, and early detection.
Do patients with bipolar disorder receive insufficient treatment for somatic diseases compared to the general population?
Do patients with bipolar disorder receive insufficient treatment for somatic diseases compared to the general population?
Patients with bipolar disorder experience disparities in the treatment of severe somatic diseases, highlighting the need for strategies to improve their medical management.
Highlights care disparities requiring integrated monitoring in bipolar disorder; leaves open optimal strategies to close the mortality gap.
BACKGROUND: Somatic diseases, including cardiovascular, respiratory, and cancer diseases, are the main contributors to a shortened life expectancy of 10-20 years in patients with bipolar disorder as compared to the general population. In the general population an increase in survival has been observed over the last decades, primarily due to the advances in primary prophylaxis, medical treatment and progress in early detection and monitoring of somatic diseases. In this narrative review, we discuss the existing literature on treatment and outcomes of cardiovascular, respiratory, and cancer diseases in patients with bipolar disorder, and put this in the context of findings in studies on patients diagnosed with other severe mental disorders. MAIN BODY: The existing literature suggests that patients with bipolar disorder receive fewer or delayed medical interventions, when admitted with severe somatic diseases, compared to those not diagnosed with bipolar disorder. Cardiovascular disease is the most investigated disease regarding outcomes in patients with severe mental illness, and novel findings indicate that the increased mortality following cardiac events in these patients can be reduced if they are intensively treated with secondary prophylactic cardiac intervention. Elderly patients diagnosed with mental disorders and cancer experience a delay in receiving specific cancer treatment. No studies have investigated treatment outcomes in patients with severe mental disease and respiratory diseases. CONCLUSION: It is surprising and of major concern that patients with bipolar disorder have not benefitted from the significant improvement that has taken place over time over time of somatic treatments in general, especially in countries with equal and free access to healthcare services. Therefore, no matter whether this situation is a result of a negative attitude from health care providers to patients with mental illness, the result of the patient's lack of awareness of their physical illness or the results of other factors, further attention including research on developing strategies for improving the management of somatic diseases in patients with bipolar disorder is needed.
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Nielsen et al. (2019) conducted a review in Bipolar disorder with comorbid somatic diseases. Bipolar disorder vs. General population without severe mental illness was evaluated. Patients with bipolar disorder receive fewer or delayed medical interventions for severe somatic diseases compared to the general population, contributing to a shortened life expectancy of 10-20 years.
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