Your Article Summary
See Latest ArticlesManic/Hypomanic Symptom Burden and Cardiovascular Mortality in Bipolar Disorder
Psychosomatic Medicine, 07/01/09
Fiedorowicz JG et al. - Participants with bipolar I disorder may face a greater risk of cardiovascular mortality than those with bipolar II disorder. This difference in cardiovascular mortality risk may reflect manic/hypomanic symptom burden.
Methods- Participants with major affective disorders were recruited for the National Institute of Mental Health Collaborative Depression Study and followed prospectively for up to 25 years.
- A total of 435 participants met the diagnostic criteria for bipolar I (n = 288) or bipolar II (n = 147) disorder based on Research Diagnostic Criteria at intake and measures of psychiatric symptoms during follow-up.
- Diagnostic subtypes were contrasted by cardiovascular mortality risk using Cox proportional hazards regression.
- Affective symptom burden (the proportion of time with clinically significant manic/hypomanic or depressive symptoms) and treatment exposure were additionally included in the models.
- Thirty-three participants died from cardiovascular causes.
- Participants with bipolar I disorder had more than double the cardiovascular mortality risk of those with bipolar II disorder, after controlling for age and gender (hazard ratio = 2.35, 95% Confidence Interval = 1.04–5.33; p = .04).
- The observed difference in cardiovascular mortality between these subtypes was at least partially confounded by the burden of clinically significant manic/hypomanic symptoms which predicted cardiovascular mortality independent of diagnosis, treatment exposure, age, gender, and cardiovascular risk factors at intake.
- Selective serotonin uptake inhibitors seemed protective although they were introduced late in follow-up. Depressive symptom burden was not related to cardiovascular mortality.
Related Articles
Cardiovascular morbidity and mortality remain similar in two cohorts of patients with long-standing rheumatoid arthritis seen in 1978 and 1995 in Malmö, Sweden
Rheumatology, 10/30/09
Relevance Score: 69%
Chronic renal insufficiency, cardiovascular disease and mortality in women: a causal relationship or coincidence?
Women's Health, 11/02/09
Relevance Score: 68%
Vitamin D and mortality in older men and women
Clinical Endocrinology, 10/16/09
Relevance Score: 68%
C-reactive protein levels and risk of mortality from cardiovascular disease in Japanese: The JACC Study
Atherosclerosis, 11/12/09
Relevance Score: 67%
Daytime napping and mortality, with a special reference to cardiovascular disease: the JACC study
International Journal of Epidemiology, 11/11/09
Relevance Score: 67%
Today in Psychiatry...keeping you current
Receive free subspecialty "5-minute updates" via email
The Role of Public Health in Addressing Racial and Ethnic Disparities in Mental Health and Mental Illness
Preventing Chronic Disease, 12/18/09
Evolving Definitions of Mental Illness and Wellness
Preventing Chronic Disease, 12/18/09
Nitrous oxide (laughing gas) inhalation as an alternative to electroconvulsive therapy
Medical Hypotheses, 12/18/09