The study results emphasize the need for personalized approaches to risk prediction and prevention of premature cause-specific mortality over the life-course of individuals.
A number of studies have established that those with BD have twice the risk of dying prematurely vs those without the disorder.
The average age at the beginning of the monitoring period was 38 years, and 57% of the cohort were women.
To determine the excess deaths directly attributable to BD, the researchers compared the ratio of deaths observed over the monitoring period in those with BD to the number expected to die in the general population, also known as the standard mortality ratio.
Of the group with BD, 3300 died during the monitoring period. The average age at death was 50, and almost two thirds (65%, or 2137) of those who died were men.
Investigators grouped excess deaths in BD patients into two categories — somatic or external.
Of those with BD who died from somatic or disease-related causes, alcohol caused the highest rate of death (29%). The second leading cause was heart disease and stroke (27%), followed by cancer (22%), respiratory diseases (4%), and diabetes (2%).=
Among the 595 patients with BD who died due to alcohol consumption, liver disease was the leading cause of death (48%). The second cause was accidental alcohol poisoning (28%), followed by alcohol dependence (10%).
The leading cause of death from external causes in BD patients was suicide (58%, or 740), nearly half of which (48%) were due to an overdose with prescribed psychotropic medications.
Overall, 64%, or 2104, of the deaths in BD patients from any cause were considered excess deaths, that is, the number of deaths above those expected for those without BD of comparable age and sex.
Most of the excess deaths from somatic illness were either due to alcohol-related causes (40%) — a rate three times higher than that of the general population — cardiovascular disease (26%), or cancer (10%).
When the team examined excess deaths from external causes, they found that 61% (651) were due to suicide, a rate eight times higher than that of the general population.
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