Kessing Lars Vedel, Vradi Eleni, McIntyre Roger S, Andersen Per Kragh
Psychiatric Center Copenhagen, Department O and University of Copenhagen Denmark.
Department of Biostatistics University of Copenhagen Copenhagen, Denmark.
J Affect Disord. 2015 Jul 15;180:142-7. doi: 10.1016/j.jad.2015.03.027. Epub 2015 Mar 23.
Accelerated aging has been proposed as a mechanism explaining the increased prevalence of comorbid general medical illnesses in bipolar disorder.
To test the hypothesis that lost life years due to natural causes starts in early and mid-adulthood, supporting the hypothesis of accelerated aging.
Using individual data from nationwide registers of patient with a diagnosis of bipolar disorder we calculated remaining life expectancies before age 90 years for values of age 15, 25, 35…75 years among all individuals alive in year 2000. Further, we estimated the reduction in life expectancy due to natural causes (physical illnesses) and unnatural causes (suicide and accidents) in relation to age.
A total of 22,635 patients with bipolar disorder were included in the study in addition to data from the entire Danish general population of 5.4 million people. At age 15 years, remaining life expectancy before age 90 years was decreased 12.7 and 8.9 life years, respectively, for men and women with bipolar disorder. For 15-year old boys with bipolar disorder, natural causes accounted for 58% of all lost life years and for 15-year old girls, natural causes accounted for 67% increasing to 74% and 80% for 45-year old men and women, respectively.
Data concern patients who get contact to hospital psychiatry only.
Natural causes of death is the most prevalent reason for lost life years already from adolescence and increases substantially during early and mid-adulthood, in this way supporting the hypothesis of accelerated aging. Early intervention in bipolar disorder should not only focus on improving outcome of the bipolar disorder but also on decreasing the risk of comorbid general medical illnesses.
加速衰老被认为是解释双相情感障碍中共病普通内科疾病患病率增加的一种机制。
检验自然原因导致的寿命损失始于成年早期和中期这一假设，以支持加速衰老的假设。
利用全国双相情感障碍患者登记册中的个体数据，我们计算了2000年所有在世个体中15、25、35……75岁时90岁前的剩余预期寿命。此外，我们估计了与年龄相关的自然原因（身体疾病）和非自然原因（自杀和事故）导致的预期寿命缩短情况。
除了来自丹麦540万普通人群的数据外，共有22635例双相情感障碍患者纳入本研究。15岁时，双相情感障碍男性和女性90岁前的剩余预期寿命分别减少了12.7年和8.9年。对于15岁患有双相情感障碍的男孩，自然原因占所有寿命损失年数的58%，对于15岁患有双相情感障碍的女孩，自然原因占67%，45岁男性和女性分别增至74%和80%。
数据仅涉及与医院精神科有接触的患者。
自然死亡原因是从青春期起寿命损失年数的最主要原因，在成年早期和中期大幅增加，以此支持加速衰老的假设。双相情感障碍的早期干预不仅应关注改善双相情感障碍的结局，还应关注降低共病普通内科疾病的风险。
