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Review
. 2019 May 5;7(1):12.
doi: 10.1186/s40345-019-0147-y.

Why are somatic diseases in bipolar disorder insufficiently treated?

René Ernst Nielsen  1   2 , Pirathiv Kugathasan  3   4 , Sune Straszek  3   4 , Svend Eggert Jensen  3   5 , Rasmus W Licht  3   4
Affiliations
Review

Why are somatic diseases in bipolar disorder insufficiently treated?

René Ernst Nielsen et al. Int J Bipolar Disord. .

Abstract

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.

Keywords: Bipolar disorder; Morbidity; Mortality; Somatic illness.

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Conflict of interest statement

RE Nielsen has received research grants from H. Lundbeck and Otsuka Pharmaceuticals for clinical trials, received speaking fees from Bristol-Myers Squibb, Astra Zeneca, Janssen & Cilag, Lundbeck, Servier, Otsuka Pharmaceuticals, and Eli Lilly and has acted as advisor to Astra Zeneca, Eli Lilly, Lundbeck, Otsuka Pharmaceuticals, Takeda, and Medivir. P Kugathasan has none to declare. SE Jensen has received research funding from The Obel Family Foundation. S Straszek has received speaking fees from Lundbeck, Servier and Otsuka Pharmaceuticals and has acted as advisor to Lundbeck. RW Licht has received research grant from Glaxo Smith Kline, honoraria for lecturing from Pfizer, Glaxo Smith Kline, Eli Lilly, Astra-Zeneca, Bristol-Myers Squibb, Janssen Cilag, Lundbeck, Otsuka, Servier and honoraria from advisory board activity from Glaxo Smith Kline, Eli Lilly, Astra-Zeneca, Bristol-Myers Squibb, Janssen Cilag, and Sunovion.

References

    1. Armstrong GL, Conn LA, Pinner RW. Trends in infectious disease mortality in the United States during the 20th century. JAMA. 1999;281(1):61–66. doi: 10.1001/jama.281.1.61. - DOI - PubMed
    1. Ashdown-Franks G, Williams J, Vancampfort D, Firth J, Schuch F, Hubbard K, Craig T, Gaughran F, Stubbs B. Is it possible for people with severe mental illness to sit less and move more? A systematic review of interventions to increase physical activity or reduce sedentary behaviour. Schizophr Res. 2018;202:3–16. doi: 10.1016/j.schres.2018.06.058. - DOI - PubMed
    1. Birkenaes AB, Opjordsmoen S, Brunborg C, Engh JA, Jonsdottir H, Ringen PA, Simonsen C, Vaskinn A, Birkeland KI, Friis S, Sundet K, Andreassen OA. The level of cardiovascular risk factors in bipolar disorder equals that of schizophrenia: a comparative study. J Clin Psychiatry. 2007;68(6):917–923. doi: 10.4088/JCP.v68n0614. - DOI - PubMed
    1. Bodén R, Molin E, Jernberg T, Kieler H, Lindahl B, Sundström J. Higher mortality after myocardial infarction in patients with severe mental illness: a nationwide cohort study. J Intern Med. 2015;277(6):727–736. doi: 10.1111/joim.12329. - DOI - PubMed
    1. Bongiorno DM, Daumit GL, Gottesman RF, Faigle R. Comorbid psychiatric disease is associated with lower rates of thrombolysis in ischemic stroke. Stroke. 2018;49(3):738–740. doi: 10.1161/STROKEAHA.117.020295. - DOI - PMC - PubMed

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