Why are somatic diseases in bipolar disorder insufficiently treated?

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 bee...

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Main Authors: René Ernst Nielsen, Pirathiv Kugathasan, Sune Straszek, Svend Eggert Jensen, Rasmus W. Licht
Format: Article
Language:English
Published: SpringerOpen 2019-05-01
Series:International Journal of Bipolar Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40345-019-0147-y
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author René Ernst Nielsen
Pirathiv Kugathasan
Sune Straszek
Svend Eggert Jensen
Rasmus W. Licht
author_facet René Ernst Nielsen
Pirathiv Kugathasan
Sune Straszek
Svend Eggert Jensen
Rasmus W. Licht
author_sort René Ernst Nielsen
collection DOAJ
description 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.
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spelling doaj.art-99ecf8118ec9459083eae943b4b934232022-12-21T19:00:44ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112019-05-01711710.1186/s40345-019-0147-yWhy are somatic diseases in bipolar disorder insufficiently treated?René Ernst Nielsen0Pirathiv Kugathasan1Sune Straszek2Svend Eggert Jensen3Rasmus W. Licht4Department of Clinical Medicine, Aalborg UniversityDepartment of Clinical Medicine, Aalborg UniversityDepartment of Clinical Medicine, Aalborg UniversityDepartment of Clinical Medicine, Aalborg UniversityDepartment of Clinical Medicine, Aalborg UniversityAbstract 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.http://link.springer.com/article/10.1186/s40345-019-0147-yBipolar disorderMortalityMorbiditySomatic illness
spellingShingle René Ernst Nielsen
Pirathiv Kugathasan
Sune Straszek
Svend Eggert Jensen
Rasmus W. Licht
Why are somatic diseases in bipolar disorder insufficiently treated?
International Journal of Bipolar Disorders
Bipolar disorder
Mortality
Morbidity
Somatic illness
title Why are somatic diseases in bipolar disorder insufficiently treated?
title_full Why are somatic diseases in bipolar disorder insufficiently treated?
title_fullStr Why are somatic diseases in bipolar disorder insufficiently treated?
title_full_unstemmed Why are somatic diseases in bipolar disorder insufficiently treated?
title_short Why are somatic diseases in bipolar disorder insufficiently treated?
title_sort why are somatic diseases in bipolar disorder insufficiently treated
topic Bipolar disorder
Mortality
Morbidity
Somatic illness
url http://link.springer.com/article/10.1186/s40345-019-0147-y
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