ArticlePsychotherapy and psychosomatics2024
Mortality and Lithium-Protective Effects after First-Episode Mania Diagnosis in Bipolar Disorder: A Nationwide Retrospective Cohort Study in Taiwan.
Article in Psychotherapy and psychosomatics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- All-cause and cause-specific mortality in gambling disorder: Evidence from a nation-wide matched and sibling cohort study in Taiwan.Addiction (Abingdon, England) · 2026Article
- All-Cause and Cause-Specific Mortality in Patients With Bipolar II Disorder.JAMA network open · 2026Observational
- Post-traumatic stress disorder and risk of all-cause and cause-specific mortality: a nationwide population and sibling-controlled cohort study in Taiwan.Epidemiology and psychiatric sciences · 2026Article
- Predicting five-year comorbid bipolar disorder after attention-deficit/hyperactivity disorder diagnosis: a population-based machine learning approach.Child and adolescent psychiatry and mental health · 2025Article
- Mortality among transgender persons: a Taiwan matched-population and sibling-comparison cohort study.The Lancet regional health. Western Pacific · 2025Article
- All-Cause and Cause-Specific Mortality Among Patients With Narcolepsy.JAMA network open · 2025Article
- Patterns of lithium exposure and mortality in bipolar disorder: A population-based cohort study.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- History of Suicide Prevention with Lithium Treatment.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Lithium for Bipolar Disorder and Risk of Thyroid Dysfunction and Chronic Kidney Disease.JAMA network open · 2025Article
- What Patients with Bipolar Disorder Need to Know about Lithium.Pharmaceuticals (Basel, Switzerland) · 2024Review
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9 authors.
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Abstract
introductionThis study aimed to estimate all-cause mortality in patients after a first-episode mania (FEM) and examine whether six guideline-recommended medications can reduce mortality.
methodsThe cohort included population-based FEM samples and matched controls from Taiwan, spanning 2007 to 2018. The primary outcomes assessed were all-cause/suicide-related mortality, while the secondary outcome focused on mortality associated with pharmacological treatments. We compared mortality in post-FEM patients and age-/sex-matched controls without any diagnosed bipolar disorders and patients with and without psychopharmacological treatment using Cox regression analysis, respectively. Statistics were presented with time-to-event adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs).
resultsThe study included 54,092 post-FEM patients and 270,460 controls, totaling 2,467,417 person-years of follow-up. Post-FEM patients had higher risks of all-cause mortality (AHR 2.38, 95% CI: 2.31-2.45) and suicide death (10.80, 5.88-19.84) than controls. Lithium (0.62, 0.55-0.70), divalproex (0.89, 0.83-0.95), and aripiprazole (0.81, 0.66-1.00) were associated with reduced all-cause mortality compared to non-users. There were no significant all-cause mortality differences for quetiapine (0.95, 0.89-1.01), risperidone (0.92, 0.82-1.02), and paliperidone (1.24, 0.88-1.76) users. When accounting for drug action onset times in sensitivity analyses, only lithium significantly reduced all-cause mortality (AHR range 0.65-0.72). There were 35 and 16 suicide deaths in post-FEM patients and controls, respectively. No drug had a significant effect on suicide deaths (lithium: 6; divalproex: 7; aripiprazole: 0; quetiapine: 10; risperidone: 4; paliperidone: 1).
conclusionPost-FEM patients had a higher risk of all-cause/suicide-related mortality, and lithium treatment might reduce all-cause mortality.
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