Chronic obstructive pulmonary disease associated with increased risk of bipolar disorder

Author:

Su Vincent Yi-Fong1234,Hu Li-Yu256,Yeh Chiu-Mei7,Chiang Huey-Ling389,Shen Cheng-Che21011,Chou Kun-Ta1212,Chen Tzeng-Ji27,Lu Ti3,Tzeng Cheng-Hwai213,Liu Chia-Jen2613

Affiliation:

1. Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

2. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

3. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

4. Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

5. Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

6. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan

7. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

8. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan

9. Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan

10. Department of Psychiatry, Taichung Veterans General Hospital, Chiayi Branch, Chiayi, Taiwan

11. Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan

12. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

13. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

Abstract

Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between COPD and subsequent bipolar disorder remains unclear. From January 1, 2000, we identified adult patients with COPD from the Taiwan National Health Insurance Research Database. A nationwide population-based study was conducted; 46,778 COPD patients and 46,778 age-, sex-, and comorbidity-matched subjects between 2000 and 2011 were enrolled. The two cohorts were followed up till December 31, 2011 and observed for occurrence of bipolar disorder. We observed the COPD and comparison cohorts for 263,020 and 267,895 person-years, respectively, from 2000 to 2011. The incidence rate for bipolar disorder was 1.6/1000 person-years in the COPD cohort and 1.2/1000 person-years in the comparison cohort ( p < 0.001). After multivariate adjustment, the hazard ratio (HR) for subsequent bipolar disorder among the COPD patients was 1.42 (95% confidence interval [CI], 1.22–1.64; p < 0.001). In the COPD patients, short-acting beta-agonists (SABAs) was associated with a significantly increased risk of bipolar disorder development (HR = 1.83, 95% CI = 1.25–2.69, p = 0.002). Other COPD medications were not associated with the risk of bipolar disorder development. The study results indicate that COPD may be an independent risk factor for the development of bipolar disorder. The regular use of SABAs might increase the risk of bipolar disorder in COPD patients.

Publisher

SAGE Publications

Subject

Pulmonary and Respiratory Medicine

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