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Erschienen in: Social Psychiatry and Psychiatric Epidemiology 9/2016

30.05.2016 | Original Paper

Increased risk of fracture in patients with bipolar disorder: a nationwide cohort study

verfasst von: Chih-Chao Hsu, Yi-Chao Hsu, Kuang-Hsi Chang, Chang-Yin Lee, Lee-Won Chong, Yu-Chiao Wang, Chung-Y Hsu, Chia-Hung Kao

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 9/2016

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Abstract

Objectives

Bipolar disorder (BD) is a systemic inflammatory disease, and disrupted bone metabolism due to the inflammatory process can cause fracture. Despite evidence of an association between lower bone mineral density and an increased risk of fracture among patients with depression, schizophrenia, and anorexia nervosa, whether BD is a risk factor for subsequent fracture is unknown. To determine the association between BD and fracture and to examine the risk factors for fracture among patients with BD.

Methods

In this study, we enrolled patients diagnosed with BD from the Taiwan National Health Insurance Research Database. Patients newly diagnosed with BD (ICD-9-CM 296) from 2001 to 2008 were included in the BD cohort, and the date of the initial diagnosis of BD was used as the index date. The comparison cohort, comprising participants without BD, was frequency matched to the BD cohort by age, sex, and index year, and the occurrence of fracture was evaluated in both cohorts.

Results

The BD and comparison cohorts were comprised of 47,271 patients with BD and 1,89,084 frequency-matched participants without BD, respectively. The incidence of fracture was higher among patients with BD than among the controls. Cox models showed that BD was an independent risk factor for fracture irrespective of comorbidities [hazard ratio (HR) = 1.79, 95 % confidence interval (CI) = 1.73–1.84, p < .001].

Conclusion

Our study showed that patients with BD have a higher risk of subsequent fracture. Additional prospective clinical studies investigating the relationship between BD and fracture are warranted.
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Metadaten
Titel
Increased risk of fracture in patients with bipolar disorder: a nationwide cohort study
verfasst von
Chih-Chao Hsu
Yi-Chao Hsu
Kuang-Hsi Chang
Chang-Yin Lee
Lee-Won Chong
Yu-Chiao Wang
Chung-Y Hsu
Chia-Hung Kao
Publikationsdatum
30.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 9/2016
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-016-1242-3

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