Document Detail

Excess cardiovascular and suicide mortality of affective disorders may be reduced by lithium prophylaxis.
MedLine Citation:
PMID:  7759663     Owner:  NLM     Status:  MEDLINE    
The mortality of patients suffering from affective disorders is much higher than that of the general population; this excess is due to both suicides and cardiovascular disease. During long-term lithium treatment, the overall mortality has not been found to differ significantly from that of the general population but the question remains whether this lowering, if it is in fact caused by lithium, is due to a reduction in suicide frequency or cardiovascular mortality, or both. We analysed data from 827 previously studied patients and used a procedure that estimated both overall mortality and cause-specific mortalities by single-case analysis. For overall mortality, the ratio of observed deaths (among the patients) to expected deaths (in the general population) was 1.14, which is not significantly different from 1.0; this was also found in our previous analysis. In the whole patient group, comprising 5600 patient years under lithium treatment, seven suicides were observed and 1.3 expected, resulting in a standard mortality ratio of 5.22; this is significantly > 1.0, but markedly lower than that found in patients with affective disorders not given lithium. Cardiovascular mortality was not found to be higher in our patients than in the general population. In view of the fact that a placebo-controlled mortality study under long-term conditions is neither ethically nor practically feasible, our findings cannot prove definitively that long-term lithium treatment counteracts factors responsible for the excess suicide and cardiovascular mortality of affective disorders. However, our observations are compatible with such a notion.
B Ahrens; B Müller-Oerlinghausen; M Schou; T Wolf; M Alda; E Grof; P Grof; G Lenz; C Simhandl; K Thau
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of affective disorders     Volume:  33     ISSN:  0165-0327     ISO Abbreviation:  J Affect Disord     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-06-27     Completed Date:  1995-06-27     Revised Date:  2009-09-28    
Medline Journal Info:
Nlm Unique ID:  7906073     Medline TA:  J Affect Disord     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  67-75     Citation Subset:  IM    
Department of Psychiatry, Freie Universität Berlin, Germany.
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MeSH Terms
Cardiovascular Diseases / etiology,  mortality*,  psychology
Lithium / therapeutic use*
Mood Disorders / complications,  drug therapy*,  mortality
Suicide / prevention & control*
Reg. No./Substance:

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