Physical health status in first-degree relatives of patients with bipolar disorder, a systematic review

Abstract

Objective

This systematic literature search aimed to investigate the physical health status of first-degree relatives to patients with bipolar disorder. There is abundant evidence for familial aggregation of both bipolar disorders, cardiovascular and autoimmune diseases. However, a review gathering data on the physical health status in first-degree relatives to patients with bipolar disorder is missing. We hypothesized that first-degree relatives of bipolar probands would express higher rates of physical diseases and somatic morbidity.

Method

We conducted a systematic literature search in three different databases PubMed, Embase and PsychInfo. The search identified 10 studies comparing 24,277 unaffected first-degree relatives with 318.933 controls persons.

Results

Seven out of 10 studies showed that first-degree relatives had statistically significantly higher rates of one or more physical diseases or increased morbidity, including cardiovascular diseases, infections, autoimmune thyroiditis, pernicious anaemia, and higher mortality compared with control persons.

Conclusion

Findings from this systematic literature review did not unambiguously confirm a possible link between bipolar disorder and overall increased risk of physical diseases in first-degree relatives of probands with bipolar disorder. However, these results could suggest that first-degree relatives of probands with bipolar disorder could have a predisposition to poorer physical health than the general population and that this aspect warrants further investigation.

Keywords:

• Bipolar disorder
• first-degree relatives
• physical diseases
• health status

Author contributions

LHM and MV conceived and planned the study. LHM and KSOS carried out the literature search supervised by MV and LVK. All contributed to the interpretation of the results. LHM and MV took the lead in writing the manuscript. All authors provided feedback and contributed to the final manuscript.

Disclosure statement

Lars Vedel Kessing has within the last three years been a consultant for Lundbeck and Teva. Maj Vinberg has within the last three years been a consultant for Lundbeck, Janssen Cilag and Sunovion. Louise Holm Madsen and Kimie Stefanie Ormstrup Sletved have no disclosures to declare.

Notes

1 ¹16 categories were included: Infectious and parasitic diseases, neoplasms, diseases of blood organs, endocrine, nutritional, metabolic, CNS and sense organs, respiratory, circulatory, digestive, skin and subcutaneous tissue, musculoskeletal and connecting tissue, genitourinary system, perinatal, congenital malformations, abnormal clinical laboratory findings, injury and poisoning and fractures, external causes of morbidity and mortality.

Additional information

Notes on contributors

Louise Holm Madsen

Louise Holm Madsen is newly educated MD with a special interest in psychiatry.

Kimie Stefanie Ormstrup Sletved

Kimie Stefanie Ormstrup Sletved is MD and PhD student with primary focus on patients with bipolar disorder and their healthy first-degree relatives.

Lars Vedel Kessing

Lars Vedel Kessing is professor and Head of the Copenhagen Affective Disorders Centre with a primary focus on the course of unipolar and bipolar disorders.

Maj Vinberg

Maj Vinberg is professor and Head of Psychiatric Research Unit, Mental Health Center, Northern Zealand with a primary focus on prevention and early invention in unipolar and bipolar disorder.