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Abstract
Objective To evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD).
Methods Using the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified.
Results Patients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74–8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89–6.93) or first 3 years (HR 4.42; 95% CI 3.63–5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD.
Conclusion Patients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.
Glossary
- BD=
- bipolar disorder;
- CI=
- confidence interval;
- HR=
- hazard ratio;
- ICD-9-CM=
- International Classification of Diseases, 9th revision, clinical modification;
- NHI=
- National Health Insurance;
- NHIRD=
- National Health Insurance Research Database;
- NTD=
- New Taiwan Dollar;
- PD=
- Parkinson disease
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 1125
- Received October 11, 2018.
- Accepted in final form February 1, 2019.
- © 2019 American Academy of Neurology
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