{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:01:58Z","timestamp":1760367718249,"version":"3.37.3"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T00:00:00Z","timestamp":1500249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011044","name":"Geocenter Denmark","doi-asserted-by":"crossref","award":["Grant 2-2011 - Iodine in the Hydrological Cycle"],"award-info":[{"award-number":["Grant 2-2011 - Iodine in the Hydrological Cycle"]}],"id":[{"id":"10.13039\/100011044","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Animal data suggest that subtherapeutic doses, including micro doses, of lithium may influence mood, and lithium levels in drinking water have been found to correlate with the rate of suicide. It has never been investigated whether consumption of lithium may prevent the development of bipolar disorder (primary prophylaxis). In a nation\u2010wide population\u2010based study, we investigated whether long\u2010term exposure to micro levels of lithium in drinking water correlates with the incidence of bipolar disorder in the general population, hypothesizing an inverse association in which higher long\u2010term lithium exposure is associated with lower incidences of bipolar disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included longitudinal individual geographical data on municipality of residence, data from drinking water lithium measurements and time\u2010specific data from all cases with a hospital contact with a diagnosis of mania\/bipolar disorder from 1995 to 2013 (N=14\u00a0820) and 10 age\u2010 and gender\u2010matched controls from the Danish population (N= 140\u00a0311). Average drinking water lithium exposure was estimated for all study individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median of the average lithium exposure did not differ between cases with a diagnosis of mania\/bipolar disorder (12.7\u00a0\u03bcg\/L; interquartile range [<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>]: 7.9\u201015.5 \u03bcg\/L) and controls (12.5\u00a0\u03bcg\/L; <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 7.6\u201015.7 \u03bcg\/L; <jats:italic>P<\/jats:italic>=.2). Further, the incidence rate ratio of mania\/bipolar disorder did not decrease with higher long\u2010term lithium exposure, overall, or within age categories (0\u201040, 41\u201060 and 61\u2010100\u00a0years of age).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher long\u2010term lithium exposure from drinking water was not associated with a lower incidence of bipolar disorder. The association should be investigated in areas with higher lithium levels than in Denmark.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12524","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T10:52:44Z","timestamp":1500288764000},"page":"563-567","source":"Crossref","is-referenced-by-count":22,"title":["Lithium in drinking water and the incidence of bipolar disorder: A nation\u2010wide population\u2010based study"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9377-9436","authenticated-orcid":false,"given":"Lars V","family":"Kessing","sequence":"first","affiliation":[{"name":"Psychiatric Center Copenhagen Rigshospitalet University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A","family":"Gerds","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikoline N","family":"Knudsen","sequence":"additional","affiliation":[{"name":"National Institute of Public Health University of Southern Denmark  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisbeth F","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Geological Survey of Denmark and Greenland  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f8ren M","family":"Kristiansen","sequence":"additional","affiliation":[{"name":"Department of Geoscience Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denitza","family":"Voutchkova","sequence":"additional","affiliation":[{"name":"Geological Survey of Denmark and Greenland  Copenhagen Denmark"},{"name":"Department of Geoscience Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vibeke","family":"Ernstsen","sequence":"additional","affiliation":[{"name":"Geological Survey of Denmark and Greenland  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Schullehner","sequence":"additional","affiliation":[{"name":"Geological Survey of Denmark and Greenland  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitte","family":"Hansen","sequence":"additional","affiliation":[{"name":"Geological Survey of Denmark and Greenland  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per K","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette K","family":"Ersb\u00f8ll","sequence":"additional","affiliation":[{"name":"National Institute of Public Health University of Southern Denmark  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-014-0015-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881109102919"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2013.770551"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12025"},{"key":"e_1_2_9_6_1","unstructured":"NICE.Bipolar disorder: the assessment and management of bipolar disorder in adults children and young people in primary and secondary care. 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