{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:48:04Z","timestamp":1791859684642,"version":"4.3.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"published-print":{"date-parts":[[2024]]},"abstract":"<b><i>Introduction:<\/i><\/b> This study aimed to estimate all-cause mortality in patients after a first-episode mania (FEM) and examine whether six guideline-recommended medications can reduce mortality. <b><i>Methods:<\/i><\/b> The cohort included population-based FEM samples and matched controls from Taiwan, spanning 2007 to 2018. The primary outcomes assessed were all-cause\/suicide-related mortality, while the secondary outcome focused on mortality associated with pharmacological treatments. We compared mortality in post-FEM patients and age-\/sex-matched controls without any diagnosed bipolar disorders and patients with and without psychopharmacological treatment using Cox regression analysis, respectively. Statistics were presented with time-to-event adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs). <b><i>Results:<\/i><\/b> The study included 54,092 post-FEM patients and 270,460 controls, totaling 2,467,417 person-years of follow-up. Post-FEM patients had higher risks of all-cause mortality (AHR 2.38, 95% CI: 2.31\u20132.45) and suicide death (10.80, 5.88\u201319.84) than controls. Lithium (0.62, 0.55\u20130.70), divalproex (0.89, 0.83\u20130.95), and aripiprazole (0.81, 0.66\u20131.00) were associated with reduced all-cause mortality compared to non-users. There were no significant all-cause mortality differences for quetiapine (0.95, 0.89\u20131.01), risperidone (0.92, 0.82\u20131.02), and paliperidone (1.24, 0.88\u20131.76) users. When accounting for drug action onset times in sensitivity analyses, only lithium significantly reduced all-cause mortality (AHR range 0.65\u20130.72). There were 35 and 16 suicide deaths in post-FEM patients and controls, respectively. No drug had a significant effect on suicide deaths (lithium: 6; divalproex: 7; aripiprazole: 0; quetiapine: 10; risperidone: 4; paliperidone: 1). <b><i>Conclusion:<\/i><\/b> Post-FEM patients had a higher risk of all-cause\/suicide-related mortality, and lithium treatment might reduce all-cause mortality.<\/jats:p>","DOI":"10.1159\/000535777","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T17:00:35Z","timestamp":1704819635000},"page":"36-45","source":"Crossref","is-referenced-by-count":19,"title":["Mortality and Lithium-Protective Effects after First-Episode Mania Diagnosis in Bipolar Disorder: A Nationwide Retrospective Cohort Study in Taiwan"],"prefix":"10.1159","volume":"93","author":[{"given":"Andre F.","family":"Carvalho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Wei","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Vieta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Solmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Marx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Berk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Sung","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Tao","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-Jen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,1,9]]},"container-title":["Psychotherapy and Psychosomatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/pps\/article-pdf\/93\/1\/36\/4171026\/000535777.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/pps\/article-pdf\/93\/1\/36\/4171026\/000535777.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T12:01:23Z","timestamp":1745409683000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000535777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,2,20]]},"published-print":{"date-parts":[[2024,2,28]]}},"URL":"https:\/\/doi.org\/10.1159\/000535777","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.24908490","asserted-by":"subject"}]},"ISSN":["0033-3190","1423-0348"],"issn-type":[{"value":"0033-3190","type":"print"},{"value":"1423-0348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]}}}