title: Increased risk of chronic liver disease in patients with bipolar disorder: A population-based study.
abstract: This study aimed to investigate the prevalence and incidence of chronic liver disease in patients with bipolar disorder.
  
  
  
  We used a random sample of 766,427 subjects aged ≥18 years from the National Health Research Institute database in the year 2005. Subjects with at least one primary diagnosis of bipolar disorder in 2005 were identified. Patients with a primary or secondary diagnosis of chronic liver disease were also defined. We compared the prevalence and associated factors of chronic liver disease between patients with bipolar disorder and the general population in 2005. We also compared the incidence of chronic liver disease in patients with bipolar disorder and the general population from 2006 to 2010.
  
  
  
  The prevalence of chronic liver disease in patients with bipolar disorder (13.9%) was 2.68 times higher than that of the general population (5.8%) in 2005. The average annual incidence of chronic liver disease in patients with bipolar disorder from 2006 to 2010 was also higher than that of the general population (2.95% vs. 1.73%; risk ratio: 1.71; 95% confidence interval: 1.46-2.01).
  
  
  
  Patients with bipolar disorder had a significantly higher prevalence and incidence of chronic liver disease than those in the general population, and younger patients with bipolar disorder have a much higher prevalence and incidence than those in the general population. Male sex, second-generation antipsychotic or antidepressant use, and hyperlipidemia were associated factors for chronic liver disease in patients with bipolar disorder.
authors.affiliation: Chia-Yi Hospital, Ministry of Health and Welfare, Chiayi City, Taiwan.
authors.forename: Jer-Hwa
authors.initials: JH
authors.lastname: Hsu
authors.affiliation: Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan; Department of Public Health & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. Electronic address: icchien@ttpc.mohw.gov.tw.
authors.forename: I-Chia
authors.initials: IC
authors.lastname: Chien
authors.affiliation: Taichung Veteran General Hospital, Taichung, Taiwan; National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000453:epidemiology*; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Analgesic; Bipolar disorder; Chronic liver disease; National Health Insurance; Prevalence; Taiwan