Scientists have found that teenagers and adults living with bipolar disorder face a higher risk of early death compared to people of the same age and sex who do not have the condition. In a recent large population-based study published in JAMA Network Open, scientists looked back at existing records from Taiwan’s national health and death registries and found that people with bipolar II disorder had a 1.6 times higher risk of death from both natural causes, such as medical illnesses, and unnatural causes, such as accidents and suicide.
How big are the risks?
Bipolar disorder (BP) is a mental health condition where a person’s mood, energy, and ability to cope with daily life can shift dramatically over time. These changes come in episodes that can last for several days or even weeks, where one’s mood becomes unusually high, overly energetic, or sometimes very irritable.
At the other end of the spectrum, during depressive episodes, people with BD feel intense sadness to a point where their ability to experience disappears. This isn’t a rare condition, as one in 200 people around the world live with some form of BD.
A team of Taiwanese researchers analyzed data from over 11,000 people with bipolar II disorder (BD-II) to understand their long-term risk of early death. This condition involves both depressive episodes and hypomanic episodes of elevated mood and energy. These symptoms are usually less severe than in bipolar I disorder (BD-I), where manic episodes can sometimes become so intense that hospital care is required.
The study included participants aged 12 and older who had been professionally diagnosed with BD-II, and about 62% were women. For comparison, it also included 45,708 people without the disorder. The study collected data from between 2001 to 2022, and where the average follow-up time across all participants was around 7.3 years.
Statistical modeling revealed that people with BD-II were about 60% more likely to die from any cause compared to people of the same age and sex without the condition. The risk of death from physical illnesses—such as heart, lung, and digestive diseases—was also 37% higher than in the general population.
In addition, they were nearly 4.5 times more likely to die from unnatural causes, including accidents, suicide, or violence. They also found that people with BD-II actually had a 24% higher risk of death overall compared to those with BD-I but the risk from unnatural causes was not very different.
The special focus on BD-II was needed because, for a long time, it wasn’t clear whether it carries a separate risk of early death. Many earlier studies grouped BD-II together with BD-I, making it difficult to understand the risks specific to BD-II and leaving doctors without the clarity they need to identify warning signs earlier and improve treatment plans.
The researchers note that the study makes a compelling case that BD-II carries a significant risk of early death across a wide range of causes, highlighting just how urgently people with this condition need comprehensive and proactive psychiatric care.
While these findings are important, they do come with limitations worth noting. The data came exclusively from a Taiwanese population, which limits how broadly the results can be applied elsewhere, and lacked information on mood severity, episode frequency, and lifestyle habits, all of which can influence mortality risk.
Further research addressing these gaps is needed to guide evidence-based, integrated psychiatric and medical care for people with BD-II.