Summary: People with bipolar disorder have higher incidences of Parkinson’s disease than those without the psychiatric condition. Manic and depressive episodes were associated with an elevated risk of developing Parkinson’s disease.
People who have bipolar disorder may be more likely to later develop Parkinson’s disease than people who do not have bipolar disorder, according at a study published in the May 22, 2019, online issue of Neurology.
“Previous studies have shown a relationship between depression and Parkinson’s disease, but few studies have looked at whether there is a relationship between bipolar disorder and Parkinson’s,” said study author Mu-Hong Chen, MD, PhD, of Taipei Veterans General Hospital in Taiwan.
For the study, researchers examined a national Taiwanese health database for people were diagnosed with bipolar disorder between 2001 and 2009 and who had no history of Parkinson’s disease, for a total of 56,340 people. They were matched with 225,360 people of the same age, sex and other factors who had never been diagnosed with bipolar disorder or Parkinson’s disease as a control group. Then the two groups were followed until the end of 2011.
During the study, 372 of the people with bipolar disorder developed Parkinson’s disease, or 0.7 percent, compared to 222 of those who did not have bipolar disorder, or 0.1 percent.
After adjusting for other factors that could affect the risk of developing Parkinson’s disease, such as age, sex, use of antipsychotic medications, and medical issues such as traumatic brain injury and cerebrovascular diseases, people with bipolar disorder were nearly seven times as likely to develop Parkinson’s disease as people who did not have bipolar disorder.
The people with bipolar disorder who developed Parkinson’s disease did so at a younger age than the control group members who developed the disease—64 years old at diagnosis compared to 73 years old.
People who were hospitalized more often for bipolar disorder were more likely to develop Parkinson’s disease than those who were hospitalized less than once per year. A total of 94 percent of those with bipolar disorder were hospitalized less than once per year; 3 percent were hospitalized one to two times per year; and 3 percent were hospitalized more than two times per year. Those who were hospitalized more than two times per year were six times more likely to develop Parkinson’s disease than those who were hospitalized less than once per year. People who were hospitalized one to two times per year were four times more likely to develop Parkinson’s disease than those who were hospitalized less than once per year.
“Further studies are needed to investigate whether these diseases share underlying processes or changes in the brain,” Chen said. “These could include genetic alterations, inflammatory processes or problems with the transmission of messages between brain cells. If we could identify the underlying cause of this relationship, that could potentially help us develop treatments that could benefit both conditions.”
A limitation of the study is it included only people who sought medical help for their bipolar disorder. Also, the database did not include information on family history of Parkinson’s disease or environmental factors that could increase people’s risk of developing the disease.
Funding: The study was supported by Taipei Veterans General Hospital and the Taiwanese Ministry of Science and Technology.
Renee Tessman – AAN
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Original Research: Closed access
“Bipolar disorder and risk of Parkinson disease: A nationwide longitudinal study”. Mao-Hsuan Huang, Chih-Ming Cheng, Kai-Lin Huang, Ju-Wei Hsu, Ya-Mei Bai, Tung-Ping Su, Cheng-Ta Li, Shih-Jen Tsai, Wei-Chen Lin, Tzeng-Ji Chen, Mu-Hong Chen.
Bipolar disorder and risk of Parkinson disease: A nationwide longitudinal study
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.