Trends in bipolar disorder or depression as a cause of death on death certificates of US residents, 1999–2009

Abstract

Temporal trends in mortality from bipolar disorder (BD) or depression in the US population, based on multiple causes (MC) rather than underlying cause (UC) alone on death certificates, apparently have not been examined. The annual US age-standardized rate (ASR) for deaths per 100,000 US residents age 15+ years, and age-specific rates, for BD or depression using MC versus UC alone was examined for 1999-2009; percentage change (PC) from 1999 to 2009 was calculated. The ASRs at age 15+ years were much higher using MC than UC alone. For BD using MC, the ASR increased from 1999 to 2009 (PC +69.2%) with larger increases in age groups within 15-64years (PCs about 200%). For depression using MC, the ASR rose from 1999 to 2003 and then declined, but the decline was restricted to age 65+ years; the ASR at age 15-64years increased from 1999 to 2009 (PC +55.5%). For deaths at age 15-64years with BD or depression as other than UC, the ASRs increased for external causes, cardiovascular diseases, external causes, and neoplasms as UC. The large increases in mortality from BD using MC are consistent with reported increases in BD prevalence rates in the US population. The temporal increases in death rates related to mood disorders at age 15-64years may provide further support for the need for interventions to address the mediators of excess mortality identified from cohort studies.