Sixteen-year mortality in patients with affective disorder commenced on lithium

Background Lithium treatment is claimed to reduce mortality in patients wit h affective disorder, but the evidence is conflicting. Aim To estimate mortality rates from a cohort of patients with affective di sorder commenced on lithium with an observation period of two years and a f ollow-up after 16 years. Method The mortality rates of patients were compared with those of the gene ral Danish population, standardised for age, gender and calendar time with respect to death from all causes, suicide and death from cardiovascular dis ease. Results Forty of the study's 133 patients died during the 16-year observati on period (11 from suicide). Mortality among patients commenced on lithium was twice that of the general population. The statistically significantly e levated mortality was due largely to an excess of suicides; mortality from all other causes was similar to the background populations. Thirty-two pati ents died after the first two years of observation and were included in the analysis of the association between death and treatment com pi lance. Suic ide occurred more frequently among those patients not complying with treatm ent. Conclusion Mortality, especially suicide, was significantly increased in un selected patients with affective disorder commenced on lithium relative to the general population. Declaration of interest None.