TY - JOUR
T1 - Sexually transmitted infection among adolescents and young adults with bipolar disorder
T2 - A nationwide longitudinal study
AU - Chen, Mu Hong
AU - Wei, Han Ting
AU - Bai, Ya Mei
AU - Huang, Kai Lin
AU - Ko, Nai Ying
AU - Su, Tung Ping
AU - Li, Cheng Ta
AU - Lin, Wei Chen
AU - Tsai, Shih Jen
AU - Chen, Tzeng Ji
AU - Hsu, Ju Wei
N1 - Funding Information:
All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosure appears at the end of the article.
Funding Information:
The study was supported by grants from Taipei Veterans General Hospital (V103E10-001, V104E10-002, V105E10-001-MY2-1, V105A-049, V106B-020, V107B-010, and V107C-181) and Ministry of Science and Technology, Taiwan (107-2314-B-075-063-MY3).
Funding Information:
Submitted: February 20, 2018; accepted September 24, 2018. Published online: March 12, 2019. Disclosure of off-label usage: The authors have determined that, to the best of their knowledge, carbamazepine, oxcarbazepine, topiramate, gabapentin, paliperidone, and clozapine are not approved by the US Food and Drug Administration for the treatment of bipolar disorder, and amisulpride is not approved by the US Food and Drug Administration. Author contributions: Drs M.-H. Chen, Wei, Hsu and Bai designed the study and wrote the protocol and manuscripts; Drs Su, Ko, Li, Tsai, Huang, and Lin assisted with the preparation and proofreading of the manuscript; and Drs Bai, T.-J. Chen, and M.-H. Chen provided advice on statistical analysis. Financial disclosure: Drs M.-H. Chen, Wei, Bai, Huang, Ko, Su, Li, Lin, Tsai, T.-J. Chen, and Hsu have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article. Funding/support: The study was supported by grants from Taipei Veterans General Hospital (V103E10-001, V104E10-002, V105E10-001-MY2-1, V105A-049, V106B-020, V107B-010, and V107C-181) and Ministry of Science and Technology, Taiwan (107-2314-B-075-063-MY3). Role of the sponsor: The funding sources had no role in any process of this study. Acknowledgments: The authors thank Mr I-Fan Hu, MA (Courtauld Institute of Art, University of London; National Taiwan University) for his friendship and support in English editing. Mr Hu has no conflicts of interest relevant to the subject of this article.
Publisher Copyright:
© Copyright 2019 Physicians Postgraduate Press, Inc.
PY - 2019/3
Y1 - 2019/3
N2 - Background: Evidence has shown a significant association between bipolar disorder and prevalence of risky sexual behaviors. However, the relationship between bipolar disorder and risk for sexually transmitted infections (STIs) requires further investigation, as do the effects of bipolar disorder medications on STI risk. Methods: In the present study, data from 26,028 adolescents and young adults with bipolar disorder (ICD-9-CM code 296 except 296.2x, 296.3x, 296.9x, and 296.82) and 104,112 age- and sex-matched non-bipolar-disorder controls from 2001 to 2009 were selected from the Taiwan National Health Insurance Research Database. Patients who contracted any type of STI-including human immunodeficiency virus, syphilis, genital warts, gonorrhea, chlamydial infection, and trichomoniasis-during the follow-up period (from enrollment to the end of 2011) were identified. Results: Cox regression analysis with full adjustment for demographic data, psychiatric comorbidities, and bipolar disorder medications showed that bipolar disorder was an independent risk factor (hazard ratio [HR] = 4.11; 95% confidence interval [CI], 3.62-4.66) for contracting an STI. Patients with bipolar disorder and substance and/or alcohol use disorders were at highest risk of STI occurrence. Long-term use of mood stabilizers (HR = 0.54; 95% CI, 0.34-0.86) and atypical antipsychotics (HR = 0.82; 95% CI, 0.71-0.95) was associated with reduced risk for contracting STIs. Conclusions: Adolescents and young adults with bipolar disorder exhibited an increased risk of subsequent STI during the follow-up period compared with those without bipolar disorder. Comorbidity of substance and alcohol use disorders further increased this risk. Long-term use of bipolar disorder medications (mood stabilizers and atypical antipsychotics) may reduce this risk.
AB - Background: Evidence has shown a significant association between bipolar disorder and prevalence of risky sexual behaviors. However, the relationship between bipolar disorder and risk for sexually transmitted infections (STIs) requires further investigation, as do the effects of bipolar disorder medications on STI risk. Methods: In the present study, data from 26,028 adolescents and young adults with bipolar disorder (ICD-9-CM code 296 except 296.2x, 296.3x, 296.9x, and 296.82) and 104,112 age- and sex-matched non-bipolar-disorder controls from 2001 to 2009 were selected from the Taiwan National Health Insurance Research Database. Patients who contracted any type of STI-including human immunodeficiency virus, syphilis, genital warts, gonorrhea, chlamydial infection, and trichomoniasis-during the follow-up period (from enrollment to the end of 2011) were identified. Results: Cox regression analysis with full adjustment for demographic data, psychiatric comorbidities, and bipolar disorder medications showed that bipolar disorder was an independent risk factor (hazard ratio [HR] = 4.11; 95% confidence interval [CI], 3.62-4.66) for contracting an STI. Patients with bipolar disorder and substance and/or alcohol use disorders were at highest risk of STI occurrence. Long-term use of mood stabilizers (HR = 0.54; 95% CI, 0.34-0.86) and atypical antipsychotics (HR = 0.82; 95% CI, 0.71-0.95) was associated with reduced risk for contracting STIs. Conclusions: Adolescents and young adults with bipolar disorder exhibited an increased risk of subsequent STI during the follow-up period compared with those without bipolar disorder. Comorbidity of substance and alcohol use disorders further increased this risk. Long-term use of bipolar disorder medications (mood stabilizers and atypical antipsychotics) may reduce this risk.
UR - https://www.scopus.com/pages/publications/85063612900
UR - https://www.scopus.com/pages/publications/85063612900#tab=citedBy
U2 - 10.4088/JCP.18m12199
DO - 10.4088/JCP.18m12199
M3 - Article
C2 - 30901168
AN - SCOPUS:85063612900
SN - 0160-6689
VL - 80
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 2
M1 - 18m12199s
ER -