Sexually Transmitted Infection Among Adolescents and Young Adults With Bipolar Disorder: A Nationwide Longitudinal Study

Instructions

Click the red REGISTER button to pay the $10 fee and take the posttest
Click here to return to the JCP CME article.

Overview

What are some risk factors for (and protective factors against) sexually transmitted infections among adolescents and young adults with bipolar disorder?

Abstract

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.

To cite: Chen MH, Wei HT, Bai YM, et al. Sexually transmitted infection among adolescents and young adults with bipolar disorder: a nationwide longitudinal study. J Clin Psychiatry. 2019;80(2):18m12199.

https://doi.org/10.4088/JCP.18m12199


Read the whole article at psychiatrist.com here:
Sexually Transmitted Infection Among Adolescents and Young Adults With Bipolar Disorder: A Nationwide Longitudinal Study

© Copyright 2019 Physicians Postgraduate Press, Inc.

Target Audience

Psychiatrists

Learning Objectives

Assess and address sexual risks in adolescent and young adult patients with bipolar disorder

Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
03/12/2019
Activity expires: 
04/30/2021
Cost:
$10.00
Rating: 
0

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.

CME Objective

After studying this article, you should be able to:

  • Assess and address sexual risks in adolescent and young adult patients with bipolar disorder

Release, Expiration, and Review Dates

This educational activity was published in March 2019 and is eligible for AMA PRA Category 1 Credit™ through April 30, 2021. The latest review of this material was February 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.

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.

FACULTY

Mu-Hong Chen, MD‡
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Han-Ting Wei, MD‡
Department of Psychiatry, Taipei Veterans General Hospital, and Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Tapiei, Taiwan

Ya-Mei Bai, MD, PhD
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Kai-Lin Huang, MD
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Nai-Ying Ko, PhD
Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan

Tung-Ping Su, MD
Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang-Ming University; and Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan

Cheng-Ta Li, MD, PhD
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Wei-Chen Lin, MD
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Shih-Jen Tsai, MD
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Tzeng-Ji Chen, MD, PhD
Department of Family Medicine, Taipei Veterans General Hospital, and Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan

Ju-Wei Hsu, MD*
Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan

Contributed equally

*Corresponding author: Ju-Wei Hsu, MD, Department of Psychiatry, No. 201, Shih-Pai Rd, Sec. 2, 11217, Taipei, Taiwan (jwhsu@vghtpe.gov.tw).

FINANCIAL DISCLOSURE

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 of The Journal of Clinical Psychiatry, 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.

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.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation

Price

Cost:
$10.00
Please login or register to take this activity.

Register for free on our site to participate in this and many free CME courses. There is a $10 processing fee for this activity.