Background:
The prevalence of bipolar disorder (BD) and major depressive disorder (MDD) has risen substantially, increasing the population requiring long-term pharmacological treatment. While essential for disease control, many psychotropic medications cause metabolic and endocrine side effects, including hyperglycemia, dyslipidemia, insulin resistance, obesity, and type 2 diabetes. Prolonged medication use may thus have cumulative systemic consequences. Obesity and metabolic dysfunction are established risk factors for colorectal cancer (CRC), and chronic endocrine disturbances may affect the hypothalamic-pituitary axis, potentially contributing to pituitary adenoma (PA). However, population-based evidence linking psychiatric medication use with CRC or PA risk remains limited.
Research Questions:
Does long-term use of medications for BD and MDD increase CRC incidence?
Does long-term use of these medications increase PA incidence?
Do metabolic and endocrine abnormalities mediate these associations?
Are specific medication classes or drugs associated with higher risks?
Objectives:
Assess associations between psychiatric medication use in BD and MDD and CRC incidence.
Assess associations with PA incidence.
Explore potential mediating roles of metabolic and endocrine dysfunction.
Scientific Rationale:
This study integrates psychiatric disorders, long-term medication exposure, metabolic/endocrine dysregulation, and cancer outcomes in a large population cohort. UK Biobank’s detailed phenotypic, medication, and longitudinal health data allow real-world assessment of these associations. Results may improve risk stratification, guide clinical monitoring, and inform balanced long-term management of mood disorders.
