Author: yes louise s larsen

Cause-specific life years lost among persons diagnosed with schizophrenia: Is it getting better or worse?

People with schizophrenia have an increased risk of premature mortality compared to the general population. This study aimed to quantify which types of causes of death contributed to the excess mortality. The findings showed that, compared to the general population, a large improvement in life years lost with respect to suicide and accidents was found in those with schizophrenia. However, this improvement was offset by an increasing number of life years lost in deaths from diseases and medical conditions.
The study has been published in Schizophrenia Research
https://www.sciencedirect.com/science/article/pii/S0920996418306339#f0005

DRISP: Annette Erlangsen & Merete Nordentoft

Partners:

  • Thomas Munk Laursen, National Center for Register-based Research, Aarhus Denmark (first author on study)
  • Oleguer Plana-Ripoll, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
  • Per Kragh Andersen, Section of Biostatistics, University of Copenhagen
  • John J McGrath, Queensland Brain Institute, University of Queensland
  • Anita Toender, National Center for Register-based Research, Aarhus Denmark
  • Vladimir Canudas-Romo, School of Demography, Australian


Psycho-social speech therapy in the Danish Suicide Prevetion Clincs

Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality.
Our findings show a lower risk of repeated deliberate self-harm and general mortality in recipients of psychosocial therapy after short-term and long-term follow-up, and a protective effect for suicide after long-term follow-up, which favour the use of psychosocial therapy interventions after deliberate self-harm.
The project was supported by Danish Health Insurance Foundation; the Research Council of Psychiatry, Region of Southern Denmark; the Research Council of Psychiatry, Capital Region of Denmark; and the Strategic Research Grant from Health Sciences, Capital Region of Denmark.

The project in the media

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New York Times
BBC
The Washington Post
Bloomberg News

The study was published in Psychological Medicine and Lancet Psychiatry.

DRISP: Annette Erlangsen & Merete Nordentoft

Partners:

  • Elizabeth A Stuart, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  • Ping Qin, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
  • Elsebeth Stenager, Department of Psychiatry, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark
  • Leaders of the Danish Suicide Prevention Clinics


Genetics of suicide attempts in individuals with and without mental disorders

Family studies shown an aggregation of suicidal behaviour in families. The aim of this study was to conduct a genome-wide association study (GWAS) and estimate single nucleotide polymorphisms (SNP) heritability for suicide attempt in a national sample of individuals with and without mental disorders. This is the largest sample investigated to date, significant SNP associations to suicide attempt were identified. The findings furthermore indicated that genetic transmission of suicide attempt is not solely explained by diagnosed mental disorders.
The study was published in Molecular Psychiatry.
The project was funded by the iPSYCH-grant from the Danish Lundbeck Foundation

DRISP: Annette Erlangsen & Merete Nordentoft

Partners:

  • Vivek Appadurai, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Yunpeng Wang, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Hospital Research Centre, Department of psychiatry, McGill University, Montreal, Canada
  • Ole Mors, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Thomas Werge, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Preben B Mortensen, DrMedSc, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Anna Starnawska, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Anders D Børglum, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Andrew Schork, MS, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Ron Nudel, DPhil, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Marie Bækvad-Hansen, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Jonas Bybjerg-Grauholm, MSc, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • David M Hougaard, DrMedSc, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Wesley K Thompson, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
  • Esben Agerbo, DrMedSc The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark


Infections and suicide

Findings suggest that infections might be linked to the development of psychiatric disorders and suicidal behaviour. To estimate the association between hospitalization with infection and the risk of death by suicide. An increased risk of death by suicide was found among individuals hospitalized with infection in prospective and dose-response relationships. These findings indicate that infections may have a relevant role in the pathophysiological mechanisms of suicidal behaviour.
The study was published in JAMA Psychiatry.
The project has received support from the Lundbeck Foundation.

DRISP: Annette Erlangsen, Trine Madsen, og Merete Nordentoft

Partners:

  • Michael E. Benros , PhD, Mental Health Centre Copenhagen, Capital Region of Denmark, Denmark
  • Holger J. Sørensen, MD,Mental Health Centre Copenhagen, Capital Region of Denmark, Denmark
  • William W. Eaton, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • Teodor T. Postolache, MD, Mood and Anxiety Disorders Program, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore


TEENS trial

Non-suicidal self-injury (NSSI) is very prevalent among adolescents estimated to a lifetime prevalence in non-clinical samples of 17%; increasing in psychiatric populations. NSSI an important predictor of later suicidal behavior. Evidence for treatment is spares but internet-based interventions guided by a therapist have been suggested. We aim to investigate the effect of internet-based ERITA compared to weekly journaling as add-on to treatment as usual in 13-17-year-old patients with NSSI referred to child– and adolescent mental health services. This pilot feasibility study (n=25) is an RCT. The experimental interventions are add-on to treatment as usual. Primary outcome is the frequency of NSSI assessed after 12 weeks. Also, adherence to treatment will be assessed.

DRISP: Britt Morthorst

Partners:

  • Child and Adolescent Mental Health Services in the Capital Region of Denmark
  • Johan Bjureberg, PhD, Karolinska Instituttet, Stockholm, Sweden
  • Clara Hellner, MD, PhD, Karolinska Instituttet, Stockholm, Sweden

Clinical development project

The aim is to implement three questionnaires regarding protective and risk factors in suicide behavior in the treatment of children and adolescents. The implementation will contribute with a quality boost to the clinical work in the Suicide Prevention Clinic for children and adolescents by structured collecting and using tested scales to assess children and adolescents’ suicide risk, experience of mental stress as well as own strengths and weaknesses (resilience). The three scales that are to be used are: K10 (the experience of psychological stress), READ (resilience) and Columbia (the frequency and the intensity of suicide behavior). For the time being this is a clinical development project that may lead to a research project on a later stage.

DRISP: Britt Morthorst

Partners:

  • Child and Adolescent Mental Health Services in the Capital Region of Denmark
  • Center for Suicide Prevention, Region South Denmark

WHO-media guidelines

Media reporting of suicidal behavior can be beneficial as well as harmful. Dramatic and sensational descriptions may lead to increased suicidal behavior in the population while objective reporting with focus on where to seek help (hopeful stories) can be preventive. WHO has in collaboration with international experts developed a set of media guide lines with recommendations on how to present suicidal events in online as well as written media.

DRISP: Britt Morthorst

WHO-medieguidelinesDownload


Partners:

  • National Health Authorities in Denmark

Paracetamol-project (Danish Pack size restriction)

Paracetamol is reported to be the most frequently used drug for overdoses in European countries. An international concern has emerged and interventions, such as age and pack size restriction on non-opioid analgesics sold OTC in pharmacies, have been implemented.
The method applied was a nationwide register study investigating the trend in hospital admissions for non-opioid analgesic poisonings before and after the implementation of age and pack size restriction in Denmark in 2011 and 2013, respectively. The trend in rates of severe poisonings was also investigated using nationwide laboratory data as blood tests taken routinely during admission in the period 2011-2013. After the age and the pack size restriction we found significantly reduced numbers of non-opioid analgesics poisonings. Also, the number of severe poisonings treated in Danish hospitals decreased after the pack size restriction indicating reduced risk of liver injury.
We concluded that a significant reduction in trends of poisoning by non-opioid analgesics treated in hospitals and fewer severe poisonings was observed after the legislative changes in Denmark.

Link to the study: https://www.sciencedirect.com/science/article/pii/S016503271932957X

The project in the media
Politiken

DRISP: Britt Morthorst

Partners:

  • Frank Eriksson, PhD, Associate Professor, Institute of Biostatistics, University of Copenhagen
  • Keith Hawton, Centre for Suicide Research, University of Oxford, United Kingdom


The AID-trial

The aim was to investigate the effect of assertive outreach focusing on problem-solving and escort to after-treatment compared to standard treatment in patients with a current suicide attempt measures as subsequent suicidal events within a year from index attempt. The study was an RCT (n=243) offering 8-10 home consolations in six months consisting of supportive consultations and escort to all kinds of after-treatment (e.g. GPs, alcohol units, somatic and psychiatric treatment and social services) in addition to safety planning, family support and crisis intervention. The study period was 207-2010. Results showed no difference in the repetition frequency between groups (17% equally). Also, there were no difference in the use of health care or social service use. The conclusion was that assertive outreach was not recommend compared to standard treatment in Denmark where standard treatment is already of high quality due to suicide preventions clinics.     

https://clinicaltrials.gov/ct2/show/NCT00700089

DRISP: Britt Morthorst

Partners:

  • Representatives with health care and social services in the Capital Region of Denmark.

Joinpoint regression analysis of suicides in Denmark during 1980-2015

Is the suicide rate in Denmark increasing or decreasing? Effective suicide prevention requires vigilant monitoring of suicide trends. The aim of this study was to assess the change in the Danish suicide rate over time using joinpoint regression analysis. The suicide rate fell sharply between 1980 and 1999 in Denmark, but since then the decrease has been modest, especially since 2007. Further reduction in the suicide rate requires new and effective measures. The study is published in Danish Medical Bulletin

DRISP: Susanne Dyvesether, Annette Erlangsen & Merete Nordentoft


Partners:

  • Julie L Forman, Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes

In this nationwide cohort study, an increased risk of mental and physical disorders, mortality, and adverse social events were noted among people bereaved by spousal suicide. Bereavement by suicide differed from bereavement by other manners of death. Surviving partners are affected on a broad range of mental, physical, and social health outcomes, suggesting a need for more proactive outreach. The findings have been published in JAMA Psychiatry.
The project was supported by the American Foundation for Suicide Prevention and the Danish Health Insurance Foundation.

DRISP: Annette Erlangsen og Merete Nordentoft

Partner:

  • Bo Runeson, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • James M. Bolton, Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
  • Holly C. Wilcox, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
  • Julie L Forman, Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • Jesper Krogh, Research Unit, Mental Health Centre Copenhagen, Denmark
  • Katherine Shear, Columbia School of Social Work, Columbia University College of Physicians and Surgeons, New York, New York
  • Yeates Conwell, Center for the Study and Prevention of Suicide, Department of Psychiatry, and Office for Aging, University of Rochester Medical Center, Rochester, New York

Workplace bullying and suicidal behaviour

Workplace bullying can be considered a stressful event, but there is little knowledge about its association with suicidal behavior. The aim of this research project was to investigate whether people who had experienced workplace bullying had a higher risk of suicidal behavior than people who had not been exposed to it.

In several large Danish surveys, more than 98,000 employees had been asked about experiences of workplace bullying. These data were linked to registry data, so that researchers could examine how many of the respondents were recorded with suicidal behavior over the subsequent 10 years from 2004-2014. The findings showed that over 10% of the people who had reported experienced workplace bullying. People who had been exposed to workplace bullying had a 1.6 times higher risk of suicidal behavior when compared to those who had not experienced bullying. The study was one of the few, which have documented this association in data where it could be determined that the bullying had been reported prior to the observed suicidal behavior.

The project has received funding from the Psychiatric Research Foundation, Region of Southern Denmark.

You can find the study here: https://www.sjweh.fi/article/4034

DRISP: Annette Erlangsen

Partners:

  • Paul Maurice Conway, Institut for Psykologi, Københavns Universitet
  • Thomas Clausen, Det Nationale Forskningscenter for Arbejdsmiljø, København
  • Annie Høgh, Institut for Psykologi, Københavns Universitet
  • Elsebeth Stenager, Department of Regional Health Research, University of Southern

Suicidal behaviour after among victims of physical or sexual abuse

Abuse of children and youth is an important problem to emphasize and prevent. This project conducts a large, representative, study of victims of sexual and physical abuse.
The project has received support from the Danish Health Care Foundation.

DRISP: Annette Erlangsen & Merete Nordentoft

Partners

  • Holly Wilcox, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
  • Prof Elizabeth J. Letourneau, Moore Center for the Prevention of Child Sexual Abuse Johns Hopkins Bloomberg School of Public Health
  • Kairi Kolves, Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre in for Research and Training in Suicide Prevention at Griffith University




Suicidal behaviour among persons with ADHD

Persons diagnosed with ADHD have been found to have an increased risk of suicidal behaviour but the pathway remains to be thoroughly explored. The aim of this study was to determine whether persons with ADHD were more likely to present with suicidal behaviour, ie. suicide attempts, and deaths by suicide if they had a comorbid psychiatric disorder.

The findings of the study revealed that having a comorbid disorder was associated with a significantly higher rate of suicidal behavior; comorbid schizophrenia or substance abuse disorder were associated with the largest increase.

The project was carried out in cooperation with Prof Søren Dalgaard from Aarhus University and has received support from the Danish Lundbeck Foundation.

Published in British Journal of Psychiatry.

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/suicidal-behaviour-among-persons-with-attentiondeficit-hyperactivity-disorder/6CECF48A64E415C871D233B2607114ED



DRISP: Cecilie Aaling, Annette Erlangsen, Merete Nordentoft

Partners:

  • Professor Søren Dalsgaard, DM National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark

Suicide among persons in same- sex and opposite-sex marriages in Denmark and Sweden

People belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using national data from Denmark and Sweden, this study investigated whether individuals entering a same-sex marriage have higher suicide rates than those entering opposite-sex marriage.

The findings revealed that people in same-sex marriages have a 1.5-fold higher suicide rate when compared to people living in opposite-sex marries. Over the periods 1989-2002 and 2003-16, the rate of suicides among people in same-sex unions fell by 46%, compared to a decline of about 28% in the number of suicides by people in heterosexual relationships.

“Although suicide rates in the general populations of Denmark and Sweden have been decreasing in recent decades, the rate for those living in same-sex marriage declined at a steeper pace, which has not been noted previously,” the study, which followed 28,000 people in same-sex partnerships for an average of 11 years, concludes Annette Erlangsen, the lead author, suggested that along with other gay rights legislation, same-sex marriage may have reduced feelings of social stigmatisation among some homosexual people. “Being married is protective against suicide,” she told Thomson Reuters Foundation

Link to study

https://www.theguardian.com/world/2019/nov/14/suicide-rates-fall-after-gay-marriage-laws-in-sweden-and-denmark



DRISP: Annette Erlangsen, Merete Nordentoft

Partners:

  • Ann Haas, PhD, American Foundation for Suicide Prevention, New York, USA
  • Gunnar Andersson, PhD, Stockholm University Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden
  • Sven Drefahl, PhD, Stockholm University Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden
  • Charlotte Björkenstam, PhD, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA