The aim is to implement three questionnaires regarding protective and risk factors in
DRISP: Britt Morthorst
Partners:
- Child and Adolescent Mental Health Services in the Capital Region of Denmark
- Center for Suicide Prevention, Region South Denmark
Author: yes louise s larsen
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
DRISP: Britt
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.
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
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,
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.
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
Link to study
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
Traumatic brain injury tied to increased risk of suicide
People who have traumatic brain injuries may be nearly twice as likely to die by suicide as individuals who don’t have a history of injuries like concussions and skull fractures, a large Danish study suggests.
Researchers examined data on more than 7.4 million people aged 10 years and older living in Denmark from 1980 to 2014. During this period, 567,823 people, or 7.6 percent, had received treatment for a traumatic brain injury. See the links below.
Internationale media
Washington Post
Reuters
ABC News
The Telegraph (
National partnership for suicide prevention
Danish Research Institute for Suicide Prevention (DRISP) did the 8 sep. 2018 join the new National Partnership for Suicide Prevention. In total, 22 organisations have committed to collaborate with the purpose of promoting suicide prevention in Denmark. The date for the formal start of the partnership coincides with the WHO World Suicide Prevention Day on September 10th, which is marked by various events throughout the country. “We are pleased to finally have a national partnership for suicide prevention. There has not been a decline observed in suicide rate over the last 15 years – it is time to make a change through a coordinated and goal-oriented effort to prevent suicidal behaviours” says program leader Annette Erlangsen, DRISP. “Internationally, we have a substantial body of evidence on effective strategies for prevention. DRISP is eager to establish evidence-based knowledge on effective measures with a focus on implementation”. DRISP has received funding to update the knowledge stand on risk predictors for suicide. In addition, Merete Nordentoft who is a professor in psychiatry and employed at Mental Health Centre Copenhagen has recently received 18 mill DKK from the Danish Ministry of Health (‘SATS-pulje’) to implement a better follow-up on patients discharged/transferred from/between psychiatric care providers. “It is extremely important to examine whether such efforts have an actual effect so that we know whether it makes sense to implement them nationally” Merete Nordentoft explains.
New International Research on Suicide Prevention
Danish Research Institute for Suicide Prevention (DRISP) disseminate international research-based knowledge directly to professionals and others interested in suicide prevention.
Each month we will summarize and comment on a recently published international study. The summaries will be in Danish. The purpose of the dissemination is to inform on international directions and important new findings. If you are interested in receiving 1-2 emails on a monthly basis on suicide prevention, please send an email to: Annette.erlangsen@regionh.dk It is possible to unsubscribe from the list at any time.
Funding for the SAFE project
DRISP at the Capital Region has received 18 million DK kr. from the Danish Ministry of Health to the implementation of the SAFE project. The purpose of the SAFE project is to test whether a more comprehensive and closer follow-up after discharge from a psychiatric hospitalization can significantly reduce the risk of suicidal behavior in the first half year after discharge, which is a period of high suicide risk.
In the project, we will hire 17 clinically working project staff as additional capacity to implement the SAFE project in the already existing clinical organization (emergency teams, district psychiatry, OP and OPUS teams and at the Competence Center for Suicide Prevention). This additional capacity to ensure that the procedures on discharge from psychiatric hospitalization are systematized and improved. Specifically, procedures should be improved and systematized by implementing the following:
1. Establish routines for personal contact with the following outpatient unit before the patient is discharged.
2. Secure outpatient contact primarily at home visits within the first week after discharge.
3. Invite relatives to the patient to discharge meeting and/or the home visit.
The SAFE project are being implemented and tested at the Psychiatric Center Copenhagen in the period 2018-2020. In a scientific evaluation of the SAFE project, we have planned an experimental design where patients discharged from the Psychiatric Center Copenhagen are compared relative to the proportion of suicidal behavior in the first half year after discharge with patients discharged from other psychiatric centers in the Capital Region of Denmark. The comparison group is selected using the propensity score matching technique to ensure that the control group is as comparable as possible with regard to known risk factors of suicidal behavior.
The SAFE project
In a recently conducted study at the Capital Region Psychiatry, Trine Madsen and colleagues from DRISP examined the effectiveness of the ‘Systematic Safer Discharge Procedure,’ known as the SAFE intervention. The aim was to evaluate whether an intervention to reduce risks of suicidal behavior after discharge from psychiatric hospitalization was effective. Previous Danish research findings have shown high suicide rates in the immediate period after being discharge from psychiatric hospitalization. During the first week after discharge, the suicide rate was more than 200-fold higher than the rate of the general population. International studies have shown that brief interventions offered immediately after discharge can be effective in preventing suicide, and this approach was provided in the SAFE intervention.
The study covered 15,208 discharges of individuals aged 18 and older over a 2-year period from 2018 to 2020. At the Mental Health Center Copenhagen, three systematic procedures were implemented to support individuals being discharged: 1) face-to-face meetings between patients and outpatient staff before discharge, 2) face-to-face meetings between patients and the same outpatient staff during the first week after being discharge, and 3) involvement of relatives.
The results did not show any significant difference in suicidal behavior between patients discharged from the Mental Health Center Copenhagen, i.e. the site of the SAFE intervention, and patients discharged from four other psychiatric centers in the Capital Region, which served as comparison groups. During the first six months after discharge, a total of 570 suicide attempts and 25 suicides were recorded. The suicide attempt rate in the first 6 months after discharge was 11,652 per 100,000 person-years at the SAFE intervention site, compared to 10,530 at the other psychiatric centers. In other words, no significant difference in suicidal behavior (OR=1.1; 95% CI: 0.9-1.4) or death by suicide (OR=1.3; 95% CI: 0.6-2.8) was observed after six months of follow-up.
An important caveat about the study was that F-ACT teams were simultaneously established at several of the centers serving as comparison groups. F-ACT teams visited patients within 2 days after discharge. Thus, a similar preventive effort was ongoing at the other centers, which may have contaminated the effect of the SAFE intervention. Although the SAFE intervention did not demonstrate an effect, the high rates of suicidal behavior in the first six months after discharge in both the intervention and comparison groups suggest that preventive efforts should include support for longer time than just the first week after discharge. The study emphasizes the importance of understanding and addressing the needs of individuals after being discharged from psychiatric care.
The study was supported by The Trygfoundation, and the SAFE intervention was funded by the Danish Health Authority.
You can find the study here.
DRISP: Trine Madsen, Eybjørg A Heygum Egilsdóttir, Annette Erlangsen, Merete Nordentoft