meretenordentoft

Cause-specific life years lost among persons with mental disorders

The aim was to quantify the life years lost with respect to cause of death and differences over time between people with and without mental disorders.
This study noted a difference of 10.2 and 7.3 excess life years lost for males and females with mental disorders, respectively. While the overall excess in life years lost between those with and without mental disorders did not change during 1995-2014 However, the excess suicide mortality among persons with mental disorders declined over this period .

The study is published in Lancet Psychiatry.

DRISP: Annette Erlangsen, Merete Nordentoft

Partners:

Per Kragh Andersen, PhD, DMSc, Section of Biostatistics, University of Copenhagen, Denmark
Thomas Munk Laursen, PhD, Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark
Anita Toender, Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark
Vladimir Canudas Romo, PhD, Max-Planck Odense Center on the Biodemography of Aging, Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Denmark

Autism spectrum disorders and suicidal behaviour

About 1% in the general population have autism-related conditions. The onset is often in childhood and may have an impact on the child’s upbringing and socialization. Although autism-related conditions have been linked to suicidal behavior, little is known regarding which characteristics are associated with suicidal behavior in this subgroup.

In this research project, DRISP, in collaboration with international researchers, sought to identify social and disease-related predictors of suicidal behavior among people with autism.

Danish registry data covering the entire Danish population (6,559,266 persons) in the period 1995-2016 were included in the analyses. The results showed that people with autism-related disorders had a more than 3-fold higher rate of both suicide attempts and suicide than people without these disorders. The excess risk of suicidal behavior among people with autism could be observed across all age groups.

People with autism who also had psychiatric disorders were found to have a significantly increased risk and this group accounted for 90% of those who had suicide attempts or died by suicide. The results suggest that people with autism who also have psychiatric disorders should be a target group for suicide preventive efforts.

The project received funding from the Helse Foundation.

You can read the study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774853

Partners:

Kairi Kõlves, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia
Stephen James Wood, University of Melbourne, Melbourne, Australia

App for people with self-harm – MYPLAN Zero Self-Harm

Some people intentionally harm themselves to relieve mental pain. It may be difficult to stop this behavior once it has been initiated. There are, unfortunately, few treatment options for people with self-harm. One recommended approach is to develop strategies in the form of a safety plan, which can be activated if the urge for self-harm arises.

The Zero Self-Harm app was developed as an extension of the MYPLAN app. People with lived experiences, in the form of current and past self-harm, were included in the development process through focus group interviews. The app helps the user to identify warning signs and to develop strategies to cope with future crises.

Zero Self-Harm is currently being tested in a research project, which consists of: 1) a randomized study to investigate whether the Zero Self-Harm app may reduce self-harming behavior, and 2) a qualitative evaluation of barriers and facilitators for using the app. The RCT is expected to be initiated in the autumn of 2020 and to be completed in 2023.

The project is supported by the TRYG Foundation.

Drisp: Lene Qvist Larsen, Annette Erlangsen, Jette Louise Skovgaard Larsen; Kate Andreasson Aamund, Merete Nordentoft, Eybjørg A Heygum Egilsdóttir; Evelyn Guerrero

Suicide risk associated with psychiatric hospitalization

People with mental illness have an increased risk of suicide. Previous Danish studies have shown that the risk is elevated in the period shortly after admission and especially after discharge from psychiatric hospital. Trine Madsen from DRISP has in an updated analyses investigated whether this is still the case or whether the recent decades of efforts in the field have led to an improved situation for people with mental vulnerability.

Register data for the entire Danish population aged 15 years or older in the period 1995-2016 were included in the analysis.

Men and women who were in inpatient treatment for a psychiatric disorder had a suicide rate of 237 and 322 per 100,000, respectively, compared to men and women who had never been inpatients. In the first week after discharge, the suicide rate was 225 and 425 times higher for men and women, respectively, when compared to those who had never been admitted. About 6% of all suicides amongst males and 13% amongst females occurred during the first week of a psychiatric admission or discharge. The study also showed that the suicide rate amongst admitted patients fell by 2.5% per year until 2009, after which the rate rose by 7.5% per year.

The study’s conclusion was that – despite falling suicide rates – the period around admission and discharge from a psychiatric hospital is still associated with an extremely high risk of death by suicide.

You can find the study here: https://onlinelibrary.wiley.com/doi/full/10.1111/acps.13221

DRISP: Trine Madsen, Merete Nordentoft & Annette Erlangsen

DiaS-project

A randomized study of 108 participants with recent suicide attempt and borderline personality disorder. The participants were offered either standard treatment (CAMS) or a short dialectical behavioral therapy course from the competence center for suicide prevention in Region H Psychiatry

DRISP: Kate Andreasson Aamund; Merete Nordentoft.

The study has been published in Depression & Anxiety:

https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22472

Suicide risk according to highest level of psychiatric service received

Different patient groups are seen across psychiatric sectors and it is relevant to know which groups are at imminent risk of suicide. In this project, the risk of suicide is examined according to the highest level of psychiatric service received. The level will be graded according to severity as well as by type of contact, such as psychiatric admission, psychiatric ER visit, psychiatric outpatient, psychiatric medicine.

DRISP: Trine Madsen, Merete Nordentoft, Annette Erlangsen

Lyme disease and risk of suicidal behaviour suicidal adfærd

The Borrelia bacterium, which exists in ticks, can develop into an infectious disease in humans when bitten. This disease is known as lyme disease (or Lyme Borreliosis) Infections have previously been associated with an increased risk of suicidal behavior. Trine Madsen from DRISP has, in collaboration with colleagues, investigated whether Lyme Borreliosis was linked to increased prevalence of psychiatric diseases and suicidal behavior.

Using register data for all persons living in Denmark from 1994 to 2016 (n=6,945,837), patients diagnosed with Lyme Borreliosis were identified based on hospital diagnoses. Their risk of developing psychiatric diseases and suicidal behavior was analyzed.

The results showed that persons who developed Lyme Borreliosis (i.e., an infection after a tick bite) had a 1.3-fold higher rate of psychiatric diseases, as well as a 2-fold higher rate of suicide attempts and a 1.75-fold higher suicide rate when compared to the background population. The highest risk of developing a psychiatric disease was observed within the first 6 months after persons developed Lyme Borreliosis. If the person had had multiple incidents of Lyme Borreliosis, this was associated with an increasing risk of suicide attempts.

In conclusion, the study showed that persons diagnosed with Lyme Borreliosis at Danish hospitals have an increased prevalence of psychiatric diseases, suicide attempts and suicide.

You can find the study here: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.20091347

DRISP: Trine Madsen, Merete Nordentoft & Annette Erlangsen

Partners:

Michael Eriksen Benros, Research Unit, Mental Health Centre Copenhagen
Brian A. Fallon, MD, Center for Neuroinflammatory Disorders and Biobehavioral Medicine and director of the Lyme and Tick-Borne Diseases Research Center at Columbia University, USA

Suicide rates in Nordic prisons 1999-2016

International research has shown an increased suicide rate among people in prison. However, studies have yet to address age structural differences. In this longitudinal the suicide rates among male prisoners is compared to the general population in three Nordic countries, Denmark, Iceland, and Norway, while adjusting for age differences.

Findings from the study shows that men in prison have a 7-fold higher suicide rate compared to the background population in Denmark, Iceland, and Norway and when accounting for age differences. For females, a rate 18-fold higher suicide rate was found among those in prison when compared to the general population. Over the 17-year study period, the suicide rate of people in prison decreased from 129 per 100,000 in 1999 to 70 per 100,000 in 2016. This decline was steeper that the decline observed for the suicide rate in the general population in the Nordic countries.

Link to study

https://www.tandfonline.com/doi/abs/10.1080/13811118.2020.1746943

DRISP: Britt Morthorst, Charlotte Mühlmann, Trine Madsen, Merete Nordentoft
og Annette Erlangsen

Partners

Lars Mehlum, Professor, National Centre for Suicide Research and Prevention, Institute of Clinical Medicine Oslo, Norway
Aiguröur Pàlsson, MD, Unit of Forensic Psychiatry, Iceland
Högni Óskarsson, md, Humus inc., Iceland Yngve Hammerlin, MD, Correctional Service of Norway Staff Academy, Norway

Neurological disorders and suicide

Neurological disorders have severe impacts on people’s lives in terms of both disability and dependency and have been linked to suicide. Yet, a comprehensive overview was lacking. This study examined whether people with specific neurological disorders die by suicide more often than other people. The study was based on the register data covering the entire population of Denmark during 1980-2016.

The findings from study, which was published in JAMA, shows that people with neurological disorders have a 75% higher suicide rate than people with no neurological disorders. Still, suicide deaths are rare events. While the suicide rate for the general population was around 20 per 100,000, the rate for people with neurological disorders is around 40 per 100,000 person-years. One out of 150 persons diagnosed with a neurological disorder dies by suicide. For severe neurological diseases, such as Huntington’s, one out of 61 diagnosed went on to die by suicide. This study is the most comprehensive assessment of neurological disorders’ link to suicide conducted to date.

The study shows that people who have been diagnosed with amyotrophic lateral sclerosis (ALS) or Huntington’s disease have a particular high risks, as the suicide rate associated with these disorders is 4-5 times higher than in the general population. People who have been exposed to traumatic brain injury, multiple sclerosis, or epilepsy have a suicide rate, which is double the level of the one found among those with no such disorders.

People with dementia were found to have a 2-3 time higher suicide rate during the first three months after being diagnosed. On the other hand, people who had been diagnosed with dementia more than a year ago were found to have a lower suicide rate than the general population.

– This is the first time we have examined this many different neurological disorders to gain a more detailed understanding of when risk of suicide is pronounced. These insights can help us shape dedicated preventive effort says Dr. Annette Erlangsen, lead author and senior researcher at Danish Research Institute for Suicide Prevention (DRISP). The project has received support from the Psychiatric Research Foundation, Region of Southern Denmark.

Link to study:

https://jamanetwork.com/journals/jama/article-abstract/2760389

DRISP: Annette Erlangsen, Merete Nordentoft

Partners:

Egon Stenager, Department of Neurology, Sønderborg, Hospital of Southern Jutland, Denmark
Yeates Conwell, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, USA
Per Krag Andersen, Section of Biostatistics, University of Copenhagen, Denmark
Keith Hawton, Centre for Suicide Research, University of Oxford, United Kingdom
Michael Eriksen Benros, Research Unit, Mental Health Centre Copenhagen, Copenhagen, Denmark
Elsebeth Stenager, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark

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

Information
TV2
Politiken
Kristeligt Dagblad
Jyllandsposten
DR

Abroad
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

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

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