Showing papers by "Merete Nordentoft published in 2002"

Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case-control study

Abstract: Objective: To estimate the risk of suicide in young people related to family and individual psychiatric and socioeconomic factors. Design: Population based nested case-control study. Setting: Data from longitudinal Danish registers. Cases and controls: 496 young people aged 10-21 years who had committed suicide during 1981-97 in Denmark and 24 800 controls matched for sex, age, and time. Main outcome measures: All suicides in Denmark compared with controls; parents and siblings identified from population based registers; inpatient information from discharge registers of national hospitals; and socioeconomic data from administrative registers. Results: Parental factors associated with an increased risk of suicide in young people were suicide or early death, admission to hospital for a mental illness, unemployment, low income, poor schooling, and divorce, as well as mental illness in siblings and mental illness and short duration of schooling in the young people themselves. The strongest risk factor was mental illness in the young people. The effect of the parents9 socioeconomic factors decreased after adjustment for a family history of mental illness and a family history of suicide. Conclusions: Recognising mental illness in young people and dealing with it appropriately could help prevent suicides. The high relative risk associated with a low socioeconomic status of the parents may be confounded and overestimated if not adjusted for mental illness and suicide in the family. What is already known on this topic Young people who commit suicide have a history of mental illness or a family history of mental illness or suicidal behaviour Dysfunctional family backgrounds and socioeconomic adversity also contribute to suicide in young people Targets for preventive strategies are controversial, as few population based studies have been conducted and none have included all the risk factors What this study adds Suicide is more likely among young people if a parent commits suicide or there is a history of mental illness in the individual and their siblings Socioeconomic risk factors seem to be less important Preventive strategies should be aimed at the early recognition and optimal treatment of mental illnesses

OPUS study: suicidal behaviour, suicidal ideation and hopelessness among patients with first-episode psychosis. One-year follow-up of a randomised controlled trial.

Abstract: Background Patients with first-episode psychosis comprise a high-risk group in terms of suicide. Aims To identify predictive factors for suicidal behaviour and to examine the effect of integrated treatment on suicidal behaviour and hopelessness. Method A total of 341 patients with a first-episode schizophrenia-spectrum disorder were randomised to integrated treatment or treatment as usual. Results During the 1-year follow-up period, 11% attempted suicide. This was associated with female gender, hopelessness, hallucinations and suicide attempt reported at baseline, with the two latter variables being the only significant ones in the final multivariate model. The integrated treatment reduced hopelessness. Conclusions Hallucinations and suicide attempt before inclusion in the study were the most significant predictors of suicide attempt in the follow-up period.

[Suicide among young people--familial, psychiatric and socioeconomic risk factors. A nested case-control study].

Abstract: INTRODUCTION: The objective of the study was to estimate the risk of adolescent and early adulthood suicide related to adverse family and individual backgrounds. MATERIAL AND METHODS: The 496 young people aged 10-21 years who committed suicide during the period 1981-1997 in Denmark and 24,800 gender-age-time-matched controls. RESULTS: Parental suicide, early death, hospitalised mental illness, unemployment, low income, educational underachievement, parental divorce, mental illness in siblings, as well as mental illness and shorter schooling in the adolescents themselves were associated with increased risk of suicide. In the multivariate analysis, the odds ratios associated with suicide or mental illness in father or mother were 2.30 (95% CI 1.10-4.80), 1.56 (1.12-2.19), 4.75 (2.10-10.8) and 1.73 (1.29-2.32), respectively. The strongest risk factor was mental illness in the adolescents themselves with risk ratios 33.1 (16.5-66.5), 24.3 (6.64-88.7), 84.9 (7.17-1006) and 10.8 (7.75-15.0) for individuals hospitalised with schizophrenia, affective disorders, eating disorders or other psychiatric diagnoses and with an overall attributable risk of 15% (12-17%). The effect of parental socioeconomic variables decreased after adjustment for family history of mental illness. DISCUSSION: Important targets in youth suicide prevention could be to decrease the prevalence of or ameliorating the negative effects of psychiatric illness including early recognition and optimal treatment. Reports of high relative risk associated with parental low socioeconomic status may be confounded and overestimated if not adjusted for the association with mental disorder and suicide in the family. Language: da

Psychiatric emergency outreach: a report on the first 2 years of functioning in Copenhagen.

Abstract: The purpose of the study was to evaluate psychiatric emergency outreach after functioning for a period of 2 years in Copenhagen, Denmark. Psychiatric emergency outreach was staffed by a psychiatrist and an ambulance driver, and the target group was defined as mentally ill and persons in severe crisis. For each of 935 calls covering 777 different patients, a registration form with social and clinically relevant data was filled out. After the 2-year period, patients were looked up in the National Cause of Death Register and the National Psychiatric Case Register. A total of 66% were previously registered as psychiatric patients, and in 37% of all calls, the patient had psychotic symptoms. In 25% of the calls, the patient was admitted to psychiatric hospital; 38% of the admissions were involuntary. Forty-eight per cent of the calls were initiated by relatives, friends or neighbours. Suicidal behaviour was frequent. There were significantly more calls in socially deprived areas. Standard Mortality Rates were ...

Drop-out and continuity of care for patients suffering from schizophrenia and schizophrenia-like psychosis evaluated by means of routine registration.

Abstract: For most patients suffering from schizophrenia or other chronic psychoses, uninterrupted contact with psychiatric services for a long period is necessary. By means of routine registrations in Copenhagen County, the use of services in 1995 for patients suffering from schizophrenia or other ICD-10 F2 diagnoses (n = 1356) was analysed. Substantial interregional differences were found in admission to more than one psychiatric department, admission to more than one similar ward, interruption in treatment and loss of contact with the patient. More than 25% had contact with at least four treatment modalities during 1995, and the proportion of patients who experienced interruption in treatment at least once during the year varied between 19% and 37%. It is concluded that routine registration of psychiatric services is a suitable means for quality assurance and ought to be used regularly in analyses like the one presented here. In concert with the literature, it is concluded that the interregional differences indicate that compliance with treatment can be improved by better organization of the psychiatric treatment.