333 research outputs found
Supplemental_Material – Supplemental material for Work-directed rehabilitation or physical activity to support work ability and mental health in common mental disorders: a pilot randomized controlled trial
No full textSupplemental material, Supplemental_Material for Work-directed rehabilitation or physical activity to support work ability and mental health in common mental disorders: a pilot randomized controlled trial by Louise Danielsson, Margda Waern, Gunnel Hensing and Kristina Holmgren in Clinical Rehabilitation</p
Supplemental Material - The Meaning of Mental Imagery in Acute Suicidal Episodes: A Qualitative Exploration of Lived Experiences
No full textSupplemental Material for The Meaning of Mental Imagery in Acute Suicidal Episodes: A Qualitative Exploration of Lived Experiences by Anna Maria Nilsson, Margda Waern, Anna Ehnvall, and Ingela Skärsäter in OMEGA - Journal of Death and Dying</p
Use of antidepressants and risk of repeat self‐harm in older adults 75+ with nonfatal self‐harm: A 1‐year prospective national study
No full textPurpose To assess exposure to antidepressants (AD) before and after nonfatal self-harm (SH) in older adults and to examine 1-year rates and risk factors for subsequent SH. Methods Longitudinal national register-based retrospective cohort study of Swedish residents aged 75+ (N = 2775) with treatment at hospital or specialist outpatient clinic in connection with SH between January 1, 2006, and December 31, 2013. The cohort was followed for 1 year after the index episode. Exposure to AD was assessed at index and at subsequent SH. Cox regression analysis was used to assess factors associated with 1-year repeat SH. Results At the index episode, 51% were prevalent AD users; 23% started AD during the following year. Overall 12% of prevalent AD users, 8% of AD nonusers, and 6% of AD new users repeated SH or died by suicide. About two-thirds of these subsequent behaviors occurred within 3 months after the index episode. Men had increased risk of subsequent SH (Hazard ratio [HR] 1.38, 95% CI: 1.09-1.74); older age (>85 years) was associated with a lower risk (HR 0.72, CI 95% 0.55-0.93). Users of AD did not have an increased risk of repeat SH. Conclusions Half of older adults who self-harmed were prevalent AD users and a further one fourth started an AD within 1 year after the index SH. Antidepressant use was not associated with increased risk of subsequent SH in this high-risk cohort of older adults
sj-docx-1-jad-10.1177_10870547231158751 – Supplemental material for Girls With Social and/or Attention Deficit Re-Examined in Young Adulthood: Prospective Study of Diagnostic Stability, Daily Life Functioning and Social Situation
No full textSupplemental material, sj-docx-1-jad-10.1177_10870547231158751 for Girls With Social and/or Attention Deficit Re-Examined in Young Adulthood: Prospective Study of Diagnostic Stability, Daily Life Functioning and Social Situation by Svenny Kopp, Karin Susanna Asztély, Sara Landberg, Margda Waern, Stefan Bergman and Christopher Gillberg in Journal of Attention Disorders</p
Suicide in late life
No full textBackground: Elderly persons have the highest suicide rates in most industrialized countries. A number of antecedents to suicide late in life have been identified, but the risk associated with these factors is unclear because controlled studies are lacking.Aim: To study the risk for suicide associated with mental and physical illness and social factors in persons 65 years and above. Physician's ability to detect suicidality and the utilization of antidepressants was also studied. Finally, a possible association between the availability of psychoactive drugs and the use of these drugs as a means of suicide was examined.Subjects and Methods: 85 elderly suicide cases (46 men, 39 women) were studied with the "psychological autopsy" method. Papers I-III: Control persons (84 men, 69 women) randomly selected from the tax register were interviewed face-to-face. Past month mental disorders were diagnosed according to DSM-IV. Illness burden was assessed according to the Cumulative Illness Rating Scale - Geriatrics. Life events during the past 24 months were assessed. Paper IV: Suicidal feelings were rated according to Paykel et al. Paper V: Post-mortem analysis of drugs was carried out in 73 of the first 75 consecutive suicides. Paper VI utilizes data from the National Prescription Survey and the Cause of Death Register, Statistics Sweden. Results: Recurrent major depression was a very strong risk factor for suicide, as was substance abuse. Minor depression, dysthymia, single episode major depression and psychotic disorders were also associated with suicide. Neurological disorders, vision impairment and malignant disease were associated with an increased risk of suicide. Serious physical illness, and high overall physical illness burden were risk factors for suicide in men. Family discord, financial problems and feelings of loneliness were psychosocial factors associated with suicide. More than one third of the elderly persons who committed suicide had communicated suicidal feelings to their doctors during this time period. Half of all the study cases were treated for affective illness during their final 6 months of life. In most cases the postmortem blood concentrations of antidepressants were within the normal range. Rates of suicide by drug poisoning decreased in all age groups between the years 1969 and 1996. The reduction was however less pronounced in the elderly. Suicide using benzodiazepines increased among the elderly during most of the study period despite decreasing prescription sales.Conclusions: Recurrent major depression was the mental disorder most strongly associated with suicide. A relatively high rate of antidepressant treatment was observed among the elderly suicides, which probably reflects changing prescription patterns. Many of the suicide decedents had not only depression but also other mental and physical illnesses and interpersonal problems that may have complicated treatment
Alcohol dependence and misuse in elderly suicides
No full textAIMS: To assess suicide risk associated with alcohol use disorder in elderly men and women, and to examine the role of social stressors in elderly suicides with and without alcohol use disorders. METHODS: This retrospective case-control study included 85 suicide cases aged 65 years and above (46 men, 39 women) and 153 randomly selected population controls (84 men, 69 women). Interviews were carried out with control persons and with informants for the suicide cases. Mental disorders were diagnosed in accordance to DSM-IV. RESULTS: A history of alcohol dependence or misuse was observed in 35% of the elderly men who died by suicide and in 18% of the women. This disorder was uncommon among persons in the control group (2% of the men and 1% of the women). Alcohol use disorder remained an independent predictor of suicide risk in the regression models for both sexes. Among suicide cases, those with alcohol use disorders were younger and less likely to be suffering from severe physical illness (35 vs 63%) than those without this disorder. CONCLUSION: Alcohol use disorder is associated with suicide in elderly men and women. Prevention programmes need to target this important subgroup
Suicides among family members of elderly suicide victims: an exploratory study
No full textThis exploratory study compares elderly suicides with (n=13) and without (n=72) family member suicide. Previous episodes of suicidal behavior were more common among suicides who lost first-degree relatives by suicide (100% vs. 65%, p = .009). Six persons had lost an offspring by suicide prior to their own deaths. Substance use disorder was more prevalent among those with offspring suicide than those without (100% vs. 25%, p = .000). While informants reported that offspring suicides played a central role in the suicide of the elderly study case, sibbling suicides were not considered precipitating factors
Use of Psychoactive Medications and Risk of Suicide in Late Life (75+): A Total Population Study
No full textAbstract Background Psychoactive medications play an important role for the mental health and risk of suicidal behaviour in the oldest segment of the population (75+). A better understanding of psychoactive medication use is advocated to prevent suicide in this age group. Purpose We investigated the risk of suicide associated with the use of psychoactive medications in the total population aged ≥ 75 years, with and without exposure to antidepressants. Method A national population-based register study, including all Swedish residents aged ≥ 75 years between 2006 and 2014 (N = 1,413,806). A nested case–control design was used to investigate psychoactive medications associated with suicide among users and non-users of antidepressants. Risk estimates were calculated in adjusted conditional logistic regression models for the entire cohort and by gender. Results Suicide occurred in 1305 persons (907 men and 398 women). Among them, 555 (42.5%) were on an antidepressant at the time of suicide. Adjusted incidence rate ratio (aIRR) for suicide was increased in those who were on hypnotics in the total cohort (aIRR 2.05, 95% confidence interval 1.74 to 2.41), in both users and non-users of antidepressants and for both genders. Elevated suicide risk was observed in those who concomitantly used anxiolytics with antidepressants (1.51, 1.25 to 1.83). Decreased risk of suicide was observed among those who were on anti-dementia drugs, in the total cohort (0.33, 0.21 to 0.52) and in both users and non-users of antidepressants. Use of antipsychotics and mood stabilisers showed no effect on suicide risk. Conclusion Use of hypnotics and concomitant use of anxiolytics with antidepressants was associated with increased risk of late-life suicide. Our findings suggest the need for careful evaluation of the benefit–risk balance of psychoactive medications as well as their availability as a possible suicide means. Future research should consider the indication of use of the psychoactive medications and the severity of psychiatric and medical illnesses of the patients
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