Young cases of schizophrenia identified in a national inpatient register

Dalman, Christina; Broms, J.; Cullberg, Johan; Allebeck, Peter

doi:10.1007/s00127-002-0582-3

Cited by 177 publications

(129 citation statements)

References 18 publications

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“…The age of onset with schizophrenia was determined according to information in the hospital discharge register, which has shown high validity with schizophrenia between different ages of onset (Dalman et al 2002). Although most of the patients in Finland with first schizophrenic psychosis are hospitalized, it is possible that mild or atypical symptoms in some patients may have caused a delay before accurate diagnosis in clinical setting.…”

Section: Discussionmentioning

confidence: 99%

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Apolipoprotein E polymorphism is associated with age of onset in schizophrenia

et al. 2004

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The aims of the study were to investigate the relationship between Apolipoprotein E (APOE) polymorphism, risk of schizophrenia, treatment response to conventional anti-psychotics, and age of onset in schizophrenia. The sample comprised 94 Finnish patients with a DSM-IV diagnosis of schizophrenia. Forty-three of the patients were good responders to conventional anti-psychotics and 51 were classified as non-responders. The control group consisted of 98 healthy blood donors. The APOE allele frequencies (e2, e3, and e4) were 4.8, 72.3, and 22.9% in patients and 7.1, 75.0, and 17.9 in controls. None of the differences between groups were statistically significant. No association between treatment response and APOE genotype was found. Patients with APOE e4/e4 genotype had a markedly lower age of onset compared with rest of the sample (p=0.0015), which remained significant when controlling for gender (p=0.02). There was an increasing linear trend between the number of e3 alleles (0, 1, or 2) and age of onset in schizophrenia (p=0.08). An inverse trend was found between the number of e4 alleles and age of onset (p=0.07). No relationship between APOE polymorphism and risk for schizophrenia was found. APOE e4/e4 genotype may be associated with early onset schizophrenia. APOE e3 allele may function protectively in later onset in this disease.

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Section: Discussionmentioning

confidence: 99%

“…This data was obtained from the hospital discharge register. In the Nordic countries, the proportion of identified cases with schizophrenia in an inpatient register is high, despite different ages of onset (Dalman et al 2002).…”

Section: Subjectsmentioning

confidence: 99%

Apolipoprotein E polymorphism is associated with age of onset in schizophrenia

et al. 2004

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“…The Swedish National Patient Register is, however, of high quality in the assessment of affective and psychotic disorders. 31,32 The validity of personality disorder diagnoses has not been evaluated in the register. In this study, the prevalence of personality disorder may be underestimated, since this diagnosis demands a more thorough evaluation and tends to be underreported in general hospitals after self-harm, according to clinical experience.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Suicide Risk After Nonfatal Self-Harm

Runeson¹,

Haglund²,

Lichtenstein³

et al. 2015

J. Clin. Psychiatry

112

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Objective: To study the short-term risk of suicide after nonfatal deliberate self-harm and its association with coexisting mental disorders and with the method of self-harm used. Method: We used linked Swedish national registers to design a cohort study with 34,219 individuals (59% females) who were admitted to hospital in 2000-2005 after deliberate selfharm (ICD-10-defined). They were followed for 3-9 years. The studied outcome was completed suicide; Cox regression models yielded hazard ratios (HRs) for suicide risk. Temporal patterns were plotted with Kaplan-Meier survival curves, calculated separately for each mental disorder and for the method used at the previous selfharm event.Results: 1,182 subjects committed suicide during follow-up (670 males and 512 females). Coexisting bipolar disorder (in males, adjusted HR = 6.3; 95% confidence interval [CI], 3.8-10.3; in females, adjusted HR = 5.8; 95% CI, 3.4-9.7) and nonorganic psychotic disorder (in males, adjusted HR = 5.1; 95% CI, 3.5-7.4; in females, adjusted HR = 4.6; 95% CI, 2.8-7.7) implied the highest risk of suicide after previous self-harm. Hanging as index self-harm method was a strong predictor of later suicide in both males (adjusted HR = 5.3; 95% CI, 4.0-7.0) and females (adjusted HR = 4.5; 95% CI, 2.5-8.1). Of those with bipolar disorder who used a method other than poisoning at the index event, 20.4% had already committed suicide after 3-9 years. Conclusion: Individuals with severe mental disorders (affective and psychotic disorders) have a poor prognosis in the first years after hospital admission due to self-harm. The risk of subsequent suicide is higher after attempts by hanging and other self-injury methods (vs selfpoisoning). Aftercare for those with a self-harm episode should focus on treatment of the mental disorder present at the time of the episode.

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“…Coverage and validity of diagnoses are fair to excellent. [19][20][21] The principal psychiatric diagnosis (except substance use disorders and personality disorders, which were included in any position) was recorded for cases and controls. Major mental disorder included psychotic disorders, affective disorders, and personality disorders.…”

Section: Psychiatric Morbiditymentioning

confidence: 99%

Killing the Mother of One’s Child

Lysell

Dahlin²,

Långström³

et al. 2016

J. Clin. Psychiatry

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Objective: To study possible psychiatric and criminological risk factors of intimate partner femicide (IPF) as well as the bereaved offspring's psychiatric morbidity and premature death. Method: We conducted a nested case-control study, based on Swedish national registries, including all perpetrators of IPF. We computed risk estimates relative to matched population controls, which were compared to those of non-IPF homicide offenders. Exposed children were matched to population controls and followed longitudinally up to 37 years. Offspring outcomes were psychiatric and substance use disorders (according to ICD) self-harm; violent crime; suicide; and premature, all-cause death. Results: We identified 261 male IPF perpetrators and 494 bereaved children from 1973 through 2009. Multivariable logistic regression suggested that major mental disorder (adjusted odds ratio [OR] = 5.9; 95% CI, 3.3-10.6) and violent crime convictions (adjusted OR = 4.4; 95% CI, 2.7-7.2) were independent risk factors of IPF, but substance use disorders were not (aOR = 0.4; 95% CI, 0.2-1.0). Children exposed to IPF before age 18 years had elevated risks of major mental disorder (adjusted hazard ratio [HR] = 5.7; 95% Cl, 3.0-10.6), substance use disorders (adjusted HR = 5.8; 95% CI, 2.8-11.9) and self-harm (adjusted HR = 5.7; 95% CI, 3.0-11.1). Offspring 18 years or older at the IPF had an increased risk of completed suicide (adjusted HR = 4.3; 95% CI, 1.3-14.5). Conclusions: Previous major mental disorder and violent behavior were strong independent risk factors for IPF. Bereavement caused by IPF had significant associations with the offspring's future life, especially for those below 18 years of age at exposure. Our findings demonstrate the need of direct support to the exposed offspring by health care providers and social services.

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Young cases of schizophrenia identified in a national inpatient register

Cited by 177 publications

References 18 publications

Apolipoprotein E polymorphism is associated with age of onset in schizophrenia

Apolipoprotein E polymorphism is associated with age of onset in schizophrenia

Suicide Risk After Nonfatal Self-Harm

Killing the Mother of One’s Child

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