Browsing by Subject "suicide attempts"

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  • Aaltonen, Kari I.; Rosenström, Tom; Jylhä, Pekka; Holma, Irina; Holma, Mikael; Pallaskorpi, Sanna; Riihimäki, Kirsi; Suominen, Kirsi; Vuorilehto, Maria; Isometsä, Erkki T. (2020)
    Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting. Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission). Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found. Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself.
  • Ruuhela, Reija (2018)
    Finnish Meteorological Insitute Contributions 147
    Human beings are able to adapt to their climatic normal conditions, but weather extremes may pose a substantial health risks. The aims of this dissertation were to model the dependence of all-cause mortality on thermal conditions in Finland, and to assess changes in the relationship over the decades and regional differences in the relationships between hospital districts. Another aim was to assess impacts of weather and climate on committed and attempted suicides Finland. Various methods were applied in these studies. Time series of all-cause mortality in three age groups in Helsinki-Uusimaa hospital district were made stationary, and thus the weather impacts were comparable over the 43-year long time period regardless of changes in population and life-expectancy. The increase in relative mortality due to hot extreme was more than due to cold extreme, when compared to seasonally varying expected mortality. However, a decrease in relative mortality in extreme temperatures over the decades was found in all age-groups, even among the 75 years and older, indicating decreased sensitivity to thermal stress in the population. Regional differences in temperature‒mortality relationships between 21 hospital districts were studied using distributed lag non-linear models (DLNM), and the differences were assessed by meta-regression with selected climatic and sociodemographic covariates. Regional differences in the relationships were not statistically significant indicating that the same temperature-mortality relationship can be applied in different parts of the country. On the other hand, the meta-regression suggested that the morbidity indices and population in the hospital districts could explain part of the small heterogeneity in the temperature‒mortality relationships. The study on committed suicides on the basis of 33-year long time series showed a significant negative association between suicides and solar radiation in the period from November to March, thus, a lack of solar radiation would increase suicide risk in winter. Men appeared to be more sensitive to variation in solar radiation than women. The study on weather dependence of attempted suicides in Helsinki on the basis of two shorter periods showed another difference between genders. The risk of suicide attempts of men increased with decreasing atmospheric pressure, while the risk of suicide attempts of women increased with increasing pressure. The outcomes of this thesis can be utilized e.g. in preparedness to weather extremes in health sector and in further studies on impacts of climate change on human health.
  • Pallaskorpi, Sanna; Suominen, Kirsi; Rosenström, Tom; Mantere, Outi; Arvilommi, Petri; Valtonen, Hanna; Leppämäki, Sami; García-Estela, Aitana; Grande, Iria; Colom, Francesc; Vieta, Eduard; Isometsä, Erkki (2019)
    ABSTRACT Background Patients with bipolar disorder (BD) differ in their relative predominance of types of episodes, yielding predominant polarity, which has important treatment implications. However, few prospective studies of predominant polarity exist. Methods In the Jorvi Bipolar Study (JoBS), a regionally representative cohort of 191 BD I and BD II in- and outpatients was followed for five years using life-chart methodology. Differences between depressive (DP), manic (MP), and no predominant polarity (NP) groups were examined regarding time ill, incidence of suicide attempts, and comorbidity. Results At baseline, 16% of patients had MP, 36% DP, and 48% NP. During the follow-up the MP group spent significantly more time euthymic, less time in major depressive episodes, and more time in manic states than the DP and NP groups. The MP group had significantly lower incidence of suicide attempts than the DP and NP group, lower prevalence of comorbid anxiety disorders but more psychotic symptoms lifetime and more often (hypo)manic first phase of the illness than the DP group. Classification of predominant polarity was influenced by the timeframe used. Limitations The retrospective counting of former phases is vulnerable to recall bias. Assignment of dominant polarity may necessitate a sufficient number of illness phases. Conclusions Predominant polarity has predictive value in predicting group differences in course of illness, but individual patients’ classification may change over time. Patients with manic polarity may represent a more distinct subgroup than the two others regarding illness course, suicide attempts, and psychiatric comorbidity.