Suicides in Mood Disorders in Psychiatric Settings in Nordic National Register-Based Studies

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dc.contributor University of Helsinki, Department of Psychiatry en Isometsä, Erkki T. 2020-09-16T09:14:01Z 2020-09-16T09:14:01Z 2020-07-23
dc.identifier.citation Isometsä , E T 2020 , ' Suicides in Mood Disorders in Psychiatric Settings in Nordic National Register-Based Studies ' , Frontiers in psychiatry , vol. 11 , 721 . en
dc.identifier.issn 1664-0640
dc.identifier.other PURE: 144550153
dc.identifier.other PURE UUID: ec106be9-5dad-4d3f-8270-062685956554
dc.identifier.other WOS: 000560080700001
dc.description.abstract Objective Although risk factors for nonfatal suicidal behavior in mood disorders have been vastly investigated, rate and risk factors of suicide deaths are less well known. Extensive health care and other population registers in the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) allow national-level studies of suicide rates and risk factors. This systematic review examined Nordic studies of suicide in mood disorders. Methods National Nordic studies published after 1.1.2000 reporting on suicide mortality or relative risk in diagnosed unipolar depression or bipolar disorder treated in psychiatric settings; temporal variations in suicide risk after discharge, or risk factors for suicide were systematically reviewed. Results Altogether 16 longitudinal studies reported on rate and risk of suicide in depression. They found 2%-8% of psychiatric inpatients with depression to have died by suicide. However, in Finland suicide risk among depressive inpatients halved since the early 1990s. Nine studies investigated suicide risk in bipolar disorder, finding 4%-long term. The relative risk of suicide was consistently found extremely high (SMR > 100) during the first weeks postdischarge, declining steeply over time to approximately SMR of five after five years. Male gender, preceding suicide attempts, high severity of depression and substance abuse were found risk factors for suicide in depression, with only minor gender differences in risk factors, but major differences in lethal methods. Three studies investigated risk factors for suicide in bipolar disorder, finding male gender, preceding suicide attempts, and depressive episodes and psychiatric comorbidity to be associated with risk. Conclusions Overall, of psychiatric inpatients with depressive of bipolar disorders in the Nordic countries, 2%-8% have died by suicide in the last few decades, but current rates may be lower. Suicide risk is approximately similar or somewhat higher among patients with bipolar disorder, risk factor studies of whom are fewer. Risk of suicide is remarkably high immediately after discharge, and higher among males than females, those with preceding suicide attempts, high severity of depression, or concurrent substance abuse. Generalizability of findings from these Nordic studies to other countries need to be investigated, and their methodological limitations understood. en
dc.format.extent 11
dc.language.iso eng
dc.relation.ispartof Frontiers in psychiatry
dc.rights en
dc.subject suicide en
dc.subject mortality en
dc.subject incidence en
dc.subject depression en
dc.subject bipolar disorder en
dc.subject register en
dc.subject risk factor en
dc.subject systematic review en
dc.subject BIPOLAR-I en
dc.subject RISK-FACTORS en
dc.subject MORTALITY en
dc.subject BEHAVIOR en
dc.subject COMORBIDITY en
dc.subject PREDICTORS en
dc.subject 3124 Neurology and psychiatry en
dc.title Suicides in Mood Disorders in Psychiatric Settings in Nordic National Register-Based Studies en
dc.type Article
dc.description.version Peer reviewed
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/publishedVersion

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