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10 year follow up study of mortality among users of hostels for homeless people in Copenhagen.

https://arctichealth.org/en/permalink/ahliterature9689
Source
BMJ. 2003 Jul 12;327(7406):81
Publication Type
Article
Date
Jul-12-2003
Author
Merete Nordentoft
Nina Wandall-Holm
Author Affiliation
Department of Psychiatry, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. merete.nordentoft@dadlnet.dk
Source
BMJ. 2003 Jul 12;327(7406):81
Date
Jul-12-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Cause of Death
Denmark - epidemiology
Female
Follow-Up Studies
Homeless Persons - statistics & numerical data
Humans
Male
Middle Aged
Mortality - trends
Registries
Regression Analysis
Research Support, Non-U.S. Gov't
Risk factors
Sex Distribution
Abstract
OBJECTIVES: To investigate mortality among users of hostels for homeless people in Copenhagen, and to identify predictors of death such as conditions during upbringing, mental illness, and misuse of alcohol and drugs. DESIGN: Register based follow up study. SETTING: Two hostels for homeless people in Copenhagen, Denmark PARTICIPANTS: 579 people who stayed in one hostel in Copenhagen in 1991, and a representative sample of 185 people who stayed in the original hostel and one other in Copenhagen. MAIN OUTCOME MEASURE: Cause specific mortality. RESULTS: The age and sex standardised mortality ratio for both sexes was 3.8 (95% confidence interval 3.5 to 4.1); 2.8 (2.6 to 3.1) for men and 5.6 (4.3 to 6.9) for women. The age and sex standardised mortality ratio for suicide for both sexes was 6.0 (3.9 to 8.1), for death from natural causes 2.6 (2.3 to 2.9), for unintentional injuries 14.6 (11.4 to 17.8), and for unknown cause of death 62.9 (52.7 to 73.2). Mortality was comparatively higher in the younger age groups. It was also significantly higher among homeless people who had stayed in a hostel more than once and stayed fewer than 11 days, compared with the rest of the study group. Risk factors for early death were premature death of the father and misuse of alcohol and sedatives. CONCLUSION: Homeless people staying in hostels, particularly young women, are more likely to die early than the general population. Other predictors of early death include adverse experiences in childhood, such as death of the father, and misuse of alcohol and sedatives.
PubMed ID
12855527 View in PubMed
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[10-year follow-up study of mortality among users of hostels for homeless people in Copenhagen].

https://arctichealth.org/en/permalink/ahliterature179879
Source
Ugeskr Laeger. 2004 Apr 26;166(18):1679-81
Publication Type
Article
Date
Apr-26-2004

Absolute risk of suicide after first hospital contact in mental disorder.

https://arctichealth.org/en/permalink/ahliterature130761
Source
Arch Gen Psychiatry. 2011 Oct;68(10):1058-64
Publication Type
Article
Date
Oct-2011
Author
Merete Nordentoft
Preben Bo Mortensen
Carsten Bøcker Pedersen
Author Affiliation
Psychiatric Centre Copenhagen, Denmark. mn@dadlnet.dk
Source
Arch Gen Psychiatry. 2011 Oct;68(10):1058-64
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Bipolar Disorder - epidemiology - psychology
Comorbidity
Denmark - epidemiology
Female
Humans
Incidence
Male
Mental Disorders - epidemiology - psychology
Middle Aged
Mood Disorders - epidemiology - psychology
Prospective Studies
Risk factors
Schizophrenia - epidemiology
Schizophrenic Psychology
Sex Factors
Substance-Related Disorders - epidemiology - psychology
Suicide - psychology - statistics & numerical data
Young Adult
Abstract
Estimates of lifetime risk of suicide in mental disorders were based on selected samples with incomplete follow-up.
To estimate, in a national cohort, the absolute risk of suicide within 36 years after the first psychiatric contact.
Prospective study of incident cases followed up for as long as 36 years. Median follow-up was 18 years.
Individual data drawn from Danish longitudinal registers.
A total of 176,347 persons born from January 1, 1955, through December 31, 1991, were followed up from their first contact with secondary mental health services after 15 years of age until death, emigration, disappearance, or the end of 2006. For each participant, 5 matched control individuals were included.
Absolute risk of suicide in percentage of individuals up to 36 years after the first contact.
Among men, the absolute risk of suicide (95% confidence interval [CI]) was highest for bipolar disorder, (7.77%; 6.01%-10.05%), followed by unipolar affective disorder (6.67%; 5.72%-7.78%) and schizophrenia (6.55%; 5.85%-7.34%). Among women, the highest risk was found among women with schizophrenia (4.91%; 95% CI, 4.03%-5.98%), followed by bipolar disorder (4.78%; 3.48%-6.56%). In the nonpsychiatric population, the risk was 0.72% (95% CI, 0.61%-0.86%) for men and 0.26% (0.20%-0.35%) for women. Comorbid substance abuse and comorbid unipolar affective disorder significantly increased the risk. The co-occurrence of deliberate self-harm increased the risk approximately 2-fold. Men with bipolar disorder and deliberate self-harm had the highest risk (17.08%; 95% CI, 11.19%-26.07%).
This is the first analysis of the absolute risk of suicide in a total national cohort of individuals followed up from the first psychiatric contact, and it represents, to our knowledge, the hitherto largest sample with the longest and most complete follow-up. Our estimates are lower than those most often cited, but they are still substantial and indicate the continuous need for prevention of suicide among people with mental disorders.
PubMed ID
21969462 View in PubMed
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Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

https://arctichealth.org/en/permalink/ahliterature269118
Source
Schizophr Res. 2015 Mar;162(1-3):74-8
Publication Type
Article
Date
Mar-2015
Author
Holger J Sørensen
Janne T Larsen
Ole Mors
Merete Nordentoft
Preben B Mortensen
Liselotte Petersen
Source
Schizophr Res. 2015 Mar;162(1-3):74-8
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Inpatients
Male
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Schizophrenia - diagnosis - epidemiology - therapy
Severity of Illness Index
Socioeconomic Factors
Abstract
Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only.
PubMed ID
25620118 View in PubMed
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Antipsychotic polypharmacy and risk of death from natural causes in patients with schizophrenia: a population-based nested case-control study.

https://arctichealth.org/en/permalink/ahliterature98770
Source
J Clin Psychiatry. 2010 Feb;71(2):103-8
Publication Type
Article
Date
Feb-2010
Author
Lone Baandrup
Christiane Gasse
Vibeke D Jensen
Birte Y Glenthoj
Merete Nordentoft
Henrik Lublin
Anders Fink-Jensen
Anne Lindhardt
Preben B Mortensen
Author Affiliation
Centre for Neuropsychiatric Schizophrenia Research, Psychiatric Centre Glostrup, Copenhagen University Hospital, Glostrup, Nordre Ringvej 29-67, DK-2600 Glostrup, Denmark. lone.baandrup@cnsr.dk
Source
J Clin Psychiatry. 2010 Feb;71(2):103-8
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Antipsychotic Agents - administration & dosage - adverse effects
Benzodiazepines - adverse effects
Case-Control Studies
Cause of Death - trends
Denmark
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Odds Ratio
Risk factors
Schizophrenia - drug therapy - mortality
Abstract
OBJECTIVE: Concomitant prescription of more than 1 antipsychotic agent (antipsychotic polypharmacy) in the treatment of schizophrenia is prevalent, although monotherapy is generally recommended. Mortality from natural causes is markedly increased in schizophrenia, and the role of polypharmacy remains controversial. The objective was to investigate if antipsychotic polypharmacy is associated with the excess mortality from natural causes among patients with schizophrenia. METHOD: A population-based nested case-control study was conducted using patient data from January 1, 1996, to December 31, 2005, obtained from central Danish registers. From the study population of 27,633 patients with ICD-8- and ICD-10-diagnosed schizophrenia or other mainly nonaffective psychoses, aged 18-53 years, we identified 193 cases who died of natural causes within a 2-year period and 1,937 age- and sex-matched controls. Current drug use was defined as at least 1 prescription filled within 90 days before the date of death or the index date. The data were analyzed by conditional logistic regression. RESULTS: Risk of natural death did not increase with the number of concurrently used antipsychotic agents compared with antipsychotic monotherapy (no antipsychotics: adjusted odds ratio [OR] = 1.48 [95% CI, 0.89-2.46]; 2 antipsychotics: OR = 0.91 [95% CI, 0.61-1.36]; 3 or more antipsychotics: OR = 1.16 [95% CI, 0.68-2.00]). Current use of benzodiazepine derivatives with long elimination half-lives (more than 24 hours) was associated with increased risk of natural death in patients with schizophrenia treated with antipsychotics (OR = 1.78 [95% CI, 1.25-2.52]). CONCLUSIONS: Antipsychotic polypharmacy did not contribute to the excess mortality from natural causes in middle-aged patients with schizophrenia. The detected increased risk of death associated with benzodiazepines with long elimination half-lives calls for further clarification.
PubMed ID
19895781 View in PubMed
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Association between alcohol and substance use disorders and all-cause and cause-specific mortality in schizophrenia, bipolar disorder, and unipolar depression: a nationwide, prospective, register-based study.

https://arctichealth.org/en/permalink/ahliterature279477
Source
Lancet Psychiatry. 2015 Sep;2(9):801-8
Publication Type
Article
Date
Sep-2015
Author
Carsten Hjorthøj
Marie Louise Drivsholm Østergaard
Michael Eriksen Benros
Nanna Gilliam Toftdahl
Annette Erlangsen
Jon Trærup Andersen
Merete Nordentoft
Source
Lancet Psychiatry. 2015 Sep;2(9):801-8
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Adult
Alcohol-Related Disorders - complications - mortality - physiopathology
Bipolar Disorder - etiology - mortality - physiopathology
Cause of Death
Denmark
Depressive Disorder, Major - etiology - mortality - physiopathology
Female
Humans
Male
Prospective Studies
Registries
Risk factors
Schizophrenia - etiology - mortality - physiopathology
Substance-Related Disorders - complications - mortality - physiopathology
Survival Rate
Young Adult
Abstract
People with severe mental illness have both increased mortality and are more likely to have a substance use disorder. We assessed the association between mortality and lifetime substance use disorder in patients with schizophrenia, bipolar disorder, or unipolar depression.
In this prospective, register-based cohort study, we obtained data for all people with schizophrenia, bipolar disorder, or unipolar depression born in Denmark in 1955 or later from linked nationwide registers. We obtained information about treatment for substance use disorders (categorised into treatment for alcohol, cannabis, or hard drug misuse), date of death, primary cause of death, and education level. We calculated hazard ratios (HRs) for all-cause mortality and subhazard ratios (SHRs) for cause-specific mortality associated with substance use disorder of alcohol, cannabis, or hard drugs. We calculated standardised mortality ratios (SMRs) to compare the mortality in the study populations to that of the background population.
Our population included 41?470 people with schizophrenia, 11?739 people with bipolar disorder, and 88?270 people with depression. In schizophrenia, the SMR in those with lifetime substance use disorder was 8·46 (95% CI 8·14-8·79), compared with 3·63 (3·42-3·83) in those without. The respective SMRs in bipolar disorder were 6·47 (5·87-7·06) and 2·93 (2·56-3·29), and in depression were 6·08 (5·82-6·34) and 1·93 (1·82-2·05). In schizophrenia, all substance use disorders were significantly associated with increased risk of all-cause mortality, both individually (alcohol, HR 1·52 [95% CI 1·40-1·65], p
Notes
Comment In: Lancet Psychiatry. 2015 Sep;2(9):767-926277045
Comment In: Evid Based Ment Health. 2016 May;19(2):5527048850
PubMed ID
26277044 View in PubMed
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The Association between Infections and General Cognitive Ability in Young Men - A Nationwide Study.

https://arctichealth.org/en/permalink/ahliterature270007
Source
PLoS One. 2015;10(5):e0124005
Publication Type
Article
Date
2015
Author
Michael Eriksen Benros
Holger Jelling Sørensen
Philip Rising Nielsen
Merete Nordentoft
Preben Bo Mortensen
Liselotte Petersen
Source
PLoS One. 2015;10(5):e0124005
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Bacterial Infections - complications - epidemiology - physiopathology - psychology
Brain - physiopathology
Cognition - physiology
Cognition Disorders - complications - epidemiology - physiopathology - psychology
Cohort Studies
Denmark - epidemiology
Humans
Intelligence Tests
Linear Models
Male
Military Personnel
Mycoses - complications - epidemiology - physiopathology
Registries
Research Design
Virus Diseases - complications - epidemiology - physiopathology - psychology
Young Adult
Abstract
Infections and activated immune responses can affect the brain through several pathways that might also affect cognition. However, no large-scale study has previously investigated the effect of infections on the general cognitive ability in the general population.
Danish nationwide registers were linked to establish a cohort of all 161,696 male conscripts during the years 2006-2012 who were tested for cognitive ability, which was based on logical, verbal, numerical and spatial reasoning at a mean age of 19.4 years. Test scores were converted to a mean of 100.00 and with a standard deviation (SD) of 15. Data were analyzed as a cohort study with severe infections requiring hospitalization as exposure using linear regression.
Adjusted effect sizes were calculated with non-exposure to severe infections as reference, ranging from 0.12 SD to 0.63 SD on general cognitive ability. A prior infection was associated with significantly lower cognitive ability by a mean of 1.76 (95%CI: -1.92 to -1.61; corresponding to 0.12 SD). The cognitive ability was affected the most by the temporal proximity of the last infection (P
Notes
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PubMed ID
25970427 View in PubMed
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The association between working alliance and clinical and functional outcome in a cohort of 400 patients with first-episode psychosis: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature261207
Source
J Clin Psychiatry. 2015 Jan;76(1):e83-90
Publication Type
Article
Date
Jan-2015
Author
Marianne Melau
Susanne Harder
Pia Jeppesen
Carsten Hjorthøj
Jens R M Jepsen
Anne Thorup
Merete Nordentoft
Source
J Clin Psychiatry. 2015 Jan;76(1):e83-90
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Case Management - standards
Cohort Studies
Cross-Sectional Studies
Denmark
Female
Humans
Male
Patient Compliance - psychology
Professional-Patient Relations
Psychotic Disorders - psychology - therapy
Randomized Controlled Trials as Topic
Schizophrenia - therapy
Schizophrenic Psychology
Young Adult
Abstract
Working alliance between patients with a first-episode psychosis and their case manager is regarded as a key element in specialized early intervention services. The impact of this patient-case manager dyad on functional and clinical outcome is unknown. We aimed to investigate if a strong working alliance was associated with fewer clinical symptoms and better social functioning.
In a cross-sectional design, patients with first-episode schizophrenia spectrum disorders (ICD-10, F20-29) were included after 18 months of treatment (N = 400). Baseline data were collected between June 2009 and December 2011. Symptoms were assessed using Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Global Assessment of Functioning (GAF), Brief Assessment of Cognition in Schizophrenia (BACS), Working Alliance Inventory (WAI), and General Self-Efficacy (GSE). Linear regression analyses were adjusted for age, sex, cognition, and self-efficacy.
Results revealed significant associations between working alliance and fewer negative (? = -0.12; 95% CI, -0.19 to -0.04) and disorganized symptoms (? = -0.06; 95% CI, -0.11 to -0.01), and between working alliance and better social functioning (? = 1.45; 95% CI, 0.55 to 2.36). General self-efficacy mediated the effect of working alliance, explaining 14%-18% of the variance in associated outcomes. Global level of cognitive functioning, compliance, and self-efficacy influenced clinical and functional outcome more strongly than working alliance.
Better working alliance was weakly associated with fewer negative and disorganized symptoms and better social functioning. A strong working alliance may be a prerequisite for adherence to the specialized early intervention services treatment, providing the basis for positive treatment outcome.
ClinicalTrials.gov identifier: NCT00914238.
PubMed ID
25650684 View in PubMed
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Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis.

https://arctichealth.org/en/permalink/ahliterature135728
Source
Eur J Health Econ. 2012 Jun;13(3):355-63
Publication Type
Article
Date
Jun-2012
Author
Lone Baandrup
Jan Sørensen
Henrik Lublin
Merete Nordentoft
Birte Glenthoj
Author Affiliation
Centre for Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Glostrup, Nordre Ringvej 29-67, 2600 Glostrup, Denmark. lone.baandrup@regionh.dk
Source
Eur J Health Econ. 2012 Jun;13(3):355-63
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - economics - therapeutic use
Confidence Intervals
Cost-Benefit Analysis
Cross-Sectional Studies
Denmark
Female
Health Care Costs - statistics & numerical data
Health Care Surveys
Humans
Linear Models
Male
Middle Aged
Multivariate Analysis
Outpatients - statistics & numerical data
Polypharmacy
Registries
Retrospective Studies
Schizophrenia - drug therapy - economics
Young Adult
Abstract
To investigate the association of antipsychotic polypharmacy in schizophrenia with cost of primary and secondary health service use.
Comparative analysis of health service cost for patients prescribed antipsychotic polypharmacy versus antipsychotic monotherapy. Resource utilisation and costs were described using central Danish registers for a 2 year period (2007-2008). We included patients attached to one of two Danish psychiatric referral centres in 1 January 2008 and/or 1 January 2009. Their prescribed treatment with either antipsychotic polypharmacy or monotherapy at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender, disease duration, psychiatric inpatient admissions, and treatment site as covariates.
The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy (2007: 25% higher costs; 2008: 17% higher costs) when adjusting for potential confounders and risk factors. A subgroup analysis suggested that the excessive costs associated with antipsychotic polypharmacy were partly accounted for by the functional level of the patients.
The results demonstrate that antipsychotic co-prescribing is associated with increased use of health care services, even though no causal relations can be inferred from an observational study.
PubMed ID
21452062 View in PubMed
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Association of Streptococcal Throat Infection With Mental Disorders: Testing Key Aspects of the PANDAS Hypothesis in a Nationwide Study.

https://arctichealth.org/en/permalink/ahliterature284102
Source
JAMA Psychiatry. 2017 Jul 01;74(7):740-746
Publication Type
Article
Date
Jul-01-2017
Author
Sonja Orlovska
Claus Høstrup Vestergaard
Bodil Hammer Bech
Merete Nordentoft
Mogens Vestergaard
Michael Eriksen Benros
Source
JAMA Psychiatry. 2017 Jul 01;74(7):740-746
Date
Jul-01-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Autoimmune Diseases - epidemiology
Child
Child, Preschool
Denmark - epidemiology
Female
Humans
Male
Obsessive-Compulsive Disorder - epidemiology - etiology - microbiology
Pharyngitis - complications - epidemiology - microbiology
Registries - statistics & numerical data
Risk
Sex Factors
Streptococcal Infections - epidemiology
Tic Disorders - epidemiology - etiology - microbiology
Abstract
Streptococcal infection has been linked with the development of obsessive-compulsive disorder (OCD) and tic disorders, a concept termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). However, previous studies of this association have been small, and the results have been conflicting.
To investigate the risk of mental disorders, specifically OCD and tic disorders, after a streptococcal throat infection.
A population-based cohort study was conducted using data from the nationwide Danish registers from January 1, 1996, to December 31, 2013, with up to 17 years of follow-up. The Danish National Health Service Register provided information on individuals with the registration of a streptococcal test. Data analysis was conducted from January 1, 2016, to February 28, 2017.
Individuals were followed up in the nationwide Psychiatric Central Register for a diagnosis of any mental disorder, OCD, or tic disorders. Incidence rate ratios (IRRs) were calculated by Poisson regression analysis.
Of the 1?067?743 children (
PubMed ID
28538981 View in PubMed
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96 records – page 1 of 10.