High prevalence of medicine-induced attempted suicides among females in Nuuk, Greenland, 2008-2009

Patterns in contacts with primary health care centres in Greenland

The aim of this study was to evaluate the activity within the primary health care (PHC) in Greenland by identifying the patterns of all registered contacts made by patients in 2021, and to compare the most frequently used types of contacts and diagnostic codes in Nuuk to the rest of Greenland. The study was designed as a cross-sectional register study using data from the national electronic medical records (EMR) and diagnostic codes from the ICPC-2-system. In 2021, 83.7% (46,522) of the Greenlandic population were in contact with the PHC, resulting in 335,494 registered contacts. The majority of the contacts with PHC was made by females (61.3%). On average, females were in contact with PHC 8.4 times per patient per year, while males were in contact with PHC 5.9 times per patient per year. The most frequently used diagnostic group was "General and unspecified", followed by "Musculoskeletal" and "Skin". The results are in line with studies from other northern countries and indicate an easily accessible PHC system, with a predominance of female contacts.

Suicide attempts among Greenlandic forensic psychiatric patients - prevalence and determinants

This nationwide cross-sectional study of the lifetime prevalence and determinants of suicide attempts includes 90% of Greenlandic forensic psychiatric patients. Retrospective data were collected from electronic patient files, court documents, and forensic psychiatric assessments using a coding form from a similar study. We used unpaired t-tests and chi² or Fisher's exact test. The lifetime prevalence of suicide attempts was 36% (n = 32), and no difference in prevalence was found between male and female patients (p = 0.95). Patients having attempted suicide had a higher rate of physical abuse in childhood (p = 0.04), family history of substance misuse (p = 0.007), and criminal convictions among family members (p = 0.03) than patients who had never attempted suicide. Women primarily used self-poisoning in their latest suicide attempts (67%), whereas men more often used sharp objects or a firearm (42%). Over a third of Greenlandic forensic patients have attempted suicide at some point in their life, and patients with traumatic childhood experiences are at higher risk of suicidal behaviour. It is not possible to conclude whether the lifetime prevalence of suicide attempts among Greenlandic forensic patients is comparable to that of other high-risk groups in other Arctic regions due to methodological differences among the very few other comparable studies.

Prevalence of patients treated with antidepressant medicine in Greenland and Denmark: a cross-sectional study

Depression is a mental illness affecting more than 260 million people worldwide. In Greenland, the prevalence of patients treated with antidepressant medicine (antidepressants) has not previously been investigated. The aim of this study was to estimate and compare the age- and gender-specific prevalence of patients treated with antidepressants in Greenland and Denmark. The study was a cross-sectional register study using data from population and medical registers in Greenland and Denmark. Included was 1,573 Greenlandic patients and 419,151 Danish patients treated with antidepressants, respectively. The overall prevalence of patients aged 10–89 years treated with antidepressants was 3.5% in Greenland, and 8.1% in Denmark, being significantly lower in Greenland compared to Denmark (p < 0.001). The age- and gender-specific prevalence was significantly lower for patients from Greenland compared to from Denmark. In both Greenland and Denmark, the prevalence of women receiving antidepressants was significantly higher than for men. Finally, there was regional differences in the prevalence of usage of antidepressants in Greenland. Undiagnosed depression might contribute to the lower prevalence in Greenland as well as limited access to primary healthcare.

Time trend by region of suicides and suicidal thoughts among Greenland Inuit

BACKGROUND

Suicides remain a major public health problem in Greenland. Their increase coincides with the modernization since 1950. Serious suicidal thoughts are reported by a significant proportion of participants in countrywide surveys.

OBJECTIVE

To analyze the time trend by region of suicides and suicidal thoughts among the Inuit in Greenland.

DESIGN

Data included the Greenland registry of causes of death for 1970-2011 and 2 cross-sectional health surveys carried out in 1993-1994 and 2005-2010 with 1,580 and 3,102 Inuit participants, respectively.

RESULTS

Suicide rates were higher among men than women while the prevalence of suicidal thoughts was higher among women. Suicide rates for men and women together increased from 1960 to 1980 and have remained around 100 per 100,000 person-years since then. The regional pattern of time trend for suicide rates varied with an early peak in the capital, a continued increase to very high rates in remote East and North Greenland and a slow increase in villages relative to towns on the West Coast. Suicidal thoughts followed the regional pattern for completed suicides. Especially for women there was a noticeable increasing trend in the villages. The relative risk for suicide was highest among those who reported suicidal thoughts, but most suicides happened outside this high-risk group.

CONCLUSION

Suicide rates and the prevalence of suicidal thoughts remain high in Greenland but different regional trends point towards an increased marginalization between towns on the central West Coast, villages and East and North Greenland. Different temporal patterns call for different regional strategies of prevention.