1
|
Momen NC, Petersen JD, Yilmaz Z, Semark BD, Petersen LV. Inpatient admissions and mortality of anorexia nervosa patients according to their preceding psychiatric and somatic diagnoses. Acta Psychiatr Scand 2024; 149:404-414. [PMID: 38408593 DOI: 10.1111/acps.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/01/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE Anorexia nervosa (AN) is associated with increased risk of mortality, but little is known about the risk of inpatient admissions and mortality outcomes in individuals with diagnoses of both AN and other psychiatric and somatic conditions. We aimed to investigate the inpatient admissions and mortality among people with AN and other diagnosed conditions using Danish national registers. METHOD This retrospective cohort study included individuals diagnosed with AN in Denmark, born 1977-2010. We identified other mental and somatic conditions in this population. We used Cox proportional hazards regression to estimate the risk of inpatient admission and mortality, focusing on (i) the number of other diagnosed conditions, and (ii) specific combinations of conditions diagnosed prior to the AN diagnosis. Categories of inpatient admissions considered were due to: (i) AN, (ii) any psychiatric disorder, and (iii) any somatic disorder. Additionally, competing risks survival analysis was used to calculate the cumulative incidence of inpatient admission and all-cause mortality over the follow-up period. RESULTS The study population included 11,489 individuals. The most common conditions individuals had prior to their AN diagnosis were other eating disorders (34.5%) and anxiety disorders (32.7%). During the follow-up, 3184 (27.7%), 4604 (40.1%), and 6636 (57.8%) individuals were admitted for AN, any psychiatric disorder, and any somatic disorder, respectively; and in total 106 (0.9%) died. The risk of all outcomes was highest among those who had received a higher number of other diagnoses. For most combinations, the risks of admission and mortality were increased. DISCUSSION Our study presents the prevalence of other conditions in patients with AN in Denmark and elucidates their association with higher rates of inpatient admission and mortality. Our findings highlight the need for comprehensive, multidisciplinary care of patients with AN considering the spectrum of other diagnosed conditions to improve health outcomes.
Collapse
Affiliation(s)
- Natalie C Momen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jindong Ding Petersen
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Birgitte D Semark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | | |
Collapse
|
2
|
Beck C, Pedersen CB, Plana-Ripoll O, Dalsgaard S, Debost JCP, Laursen TM, Musliner KL, Mortensen PB, Pedersen MG, Petersen LV, Yilmaz Z, McGrath J, Agerbo E. A comprehensive analysis of age of onset and cumulative incidence of mental disorders: A Danish register study. Acta Psychiatr Scand 2024. [PMID: 38523413 DOI: 10.1111/acps.13682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND The age of onset (AOO), incidence and cumulative incidence of mental disorders are critical epidemiological measures, providing essential insights into the development and course of these disorders across the lifespan. This study aims to provide up-to-date estimates of the AOO, age-specific incidence, and cumulative incidence for a comprehensive range of mental disorders using data from Danish registers. METHODS We conducted a follow-up study encompassing all Danish residents from January 1, 2004, to December 31, 2021, totaling 91,613,465 person-years. Data were sourced from the Danish Psychiatric Central Research Register, identifying individuals treated for various mental disorders in psychiatric hospitals, outpatient departments, and accident/emergency departments, that is, treated in secondary care settings. We investigated specific categories of mental disorders, including substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, borderline personality disorders, intellectual disabilities, pervasive developmental disorders, and behavioral and emotional disorders. Age-sex-specific incidence rates were estimated using Poisson generalized linear models, and cumulative incidence was calculated using Aalen-Johansen's competing risks model. The study provides estimates of AOO, incidence, and cumulative incidence for various mental disorders, including their age and sex distributions. RESULTS The cumulative incidence by age 80 years for any mental disorder was 30.72% (95% confidence interval: 30.62%-30.83%) for males and 34.46% (34.35%-34.57%) for females. The most common types of mental disorders were anxiety-related disorders 16.27% (16.19%-16.36%) for males and 23.39% (23.29%-23.50%) for females, and followed by mood disorder 10.34% (10.27%-10.41%) for males and 16.67% (16.58%-16.77%) for females. For those who develop mental disorder, half will have developed their disorder by approximately age 22 years (median and interquartile range: males 21.37 (11.85-36.00); females 22.55 (16.31-36.08)). CONCLUSIONS Approximately one in three individuals will seek treatment for at least one mental disorder in a secondary care setting by age 80. Given that half of these individuals develop mental disorders before age 22, it is crucial to tailor service planning to meet the specific needs of young individuals. Web-based interactive data-visualization tools are provided for clinical utility.
Collapse
Affiliation(s)
- Christoffer Beck
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Carsten Bøcker Pedersen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
- Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Søren Dalsgaard
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Hellerup, Denmark
| | - Jean-Christophe Philippe Debost
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Department of Affective Disorders, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Thomas Munk Laursen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Katherine Louise Musliner
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Preben Bo Mortensen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
- Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
| | | | | | - Zeynep Yilmaz
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John McGrath
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - Esben Agerbo
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| |
Collapse
|
3
|
Jefsen OH, Holde K, McGrath JJ, Rajagopal VM, Albiñana C, Vilhjálmsson BJ, Grove J, Agerbo E, Yilmaz Z, Plana-Ripoll O, Munk-Olsen T, Demontis D, Børglum A, Mors O, Bulik CM, Mortensen PB, Petersen LV. Polygenic Risk of Mental Disorders and Subject-Specific School Grades. Biol Psychiatry 2023:S0006-3223(23)01749-3. [PMID: 38061465 DOI: 10.1016/j.biopsych.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/04/2023] [Accepted: 11/18/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Education is essential for socioeconomic security and long-term mental health; however, mental disorders are often detrimental to the educational trajectory. Genetic correlations between mental disorders and educational attainment do not always align with corresponding phenotypic associations, implying heterogeneity in the genetic overlap. METHODS We unraveled this heterogeneity by investigating associations between polygenic risk scores for 6 mental disorders and fine-grained school outcomes: school grades in language and mathematics in ninth grade and high school, as well as educational attainment by age 25, using nationwide-representative data from established cohorts (N = 79,489). RESULTS High polygenic liability of attention-deficit/hyperactivity disorder was associated with lower grades in language and mathematics, whereas high polygenic risk of anorexia nervosa or bipolar disorder was associated with higher grades in language and mathematics. Associations between polygenic risk and school grades were mixed for schizophrenia and major depressive disorder and neutral for autism spectrum disorder. CONCLUSIONS Polygenic risk scores for mental disorders are differentially associated with language and mathematics school grades.
Collapse
Affiliation(s)
- Oskar Hougaard Jefsen
- Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark; Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Katrine Holde
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - John J McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; Queensland Brain Institute, University of Queensland, St. Lucia, Brisbane, Queensland, Australia
| | - Veera Manikandan Rajagopal
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Clara Albiñana
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Bjarni Jóhann Vilhjálmsson
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Jakob Grove
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Oleguer Plana-Ripoll
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Ditte Demontis
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Anders Børglum
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| |
Collapse
|
4
|
Rommel AS, Semark BD, Liu X, Madsen KB, Agerbo E, Munk-Olsen T, Petersen LV, Bergink V. Prenatal antidepressant exposure and the risk of decreased gestational age and lower birthweight: A polygenic score approach to investigate confounding by indication. Acta Psychiatr Scand 2023. [PMID: 37990478 DOI: 10.1111/acps.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/13/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Prenatal antidepressant exposure has been associated with lower gestational age and birthweight. Yet, unmeasured residual confounding may inflate this association. We explored if maternal genetic liability for major depression explains part of the association of antidepressant use in pregnancy with lower gestational age and birthweight. MATERIAL AND METHODS We employed the maternal polygenic score (PGS) for major depression as a measure of genetic liability. We used generalised linear models to estimate the differences in gestational age and birthweight at each PGS quintile between children whose mothers continued antidepressant use during pregnancy (continuation group), children whose mothers discontinued antidepressant use during pregnancy (discontinuation group) and unexposed children. RESULTS After adjusting for confounders, we found significant differences in birthweight between PGS quintiles in the continuation and unexposed group. Yet, this relationship was not linear. Furthermore, at the lowest and highest PGS quintiles, the continuation group had significantly reduced mean gestational ages (adjusted β ranges: 1.7-4.5 days, p < 0.001-0.008) and lower mean birthweights (adjusted β ranges: 58.6-165.4 g, p = 0.001-0.008) than the discontinuation and unexposed groups. CONCLUSION We confirmed that antidepressant use in pregnancy was associated with small reductions in gestational age and birthweight but found that genetic liability for depression was not linearly associated with this risk. The causality of the observed associations could not be established due to the observational nature of the study. Residual confounding linked to the underlying disease was likely still present.
Collapse
Affiliation(s)
- Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Birgitte Dige Semark
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Kathrine Bang Madsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU-Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Liselotte Vogdrup Petersen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
5
|
Johannsen BMW, Larsen JT, Liu X, Madsen KB, Mægbæk ML, Albiñana C, Bergink V, Laursen TM, Bech BH, Mortensen PB, Nordentoft M, Børglum AD, Werge T, Hougaard DM, Agerbo E, Petersen LV, Munk-Olsen T. Identification of women at high risk of postpartum psychiatric episodes: A population-based study quantifying relative and absolute risks following exposure to selected risk factors and genetic liability. Acta Psychiatr Scand 2023:10.1111/acps.13622. [PMID: 37871908 PMCID: PMC11035484 DOI: 10.1111/acps.13622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/18/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND We quantified relative and absolute risks of postpartum psychiatric episodes (PPE) following risk factors: Young age, past personal or family history of psychiatric disorders, and genetic liability. METHODS We conducted a register-based study using the iPSYCH2012 case-cohort sample. Exposures were personal history of psychiatric episodes prior to childbirth, being a young mother (giving birth before the age of 21.5 years), having a family history of psychiatric disorders, and a high (highest quartile) polygenic score (PGS) for major depression. PPE was defined within 12 months postpartum by prescription of psychotropic medication or in- and outpatient contact to a psychiatric facility. We included primiparous women born 1981-1999, giving birth before January 1st, 2016. We conducted Cox regression to calculate hazard ratios (HRs) of PPE, absolute risks were calculated using cumulative incidence functions. RESULTS We included 8174 primiparous women, and the estimated baseline PPE risk was 6.9% (95% CI 6.0%-7.8%, number of PPE cases: 2169). For young mothers with a personal and family history of psychiatric disorders, the absolute risk of PPE was 21.6% (95% CI 15.9%-27.8%). Adding information on high genetic liability to depression, the risk increased to 29.2% (95% CI 21.3%-38.4%) for PPE. CONCLUSIONS Information on prior personal and family psychiatric episodes as well as age may assist in estimating a personalized risk of PPE. Furthermore, additional information on genetic liability could add even further to this risk assessment.
Collapse
Affiliation(s)
| | | | - Xiaoqin Liu
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | | | - Merete Lund Mægbæk
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Clara Albiñana
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Thomas M. Laursen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- CIRRAU, Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bodil H. Bech
- Department of Public Health, Research Unit of Epidemiology, Aarhus University, Aarhus, Denmark
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Merete Nordentoft
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- CORE Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders D. Børglum
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department of Biomedicine—Human Genetics and the iSEQ Center, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, CGPM, Aarhus, Denmark
| | - Thomas Werge
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- LF Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - David M. Hougaard
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department for Congenital Disorders and Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - Esben Agerbo
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- CIRRAU, Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- CIRRAU, Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Psychiatric Research Unit, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
6
|
Chatwin H, Holde K, Yilmaz Z, Larsen JT, Albiñana C, Vilhjálmsson BJ, Mortensen PB, Thornton LM, Bulik CM, Petersen LV. Risk factors for anorexia nervosa: A population-based investigation of sex differences in polygenic risk and early life exposures. Int J Eat Disord 2023; 56:1703-1716. [PMID: 37232007 PMCID: PMC10524536 DOI: 10.1002/eat.23997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To examine sex differences in risk factors for anorexia nervosa (AN). METHOD This population-based study involved 44,743 individuals (6,239 AN cases including 5,818 females and 421 males, and 38,504 controls including 18,818 females and 19,686 males) born in Denmark between May 1981 and December 2009. Follow-up began on the individual's sixth birthday and ended at AN diagnosis, emigration, death, or December 31, 2016, whichever occurred first. Exposures included socioeconomic status (SES), pregnancy, birth, and early childhood factors based on data from Danish registers, and psychiatric and metabolic polygenic risk scores (PRS) based on genetic data. Hazard ratios were estimated using weighted Cox proportional hazards models stratified by sex (assigned at birth), with AN diagnosis as the outcome. RESULTS The effects of early life exposures and PRS on AN risk were comparable between females and males. Although we observed some differences in the magnitude and direction of effects, there were no significant interactions between sex and SES, pregnancy, birth, or early childhood exposures. The effects of most PRS on AN risk were highly similar between the sexes. We observed significant sex-specific effects of parental psychiatric history and body mass index PRS, though these effects did not survive corrections for multiple comparisons. CONCLUSIONS Risk factors for AN are comparable between females and males. Collaboration across countries with large registers is needed to further investigate sex-specific effects of genetic, biological, and environmental exposures on AN risk, including exposures in later childhood and adolescence as well as the additive effects of exposures. PUBLIC SIGNIFICANCE Sex differences in the prevalence and clinical presentation of AN warrant examination of sex-specific risk factors. This population-based study indicates that the effects of polygenic risk and early life exposures on AN risk are comparable between females and males. Collaboration between countries with large registers is needed to further investigate sex-specific AN risk factors and improve early identification of AN.
Collapse
Affiliation(s)
- Hannah Chatwin
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Katrine Holde
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Zeynep Yilmaz
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Janne Tidselbak Larsen
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Clara Albiñana
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
| | - Bjarni Jóhann Vilhjálmsson
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Preben Bo Mortensen
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Liselotte Vogdrup Petersen
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
| |
Collapse
|
7
|
Munk-Olsen T, Di Florio A, Bergink V, Agerbo E, Madsen KB, Petersen LV, Liu X. Genetic liability to bipolar disorder and onset of postpartum mental disorders. BMJ Ment Health 2023; 26:e300835. [PMID: 37640501 PMCID: PMC10577749 DOI: 10.1136/bmjment-2023-300835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Trine Munk-Olsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- NCRR - The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH - Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Arianna Di Florio
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Veerle Bergink
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Esben Agerbo
- NCRR - The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH - Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Kathrine Bang Madsen
- NCRR - The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH - Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- NCRR - The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH - Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Xiaoqin Liu
- NCRR - The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- iPSYCH - Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| |
Collapse
|
8
|
Trinh NTH, Semark BD, Munk-Olsen T, Liu X, Thapa SB, Yilmaz Z, Petersen LV, Lupattelli A. Antidepressant treatment in pregnancy: a Danish registry linkage study in pregnant women with pre-existing obsessive-compulsive disorder. Transl Psychiatry 2023; 13:223. [PMID: 37353477 DOI: 10.1038/s41398-023-02516-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023] Open
Abstract
The association between antidepressant continuation during pregnancy and postpartum mental health in women with obsessive-compulsive disorder (OCD) is uncertain. We identified 1317 women with live-birth singleton pregnancies and having outpatient/inpatient visits for OCD in the 4 years pre-pregnancy from the Danish registries. We defined three groups based on antidepressant prescriptions filled in the 2 years before pregnancy to delivery: (i) unexposed (n = 449); (ii) discontinuers (n = 346), i.e., with pre-pregnancy antidepressant fills only; (iii) continuers (n = 522), i.e., with antidepressant fills before and during pregnancy. We estimated crude and propensity score weighted hazard ratio (HRs) of postpartum visit for OCD and mood/anxiety disorders using Cox proportional hazard models. In weighted analyses, we found no difference in the probability of a postpartum visit for OCD or MADs with antidepressant continuation compared to unexposed and discontinuers. The likelihood of a postpartum OCD visit was higher in pregnancies having only one prescription fill during pregnancy compared to unexposed (HR = 3.44, 95% CI: 1.24, 9.54) or discontinuers (HR = 2.49, 95% CI: 0.91, 6.83). Continuers in pregnancy without antidepressant fill in the first three months postpartum had higher probability for postpartum visit for mood/anxiety disorders compared to discontinuers (HR = 3.84, 95% CI: 1.49, 9.92). Among pregnant women with pre-existing OCD, we found similar probabilities of a postpartum visit for OCD or mood/anxiety disorders in antidepressant continuers compared to unexposed and discontinuers. Continuers with a single prescription fill during pregnancy or no fill postpartum may have higher risks for these outcomes. Our findings highlight the importance of continuity of treatment throughout the perinatal period.
Collapse
Affiliation(s)
- Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway.
| | - Birgitte Dige Semark
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Aarhus, Denmark
| | - Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Suraj Bahadur Thapa
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zeynep Yilmaz
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| |
Collapse
|
9
|
Trinh NTH, Semark BD, Munk-Olsen T, Liu X, Rø Ø, Bulik CM, Torgersen L, Lupattelli A, Petersen LV. Psychiatric visits during the postpartum year in women with eating disorders who continue or discontinue antidepressant treatment in pregnancy. Int J Eat Disord 2023; 56:582-594. [PMID: 36524675 PMCID: PMC10853670 DOI: 10.1002/eat.23877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/23/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the association between continued antidepressant use in pregnancy and postpartum psychiatric visits for eating (ED) or mood/anxiety disorders in women with preexisting ED. METHOD Using Danish health registry data (1998-2015), we identified 3529 pregnancies in women with ED prepregnancy: (i) 564 with continued antidepressant use before and during pregnancy; (ii) 778 with discontinued antidepressants before pregnancy; (iii) 2137 unexposed. Outpatient and inpatient postpartum visits for an ED or a mood/anxiety disorder constituted the outcome measures. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) using Cox regression with inverse probability of treatment weighting, and performed stratified analyses by antidepressant prescription filling in the first 3 months postpartum. RESULTS The weighted cumulative incidence for an ED visit at end of follow-up was 4.5% (continued) and 4.8% (discontinued). We found no association between continued antidepressant and postpartum ED visit, relative to discontinued (HR: 0.89, 95% CI: 0.52-1.52). The HR for postpartum mood/anxiety disorder visit was 1.27 (95% CI: 0.68-2.36) with continued antidepressants versus discontinued but decreased if more than two antidepressant prescriptions were refilled. Continued antidepressant use was associated with a 57% reduced likelihood of a postpartum ED visit versus discontinued use in pregnancies with antidepressant prescription refills in the early postpartum. CONCLUSION Among women with preexisting ED, there was no association between continued antidepressant use during pregnancy and the likelihood of postpartum psychiatric visits, relative to discontinued antidepressants before pregnancy. Continuation of treatment into the early postpartum is associated with reduced likelihood of postpartum ED visit. PUBLIC SIGNIFICANCE Based on data from the Danish registries, we identified 3529 pregnancies among women with preexisting eating disorders before pregnancy. Women with continued antidepressant treatment both before and during pregnancy did not have a lower probability of having postpartum psychiatric visits for an eating disorder or for mood/anxiety disorders (often coexisting with eating disorders), relative to those who discontinued antidepressants before pregnancy. Further continuation of antidepressant treatment into the early postpartum is associated with improved maternal postpartum outcomes. However, residual confounding by disease severity limits confidence in this conclusion.
Collapse
Affiliation(s)
- Nhung TH Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Birgitte Dige Semark
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
| | - Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Cynthia M Bulik
- UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina at Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina at Chapel Hill, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Leila Torgersen
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | | |
Collapse
|
10
|
Brikell I, Wimberley T, Albiñana C, Vilhjálmsson BJ, Agerbo E, Børglum AD, Demontis D, Schork AJ, LaBianca S, Werge T, Hougaard DM, Nordentoft M, Mors O, Mortensen PB, Petersen LV, Dalsgaard S. Interplay of ADHD Polygenic Liability With Birth-Related, Somatic, and Psychosocial Factors in ADHD: A Nationwide Study. Am J Psychiatry 2023; 180:73-88. [PMID: 36069019 DOI: 10.1176/appi.ajp.21111105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder, yet the interplay between ADHD polygenic risk scores (PRSs) and other risk factors remains relatively unexplored. The authors investigated associations, confounding, and interactions of ADHD PRS with birth-related, somatic, and psychosocial factors previously associated with ADHD. METHODS Participants included a random general population sample (N=21,578) and individuals diagnosed with ADHD (N=13,697) from the genotyped Danish iPSYCH2012 case cohort, born between 1981 and 2005. The authors derived ADHD PRSs and identified 24 factors previously associated with ADHD using national registers. Logistic regression was used to estimate associations of ADHD PRS with each risk factor in the general population. Cox models were used to evaluate confounding of risk factor associations with ADHD diagnosis by ADHD PRS and parental psychiatric history, and interactions between ADHD PRS and each risk factor. RESULTS ADHD PRS was associated with 12 of 24 risk factors (odds ratio range, 1.03-1.30), namely, small gestational age, infections, traumatic brain injury, and most psychosocial risk factors. Nineteen risk factors were associated with ADHD diagnosis (odds ratio range, 1.20-3.68), and adjusting for ADHD PRS and parental psychiatric history led to only minor attenuations. Only the interaction between ADHD PRS and maternal autoimmune disease survived correction for multiple testing. CONCLUSIONS Higher ADHD PRS in the general population is associated with small increases in risk for certain birth-related and somatic ADHD risk factors, and broadly to psychosocial adversity. Evidence of gene-environment interaction was limited, as was confounding by ADHD PRS and family psychiatric history on ADHD risk factor associations. This suggests that the majority of the investigated ADHD risk factors act largely independently of current ADHD PRS to increase risk of ADHD.
Collapse
Affiliation(s)
- Isabell Brikell
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Theresa Wimberley
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Clara Albiñana
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Bjarni Jóhann Vilhjálmsson
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Esben Agerbo
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Anders D Børglum
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Ditte Demontis
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Andrew J Schork
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Sonja LaBianca
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Thomas Werge
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - David M Hougaard
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Merete Nordentoft
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Ole Mors
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Preben Bo Mortensen
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Liselotte Vogdrup Petersen
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Søren Dalsgaard
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| |
Collapse
|
11
|
Debost JPG, Thorsteinsson E, Trabjerg B, Benros ME, Albiñana C, Vilhjalmsson BJ, Børglum A, Mors O, Werge T, Mortensen PB, Agerbo E, Petersen LV. Genetic and psychosocial influence on the association between early childhood infections and later psychiatric disorders. Acta Psychiatr Scand 2022; 146:406-419. [PMID: 35999619 PMCID: PMC9826256 DOI: 10.1111/acps.13491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 01/29/2023]
Abstract
To evaluate the influence of extensive genetic and psychosocial confounding on the association between early childhood infection and five major psychiatric disorders METHODS: A case-cohort study including participants from the Danish iPSYCH2012 sample, a case-cohort sample where all cases born between May 1, 1981, and December 31, 2005, diagnosed with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar affective disorder (BIP), Major Depressive Disorder (MDD) or schizophrenia (SCZ), were identified and pooled with a representative sample (subcohort) of the Danish population. We used Cox proportional hazards regression customized to the case-cohort setup to calculate hazard ratios of outcome with 95% confidence intervals (CIs), following exposure to early childhood infection before the age of 5 years for ADHD and ASD, and before the age of 10 years for BIP, MDD, and SCZ. To evaluate psychosocial confounding we included sex, calendar period, sibling infections, urbanicity, parental socio-economic status, parental mental health information, and polygenic risk scores for all five disorders, as covariates. To estimate how liability for psychiatric disorders measured through the PRS influenced the risk of early childhood infection, we calculated odds ratios (ORs) with 95% CIs, using logistic regression RESULTS: Early childhood infection was associated with ADHD, ASD, MDD, and SCZ with number of childhood infections increasing the hazard. The HR was still significant in the model with full adjustments after 1 infection for ADHD (HR 1.29, 95% CI: 1.19-1.41), ASD (HR 1.28, 95% CI: 1.18-1.40), MDD (HR 1.23, 95% CI: 1.14-1.33), and SCZ (HR 1.21, 95% CI: 1.07-1.36), but not for BIP (HR1.17, 95% CI: 0.96-1.42). Probands exposed to sibling infections, but not own infection had an absolute risk of ADHD, BIP, MDD, and SCZ that closely approached the absolute risk for individuals exposed to own infections. We found evidence of gene-environment correlation with higher PRS of MDD and to some extent SCZ increasing the risk of infections and higher PRS of BIP associated with significantly decreased risk CONCLUSION: Early childhood infection is significantly associated with ADHD, ASD, MDD, and SCZ and not explained by genetic or psychosocial confounding. Although we found evidence of gene-environment correlation, it had minor impact on the results.
Collapse
Affiliation(s)
- Jean‐Christophe Philippe Goldtsche Debost
- Department of PsychosisAarhus University Hospital – PsychiatryAarhusDenmark,National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark
| | - Erla Thorsteinsson
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark
| | - Betina Trabjerg
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark
| | - Michael Eriksen Benros
- Biological and Precision Psychiatry, Copenhagen Research Centre for Mental Health, Mental Health Centre CopenhagenCopenhagen UniversityCopenhagenDenmark,Department of Immunology and Microbiology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Clara Albiñana
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark
| | - Bjarni Johann Vilhjalmsson
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark
| | - Anders Børglum
- iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark,Department of Biomedicine and Centre for Integrative Sequencing, iSEQAarhus UniversityAarhusDenmark,Center for Genomics and Personalized MedicineCentral Region Denmark and Aarhus UniversityAarhusDenmark
| | - Ole Mors
- iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark,Psychosis Research UnitAarhus University Hospital – PsychiatryAarhusDenmark
| | - Thomas Werge
- iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark,Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health ServicesRoskildeDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark,Center for GeoGeneticsGLOBE Institute, University of CopenhagenCopenhagenDenmark
| | - Preben Bo Mortensen
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark,CIRRAU – Centre for Integrated Register‐based ResearchAarhus UniversityAarhusDenmark
| | - Esben Agerbo
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark,CIRRAU – Centre for Integrated Register‐based ResearchAarhus UniversityAarhusDenmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register‐based Research, Department of Economics and Business EconomicsAarhus UniversityAarhusDenmark,iPSYCH ‐ The Lundbeck Foundation Initiative for Integrative Psychiatric ResearchDenmark
| |
Collapse
|
12
|
Munk-Olsen T, Liu X, Madsen KB, Kjeldsen MMZ, Petersen LV, Bergink V, Skalkidou A, Vigod SN, Frokjaer VG, Pedersen CB, Maegbaek ML. Postpartum depression: a developed and validated model predicting individual risk in new mothers. Transl Psychiatry 2022; 12:419. [PMID: 36180471 PMCID: PMC9525696 DOI: 10.1038/s41398-022-02190-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/09/2022] Open
Abstract
Postpartum depression (PPD) is a serious condition associated with potentially tragic outcomes, and in an ideal world PPDs should be prevented. Risk prediction models have been developed in psychiatry estimating an individual's probability of developing a specific condition, and recently a few models have also emerged within the field of PPD research, although none are implemented in clinical care. For the present study we aimed to develop and validate a prediction model to assess individualized risk of PPD and provide a tentative template for individualized risk calculation offering opportunities for additional external validation of this tool. Danish population registers served as our data sources and PPD was defined as recorded contact to a psychiatric treatment facility (ICD-10 code DF32-33) or redeemed antidepressant prescriptions (ATC code N06A), resulting in a sample of 6,402 PPD cases (development sample) and 2,379 (validation sample). Candidate predictors covered background information including cohabitating status, age, education, and previous psychiatric episodes in index mother (Core model), additional variables related to pregnancy and childbirth (Extended model), and further health information about the mother and her family (Extended+ model). Results indicated our recalibrated Extended model with 14 variables achieved highest performance with satisfying calibration and discrimination. Previous psychiatric history, maternal age, low education, and hyperemesis gravidarum were the most important predictors. Moving forward, external validation of the model represents the next step, while considering who will benefit from preventive PPD interventions, as well as considering potential consequences from false positive and negative test results, defined through different threshold values.
Collapse
Affiliation(s)
- Trine Munk-Olsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark. .,National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark.
| | - Xiaoqin Liu
- grid.7048.b0000 0001 1956 2722National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Kathrine Bang Madsen
- grid.7048.b0000 0001 1956 2722National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Mette-Marie Zacher Kjeldsen
- grid.7048.b0000 0001 1956 2722National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- grid.7048.b0000 0001 1956 2722National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Veerle Bergink
- grid.5645.2000000040459992XDepartment of Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands ,grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY USA
| | - Alkistis Skalkidou
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Simone N. Vigod
- grid.17063.330000 0001 2157 2938Women’s College Hospital and Women’s College Research Institute, Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Vibe G. Frokjaer
- grid.466916.a0000 0004 0631 4836Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark ,grid.4973.90000 0004 0646 7373Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Carsten B. Pedersen
- grid.7048.b0000 0001 1956 2722National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Merete L. Maegbaek
- grid.7048.b0000 0001 1956 2722National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| |
Collapse
|
13
|
Koch SV, Larsen JT, Plessen KJ, Thornton LM, Bulik CM, Petersen LV. Associations between parental socioeconomic-, family-, and sibling status and risk of eating disorders in offspring in a Danish national female cohort. Int J Eat Disord 2022; 55:1130-1142. [PMID: 35809040 PMCID: PMC9546370 DOI: 10.1002/eat.23771] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Studies on parental socioeconomic status (SES) and family risk factors for eating disorders (EDs) have yielded inconsistent results; however, several studies have identified high parental educational attainment as a risk factor. The aim was to evaluate associations of parental SES and family composition with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) in the offspring, adjusting for parental age and parental mental health. METHODS The cohort included women born in Denmark between January 1, 1989 and December 31, 2010, derived from Danish national registers. Each person was followed from their sixth birthday until onset of the disorder of interest or to December 31, 2016. Exposure variables were: childhood SES, defined as individually evaluated parental level of income, occupation, and education; sibling status; and family composition. Outcomes were: AN, BN, EDNOS, and major depressive disorder (MDD), included as a psychiatric comparison disorder. Risks were estimated using Cox proportional hazards. RESULTS High parental SES was associated with increased risk of especially AN, and less so BN and EDNOS, in offspring. In comparison, low SES was associated with a higher risk of MDD. No differences between maternal or paternal socioeconomic risk factors were found. Family composition and sibling status showed limited influence on ED risk. DISCUSSION SES shows opposite associations with AN than MDD, whereas associations with BN and EDNOS are intermediate. The socioeconomic backdrop of AN differs markedly from that reported in other psychiatric disorders. Whether that is due to genetic and/or environmental factors remains unknown. PUBLIC SIGNIFICANCE STATEMENT Parental socioeconomic background (SES) may influence eating disorders risk in offspring somewhat differently than other psychiatric disorders. In Denmark, higher parental SES was associated with increased risk of, particularly, anorexia nervosa (AN). Importantly AN does strike across the SES spectrum. We must ensure that individuals of all backgrounds have equal access to care and are equally likely to be detected and treated appropriately for eating disorders.
Collapse
Affiliation(s)
- Susanne Vinkel Koch
- Department of Child and Adolescent PsychiatryCopenhagen University Hospital ‐ Psychiatry Region ZealandCopenhagenDenmark,Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Janne Tidselbak Larsen
- National Centre for Register‐based Research, Aarhus BSSAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)Aarhus UniversityAarhusDenmark,Centre for Integrated Register‐based Research (CIRRAU)Aarhus UniversityAarhusDenmark
| | - Kerstin J. Plessen
- Division of Child and Adolescent Psychiatry, Department of PsychiatryUniversity Hospital Lausanne, University of LausanneLausanneSwitzerland
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Liselotte Vogdrup Petersen
- National Centre for Register‐based Research, Aarhus BSSAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)Aarhus UniversityAarhusDenmark,Centre for Integrated Register‐based Research (CIRRAU)Aarhus UniversityAarhusDenmark
| |
Collapse
|
14
|
Yilmaz Z, Larsen JT, Nissen JB, Crowley JJ, Mattheisen M, Bulik CM, Petersen LV. The role of early-life family composition and parental socio-economic status as risk factors for obsessive-compulsive disorder in a Danish national cohort. J Psychiatr Res 2022; 149:18-27. [PMID: 35219872 PMCID: PMC9627644 DOI: 10.1016/j.jpsychires.2022.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 01/16/2023]
Abstract
Research on early-life family environment on obsessive-compulsive disorder (OCD) risk is limited, and sex differences have not been sufficiently studied. We investigated early-life family composition and parental socio-economic status (SES) as OCD risk factors while stratifying for sex in a sample of 1,154,067 individuals from the Danish population (7550 of whom had OCD). Data on early-life family composition (birth order, number of siblings, number of parents in household at proband age 6), parental SES at age 6 (parental income, occupation, and education level), history of parental psychiatric illness, and parental age at birth on OCD risk (i.e., an ICD-10 diagnosis of F42.x) were obtained from Danish population registers. Survival analyses using Cox regression were performed with age as the underlying time variable. Analyses were adjusted for calendar time, and differential effect by sex was tested for exposures. We found that birth order and advanced maternal age were risk factors for OCD in males, and being an only child was associated with increased OCD risk in both sexes. Early childhood SES variables including parental education, occupation, and income were associated with OCD risk, and these effects were more pronounced in females. Significant interaction effects for parental education/occupation and the presence of non-OCD psychiatric diagnoses in the proband also emerged. Our results suggest that early-life SES and family composition may be important risk factors for OCD, and heterogeneity in OCD cases in terms of psychiatric comorbidities, as well as sex differences should be carefully examined in relation to risk factors.
Collapse
Affiliation(s)
- Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, 8210, Denmark; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 27599-7160; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | - Janne Tidselbak Larsen
- National Centre for Register-based Research, Aarhus BSS,
Aarhus University, Aarhus, Denmark, 8210,Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Centre for Integrated Register-based Research (CIRRAU),
Aarhus University, Aarhus, Denmark, 8210
| | - Judith Becker Nissen
- Department of Child and Adolescent Psychiatry, Aarhus
University Hospital, Aarhus, Denmark, 8200
| | - James J. Crowley
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7160,Department of Genetics, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7264,Department of Clinical Neuroscience, Karolinska Institutet,
Stockholm, Sweden, 171 77
| | - Manuel Mattheisen
- Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Department of Clinical Neuroscience, Karolinska Institutet,
Stockholm, Sweden, 171 77,Department of Biomedicine, Aarhus University, Aarhus,
Denmark, 8000,Department of Psychiatry, Dalhousie University, Halifax,
Nova Scotia, Canada, B3H 2E2
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7160,Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden, 171 77,Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7400
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus BSS,
Aarhus University, Aarhus, Denmark, 8210,Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Centre for Integrated Register-based Research (CIRRAU),
Aarhus University, Aarhus, Denmark, 8210
| |
Collapse
|
15
|
Momen NC, Plana-Ripoll O, Yilmaz Z, Thornton LM, McGrath JJ, Bulik CM, Petersen LV. Comorbidity between eating disorders and psychiatric disorders. Int J Eat Disord 2022; 55:505-517. [PMID: 35084057 PMCID: PMC9763547 DOI: 10.1002/eat.23687] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Previous literature has established an increased risk of eating disorders among individuals with other psychiatric disorders and vice versa. However, often studies have focused on eating disorders as a single diagnostic entity and/or investigated selected psychiatric comorbidities. We conducted a comprehensive study, exploring bidirectional associations between different types of eating disorders and broad groups of all other psychiatric disorders, to identify patterns of comorbidity. METHOD We included all people born in Denmark 1963-2010. We collected information on eating disorders and considered the risk of subsequent psychiatric disorders using Cox-proportional hazards regression. Absolute risks were calculated using competing risks survival analyses. We also considered prior psychiatric disorders and subsequent eating disorders. RESULTS An increased risk was seen for almost all disorder pairs of diagnoses evaluated. Following an anorexia nervosa (AN) diagnosis, the median hazard ratio for the different subsequent psychiatric disorders was 3.80 (range 2.48-6.15); following an other eating disorder (OED) diagnosis, it was 3.16 (range 2.05-5.14). After different psychiatric disorder diagnoses, the median hazard ratio was 2.66 for later AN (range 1.21-5.31), and 2.51 for later OED (range 1.25-4.10). Absolute risk of eating disorders was also higher among those with other psychiatric disorders than those without. DISCUSSION In this broad examination, we identified bidirectional increases in risk of comorbidity for those with both eating disorder diagnoses and psychiatric disorder diagnoses. Although our findings indicate different patterns of comorbidity between eating disorders, these variations were generally small.
Collapse
Affiliation(s)
- Natalie C. Momen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John J. McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,Queensland Brain Institute, University of Queensland, St Lucia QLD 4072, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| |
Collapse
|
16
|
Orlovska-Waast S, Petersen LV, Gasse C, Nordentoft M, Mortensen PB, Kondziella D, Benros ME. Cerebrospinal fluid test results and associations with subsequent mental disorders, neurological diseases, and CNS infections: A population-based cohort study. Brain Behav Immun 2021; 98:210-218. [PMID: 34390802 DOI: 10.1016/j.bbi.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/15/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cerebrospinal fluid (CSF) immune alterations have been associated with mental disorders, neurological disease, and CNS infections; however, comprehensive large-scale longitudinal CSF studies are lacking. METHODS By using the Clinical Laboratory Information System (LABKA) Research Database in the Central Denmark Region (1994-2012), we included 15,030 individuals tested for CSF WBC, CSF/serum albumin ratio, IgG index, total protein, albumin, or IgG with follow-up for the risk of mental disorders, psychotropic prescriptions, neurological diseases, or CNS infections, estimated by Cox regression. RESULTS Among individuals receiving a mental disorder diagnosis (N = 1,147) after a CSF test, 30·0% had an abnormal CSF test result, while for those with a neurological disease (N = 3,201), 39·9% had abnormal test results, and among individuals with CNS infections (N = 1,276), 73·0% had abnormal test results. Individuals with abnormal CSF test results had an increased risk of mental disorders (HR = 3·20; 95%CI = 2·86-3·59), neurological diseases (HR = 12·40; 95%CI = 11·65-13·20), and CNS infections (HR = 338·59; 95%CI = 299·06-383·35) compared to individuals not registered with a CSF test. However, the risk of mental disorders was higher (P < 0·001) after CSF test results within the normal range (HR = 4·45; 95%CI = 4·08-4·86), whereas for neurological diseases (HR = 9·72; 95%CI = 9·19-10·29) and CNS infections (HR = 55·17; 95%CI = 47·12-64·60), the risk was highest after abnormal CSF test results (all P < 0·001). The risk of organic mental disorders tended to be highest in individuals with abnormal CSF test results (HR = 19·30; 95%CI = 13·44-27·71) even though not significantly different from the risk in the group of individuals with CSF test results in the normal range (HR = 13·55; 95%CI = 9·36-19·60) (P ≥ 0·05). Abnormal CSF test results were associated with an elevated risk of psychotropic prescriptions (HR = 3·91; 95%CI = 3·66-4·18), as were CSF test results within the normal range (HR = 4·26; 95%CI = 4·03-4·51) (P < 0·05). CONCLUSIONS Immunological CSF abnormalities are associated with an increased risk of mental disorders, neurological disease, and particularly CNS infections; however, the included CSF parameters were not specific for mental disorders and the relevant CSF biomarkers in psychiatry are yet to be discovered.
Collapse
Affiliation(s)
- Sonja Orlovska-Waast
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15 4th Floor, 2900 Hellerup, Denmark.
| | - Liselotte Vogdrup Petersen
- Centre for Integrated Register-Based Research at Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.
| | - Christiane Gasse
- Department of Depression and Anxiety and Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark.
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15 4th Floor, 2900 Hellerup, Denmark.
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark; National Centre for Register-Based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Denmark.
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Inge Lehmanns Vej 8, 2100 Copenhagen Ø, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Blegdamsvej 3B, 2200 Copenhagen N, University of Copenhagen, Denmark.
| | - Michael Eriksen Benros
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15 4th Floor, 2900 Hellerup, Denmark; National Centre for Register-Based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Denmark; Department of Immunology & Microbiology, Faculty of Health and Medical Sciences, Blegdamsvej 3B, 2200 Copenhagen N, University of Copenhagen, Denmark.
| |
Collapse
|
17
|
Madsen KB, Momen NC, Petersen LV, Plana-Ripoll O, Haarman BCM, Drexhage H, Mortensen PB, McGrath JJ, Munk-Olsen T. Bidirectional associations between treatment-resistant depression and general medical conditions. Eur Neuropsychopharmacol 2021; 51:7-19. [PMID: 34023798 DOI: 10.1016/j.euroneuro.2021.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 12/12/2022]
Abstract
Depression is associated with general medical conditions (GMCs), but it is not known if treatment-resistant depression (TRD) affects GMC risk and vice versa. We estimated bidirectional associations between TRD and GMCs (prior and subsequent). All individuals aged 18-69 years, born and living in Denmark, with a first-time prescription for an antidepressant between 2005 and 2012 were identified in the Danish Prescription Registry (N = 154,513). TRD was defined as at least two shifts in treatment regimes. For prior GMCs, we estimated odds ratios (ORs) using conditional logistic regression comparing TRD patients with matched non-TRD controls adjusted for other GMCs and number of other GMCs. For subsequent GMCs, we used Cox regression to calculate hazard ratios (HRs) in TRD vs. non-TRD patients adjusted for age at first prescription, calendar time, other GMCs and number of other GMCs. Patients with TRD had higher prevalence of prior GMCs related to the immune or neurological systems; musculoskeletal disorders (women aOR: 1.35, 95% CI: 1.26-1.46, men aOR: 1.30, 95% CI: 1.19-1.42) and migraine (women aOR: 1.22, 95% CI: 1.09-1.36, men aOR: 1.25, 95% CI: 1.00-1.56). Subsequent GMCs were related to a broader spectrum; cardiovascular (women aHR: 1.43, 95% CI: 1.32-1.54, men aHR: 1.31, 95% CI: 1.19-1.43), endocrine (women aHR: 1.52, 95% CI: 1.37-1.67, men aHR: 1.24, 95% CI: 1.07-1.44), and neurological disorders (women aHR: 1.24, 95% CI: 1.13-1.35, men aHR: 1.19, 95% CI: 1.07-1.34). Our study presents a broad overview of comorbid medical conditions in patients with TRD and further studies are needed to explore the associations in detail.
Collapse
Affiliation(s)
- Kathrine Bang Madsen
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
| | - Natalie C Momen
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Hemmo Drexhage
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - John J McGrath
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark; Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| |
Collapse
|
18
|
Larsen JT, Yilmaz Z, Vilhjálmsson BJ, Thornton LM, Benros ME, Musliner KL, Werge T, Hougaard DM, Mortensen PB, Bulik CM, Petersen LV. Anorexia nervosa and inflammatory bowel diseases—Diagnostic and genetic associations. JCPP Advances 2021. [DOI: 10.1002/jcv2.12036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Janne Tidselbak Larsen
- National Centre for Register‐based Research Aarhus BSS Aarhus University Aarhus Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Zeynep Yilmaz
- National Centre for Register‐based Research Aarhus BSS Aarhus University Aarhus Denmark
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Bjarni Jóhann Vilhjálmsson
- National Centre for Register‐based Research Aarhus BSS Aarhus University Aarhus Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
| | - Laura M. Thornton
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Michael Eriksen Benros
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
- Copenhagen Research Centre for Mental Health Mental Health Centre Copenhagen Copenhagen University Hospital Hellerup Denmark
| | - Katherine L. Musliner
- National Centre for Register‐based Research Aarhus BSS Aarhus University Aarhus Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
| | - Thomas Werge
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
- Research Institute of Biological Psychiatry Mental Health Center Sanct Hans Copenhagen University Hospital Roskilde Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - David M. Hougaard
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
- Danish Center for Neonatal Screening Department of Congenital Disorders Statens Serum Institut Copenhagen Denmark
| | - Preben Bo Mortensen
- National Centre for Register‐based Research Aarhus BSS Aarhus University Aarhus Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
| | - Cynthia M. Bulik
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Nutrition University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Liselotte Vogdrup Petersen
- National Centre for Register‐based Research Aarhus BSS Aarhus University Aarhus Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus University Aarhus Denmark
| | | |
Collapse
|
19
|
Momen NC, Plana-Ripoll O, Bulik CM, McGrath JJ, Thornton LM, Yilmaz Z, Petersen LV. Comorbidity between types of eating disorder and general medical conditions. Br J Psychiatry 2021; 220:1-8. [PMID: 35049471 PMCID: PMC10853638 DOI: 10.1192/bjp.2021.104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Comorbidity with general medical conditions is common in individuals with eating disorders. Many previous studies do not evaluate types of eating disorder. AIMS To provide relative and absolute risks of bidirectional associations between (a) anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and (b) 12 general medical conditions. METHOD We included all people born in Denmark between 1977 and 2010. We collected information on eating disorders and considered the risk of subsequent medical conditions, using Cox proportional hazards regression. Absolute risks were calculated using competing risks survival analyses. We also considered risks for prior medical conditions and subsequent eating disorders. RESULTS An increased risk was seen for almost all disorder pairs (69 of 70). Hazard ratios for those with a prior eating disorder receiving a subsequent diagnosis of a medical condition ranged from 0.94 (95% CI 0.57-1.55) to 2.05 (95% CI 1.86-2.27). For those with a prior medical condition, hazard ratios for later eating disorders ranged from 1.35 (95% CI 1.26-1.45) to 1.98 (95% CI 1.71-2.28). Absolute risks for most later disorders were increased for persons with prior disorders, compared with reference groups. CONCLUSIONS This is the largest and most detailed examination of eating disorder-medical condition comorbidity. The findings indicate that medical condition comorbidity is increased among those with eating disorders and vice versa. Although there was some variation in comorbidity observed across eating disorder types, magnitudes of relative risks did not differ greatly.
Collapse
Affiliation(s)
- Natalie C Momen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John J McGrath
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; and Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia; and Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark; and Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; and Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; and Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| |
Collapse
|
20
|
Madsen KB, Plana-Ripoll O, Musliner KL, Debost JCP, Petersen LV, Munk-Olsen T. Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study. J Affect Disord 2021; 280:250-257. [PMID: 33220561 DOI: 10.1016/j.jad.2020.11.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/14/2020] [Accepted: 11/07/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression is associated with excess mortality, but it is not known how treatment-resistance influences life expectancy. We estimated cause-specific excess mortality and Life Years Lost (LYL) in patients with treatment-resistant depression (TRD). METHODS The population included all individuals born and living in Denmark who redeemed their first prescription for an antidepressant at age 18-69 years between 2005 and 2012, identified in the Danish National Prescription Registry. TRD was defined as at least two additional and different antidepressant trials within two years. Mortality rate ratios (MRRs) were estimated with Cox regression adjusted for age at first prescription, calendar year and comorbidity. Differences in life expectancy were estimated by the Life Years Lost (LYL) method. RESULTS The cohort included 154,513 first-time pharmacologically treated patients with depression, of whom 8,294 (5.4%) were identified as having TRD. Patients were followed for 1,032,245 person-years during which 9,795 deaths occurred. Men and women with TRD had significantly higher mortality than non-TRD (aMRR: 1.34, 95% CI 1.18-1.52 and aMRR: 1.39, 95% CI 1.19-1.63, respectively). Life expectancy for men and women with TRD was 1.21 (95% CI 0.36-2.44) and 1.24 (95% CI 0.35-2.34) years shorter than in all patients with depression. Suicide accounted for the majority of excess LYL, with 1.10 (95% CI 0.46-1.61) years in men and 0.82 (95% CI 0.44-1.27) years in women with TRD. LIMITATIONS Using redeemed prescriptions to define TRD may increase the risk of misclassification. CONCLUSIONS Patients not responding adequately to several treatment trials are at increased risk for premature death, particularly suicide.
Collapse
Affiliation(s)
- Kathrine Bang Madsen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; MOODSTRATIFICATION- EU project 754740.
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark
| | - Katherine L Musliner
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Jean-Christophe Philippe Debost
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Aarhus University Hospital, Department of Neurology, Denmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; MOODSTRATIFICATION- EU project 754740
| |
Collapse
|
21
|
Bang Madsen K, Vogdrup Petersen L, Plana-Ripoll O, Musliner KL, Philippe Debost JC, Hordam Gronemann F, Mortensen PB, Munk-Olsen T. Early labor force exits in patients with treatment-resistant depression: an assessment of work years lost in a Danish nationwide register-based cohort study. Ther Adv Psychopharmacol 2020; 10:2045125320973791. [PMID: 33282176 PMCID: PMC7682207 DOI: 10.1177/2045125320973791] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/20/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Depression is one of the leading causes of premature workforce exit in many Western countries, but little is known about the extent to which treatment-resistance reduces number of work-years. We compared the risk of premature workforce exit among patients with treatment-resistant depression (TRD) relative to non-TRD patients and estimated work years lost (WYL) before scheduled retirement age. METHODS The study population, identified in the Danish National Prescription Registry, included all individuals born and living in Denmark who redeemed their first antidepressant (AD) prescription for depression at age 18-60 years between 2005 and 2012. TRD was defined as failure to respond to at least two different treatment trials. Premature workforce exit was measured using disability pension records. We used Cox regression to estimate the hazard ratio (HR) for premature workforce exit in TRD relative to non-TRD patients, adjusting for calendar year, psychiatric and somatic comorbidity, and educational level. Differences in WYL in patients with TRD and all depression patients were estimated through a competing risks model. RESULTS Out of the total sample of patients with depression (N = 129,945), 7478 (5.75%) were classified as having TRD. During follow up, 17% of patients with TRD and 8% of non-TRD patients received disability pension, resulting in a greater than three-fold larger risk of premature workforce exit [adjusted HR (aHR) 3.23 95% confidence interval (CI) 3.05-3.43]. The TRD group lost on average six work-years (95% CI 5.64-6.47) more than the total sample due to early labor force exit. The association between TRD and age at premature workforce exit was inversely U-shaped; the hazard rate of premature workforce exit for patients with TRD compared with non-TRD patients was highest in the age groups 31-35, 36-40, and 41-45 years. CONCLUSION Patients with TRD constitute a small group within depression patients, but contribute disproportionally to societal costs due to premature workforce exit at a young age.
Collapse
Affiliation(s)
- Kathrine Bang Madsen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Fuglesangs Allé 26, Building R, Aarhus V, 8210, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Katherine L. Musliner
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Jean-Christophe Philippe Debost
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Psychosis, Aarhus University Hospital Skejby, Denmark
| | | | - Preben Bo Mortensen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- CIRRAU - Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| |
Collapse
|
22
|
Plana‐Ripoll O, Musliner KL, Dalsgaard S, Momen NC, Weye N, Christensen MK, Agerbo E, Iburg KM, Laursen TM, Mortensen PB, Pedersen CB, Petersen LV, Santomauro DF, Vilhjálmsson BJ, Whiteford HA, McGrath JJ. Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study. World Psychiatry 2020; 19:339-349. [PMID: 32931098 PMCID: PMC7491620 DOI: 10.1002/wps.20802] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The nature and prevalence of combinations of mental disorders and their associations with premature mortality have never been reported in a comprehensive way. We describe the most common combinations of mental disorders and estimate excess mortality associated with these combinations. We designed a population-based cohort study including all 7,505,576 persons living in Denmark at some point between January 1, 1995 and December 31, 2016. Information on mental disorders and mortality was obtained from national registers. A total of 546,090 individuals (10.5%) living in Denmark on January 1, 1995 were diagnosed with at least one mental disorder during the 22-year follow-up period. The overall crude rate of diagnosis of mental disorders was 9.28 (95% CI: 9.26-9.30) per 1,000 person-years. The rate of diagnosis of additional mental disorders was 70.01 (95% CI: 69.80-70.26) per 1,000 person-years for individuals with one disorder already diagnosed. At the end of follow-up, two out of five individuals with mental disorders were diagnosed with two or more disorder types. The most prevalent were neurotic/stress-related/somatoform disorders (ICD-10 F40-F48) and mood disorders (ICD-10 F30-F39), which - alone or in combination with other disorders - were present in 64.8% of individuals diagnosed with any mental disorder. Mortality rates were higher for people with mental disorders compared to those without mental disorders. The highest mortality rate ratio was 5.97 (95% CI: 5.52-6.45) for the combination of schizophrenia (ICD-10 F20-F29), neurotic/stress-related/somatoform disorders and substance use disorders (ICD-10 F10-F19). Any combination of mental disorders was associated with a shorter life expectancy compared to the general Danish population, with differences in remaining life expectancy ranging from 5.06 years (95% CI: 5.01-5.11) to 17.46 years (95% CI: 16.86-18.03). The largest excess mortality was observed for combinations that included substance use disorders. This study reports novel estimates related to the "force of comorbidity" and provides new insights into the contribution of substance use disorders to premature mortality in those with comorbid mental disorders.
Collapse
Affiliation(s)
| | - Katherine L. Musliner
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark
| | - Søren Dalsgaard
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark
| | - Natalie C. Momen
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark
| | - Nanna Weye
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark
| | - Maria K. Christensen
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Department of Public HealthAarhus UniversityAarhusDenmark
| | - Esben Agerbo
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark,Centre for Integrated Register‐based Research at Aarhus UniversityAarhusDenmark
| | | | | | - Preben Bo Mortensen
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark,Centre for Integrated Register‐based Research at Aarhus UniversityAarhusDenmark
| | - Carsten Bøcker Pedersen
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark,Centre for Integrated Register‐based Research at Aarhus UniversityAarhusDenmark,Big Data Centre for Environment and HealthAarhus UniversityAarhusDenmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark
| | - Damian F. Santomauro
- Queensland Centre for Mental Health ResearchWacol, QLDAustralia,School of Public HealthUniversity of QueenslandBrisbane, QLDAustralia,Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWAUSA
| | - Bjarni J. Vilhjálmsson
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)AarhusDenmark
| | - Harvey A. Whiteford
- Queensland Centre for Mental Health ResearchWacol, QLDAustralia,School of Public HealthUniversity of QueenslandBrisbane, QLDAustralia,Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWAUSA
| | - John J. McGrath
- National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark,Queensland Centre for Mental Health ResearchWacol, QLDAustralia,Queensland Brain InstituteUniversity of QueenslandSt. Lucia, QLDAustralia
| |
Collapse
|
23
|
Rania M, Petersen LV, Benros ME, Liu Z, Diaz L, Bulik CM. Correction to: Psychiatric comorbidity in individuals with bullous pemphigoid and all bullous disorders in the Danish national registers. BMC Psychiatry 2020; 20:432. [PMID: 32887554 PMCID: PMC7650516 DOI: 10.1186/s12888-020-02842-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
Collapse
Affiliation(s)
- Marianna Rania
- grid.411489.10000 0001 2168 2547Department of Health Sciences, University Magna Graecia of Catanzar, Catanzaro, Italy ,Center for Clinical Research and Treatment of Eating Disorders, Mater Domini University Hospital, Catanzaro, Italy ,grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Liselotte Vogdrup Petersen
- grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Michael Eriksen Benros
- Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Zhi Liu
- grid.10698.360000000122483208Departments of Dermatology, Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Luis Diaz
- grid.10698.360000000122483208Departments of Dermatology, Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Cynthia M. Bulik
- grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ,grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| |
Collapse
|
24
|
Rania M, Petersen LV, Benros ME, Liu Z, Diaz L, Bulik CM. Psychiatric comorbidity in individuals with bullous pemphigoid and all bullous disorders in the Danish national registers. BMC Psychiatry 2020; 20:411. [PMID: 32819315 PMCID: PMC7439544 DOI: 10.1186/s12888-020-02810-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/05/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Bullous pemphigoid (BP) is an autoimmune blistering skin disease that takes a profound physical and mental toll on those affected. The aim of the study was to investigate the bidirectional association between BP and all bullous disorders (ABD) with a broad array of psychiatric disorders, exploring the influence of prescribed medications. METHODS This nationwide, register-based cohort study encompassed 6,470,450 individuals born in Denmark and alive from 1994 to 2016. The hazard ratios (HRs) of a subsequent psychiatric disorder in patients with BP/ABD and the reverse exposure and outcome were evaluated. RESULTS Several psychiatric disorders were associated with increased risk of subsequent BP (4.18-fold for intellectual disorders, 2.32-fold for substance use disorders, 2.01-fold for schizophrenia and personality disorders, 1.92-1.85-1.49-fold increased risk for organic disorders, neurotic and mood disorders), independent of psychiatric medications. The association between BP and subsequent psychiatric disorders was not significant after adjusting for BP medications, except for organic disorders (HR 1.27, CI 1.04-1.54). Similar results emerged with ABD. CONCLUSION Psychiatric disorders increase the risk of a subsequent diagnosis of BP/ABD independent of medications, whereas medications used for the treatment of BP/ABD appear to account for the subsequent onset of psychiatric disorders. Clinically, an integrated approach attending to both dermatological and psychiatric symptoms is recommended, and dermatologists should remain vigilant for early symptoms of psychiatric disorders to decrease mental health comorbidity.
Collapse
Affiliation(s)
- Marianna Rania
- grid.411489.10000 0001 2168 2547Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy ,Center for Clinical Research and Treatment of Eating Disorders, Mater Domini University Hospital, Catanzaro, Italy ,grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Liselotte Vogdrup Petersen
- grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Michael Erikson Benros
- grid.4973.90000 0004 0646 7373Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Zhi Liu
- grid.10698.360000000122483208Departments of Dermatology, Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Luis Diaz
- grid.10698.360000000122483208Departments of Dermatology, Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Cynthia M. Bulik
- grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ,grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| |
Collapse
|
25
|
Jefsen OH, Petersen LV, Bek T, Østergaard SD. Is Early Blindness Protective of Psychosis or Are We Turning a Blind Eye to the Lack of Statistical Power? Schizophr Bull 2020; 46:1335-1336. [PMID: 32232391 PMCID: PMC7707070 DOI: 10.1093/schbul/sbaa048] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Oskar Hougaard Jefsen
- Psychiatric Research Academy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,To whom correspondence should be addressed; tel: +45 30112066, e-mail:
| | - Liselotte Vogdrup Petersen
- The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Aarhus, Denmark,Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Toke Bek
- Department of Ophthalmology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Dinesen Østergaard
- Department of Affective Disorders, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
26
|
Poulsen PH, Biering K, Winding TN, Nohr EA, Petersen LV, Ulijaszek SJ, Andersen JH. How does psychosocial stress affect the relationship between socioeconomic disadvantage and overweight and obesity? Examining Hemmingsson's model with data from a Danish longitudinal study. BMC Public Health 2019; 19:1475. [PMID: 31699059 PMCID: PMC6839153 DOI: 10.1186/s12889-019-7699-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/26/2019] [Indexed: 11/23/2022] Open
Abstract
Background Chronic stress in childhood may increase the risk of overweight and obesity in young people. Erik Hemmingsson has suggested a new obesity causation model which focuses on psychosocial stress. The aim was to examine the associations between socioeconomic disadvantage and overweight and obesity and examine if these associations attenuate, when the effect of the different domains from Eric Hemmingsson’s obesity causation model were taken into account. Methods A longitudinal study using data from The West Jutland Cohort Study (N = 2879). Outcome was overweight and obesity combined derived from self-reported weight and height at age 15, 18, 21 and 28 years. Exposure variables were equivalised household income, educational level and labour market participation of the mother derived from registers and psychosocial variables derived from questionnaires. A three-step adjustment model using logistic regression and stratified by gender was applied. Results Mother’s low educational level was associated with a 3-fold increased odds of obesity in 18 year-old-girls, which attenuated when adjusting for the domains adult distress, disharmonious family environment and offspring distress. In 28 year-old girls, a 2.5-fold increased odds of obesity was observed, which attenuated when mutual adjusted for other socioeconomic variables and attenuated even further when adjusting for all the domains. In 18-year-old boys, a 3-fold increased odds of obesity was observed which attenuated after adjustments for adult distress, disharmonious family environment and offspring distress. In 21-year old boys, a four-fold increased odds of obesity was observed that attenuated after adjustments. At age 28 years, a three-fold increased odds of obesity was observed, which vanished in the fully adjusted model. Conclusions Our study confirms to some extent that the associations between socioeconomic disadvantage and overweight and obesity can be explained by the domains included in Erik Hemmingsson’s model, although our results should be interpreted with caution. Adult distress, disharmonious family environment and offspring distress accounted for some of the association in girls, whereas in boys it was primarily offspring distress, which had the greatest impact. Young people’s educational attainment can act as a buffer in the relationship between mother’s lower educational level and obesity at age 28 years.
Collapse
Affiliation(s)
- Per Hoegh Poulsen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Trine Nøhr Winding
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Ellen Aagaard Nohr
- Institute of Clinical Research, Department of Obstetrics & Gynecology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Liselotte Vogdrup Petersen
- National Center for Register-Based Research, Aarhus University, Fuglesangs Allé 26, 8210, Aarhus V, Denmark
| | - Stanley J Ulijaszek
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| |
Collapse
|
27
|
Debost JC, Larsen JT, Munk-Olsen T, Mortensen PB, Agerbo E, Petersen LV. Childhood infections and schizophrenia: The impact of parental SES and mental illness, and childhood adversities. Brain Behav Immun 2019; 81:341-347. [PMID: 31247291 DOI: 10.1016/j.bbi.2019.06.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/14/2019] [Accepted: 06/22/2019] [Indexed: 01/19/2023] Open
Abstract
Childhood infection has been proposed as an important etiologic factor for schizophrenia. However, it is unclear to what extent the association between childhood infection and schizophrenia is confounded by parental socioeconomic status and mental illness, and childhood adversity, and whether the association is explained by familial liability for infections. We used a historical, population-based cohort design, selecting all singletons born in Denmark between 1981 and 1998 (n = 882,813). We identified exposure to infection as having been hospitalized with an infection in the Danish national registers. Data from a range of population-based registers were used to construct a childhood adversity index. The index included the following adversities: family disruption, parental incarceration, parental chronic somatic disease, death of a parent, parent permanently outside of workforce, childhood abuse and placement in out-of-home care. We also assessed parental socioeconomic status and mental illness. Multiple admissions with infections during childhood increased the risk of schizophrenia with an Incidence Rate Ratio (IRR) of 1.28 (95% CI: 1.19-1.38) for 1 infection to an IRR of 1.43 (95% CI: 1.30-1.58) for 2-3 infections and an IRR of 1.95 (95% CI: 1.66-2.29) for ≥4 infections. Parental socioeconomic status and mental illness, and childhood adversities increased the odds of acquiring childhood infections and was associated with schizophrenia, but did not explain the results. Similarly did familial liability for infection increase the risk of schizophrenia, but did not explain the association between infection and schizophrenia. Parental mental health modified the association between childhood infection and schizophrenia (p-value 0.02), and we found no significant effect of childhood infection in those with propensity for psychotic disorders.
Collapse
Affiliation(s)
- Jean-Christophe Debost
- Aarhus University Hospital, Skejby, Department of Psychosis, Denmark; The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
| | - Janne Tidselbak Larsen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Trine Munk-Olsen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Preben Bo Mortensen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| |
Collapse
|