Alcohol use disorders increase the risk of completed suicide — Irrespective of other psychiatric disorders. A longitudinal cohort study

ObjectivesStudies have found a ‘healthy-migrant effect’ (HME) among arriving migrants, that is, a better health status compared with others in the home country, but also in comparison with the population in the host country. The aims were to investigate whether the HME hypothesis is applicable to the Swedish context, that is, if health outcomes differed between a group of mainly labour migrants (Western migrants) and a group of mainly refugee/family reunion migrants (non-Western migrants) compared with the native Swedish population, and if there were any correlations between labour market attachment (LMA) and these health outcomes.DesignRegister-based, longitudinal cohort study.ParticipantsThe cohort was defined on 31 December 1990 and consisted of all migrants aged 18–47 years who arrived in Sweden in 1985–1990 (n=74 954) and a reference population of native Swedes (n=1 405 047) in the same age span. They were followed for three consecutive 6-year periods (1991–1996, 1997–2002 and 2003–2008) and were assessed for five measures of health: hospitalisation for cardiovascular and psychiatric disorders, mortality, disability pension, and sick leave.ResultsWestern migrants had, compared with native Swedes, lower or equal HRs for all health measures during all time periods, while non-Western migrants displayed higher or equal HRs for all health measures, except for mortality, during all time periods. Age, educational level, occupation and LMA explained part of the difference between migrants and native Swedes. High LMA was associated with higher HRs for cardiovascular disorders among Western migrants, higher HRs of psychiatric disorders among non-Western migrants and higher HRs of mortality among both migrant groups compared with native Swedes.ConclusionsThere were indications of a HME among Western migrants, while less proof of a HME among non-Western migrants. Stratification for LMA and different migrant categories showed some interesting differences, and measurements of the HME may be inconclusive if not stratified by migrant category or other relevant variables.

Download Full-text

Prolonged periods of waiting for an asylum decision and the risk of psychiatric diagnoses: a 22-year longitudinal cohort study from Denmark

International Journal of Epidemiology ◽

10.1093/ije/dyz091 ◽

2019 ◽

Vol 49 (2) ◽

pp. 400-409 ◽

Cited By ~ 1

Author(s):

Camilla Hvidtfeldt ◽

Jørgen Holm Petersen ◽

Marie Norredam

Keyword(s):

Mental Illness ◽

Cohort Study ◽

Psychiatric Disorders ◽

Psychotic Disorders ◽

Longitudinal Cohort Study ◽

Registration System ◽

Longitudinal Cohort ◽

Increased Risk ◽

Waiting Periods

Abstract Background The high prevalence of psychiatric disorders among resettled refugees necessitates identification of factors that reduce the risk of mental illness. In this 22-year longitudinal cohort study, we assessed whether the length of asylum-decision waiting periods is associated with resettled refugees’ risk of being diagnosed with a psychiatric disorder. Methods We used full-population data from the Danish Civil Registration System to establish a cohort of 46 104 refugees resettled in Denmark during 1995–2016. Hazard ratios (HRs) for first-time psychiatric hospital contact (ICD-10) after residence permit issuance across varying lengths of asylum-decision waiting periods were estimated by cross-linkage with the Danish National Patient Register. Results Long asylum-decision waiting periods were associated with an increased risk of psychiatric disorders. Compared with refugees who waited 0–6 months for their asylum decision, the HRs of any psychiatric diagnosis were 1.22 [95% confidence interval (CI): 1.12–1.33] for those who waited 13–24 months and 1.46 (95% CI: 1.27–1.69) for those who waited 25–71 months. Associations varied across diagnoses and length of follow-up: whereas the risk of nervous disorders increased with longer asylum-decision waiting periods in the follow-ups of 0–2.9, 3–5.9 and 6–11.9 years, the risk of psychotic disorders was associated with longer asylum-decision procedures only in the 0–2.9-year follow-up. Conclusion Resettled refugees who waited longer than 1 year for an asylum decision face an increased risk of psychiatric disorders. Host countries should consider that long asylum-decision waiting periods could lead to mental illness among refugees.

Download Full-text

Substance use disorders, psychiatric disorders, and mortality after release from prison: a nationwide longitudinal cohort study

The Lancet Psychiatry ◽

10.1016/s2215-0366(15)00088-7 ◽

2015 ◽

Vol 2 (5) ◽

pp. 422-430 ◽

Cited By ~ 48

Author(s):

Zheng Chang ◽

Paul Lichtenstein ◽

Henrik Larsson ◽

Seena Fazel

Keyword(s):

Substance Use ◽

Cohort Study ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort ◽

Release From Prison

Download Full-text

Intelligence in young adulthood and alcohol use disorders in a prospective cohort study of Danish men: the role of psychiatric disorders and parental psychiatric history

BMJ Open ◽

10.1136/bmjopen-2019-028997 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028997

Author(s):

Emilie Just-Østergaard ◽

Trine Flensborg-Madsen ◽

Joachim Knop ◽

Holger Jelling Sørensen ◽

Ulrik Becker ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Use ◽

Psychiatric Disorders ◽

Young Adulthood ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Primary Outcome ◽

Alcohol Use Disorders ◽

Parental Psychiatric Disorders

ObjectivesThe aims were to estimate the association between intelligence measured in young adulthood and risk of alcohol use disorders (AUD) in men and to investigate the potential modification of this association by psychiatric disorders, parental AUD and parental psychiatric disorders.DesignProspective cohort study based on a linkage of intelligence test scores from draft board examinations and register data on AUD diagnoses during 36 years of follow-up.SettingDenmark.Participants3287 Danish men from the Copenhagen Perinatal Cohort (born 1959–1961) who appeared before the draft board at a mean age of 18.7 years.Primary outcome measureFirst registration with AUD during follow-up was the primary outcome. Information on AUD was based on diagnoses retrieved from national hospital and outpatient treatment registers, defined according to the International Classification of Diseases.Results361 (11.0%) men were registered with AUD during follow-up. Low intelligence scores were associated with increased odds of AUD adjusting for parental AUD, parental psychiatric disorders, maternal smoking during pregnancy, birth weight, maternal age at birth, parity and childhood socioeconomic position (OR per SD decrease in intelligence=1.69, 95% CI 1.49 to 1.92). Separate analyses indicated significant interaction (p<0.001) between intelligence and psychiatric disorders. The adjusted OR per SD decrease in intelligence score was 2.04 (95% CI 1.67 to 2.49) in men without other psychiatric disorders whereas the OR was 1.21 (95% CI 1.01 to 1.46) in men with other psychiatric disorders. No interaction was found between intelligence and parental AUD or between intelligence and parental psychiatric disorders.ConclusionsThe association between intelligence in young adulthood and AUD is modified by other psychiatric disorders as low intelligence is primarily a risk factor for men without other psychiatric disorders. Future studies should take other psychiatric disorders into account when investigating associations between intelligence and AUD.

Download Full-text