Risk Factors for Suicide After Bariatric Surgery in a Population-based Nationwide Study in Five Nordic Countries

Abstract Much of our knowledge about the risk factors for suicide comes from case–control studies that either use a psychological autopsy approach or are nested within large register-based cohort studies. We would argue that case–control studies are appropriate in the context of a rare outcome like suicide, but there are issues with using this design. Some of these issues are common in psychological autopsy studies and relate to the selection of controls (e.g. selection bias caused by the use of controls who have died by other causes, rather than live controls) and the reliance on interviewing informants (e.g. recall bias caused by the loved ones of cases having thought about the events leading up to the suicide in considerable detail). Register-based studies can overcome some of these problems because they draw upon contain information that is routinely collected for administrative purposes and gathered in the same way for cases and controls. However, they face issues that mean that psychological autopsy studies will still sometimes be the study design of choice for investigating risk factors for suicide. Some countries, particularly low and middle income countries, don't have sophisticated population-based registers. Even where they do exist, there will be variable of interest that are not captured by them (e.g. acute stressful life events that may immediately precede a suicide death), or not captured in a comprehensive way (e.g. suicide attempts and mental illness that do not result in hospital admissions). Future studies of risk factors should be designed to progress knowledge in the field and overcome the problems with the existing studies, particularly those using a case–control design. The priority should be pinning down the risk factors that are amenable to modification or mitigation through interventions that can successfully be rolled out at scale.

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Re: Abnormally invasive placenta-Prevalence, risk factors and antenatal suspicion: results from a large population-based pregnancy cohort study in the Nordic countries

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.14284 ◽

2016 ◽

Vol 124 (1) ◽

pp. 164-165 ◽

Cited By ~ 1

Author(s):

Eric Jauniaux ◽

Sally L Collins

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Large Population ◽

Population Based ◽

Nordic Countries ◽

Pregnancy Cohort ◽

Invasive Placenta ◽

Abnormally Invasive Placenta

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Authors' reply re: Abnormally invasive placenta-Prevalence, risk factors and antenatal suspicion: results from a large population-based pregnancy cohort study in the Nordic countries

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.14287 ◽

2016 ◽

Vol 124 (1) ◽

pp. 165-166

Author(s):

Pelle G Lindqvist ◽

Lars Thurn

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Large Population ◽

Population Based ◽

Nordic Countries ◽

Pregnancy Cohort ◽

Invasive Placenta ◽

Abnormally Invasive Placenta

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Communication and Trust in the Care Provided to a Dying Parent: A Nationwide Study of Cancer-Bereaved Youths

Journal of Clinical Oncology ◽

10.1200/jco.2012.46.6102 ◽

2013 ◽

Vol 31 (23) ◽

pp. 2886-2894 ◽

Cited By ~ 29

Author(s):

Tove Bylund Grenklo ◽

Ulrika C. Kreicbergs ◽

Unnur A. Valdimarsdóttir ◽

Tommy Nyberg ◽

Gunnar Steineck ◽

...

Keyword(s):

Risk Factors ◽

End Of Life ◽

Medical Information ◽

Population Based ◽

Disease Treatment ◽

Nationwide Study ◽

Potential Risk Factors ◽

Professional Information ◽

Poor Relationship ◽

Population Based Survey

Purpose To assess children's trust in the care provided to a dying parent during the final week of life in relation to end-of-life medical information about disease, treatment, and death. Methods This nationwide population-based survey included 622 (73%) of 851 youths who, 6 to 9 years earlier, at age 13 to 16 years, lost a parent to cancer. We asked about the children's reception of end-of-life professional information and trust in the care provided. We also asked about depression and several potential risk factors of distrust in the care provided. Results A majority (82%) reported moderate/very much trust in the care provided. Compared with children who received end-of-life medical information before their loss, the risk of distrust in the care provided was higher in those who received no information (risk ratio [RR], 2.5; 95% CI, 1.5 to 4.1), in those who only received information afterward (RR, 3.2; 95% CI, 1.7 to 5.9), and in those who did not know or remember if end-of-life medical information was provided (RR, 1.7; 95% CI, 1.1 to 2.5). Those reporting distrust in the care provided had an RR of 2.3 (95% CI, 1.5 to 3.5) for depression. Furthermore, the risk of distrust in the care provided was higher among children reporting poor efforts to cure (RR, 5.1; 95% CI, 3.6 to 7.3), and/or a poor relationship with the surviving parent (RR, 2.9; 95% CI, 2.0 to 4.1). Conclusion Our study suggests that children's trust in the care provided to a dying parent was highest when they received end-of-life medical information before their loss.

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