Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study

BackgroundPeople with physical illness often have psychiatric disorder and this comorbidity may have a specific influence on their risk of suicide.AimsTo examine how physical illness and psychiatric comorbidity interact to influence risk of suicide, with particular focus on relative timing of onset of the two types of illness.MethodBased on the national population of Denmark, individual-level data were retrieved from five national registers on 27 262 suicide cases and 468 007 gender- and birth-date matched living controls. Data were analysed using conditional logistic regression.ResultsBoth suicides and controls with physical illness more often had comorbid psychiatric disorder than their physically healthy counterparts. Although both physical and psychiatric illnesses constituted significant risk factors for suicide, their relative timing of onset in individuals with comorbidity significantly differentiated the associated risk of suicide. While suicide risk was highly elevated when onsets of both physical and psychiatric illness occurred close in time to each other, regardless which came first, psychiatric comorbidity developed some time after onset of physical illness exacerbated the risk of suicide substantially.ConclusionsSuicide risk in physically ill people varies substantially by presence of psychiatric comorbidity, particularly the relative timing of onset of the two types of illness. Closer collaboration between general and mental health services should be an essential component of suicide prevention strategies.

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Physical illness leading to absence from work and the risk of subsequent suicide: a national register-based study

European Journal of Public Health ◽

10.1093/eurpub/ckz101 ◽

2019 ◽

Vol 29 (6) ◽

pp. 1073-1078 ◽

Cited By ~ 3

Author(s):

Fang Tang ◽

Lars Mehlum ◽

Ingrid S Mehlum ◽

Ping Qin

Keyword(s):

Mental Illness ◽

Suicide Risk ◽

Conditional Logistic Regression ◽

Physical Illness ◽

Income Status ◽

Increased Risk ◽

Physical Health Problems ◽

History Of ◽

Absence From Work ◽

Nested Case Control

Abstract Background Studies have shown that people with physical illness are at increased risk of suicide, but knowledge on the association between absence from work due to specific physical health problems and suicide risk is limited. This study aimed to examine the relationship between suicide risk and physical illness requiring leave from work across a range of specific physical diagnoses, and to study the interactions of mental illness and socioeconomic factors on this relationship. Methods Using a nested case-control design, 9313 suicide cases and 169 235 matched controls were retrieved and interlinked from Norwegian national registries. Data on sick leave and related physical illness were derived from claims for sickness benefit and analyzed using conditional logistic regression. Results For males, the risk of suicide increased progressively with the number of previous physical illness-related absences and the duration of recent physical illness-related absences. Absences related to digestive, musculoskeletal and neurological disorders as well as cancer and accidents/injuries were associated with a significantly increased risk of suicide. In contrast, females with a history of physical illness-related absence and a diagnosis of most organ or system specific illnesses were at a relatively reduced risk of suicide. In both genders, the suicide risk associated with physical illness resulting in absence from work differentiated significantly by history of sickness absence due to mental illness, and by education and income levels. Conclusions The risk of suicide associated with physical illness requiring leave from work varied significantly by gender and by education and income status.

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A Metabolomics Analysis of Postmenopausal Breast Cancer Risk in the Cancer Prevention Study II

Metabolites ◽

10.3390/metabo11020095 ◽

2021 ◽

Vol 11 (2) ◽

pp. 95

Author(s):

Steven C. Moore ◽

Kaitlyn M. Mazzilli ◽

Joshua N. Sampson ◽

Charles E. Matthews ◽

Brian D. Carter ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Conditional Logistic Regression ◽

Postmenopausal Breast Cancer ◽

Sex Steroid ◽

Birth Date ◽

Blood Draw ◽

Metabolomics Analysis

Breast cancer is the most common cancer in women, but its incidence can only be partially explained through established risk factors. Our aim was to use metabolomics to identify novel risk factors for breast cancer and to validate recently reported metabolite-breast cancer findings. We measured levels of 1275 metabolites in prediagnostic serum in a nested case-control study of 782 postmenopausal breast cancer cases and 782 matched controls. Metabolomics analysis was performed by Metabolon Inc using ultra-performance liquid chromatography and a Q-Exactive high resolution/accurate mass spectrometer. Controls were matched by birth date, date of blood draw, and race/ethnicity. Odds ratios (ORs) and 95% confidence intervals (CIs) of breast cancer at the 90th versus 10th percentile (modeled on a continuous basis) of metabolite levels were estimated using conditional logistic regression, with adjustment for age. Twenty-four metabolites were significantly associated with breast cancer risk at a false discovery rate <0.20. For the nine metabolites positively associated with risk, the ORs ranged from 1.75 (95% CI: 1.29–2.36) to 1.45 (95% CI: 1.13–1.85), and for the 15 metabolites inversely associated with risk, ORs ranged from 0.59 (95% CI: 0.43–0.79) to 0.69 (95% CI: 0.55–0.87). These metabolites largely comprised carnitines, glycerolipids, and sex steroid metabolites. Associations for three sex steroid metabolites validated findings from recent studies and the remainder were novel. These findings contribute to growing data on metabolite-breast cancer associations by confirming prior findings and identifying novel leads for future validation efforts.

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A measure of the ‘sick’ label in psychiatric disorder and physical illness

Social Science & Medicine ◽

10.1016/0277-9536(87)90228-0 ◽

1987 ◽

Vol 25 (3) ◽

pp. 251-261 ◽

Cited By ~ 14

Author(s):

Morton Beiser ◽

Nancy Waxler-Morrison ◽

William G. Iacono ◽

Tsung-Yi Lin ◽

Jonathan A.E. Fleming ◽

...

Keyword(s):

Psychiatric Disorder ◽

Physical Illness

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Adults with intellectual disabilities in China: comorbid psychiatric disorder and its association with health service utilisation

Journal of Intellectual Disability Research ◽

10.1111/jir.12451 ◽

2017 ◽

Vol 62 (2) ◽

pp. 106-114 ◽

Cited By ~ 2

Author(s):

P. He ◽

G. Chen ◽

Z. Wang ◽

C. Guo ◽

N. Li ◽

...

Keyword(s):

Health Service ◽

Psychiatric Disorder ◽

Intellectual Disabilities ◽

Health Service Utilisation ◽

Service Utilisation ◽

Comorbid Psychiatric Disorder ◽

Adults With Intellectual Disabilities

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Psychiatric comorbidity and suicide risk in patients with psoriasis

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1421 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S395-S396 ◽

Cited By ~ 1

Author(s):

M. Pompili ◽

M. Innamorati ◽

D. Erbuto ◽

A. Costanzo

Keyword(s):

Suicidal Ideation ◽

Suicide Risk ◽

Psychiatric Comorbidity ◽

Rating Scale ◽

Suicide Attempts ◽

The Other ◽

Depression And Anxiety ◽

Melanoma Patients ◽

Competing Interest ◽

Hamilton Rating Scale

IntroductionPsoriasis has a significant impact on the mental and emotional functioning.ObjectiveIt has been reported that the risk of psychiatric comorbidity increases with the severity of the disorder, and the most frequent associations appear to be those with depression and anxiety.AimsTo analyze the association between psoriasis, mental disorders and suicidal ideation in a sample of patients affected by psoriasis. To investigate the differences between psoriasis patients and patients with other dermatologic diseases.MethodsParticipants were 242 consecutive patients (142 women and 100 men), 112 patients with psoriasis (46.3%), 77 with melanoma (31.8%) and 53 with allergy (21.0%). All patients were administered a structured sociodemographic interview and the following measures: the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). We also assessed current and previous suicidal ideation and previous suicide attempts.ResultsPatients with psoriasis (compared to other groups of patients) more frequently had a comorbid mood disorder (16.1% vs 3.9% and 0.0%, respectively for patients with melanoma and patients with allergy; χ22 = 14.98; P < 0.001), past suicidal ideation (33.9% vs 15.6% and 18.9%, respectively for patients with melanoma and patients with allergy; χ22 = 2.05; P < 0.01) and attempts (6.3% vs 0.0% and 0.0%, for the other groups of patients; χ22 = 8.37; P < 0.05). Patients with psoriasis reported higher HAM-D scores than melanoma patients.ConclusionsThe clinical evaluation of patients with psoriasis should include the assessment of psychiatric comorbidities and the routinely assessment of suicide risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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What Are the Psychosocial Factors Associated With Migraine in the Child? Comorbid Psychiatric Disorders, Family Functioning, Parenting Style, or Mom’s Psychiatric Symptoms?

Journal of Child Neurology ◽

10.1177/0883073817749377 ◽

2018 ◽

Vol 33 (2) ◽

pp. 174-181 ◽

Cited By ~ 5

Author(s):

Gozde Kandemir ◽

Selma Tural Hesapcioglu ◽

Aysegül N. Citak Kurt

Keyword(s):

Psychiatric Disorder ◽

Family Functioning ◽

Psychiatric Disorders ◽

Parenting Style ◽

Psychiatric Comorbidity ◽

Psychiatric Symptoms ◽

Treatment Plan ◽

Depression And Anxiety ◽

Factors Associated ◽

Migraine Group

Objective: Psychiatric diagnoses, parenting style, family functioning among children and adolescents with migraine, and psychiatric symptoms of their mothers were examined. Methods: The K-SADS and other measurements were used to assess psychiatric disorders in 50 children with migraine (aged 8-18) and matched 50 controls. Results: At least one psychiatric disorder was diagnosed in 56% of the migraine group. The presence of any psychiatric disorder in children (odds ratio [OR] = 2.765, P = .027) and somatization symptoms in their mothers (OR = 2.061, P = .025) were increasing the risk of migraine diagnosis. The parenting style scale assessments revealed that parents in the migraine group grant their children less autonomy. Conclusion: Psychiatric comorbidity, especially depression and anxiety disorders, is more common in children with migraine. The frequency of eating disorder is also higher. Evaluating comorbidity, family functioning, and particularly affective responsiveness in migraine families may guide the clinician to a targeted treatment plan.

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Vitamin Deficiency and Mental Symptoms

The British Journal of Psychiatry ◽

10.1192/bjp.156.6.878 ◽

1990 ◽

Vol 156 (6) ◽

pp. 878-882 ◽

Cited By ~ 9

Author(s):

M. W. P. Carney

Keyword(s):

Mental Illness ◽

Ascorbic Acid ◽

Folic Acid ◽

Psychiatric Disorder ◽

Physical Illness ◽

False Positives ◽

Vitamin Deficiency ◽

The Other ◽

Present Evidence ◽

Mental Symptoms

Recently, research into the connection between vitamins and psychiatric disorder, particularly affective changes, has been in the doldrums, with the exceptions perhaps of studies of folic acid and pyridoxine. The best way for research to proceed is first to establish that the association of a vitamin deficiency with a psychiatric disorder is beyond a chance finding. Then, questions should be asked about what mental symptoms it is linked with, and what the other associations (malnutrition, drugs, physical illness, etc) are. Lastly, queries should be raised about whether the association is causal or if the mental symptoms are merely secondary to the anorexia and poor diet so common in mental illness (or whether they are linked in a vicious circle as suggested by Reynoldset al(1971)). These questions became pertinent in the mid-1960s when reliable ways of assaying B vitamins such as folic acid became more generally available. In this review, I present evidence that deficiencies of folic acid, B12, thiamine, riboflavin, pyridoxine and ascorbic acid are not infrequently found in psychiatric practice. It should be remembered, however, that some ways of assaying vitamins are liable to give a larger proportion of spurious low results than other methods (false positives), although the adoption of more reliable ways of assaying vitamins should reduce this.

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