scholarly journals Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study

2014 ◽  
Vol 170 (2) ◽  
pp. 341-348 ◽  
Author(s):  
Frans Brandt ◽  
Marianne Thvilum ◽  
Dorthe Almind ◽  
Kaare Christensen ◽  
Anders Green ◽  
...  
Keyword(s):  
Cox Regression ◽  
Psychiatric Morbidity ◽  
Fetal Brain ◽  
Psychiatric Diagnoses ◽  
National Patient Registry ◽  
Increased Risk ◽  
Before And After ◽  
National Patient ◽  
Nationwide Register Study

ObjectiveThyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. In this study, we aimed to investigate the association and temporal relationship between hyperthyroidism and psychiatric morbidity.DesignRegister-based nationwide cohort study.MethodData on hyperthyroidism and psychiatric morbidity were obtained by record linkage of the Danish National Patient Registry and the Danish National Prescription Registry. A total of 2631 hyperthyroid individuals were identified and matched 1:4 with non-hyperthyroid controls and followed for a mean duration of 6 years (range 0–13). Logistic and Cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hyperthyroidism respectively.ResultsBefore the diagnosis of hyperthyroidism, such individuals had an increased risk of being hospitalized with psychiatric diagnoses (odds ratio (OR): 1.33; 95% CI: 0.98–1.80) and an increased risk of being treated with antipsychotics (OR: 1.17; 95% CI: 1.00–1.38), antidepressants (OR: 1.13; 95% CI: 1.01–1.27), or anxiolytics (OR: 1.28; 95% CI: 1.16–1.42). After the diagnosis of hyperthyroidism, there was a higher risk of being hospitalized with psychiatric diagnoses (hazard ratio (HR): 1.51; 95% CI: 1.11–2.05) and an increased risk of being treated with antipsychotics (HR: 1.46; 95% CI: 1.20–1.79), antidepressants (HR: 1.54; 95% CI: 1.36–1.74), or anxiolytics (HR: 1.47; 95% CI: 1.27–1.69).ConclusionsHyperthyroid individuals have an increased risk of being hospitalized with psychiatric diagnoses and being treated with antipsychotics, antidepressants, and anxiolytics, both before and after the diagnosis of hyperthyroidism.

scholarly journals Risk of hypersensitivity pneumonitis and interstitial lung diseases among pigeon breeders

2016 ◽  
Vol 48 (3) ◽  
pp. 818-825 ◽  
Author(s):  
Christine Cramer ◽  
Vivi Schlünssen ◽  
Elisabeth Bendstrup ◽  
Zara Ann Stokholm ◽  
Jesper Medom Vestergaard ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Cox Regression ◽  
Interstitial Lung Diseases ◽  
Protective Measures ◽  
National Patient Registry ◽  
Hazard Ratios ◽  
Increased Risk ◽  
National Patient

We studied the risk of hypersensitivity pneumonitis and other interstitial lung diseases (ILDs) among pigeon breeders.This is a retrospective follow-up study from 1980 to 2013 of 6920 pigeon breeders identified in the records of the Danish Racing Pigeon Association. They were compared with 276 800 individually matched referents randomly drawn from the Danish population. Hospital based diagnoses of hypersensitivity pneumonitis and other ILDs were identified in the National Patient Registry 1977–2013. Stratified Cox regression analyses estimated the hazard ratios (HR) of hypersensitivity pneumonitis and other ILDs adjusted for occupation, residence and redeemed prescription of medication with ILDs as a possible side-effect. Subjects were censored at death, emigration or a diagnosis of connective tissue disease.The overall incidence rate of ILD was 77.4 per 100 000 person-years among the pigeon breeders and 50.0 among the referents. This difference corresponded to an adjusted HR of 1.56 (95% CI 1.26–1.94). The adjusted HRs of hypersensitivity pneumonitis and other ILDs for pigeon breeders were 14.36 (95% CI 8.10–25.44) and 1.33 (95% CI 1.05–1.69), respectively.This study shows an increased risk of ILD among pigeon breeders compared with the referent population. Protective measures are recommended even though ILD leading to hospital contact remains rare among pigeon breeders.

Perceived quality of life before and after implantation of an internal cardioverter defibrillator

1995 ◽  
Vol 4 (1) ◽  
pp. 36-43 ◽  
Author(s):  
EM Bainger ◽  
JI Fernsler
Keyword(s):  
Quality Of Life ◽  
Perceived Quality ◽  
Convenience Sample ◽  
Cardioverter Defibrillator ◽  
Perceived Quality Of Life ◽  
Increased Risk ◽  
Significant Difference ◽  
Before And After ◽  
Internal Cardioverter Defibrillator

BACKGROUND: Although use of the internal cardioverter defibrillator in selected high-risk patient groups has significantly improved survival, questions have arisen regarding its impact on psychological adjustment and quality of life. OBJECTIVES: To determine whether there was a difference in perceived quality of life of internal cardioverter defibrillator recipients before implantation, reported retrospectively, and after implantation. METHODS: Survey packets containing a demographic data form, a modified version of the Ferrans and Powers Quality of Life Index: Cardiac Version, and a consent form were mailed to internal cardioverter defibrillator recipients accrued from two hospitals; 70 patients comprised the convenience sample. RESULTS: No significant difference in perceived overall quality of life was revealed by before and after implantation scores of t tests or analyses of variance. Young, unemployed patients with multiple health problems were most at risk for quality of life deficits. Overall, recipients in this study appeared to adapt effectively to the stresses associated with the device. CONCLUSIONS: Our results suggest that the internal cardioverter defibrillator did not prolong life at a sacrifice to quality of life. These findings can help identify patients at increased risk for quality of life deficits.

Electroconvulsive therapy, depression severity and mortality: Data from the Danish National Patient Registry

2020 ◽  
Vol 34 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Martin Balslev Jørgensen ◽  
Maarten Pieter Rozing ◽  
Charles H Kellner ◽  
Merete Osler
Keyword(s):  
Electroconvulsive Therapy ◽  
Cox Regression ◽  
Severe Depression ◽  
Patient Registry ◽  
Psychotic Symptoms ◽  
Mortality Data ◽  
Depression Severity ◽  
National Patient Registry ◽  
Danish National Patient Registry ◽  
National Patient

Background: The effects of electroconvulsive therapy are usually estimated from changes in depression scales from studies with relatively small patient samples. Larger patient samples can be achieved from epidemiological registers, which provide information on other social and clinical predictors, results and risks. Aims: To examine whether depression severity predicts the use of electroconvulsive therapy, risk of re-hospitalization, suicidal behaviour and mortality following electroconvulsive therapy in patients with major depression. Methods: A cohort of 92,895 patients diagnosed with single or recurrent depression between 2005 and 2016 in the Danish National Patient Registry was followed for electroconvulsive therapy and adverse outcomes. Associations between electroconvulsive therapy and outcomes were analysed using Cox regression. Results: A total of 5004 (5.4%) patients were treated with electroconvulsive therapy. Depression severity was the strongest predictor of electroconvulsive therapy. Electroconvulsive therapy was used more frequently above age 70, in those better educated or married, whereas comorbid alcohol abuse or history of prior stroke at study entry were associated with lower rates. Electroconvulsive therapy was associated with lower mortality. The adjusted hazard ratio for the association between electroconvulsive therapy and suicide in patients with mild depression was 6.99 (3.30–14.43), whereas it was 1.10 (0.55–2.20) in those with severe depression and psychotic symptoms. A similar pattern was seen for emergency contacts and attempted suicide. Conclusions: Electroconvulsive therapy was associated with lower all-cause mortality and the relative risk for re-hospitalization and attempted and committed suicide was lowest in patients with the most severe depression. Electroconvulsive therapy is an important treatment, with significant public health benefits, for patients with severe depression.

scholarly journals Population-based study of amyotrophic lateral sclerosis and occupational lead exposure in Denmark

2019 ◽  
pp. oemed-2018-105469 ◽  
Author(s):  
Aisha S Dickerson ◽  
Johnni Hansen ◽  
Aaron J Specht ◽  
Ole Gredal ◽  
Marc G Weisskopf
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Population Based Study ◽  
Employment History ◽  
National Patient Registry ◽  
Increased Risk ◽  
National Patient ◽  
Pb Exposure ◽  
Lateral Sclerosis

ObjectivesPrevious research has indicated links between lead (Pb) exposure and increased risk of neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). In this study, we evaluated the association between occupational Pb exposures and ALS.MethodsALS cases were ascertained through the Danish National Patient Registry from 1982 to 2013 and age and sex-matched to 100 controls. Using complete employment history since 1964 from the Danish Pension Fund, cumulative Pb exposure was estimated for each subject via a Danish job exposure matrix. Associations were evaluated using conditional logistic regression analyses and stratified by sex.ResultsFor men with >50% probability of exposure, there was an increase in odds of ALS for exposures in the 60th percentile or higher during any time 5 years prior to diagnosis (aOR: 1.35; 95% CI 1.04 to 1.76) and 10 years prior to diagnosis (aOR: 1.33; 95% CI 1.03 to 1.72). No significant associations were observed in women, and there were no linear trends seen for Pb exposures for either sex.ConclusionsOur study indicates an association between consistently higher occupational Pb exposures and ALS. These findings support those of previously reported associations between ALS and specific occupations that commonly experience Pb exposure.

scholarly journals The association between sociodemographic characteristics and dementia in patients with atrial fibrillation

2020 ◽  
Vol 32 (11) ◽  
pp. 2319-2327 ◽  
Author(s):  
Per Wändell ◽  
Axel C. Carlsson ◽  
Xinjun Li ◽  
Danijela Gasevic ◽  
Jan Sundquist ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Economic Status ◽  
Demographic Factors ◽  
Middle Level ◽  
Men And Women ◽  
Socio Economic Status ◽  
Increased Risk ◽  
National Patient ◽  
Socio Demographic Factors

Abstract Objectives Association between socio-demographic factors and dementia risk is studied in general but not for atrial fibrillation (AF) patients. Methods We studied AF patients ≥ 45 years in Sweden 1998–2012 (n = 537,513) using the Total Population Register for socio-demographic factors, the Swedish Cause of Death Register, and the National Patient Register (NPR) for incident dementia. Cox regression with hazard ratios (HR) and 95% confidence intervals (CI) was used for the association between exposure and outcome, adjusting for age and comorbidities. Results Totally 30,332 patients (5.6%) were diagnosed with dementia during the follow-up (mean 5.4 years). Of these, 14,097 were men (4.9%) and 16,235 were women (6.5%). Lower educational levels (reference: highest level) were associated with increased dementia, HRs (95% CI) for basic school for men 1.23 (1.18–1.29) and women 1.36 (1.30–1.42), and middle-level school for men 1.17 (1.11–1.22) and women 1.28 (1.22–1.34). Divorced men and women (reference: married) showed increased risk of dementia, HR 1.07 (1.01–1.13) and 1.12 (1.06–1.18), respectively, while widowed men showed lower risk, HR 0.84 (0.80–0.88). High deprivation neighborhood socio-economic status (NSES; reference: medium level) was associated with increased dementia in men, HR 1.11 (1.05–1.17), and low deprivation neighborhood socio-economic status (NSES) with increased dementia in men and women, HR 1.12 (1.06–1.18) and 1.18 (1.12–1.24), respectively. Conclusions Some results were expected, i.e. association between lower educational level and dementia. The higher risk of dementia in low deprivation NSES-areas could be due to a higher awareness about dementia, and subsequent earlier diagnosis and treatment of dementia.

scholarly journals Increased risk of acute arterial events in young patients and severely active IBD: a nationwide French cohort study

Gut ◽  
2017 ◽  
Vol 67 (7) ◽  
pp. 1261-1268 ◽  
Author(s):  
Julien Kirchgesner ◽  
Laurent Beaugerie ◽  
Fabrice Carrat ◽  
Nynne Nyboe Andersen ◽  
Tine Jess ◽  
...  
Keyword(s):  
Cox Regression ◽  
Young Patients ◽  
National Hospital ◽  
Increased Risk ◽  
Before And After ◽  
Related Hospitalisation ◽  
The Impact ◽  
Discharge Database ◽  
French Cohort ◽  
Active Disease

ObjectiveMagnitude and independent drivers of the risk of acute arterial events in IBD are still unclear. We addressed this question in patients with IBD compared with the general population at a nationwide level.DesignUsing the French National Hospital Discharge Database from 2008 to 2013, all patients aged 15 years or older and diagnosed with IBD were identified and followed up until 31 December 2013. The rates of incident acute arterial events were calculated and the impact of time with active disease (period around hospitalisation for IBD flare or IBD-related surgery) on the risk was assessed by Cox regression adjusted for traditional cardiovascular risk factors.ResultsAmong 210 162 individuals with IBD (Crohn’s disease (CD), n=97 708; UC, n=112 454), 5554 incident acute arterial events were identified. Both patients with CD and UC had a statistically significant overall increased risk of acute arterial events (standardised incidence ratio (SIR) 1.35; 95% CI 1.30 to 1.41 and SIR 1.10; 95 CI 1.06 to 1.13, respectively). The highest risk was observed in patients under the age of 55 years, both in CD and UC. The 3-month periods before and after IBD-related hospitalisation were associated with an increased risk of acute arterial events in both CD and UC (HR 1.74; 95 CI 1.44 to 2.09 and 1.87; 95% CI 1.58 to 2.22, respectively).ConclusionPatients with IBD are at increased risk of acute arterial events, with the highest risk in young patients. Disease activity may also have an independent impact on the risk.

scholarly journals Psychological impact of cancer diagnosis among gynaecological cancer subjects in a tertiary care centre

2017 ◽  
Vol 4 (2) ◽  
pp. 433 ◽  
Author(s):  
Ranjini Nanjaiah ◽  
Mudassir A. Khan ◽  
Vadiraja N. Rao
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Young Women ◽  
Cancer Diagnosis ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Gynaecological Cancer ◽  
Anxiety And Depression ◽  
Increased Risk

Background: The survival rate of cancer patients has improved and focus has shifted to improve the quality of life of the survivors. An adequate knowledge is required for psychosocial interventions and designing programs aimed at improving the quality of life of the cancer patients. The purpose of the study is to assess Anxiety and Depression [Psychiatric morbidity] among gynaecological cancer subjects and its association with duration since diagnosis, type of cancer, mode of treatment and socio-demographic variables.Methods: This is an interview based cross sectional study involving 131 patients diagnosed to have gynaecological cancer who were evaluated using hospital anxiety and depression scale (HADS). The gynaecological and socio-demographic data was analyzed for any correlation with HADS scores.Results: The prevalence of at least one psychiatric disorder was 90% (n=118). Sixty subjects [45.8%] had anxiety, 71 subjects [54%] had depression and 118 cases [90%] had psychiatric morbidity.  Patients suffering for less than three months had anxiety; three to 12 months were both anxious and depressed; more than 12 months were depressed. Young women with less education were more anxious compared to educated women.Conclusions: Given a gynaecological cancer an individual will have 0.9 chance of developing psychiatric morbidity. Young women with less education aware of cancer diagnosis for three to 12 months were at increased risk and needs intervention. As cancer incidence is increasing and psychiatric morbidity is common among cancer patients, training of health care personnel in cancer screening and recognizing patients with common mental disorders is required to improve their quality of life. Creating awareness of public regarding risk factors of cancers, importance of screening and cancer treatment is necessary.

scholarly journals MO131THE SHRUNKEN PORE SYNDROME IS ASSOCIATED WITH POOR PROGNOSIS AND LOWER QUALITY OF LIFE IN HEART FAILURE PATIENTS- THE HARVEST-MALMÖ STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Liana Xhakollari ◽  
Anders Grubb ◽  
Amra Jujic ◽  
Erasmus Bachus ◽  
Peter M Nilsson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Poor Prognosis ◽  
Kansas City ◽  
Cox Regression ◽  
Cardiorenal Syndrome ◽  
Risk Of Death ◽  
Increased Risk ◽  
Health Related Qol

Abstract Background and Aims The cardiorenal syndrome was studied in heart failure (HF) patients with respect to the “Shrunken pore syndrome” (SPS) that is characterized by a difference in renal filtration between cystatin C and creatinine, resulting in a low eGFRcystatin C/eGFRcreatinine-ratio. Method 373 patients hospitalized for HF were retrieved from the HeARt and brain failure inVESTigation trial (HARVEST-Malmö). We used CKD-EPI formulas for estimated glomerular filtration rate (eGFR). Presence of SPS was defined as eGFRcystatinC ≤60% of eGFRcreatinine. In Cox regression multivariate models, associations between SPS, risk of death and risk of 30-day re-hospitalization were studied. Associations between SPS and impaired quality of life (QoL) were studied using multivariate logistic regressions. Results SPS was associated with all-cause mortality (124 events; hazard ratio (HR) 2.35; confidence interval (CI95%) 1.17-4.71; p=0.016 and with 30-day re-hospitalization (70 events; HR 1.82; CI95% 1.04-3.18; p=0.036). Analyses of QoL, based on a Kansas City Cardiomyopathy Questionnaire overall score <50, revealed that SPS was associated with increased risk of low health-related QoL (odds ratios (OR) 2.15 (CI95% 1.03-4.49; p=0.042). Conclusion The results of this observational study show for the first time an association between SPS and poor prognosis in HF. Further studies are needed to confirm the results in HF cohorts and experimental settings to identify pathophysiological mechanisms.

Risk of solid cancers overall and by subtypes in patients with psoriatic arthritis treated with TNF inhibitors – a Nordic cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Karin Hellgren ◽  
Christine Ballegaard ◽  
Bénédicte Delcoigne ◽  
René Cordtz ◽  
Dan Nordström ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psoriatic Arthritis ◽  
Cox Regression ◽  
Tnf Inhibitors ◽  
Solid Cancer ◽  
Increased Risk ◽  
National Patient ◽  
Large Cohort Study ◽  
Cancer Types ◽  
Estimate Hazard Ratio

Abstract Objectives To investigate whether TNF inhibitors (TNFi) are associated with increased risk of solid cancer in patients with psoriatic arthritis (PsA). Methods From the Nordic clinical rheumatology registers (CRR) here: SRQ/ARTIS (Sweden), DANBIO (Denmark), NOR-DMARD (Norway), ROB-FIN (Finland) and ICEBIO (Iceland) we identified PsA patients who started a first TNFi 2001–2017 (n = 9655). We identified patients with PsA not treated with biologics from (i) the CRR (n = 14 809) and (ii) the national patient registers (PR, n = 31 350). By linkage to the national cancer registers, we collected information on incident solid cancer overall and for eight cancer types. We used Cox regression to estimate hazard ratio (HR) with 95% CI of cancer (per country and pooled) in TNFi-exposed vs biologics-naïve, adjusting for age, sex, calendar period, comorbidities and disease activity. We also assessed standardized incidence ratios (SIR) in TNFi-exposed PsA vs the general population (GP). Results We identified 296 solid cancers among the TNFi-exposed PsA patients (55 850 person-years); the pooled adjusted HR for solid cancer overall was 1.0 (0.9–1.2) for TNFi-exposed vs biologics-naïve PsA from the CRR, and 0.8 (0.7–1.0) vs biologics-naïve PsA from the PRs. There were no significantly increased risks for any of the cancer types under study. The pooled SIR of solid cancer overall in TNFi treated PsA vs GP was 1.0 (0.9–1.1). Conclusion In this large cohort study from five Nordic countries, we found no increased risk of solid cancer in TNFi-treated PsA patients, neither for solid cancer overall nor for eight common cancer types.

scholarly journals Psychosocial working conditions and the risk of diagnosed depression: a Swedish register-based study

2021 ◽  
pp. 1-9
Author(s):  
Melody Almroth ◽  
Tomas Hemmingsson ◽  
Alma Sörberg Wallin ◽  
Katarina Kjellberg ◽  
Bo Burström ◽  
...  
Keyword(s):  
Cox Regression ◽  
Job Strain ◽  
Job Demands ◽  
Sociodemographic Factors ◽  
Job Control ◽  
Psychiatric Diagnoses ◽  
Men And Women ◽  
Increased Risk ◽  
Psychosocial Workload ◽  
Objectively Measured

Abstract Background High job demands, low job control, and their combination (job strain) may increase workers' risk of depression. Previous research is limited by small populations, not controlling for previous depression, and relying on the same informant for reporting exposure and outcome. This study aims to examine the relationship between objectively measured workplace factors and the risk of developing clinical depression among the Swedish working population while controlling for previous psychiatric diagnoses and sociodemographic factors. Methods Control, demands, and job strain were measured using the Swedish Job Exposure Matrix (JEM) measuring psychosocial workload linked to around 3 million individuals based on their occupational titles in 2005. Cox regression models were built to estimate associations between these factors and diagnoses of depression recorded in patient registers. Results Lower job control was associated with an increased risk of developing depression (HR 1.43, 95% CI 1.39–1.48 and HR 1.27, 95% CI 1.24–1.30 for men and women with the lowest control, respectively), and this showed a dose–response relationship among men. Having high job demands was associated with a slight decrease in depression risk for men and women. High strain and passive jobs (both low control jobs) were associated with an increased risk of depression among men, and passive jobs were associated with an increased risk among women. Conclusion High job control appears important for reducing the risk of developing depression even when accounting for previous psychiatric diagnoses and sociodemographic factors. This is an important finding concerning strategies to improve occupational and in turn mental health.

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