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- Ludvigsson, Jonas F., et al.
(författare)
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Coeliac disease and risk of mood disorders : a general population-based cohort study
- 2007
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Ingår i: Journal of Affective Disorders. - Amsterdam : Elsevier Biomedical. - 0165-0327 .- 1573-2517. ; 99:1, s. 117-126
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundEarlier research has indicated a positive association between coeliac disease (CD) and some mental disorders. Studies on CD and depression have inconsistent findings and we know of no study of CD and the risk of bipolar disorder (BD).MethodsWe used Cox regression to investigate the risk of subsequent mood disorders (MD); depression and BD in 13,776 individuals with CD and 66,815 age- and sex-matched reference individuals in a general population-based cohort study in Sweden. We also studied the association between prior MD and CD through conditional logistic regression.ResultsCD was associated with an increased risk of subsequent depression (Hazard ratio (HR)=1.8; 95% CI=1.6–2.2; p<0.001, based on 181 positive events in individuals with CD and 529 positive events in reference individuals). CD was not associated with subsequent BD (HR=1.1; 95% CI=0.7–1.7; p=0.779, based on 22 and 99 positive events). Individuals with prior depression (OR=2.3; 95% CI=2.0–2.8; p<0.001) or prior BD (OR=1.7; 95% CI=1.2–2.3; p=0.001) were at increased risk of a subsequent diagnosis of CD.LimitationsStudy participants with CD and MD may have more severe disease than the average patient with these disorders since they were identified through a hospital-based register.ConclusionsCD is positively associated with subsequent depression. The risk increase for CD in individuals with prior depression and BD may be due to screening for CD among those with MD.
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| 2. |
- Ösby, Urban
(författare)
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Mortality in schizophrenia and affective disorder
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patients with psychiatric disorders such as schizophrenia, bipolar disorder and unipolar disorder have a considerably increased mortality compared to the population. To reduce this increased mortality is a major task for clinical psychiatry, and the aim of this study is to improve the knowledge about the increased mortality in order to reduce its effects for the patients. The studies in this thesis are based upon register linkages. Information about diagnosis and time of admission and discharge from the Patient register has been linked with information about cause and time of death from the Cause-of-death register, and information about first-degree relatives from the Second-generation register. First admissions with schizophrenia in Stockholm County during 1978 to 1994 were reduced by 1.3% yearly for males and 1.9% for females, while first admissions with either schizophrenia or paranoid psychosis were unchanged for both sexes, indicating that the reduction of first schizophrenia admissions may be an effect of diagnostic changes during the study period. For schizophrenics in Stockholm County followed-up from the first diagnosis, standardized mortality ratios (SMR:s) for all causes of death were increased to 2.8 for males and 2.4 for females. SMR was most increased in suicide, with 15.7 for males and 19.7 for females, and in unspecified violence, with 11.7 for males and 9.9 for females. SMR:s for suicide were particularly increased for young patients during the first year after the first admission. More excess deaths were caused by natural (somatic) than by unnatural causes of death, although the specific causes of death that caused most extra deaths were suicide in males and cardiovascular disease in females. Time trends in SMR for all causes of death during 1976 to 1995, for patients in Stockholm County diagnosed with schizophrenia for the first time, increased 1.7 times for males and 1.3 times for females. Cardiovascular death increased 4.7 times for males and 2.7 times for females, while all unnatural causes of death increased 1.8 times for males and suicide increased 1.9 times for females. The increase in mortality may be an effect of the concomitant reduction with 64% of days in hospital for schizophrenia. SMR:s for all patients with a hospital diagnosis of bipolar or unipolar disorder in Sweden for all causes of death were 2.5 for males and 2.7 for females in bipolar disorder, and 2.0 for both sexes in unipolar disorder. SMR:s for suicide in bipolar disorder were 15.0 for males and 22.4 for females, and in unipolar disorder 20.9 and 27.0 respectively. In bipolar disorder, most extra deaths were caused by natural causes, while in unipolar disorder, unnatural causes caused most extra deaths. Time trends for suicide mortality increased, both for bipolar and unipolar disorder. SMR:s for suicide for siblings to patients with schizophrenia, bipolar or unipolar disorder were not increased, unless the siblings had a psychiatric diagnosis of their own. Siblings with psychiatric diagnoses had as high suicide mortality as the probands. However, previous suicide in the family increased the suicide risk for patients with schizophrenia and bipolar disorder, but not unipolar disorder.
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