| 1. |
- Papadopoulos, Fotios C., et al.
(author)
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Age at onset of anorexia nervosa and breast cancer risk
- 2009
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In: European Journal of Cancer Prevention. - 0959-8278 .- 1473-5709. ; 18:3, s. 207-211
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Journal article (peer-reviewed)abstract
- The objective of this study was to investigate breast cancer occurrence among women treated for anorexia nervosa (AN), with emphasis on age at the onset of this disorder. We conducted a register-based retrospective cohort with a total of 6009 women with at least one admission with an AN diagnosis (luring the period 1973-2003 in Sweden. During a mean follow-up of 13.4 years, information on 80057 women-years was generated. The standardized incidence ratio (SIR) - the ratio of observed-to-expected number of cases - was used as the measure of relative risk. Overall, 16 women developed breast cancer versus 25.5 expected cases [SIR: 0.6, 95% confidence interval (CI): 0.4-0.9]. Among women who were first admitted for AN between the age of 10 and 24 years, four developed breast cancer versus 11.3 expected (SIR: 0.4, 95% CI: 0.1-0.9). In this group of women with early onset AN, only one parous woman developed breast cancer versus 6.3 expected (SIR: 0.2,95% CI: 0-0.9). Among women first hospitalized for AN between the age of 25 and 40 years, 12 developed breast cancer, whereas the expected number was 14.2, a nonsignificant deficit Our results suggest that early onset AN may play an important role in the development of breast cancer, possibly because of the extreme restriction of energy intake at a crucial period for mammary gland development. Late onset AN is likely to play a relatively less important role.
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| 2. |
- Papadopoulos, Fotios C., et al.
(author)
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Doping use among tertiary education students in six developed countries
- 2006
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In: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 21:4, s. 307-313
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Journal article (peer-reviewed)abstract
- Data on doping among young non-professional athletes are scarce. In order to estimate the prevalence and predictors of doping use, a standardized, anonymous questionnaire was self-administered by 2650 tertiary education students from five European Union countries (Finland, France, Germany, Greece, Italy) and Israel. The reported usage rate of a doping agent (at least once) was 2.6%, with no significant variation in the frequency of doping reporting among the participating countries. Doping was, however, less common among students of biomedical schools (OR: 0.49, 95% CI: 0.27-0.89) and was higher among males (OR: 2.16, 95% CI: 1.25-3.74). Students, who use to drink coffee or recall frequent occasions of involvement in drunkenness episodes, were more likely (twice and three times, respectively) to report doping, and students using nutritional supplements or having participated in a major athletic event were more likely (four times and twice, respectively) to report doping in comparison with students who do not. Of note is the high odds ratio for reporting individual doping when having a friend who uses doping (OR: 8.61, 95% CI: 4.49-16.53). Given the large size of the physically active young individuals in the population and the small number of professional athletes, doping in the general population may be, in absolute terms, as sizeable problem as it is among the professional athletes. There was evidence that high-risk behaviour and supplement use increased the risk of doping.
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| 3. |
- Papadopoulos, Fotios C, et al.
(author)
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Excess mortality, causes of death and prognostic factors in anorexia nervosa
- 2009
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In: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 194:1, s. 10-17
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Journal article (peer-reviewed)abstract
- BACKGROUND: Anorexia nervosa is a mental disorder with high mortality. AIMS: To estimate standardised mortality ratios (SMRs) and to investigate potential prognostic factors. METHOD: Six thousand and nine women who had in-patient treatment for anorexia nervosa were followed-up retrospectively using Swedish registers. RESULTS: The overall SMR for anorexia nervosa was 6.2 (95% CI 5.5-7.0). Anorexia nervosa, psychoactive substance use and suicide had the highest SMR. The SMR was significantly increased for almost all natural and unnatural causes of death. The SMR 20 years or more after the first hospitalisation remained significantly high. Lower mortality was found during the last two decades. Younger age and longer hospital stay at first hospitalisation was associated with better outcome, and psychiatric and somatic comorbidity worsened the outcome. CONCLUSIONS: Anorexia nervosa is characterised by high lifetime mortality from both natural and unnatural causes. Assessment and treatment of psychiatric comorbidity, especially alcohol misuse, may be a pathway to better long-term outcome.
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| 4. |
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| 5. |
- Papadopoulos, Fotios C., et al.
(author)
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Preventing suicide and homicide in the United States : the potential benefit in human lives
- 2009
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In: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123. ; 169:2, s. 154-158
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Journal article (peer-reviewed)abstract
- In order to assess the potential benefit in human lives if all geographical regions in the US (Northeast, South, Midwest, and West) achieved the lowest suicide and homicide rates observed within these regions, age-, race- and gender-adjusted suicide and homicide rates for each of the four regions were calculated based on data retrieved using the Centers for Disease Control and Prevention database for 1999-2004. Data on known risk factors were retrieved from online sources. Overall suicide rates (10.42 per 100,000) exceeded homicide rates (6.97 per 100,000). Almost 27% (12,942 lives per year) of the 288,222 suicide and homicide deaths during the study period might have been avoided if all US regions achieved the mortality rate reported by the Northeast. A firearm was used in 55% of all suicides and 66% of all homicides. In the total estimate of avoidable deaths, firearm suicides (90%) and firearm homicides (75%) were overrepresented. The Northeast had the lowest access to firearms (20%) contrasted to almost double in the other regions, whereas greater firearms availability was related to unrestricted firearm legislation. Measures to restrict firearms availability should be highly prioritized in the public health agenda in order to achieve an impressive benefit in human lives.
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| 6. |
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| 7. |
- Reutfors, J., et al.
(author)
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Seasonality of suicide in Sweden : relationship with psychiatric disorder
- 2009
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 119:1-3, s. 59-65
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Journal article (peer-reviewed)abstract
- Background: Little is known as to whether suicide seasonality is related to psychiatric disorders affecting suicide risk/incidence. The present study aims to assess suicide seasonality patterns with regard to the history of psychiatric morbidity among suicide victims. Methods: The history of psychiatric inpatient diagnoses in the five years prior to suicide was identified among all suicides in Sweden from 1992 to 2003. Suicide seasonality was estimated as the relative risk of suicide during the month of highest to that in the month of lowest suicide incidence. Analyses were performed with respect to sex, suicide method and history of inpatient treatment of psychiatric disorder. Results: Among both male (n = 9,902) and female (n = 4,128) suicide victims, there were peaks in suicide incidence in the spring/early summer. This seasonal variation was more evident in suicide victims with a psychiatric inpatient diagnosis than in those without such a diagnosis. A seasonal variation was found in most diagnostic groups, with significant peaks in males with a history of depression and in females with a history of a neurotic, stress-related, or somatoform disorder. Overall, suicide seasonality was more evident in violent than in non-violent suicide methods. Limitation: Only psychiatric disorders severe enough to require hospital admission were studied. Conclusion: A history of inpatient-treated psychiatric disorder appears to be associated with an increase in suicide seasonality, especially in violent suicide methods. This increase is found in several psychiatric disorders.
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| 8. |
- Skalkidou, Alkistis, et al.
(author)
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Risk of postpartum depression in association with serum leptin and interleukin-6 levels at delivery : a nested case-control study within the UPPSAT cohort
- 2009
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In: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 34:9, s. 1329-1337
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Journal article (peer-reviewed)abstract
- Although postpartum depression (PPD) is a common condition, it often goes undiagnosed and untreated, with devastating consequences for the woman's ability to perform daily activities, to bond with her infant and to relate to the infant's father. Leptin, a protein synthesised in the adipose tissue and involved in regulation of food intake and energy expenditure has been related to depressive disorders, but studies report conflicting results. The aim of this study was to evaluate the association between serum leptin levels at the time of delivery and the subsequent development of postpartum depression in women, using data from a population-based cohort of delivering women in Uppsala, Sweden. Three hundred and forty seven women from which serum was obtained at the time of delivery filled out at least one of three structured questionnaires containing the Edinburgh Scale for Postnatal Depression (EPDS) at five days, six weeks and six months after delivery. Mean leptin levels at delivery did not significantly differ between the 67 cases of PPD and the 280 controls. Using linear regression analysis and adjusting for maternal age, body-mass index, smoking, interleukin-6 levels, duration of gestation and gender of the newborn, the EPDS scores at six weeks and six months after delivery were found to be negatively associated with leptin levels at delivery (p<0.05). Serum leptin levels at delivery were found to be negatively associated with self-reported depression during the first six months after delivery. No such association was found concerning serum IL-6 levels at delivery. If these finding are replicated by other studies, leptin levels at delivery could eventually serve as a biological marker for the prediction of postpartum depression.
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