Psychotic Illness in First-Time Mothers with No Previous Psychiatric Hospitalizations: A Population-Based Study

Unnur Valdimarsdóttir and colleagues studied the risk factors for psychiatric illness following childbirth and found that, for women who had never previously been hospitalized for a psychiatric illness, the risk of mental illness was greatly increased following childbirth

Physical activity and sleep in Icelandic adolescents

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesInngangur: Hreyfing og svefn eru mikilvægir áhrifaþættir heilsufars. Alþjóðlegar ráðleggingar mæla með því að börn og unglingar hreyfi sig að lágmarki 60 mínútur daglega af miðlungs eða mikilli ákefð og sofi í 8 til 10 klukkustundir á sólarhring. Tengsl hreyfingar og svefns meðal ungmenna eru ekki vel þekkt. Markmið rannsóknarinnar voru að meta: a) hversu hátt hlutfall 16 ára reykvískra ungmenna uppfyllir viðmið um hreyfingu og svefn, b) hvort tengsl séu milli hreyfingar og svefns og c) kynjamun á hreyfingu og svefni. Efniviður og aðferðir: Alls var 411 nemendum 10. bekkjar 6 grunnskóla í Reykjavík boðin þátttaka í rannsókninni vorið 2015. Gild gögn fengust frá 106 drengjum og 160 stúlkum. Hlutlægar og huglægar mælingar á hreyfingu og svefni voru gerðar með hröðunarmælum og spurningalistum. Niðurstöður: Um helmingur þátttakenda náði viðmiðum um hreyfingu samkvæmt niðurstöðum spurningalista. Þrátt fyrir að 51,9% teldu sig sofa nógu mikið náðu þó einungis 22,9% viðmiðum um ráðlagða svefnlengd samkvæmt hröðunarmælum. Engin tengsl fundust milli svefnlengdar og hreyfingar samkvæmt spurningalistum. Stúlkur hreyfðu sig marktækt meira en drengir á frídögum (p<0,01) samkvæmt hröðunarmælum en ekki var marktækur munur á meðaltali hreyfingar stúlkna og drengja yfir vikuna. Hvorki var marktækur kynjamunur á svefnlengd mældri með hröðunarmælum né spurningalista. Ályktun: Lífsstíll íslenskra ungmenna virðist ekki endurspegla viðmið opinberra aðila um daglega hreyfingu og svefn. Einungis 22,9% náðu viðmiðum um ráðlagðan svefntíma, og 11,3% uppfylltu bæði viðmið um hreyfingu og svefn.Introduction: Physical activity and sleep are major determinants of overall health. According to international recommendations, adolescents should engage in moderate to vigorous physical activity for at least 60 min each day and sleep eight to ten hours each night. The association between physical activity and sleep in adolescents is not well known. The aim of the study was to estimate a) the proportion of Icelandic adolescents that achieves recommended physical activity and sleep, b) if there is an association between physical activity and sleep patterns, and c) sex differences in physical activity and sleep. Material and methods: A total of 411 adolescents from the 10th grade in six schools in Reykjavik were invited to participate in a cross-sectional study in the spring of 2015. Valid data was obtained from 106 boys and 160 girls. Objective and subjective measures of physical activity and sleep were made by wrist-worn accelerometers and a questionnaire. Results: Almost half of the participants fulfilled the physical activity recommendations according to the questionnaire. Although 51.1% reported usually getting enough sleep, only 22.9% achieved the recommended sleep length according to objective assessment. No associations were observed between sleep and subjective physical activity. Girls had higher accelerometer-measured physical activity than boys on non-school days (p<0.01), but weekly averages were not different between sexes. Girls and boys did not differ in subjective or objective measures of sleep. Conclusion: The behavior of Icelandic adolescents does not reflect recommended amount of sleep and physical activity. Only 22.9% obtained the recommended sleep length and just 11.3% fulfilled recommendations of both sleep and physical activity.Ranní

Association between Childhood Body Size and Premenstrual Disorders in Young Adulthood

The work is supported by grant 2020-01003 from the Swedish Research Council (Vetenskapsrådet) (Dr Lu) and grant 2020-00971 from the Swedish Research Council for Health, Working Life, and Welfare (FORTE) (Dr Lu). The Growing Up Today Study is supported by grants R03 CA106238 and U01 HL145386 from the National Institutes of Health. Publisher Copyright: © 2022 American Medical Association. All rights reserved.Importance: Emerging data suggest that more than two-thirds of premenstrual disorders (PMDs), including premenstrual syndrome and premenstrual dysphoric disorder, have symptom onset during the teen years. Adulthood adiposity has been associated with PMDs; however, the association with childhood and adolescent body size is unknown. Objective: To examine the association between childhood and adolescent body size and risk of PMDs in young adulthood. Design, Setting, and Participants: This prospective cohort study included 6524 US female participants from the Growing Up Today Study (1996-2013). Data were analyzed from February 26, 2020, to June 23, 2021. Exposures: Body mass index (BMI) was estimated using self-reported height and weight through adolescence and converted to BMI for age (z score). Main Outcomes and Measures: In 2013, premenstrual symptoms and identified PMDs were assessed with a validated scale based on the Calendar of Premenstrual Experiences. The associations of BMI for age with PMDs and premenstrual symptoms were examined using log-binomial and linear regressions, respectively. Results: Among 6524 participants (mean [SD] age, 26 [3.5] years; 6108 [93.6%] White), 1004 (15.4%) met the criteria for a PMD. Baseline BMI for age reported at a mean (SD) age of 12.7 (1.1) years was associated with increased risk of PMDs (confounding-adjusted relative risk, 1.09 per unit of z score; 95% CI, 1.03-1.15) and higher burden of premenstrual symptoms (β = 0.06; 95% CI, 0.04-0.08). Associations were particularly pronounced for premenstrual dysphoric disorder and for PMDs with symptom onset before 20 years of age and remained in the absence of psychiatric comorbidities, including depression, anxiety, and disordered eating behavior. When analyzing BMI change over time, individuals with high BMI throughout adolescence had a higher burden of premenstrual symptoms (β = 0.17; 95% CI, 0.08-0.27) compared with those with normal BMI throughout adolescence. Individuals with high BMI early followed by a mild decrease later did not report higher premenstrual symptoms (β = 0.06; 95% CI, 0.00-0.12). Conclusions and Relevance: In this cohort study, childhood body size was associated with PMD risk and premenstrual symptoms in young adulthood. These findings suggest that maintaining a normal body mass in childhood may be considered for lowering the burden of PMDs in adulthood..Peer reviewe

Association between Adverse Childhood Experiences and Multiple Sclerosis in Icelandic Women-A Population-Based Cohort Study

BACKGROUND: A growing literature, mostly based on selected populations, indicates that traumas may be associated with autoimmune diseases, yet few studies exist on adverse childhood experiences (ACEs) and multiple sclerosis (MS) in the general population. OBJECTIVE: We assessed cross-sectional associations between self-reported ACEs and MS among Icelandic women in the population-based Stress-And-Gene-Analysis (SAGA) cohort. METHODS: Participants (n = 27,870; mean age 44.9 years) answered a web-based survey that included the ACE-International Questionnaire and a question about MS diagnosis. Log-linear Poisson regression models estimated MS prevalence ratios and 95% confidence intervals for ACEs adjusted for covariates. RESULTS: 214 women reported having been diagnosed with MS (crude prevalence = 7.7 per 1000). Compared to women without MS, women with MS reported more fatigue, body pain and bladder problems. The average cumulative number of ACEs was 2.1. After adjustment for age, education, childhood deprivation, smoking and depressive symptoms, MS prevalence did not increase with increasing ACEs exposure (PR = 1.00, 95% CI = 0.92, 1.09). Thirteen ACE categories, including abuse, neglect, household dysfunction and violence were not individually or independently associated with MS. CONCLUSION: Limited by self-reported data and cross-sectional design, results do not consistently support associations between ACEs in the development of MS among adult Icelandic women.Peer reviewe

A shared genetic contribution to breast cancer and schizophrenia

An association between schizophrenia and subsequent breast cancer has been suggested; however the risk of schizophrenia following a breast cancer is unknown. Moreover, the driving forces of the link are largely unclear. Here, we report the phenotypic and genetic positive associations of schizophrenia with breast cancer and vice versa, based on a Swedish population-based cohort and GWAS data from international consortia. We observe a genetic correlation of 0.14 (95% CI 0.09–0.19) and identify a shared locus at 19p13 (GATAD2A) associated with risks of breast cancer and schizophrenia. The epidemiological bidirectional association between breast cancer and schizophrenia may partly be explained by the genetic overlap between the two phenotypes and, hence, shared biological mechanisms

Mental health indicators in Sweden over a 12-month period during the COVID-19 pandemic – Baseline data of the Omtanke2020 Study

Funding Information: This study was funded with grants from NordForsk (CovidMent, 105668 ), Horizon 2020 (CoMorMent, 847776 ), and the Karolinska Institutet . Funding Information: The Omtanke2020 study is supported by NordForsk (project No. 105668 ) and Karolinska Institute (Strategic Research Area in Epidemiology and Senior Researcher Award). We acknowledge The Swedish Twin Registry for access to contact information to participating twins. The Swedish Twin Registry is managed by Karolinska Institutet and receives funding through the Swedish Research Council under the grant no 2017-00641. The Funding Sources had no direct or indirect impact on the analysis and interpretation of the results. Publisher Copyright: © 2022 The AuthorsBackground: The ongoing COVID-19 pandemic has had an unprecedented impact on the lives of people globally and is expected to have profound effects on mental health. Here we aim to describe the mental health burden experienced in Sweden using baseline data of the Omtanke2020 Study. Method: We analysed self-reported, cross-sectional baseline data collected over a 12-month period (June 9, 2020–June 8, 2021) from the Omtanke2020 Study including 27,950 adults in Sweden. Participants were volunteers or actively recruited through existing cohorts and, after providing informed consent, responded to online questionnaires on socio-demographics, mental and physical health, as well as COVID-19 infection and impact. Poisson regression was fitted to assess the relative risk of demonstrating high level symptoms of depression, anxiety, and COVID-19 related distress. Result: The proportion of persons with high level of symptoms was 15.6 %, 9.5 % and 24.5 % for depression, anxiety, and COVID-19 specific post-traumatic stress disorder (PTSD), respectively. Overall, 43.4 % of the participants had significant, clinically relevant symptoms for at least one of the three mental health outcomes and 7.3 % had significant symptoms for all three outcomes. We also observed differences in the prevalence of these outcomes across strata of sex, age, recruitment type, COVID-19 status, region, and seasonality. Conclusion: While the proportion of persons with high mental health burden remains higher than the ones reported in pre-pandemic publications, our estimates are lower than previously reported levels of depression, anxiety, and PTSD during the pandemic in Sweden and elsewhere.Peer reviewe

Stress related disorders and subsequent risk of life threatening infections: population based sibling controlled cohort study.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadOBJECTIVE: To assess whether severe psychiatric reactions to trauma and other adversities are associated with subsequent risk of life threatening infections. DESIGN: Population and sibling matched cohort study. SETTING: Swedish population. PARTICIPANTS: 144 919 individuals with stress related disorders (post-traumatic stress disorder (PTSD), acute stress reaction, adjustment disorder, and other stress reactions) identified from 1987 to 2013 compared with 184 612 full siblings of individuals with a diagnosed stress related disorder and 1 449 190 matched individuals without such a diagnosis from the general population. MAIN OUTCOME MEASURES: A first inpatient or outpatient visit with a primary diagnosis of severe infections with high mortality rates (ie, sepsis, endocarditis, and meningitis or other central nervous system infections) from the Swedish National Patient Register, and deaths from these infections or infections of any origin from the Cause of Death Register. After controlling for multiple confounders, Cox models were used to estimate hazard ratios of these life threatening infections. RESULTS: The average age at diagnosis of a stress related disorder was 37 years (55 541, 38.3% men). During a mean follow-up of eight years, the incidence of life threatening infections per 1000 person years was 2.9 in individuals with a stress related disorder, 1.7 in siblings without a diagnosis, and 1.3 in matched individuals without a diagnosis. Compared with full siblings without a diagnosis of a stress related disorder, individuals with such a diagnosis were at increased risk of life threatening infections (hazard ratio for any stress related disorder was 1.47 (95% confidence intervals1.37 to 1.58) and for PTSD was 1.92 (1.46 to 2.52)). Corresponding estimates in the population based analysis were similar (1.58 (1.51 to 1.65) for any stress related disorder, P=0.09 for difference between sibling and population based comparison, and 1.95 (1.66 to 2.28) for PTSD, P=0.92 for difference). Stress related disorders were associated with all studied life threatening infections, with the highest relative risk observed for meningitis (sibling based analysis 1.63 (1.23 to 2.16)) and endocarditis (1.57 (1.08 to 2.30)). Younger age at diagnosis of a stress related disorder and the presence of psychiatric comorbidity, especially substance use disorders, were associated with higher hazard ratios, whereas use of selective serotonin reuptake inhibitors in the first year after diagnosis of a stress related disorder was associated with attenuated hazard ratios. CONCLUSION: In the Swedish population, stress related disorders were associated with a subsequent risk of life threatening infections, after controlling for familial background and physical or psychiatric comorbidities.Grant of Excellence, Icelandic Research Fund European Research Council (ERC) Karolinska Institutet Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) West China Hospital, Sichuan University (1.3.5 Project for Disciplines of Excellence

Genome-wide association study of posttraumatic stress disorder among childhood cancer survivors : results from the Childhood Cancer Survivor Study and the St. Jude Lifetime Cohort

Funding Information: This work was supported by the National Cancer Institute (CA55727, G.T. Armstrong, Principal Investigator). The St. Jude Lifetime Cohort study was supported by the National Cancer Institute (U01CA195547, M.M. Hudson/L.L. Robison, Principal Investigators). Support to St. Jude Children’s Research Hospital was also provided by the Cancer Center Support (CORE) grant (CA21765, C. Roberts, Principal Investigator) and the American Lebanese-Syrian Associated Charities (ALSAC). Dr. Lu was supported by a research fellowship at the Dana-Farber Cancer Institute funded by the Swim Across America and the Grant of Excellence from the Icelandic Research Fund (163362-051 to Dr. Valdimarsdóttir). Open access funding provided by Karolinska Institute. Publisher Copyright: © 2022, The Author(s).Genetic influence shapes who develops posttraumatic stress disorder (PTSD) after traumatic events. However, the genetic variants identified for PTSD may in fact be associated with traumatic exposures (e.g., interpersonal violence), which appear heritable as well. Childhood cancer survivors (CCS) are at risk for PTSD, but genetic influences affecting cancer are unlikely to overlap with those affecting PTSD. This offers a unique opportunity to identify variants specific to PTSD risk. In a genome-wide association study (GWAS), 3984 5-year survivors of childhood cancer of European-ancestry from the Childhood Cancer Survivor Study (CCSS) were evaluated for discovery and 1467 survivors from the St. Jude Lifetime (SJLIFE) cohort for replication. Childhood cancer-related PTSD symptoms were assessed using the Posttraumatic Stress Diagnostic Scale in CCSS. GWAS was performed in CCSS using logistic regression and lead markers were replicated/meta-analyzed using SJLIFE. Cross-associations of identified loci were examined between CCS and the general population. PTSD criteria were met for 671 participants in CCSS and 161 in SJLIFE. Locus 10q26.3 was significantly associated with PTSD (rs34713356, functionally mapped to ECHS1, P = 1.36 × 10–8, OR 1.57), and was replicated in SJLIFE (P = 0.047, OR 1.37). Variants in locus 6q24.3-q25.1 reached marginal significance (rs9390543, SASH1, P = 3.56 × 10–6, OR 0.75) in CCSS and significance when meta-analyzing with SJLIFE (P = 2.02 × 10–8, OR 0.75). Both loci were exclusively associated with PTSD in CCS rather than PTSD/stress-related disorders in general population (P-for-heterogeneity < 5 × 10–6). Our CCS findings support the role of genetic variation in PTSD development and may provide implications for understanding PTSD heterogeneity.Peer reviewe