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Highlights from the Nordic Journal of Psychiatry (June - October of 2023)


The Nordic Journal of Psychiatry, formerly “Nordisk Psykiatrisk Tidsskrift”, is an international journal that publishes excellent psychiatric research with a broad scope. It is the official journal for the eight psychiatric associations in the Nordic and Baltic countries. It is a main source of information about current Nordic psychiatry and related fields, The journal is distributed to members of the Nordic and Baltic Psychiatric Associations as well as to members of Associations for Child and Adolescent Psychiatry. This gives access to all articles published in the journal from 1946.

Creative activities as intervention

This study explored to what extent and in which way people with severe mental illness experience well-being, performance, and satisfaction with daily living when participating in creative activities as intervention. A sequential mixed-methods design was applied. Data was obtained at two measurement points two-three weeks apart using the WHO-5 questionnaire and COPM questionnaire from a sample of 33 participants participating in interventions with creative activities. In addition, eight of the participants took part in qualitative semi-structured interviews, and data was analysed using content analysis on a manifest level. Participation resulted in improved self-rated well-being self-perceived occupational performance of daily living and satisfaction with occupational performance. The changes in well-being and daily living were explained by a work-like content and structure, positive intrapersonal and social acceptability experiences, and greater self-esteem due to the experience of being an artist.

The authors conclude that the study contributes with knowledge about participation in creative activities as intervention even for a short period enables well-being, and performance and satisfaction with daily living for people experiencing severe mental illness.

Hansen BW, Pedersen HA, Brandt Å, Berring LL. Creative activities as intervention: experiences of well-being and satisfaction with daily living in a mental health context. Nord J Psychiatry 2023 Sep 8:1-11. doi: 10.1080/08039488.2023.2253236. Online ahead of print. PMID: 37682638

Nordic region suicide trends 2000-2018; sex and age groups

Overall, suicide rates in the Nordic region, Denmark, Finland, Iceland, Norway, and Sweden, have declined in the past 40 years. The aim of this study was to determine trends in suicide mortality from 2000 to 2018. Data were obtained from official suicide statistics for men and women, 15 years and older. Gender and age groups in four calendar periods were analyzed using Joinpoint Estimated Regression Coefficient. The crude regional suicide rate was 17.1, 2000-2004, decreased to 14.1 per 100,000 inhabitants in 2015-2018. The crude rate decreased by 19.5% (16.3% age-standardized), 19.3% for males and 20.5% for females. The largest decrease was found in Finland (34.9%), the smallest in Norway (1.4%). In males, the exception was an increased suicide rate among all Icelandic except 15-24-year olds, and in 45-64 year-old Norwegians. Among females, an increase was seen among 15-24-year olds in all countries except Iceland, in all age groups in Norway, and in 25-44-year olds in Sweden. In males, a decline of the suicide rated lower than 10% was noted in 25-44 olds in Norway and in 15-64 year-olds in Sweden.

The authors conclude that a robust decrease was observed in the overall regional suicide rate in recent years. Exceptions are rising rates in Icelandic males, in Norwegian females, and the youngest female groups in all except Iceland. The small decline among middle-aged males in Norway and Sweden is of concern.

Oskarsson H, Mehlum L, Titelman D, Isometsä E, Erlangsen A, Nordentoft M, Mittendorfer-Rutz E, Hökby S, Tomasson H, Palsson S. Nordic region suicide trends 2000-2018; sex and age groups. Nord J Psychiatry. 2023 Oct;77(7):721-730. doi: 10.1080/08039488.2023.2231918. Epub 2023 Jul 12. PMID: 37435817

The prevalence of self-harm and mental disorders among individuals with intellectual disabilities

Mental health disorders are prevalent among individuals with intellectual disabilities (ID). However, there is a lack of research on the impact of concomitant autism spectrum disorders (ASD) or attention deficit hyperactivity disorder (ADHD) on the mental health within this population. The authors aimed to investigate the prevalence of mental health disorders and registered healthcare visits due to self-harm among individuals with ID. They used administrative data for all healthcare with at least one recorded diagnosis of mental health disorder or self-harm during 2007-2017 among people with a diagnosis of Down syndrome and with ID without DS (IDnonDS) using the rest of the population in Stockholm Region for comparison. The highest odds ratios for a mental health disorder were present in females with IDnonDS (9.01) followed by males with IDnonDS (8.50), compared to the general population. The ORs for self-harm among individuals with IDnonDS were high (8.00 for females and 6.60 for males). There were no registered cases of self-harm among individuals with DS. The prevalence of an anxiety or affective disorder was higher among individuals with ID including DS with concomitant ASD or ADHD. Neighbourhood socio-economic status was associated with a lower occurrence of mental health disorders and self-harm in wealthier areas for all outcomes and for all groups.

The authors conclude that self-harm and psychiatric comorbidities were common among individuals with ID without DS with an attenuated difference among those with concomitant ASD or ADHD, which calls for attention.

Wallén EF G, Wahlström L, Pettersson D, Carlsson AC P. The prevalence of self-harm and mental disorders among individuals with intellectual disabilities. Nord J Psychiatry 2023 Oct;77(7):712-720. doi: 10.1080/08039488.2023.2228292. Epub 2023 Jun 30. PMID: 37387438

Suicidal behaviour in over-indebted individuals

Associations between debt and suicidal behaviour have been identified, but the research is sparse. The study aimed to generate further knowledge about over-indebted individuals who have attempted suicide at least once. Participants were a Swedish sample comprising 641 over-indebted individuals. Participants answered questionnaires regarding socio-demographic variables, debt size, history of suicide attempt, critical life events, and social contacts, and filled the Hospital Anxiety and Depression Scale (HADS). The analysis revealed that nearly one in five had attempted suicide at least once. A larger part of the respondents who had a history of suicide attempts reported that they were living alone. Many of those living alone were women.

The authors conclude that that economic vulnerability is an important psychosocial aspect to take into serious consideration concerning mental health and suicide prevention. Longitudinal research is needed to explain, predict, and prevent suicide due to over-indebtedness.

Henrik Levinsson 1, Sara Probert-Lindström 2 3, Rebecka Holmgren 4, Emma Nilsson Sundström 1, Richard Ahlström. Suicidal behaviour in over-indebted individuals: a cross-sectional study in Sweden. Nord J Psychiatry. 2023 Oct;77(7):669-675. doi: 10.1080/08039488. 2023.2218349. Epub 2023 Jun 1. PMID: 37261778 □


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