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Biomedical subjects

L V Kessing

Publications and source records attributed to L V Kessing.

At least 19 recordsLinked to original sources
PubMed2006

Increased relative risk of subsequent affective disorders in patients with a hospital diagnosis of obesity.

OBJECTIVE: To investigate the risk of clinical affective disorders of patients who were hospitalized because of obesity in the study period 1 January 1977 to 31 December 1999. METHOD: Using data from Danish hospital registers, three study cohorts were identified by their diagnoses at discharge from hospital: one cohort comprising all patients with a first hospital admission with an index diagnosis of obesity, and two control cohorts comprising all patients with a first hospital admission with an index diagnosis of osteoarthritis or of non-toxic goiter, respectively. Later admissions to psychiatric hospital wards with discharge diagnoses of affective disorders were used as outcome events. Rates of readmission were estimated using competing risks models in survival analyses. Age, sex, abuse, and calendar time were included as covariables in the analyses. RESULTS: A study sample of 165,425 patients discharged with an index diagnosis was identified. In total, 1081 events occurred in the observation period. An index diagnosis of obesity was associated with an increased risk of affective-disorders hospitalization when compared with patients with osteoarthritis (Rate ratio: 1.35 (95% CI: 1.09-1.67)) and tended to be associated with an increased risk when compared to patients with non-toxic goiter (Rate ratio: 1.23 (95% CI: 0.99-1.53)). Patients with obesity diagnoses who did not have additional hospital diagnoses of substance- or alcohol abuse had a risk of affective disorders that was 1.55 (95% CI: 1.23-1.95) times greater than that of osteoarthritis patients without abuse diagnoses. CONCLUSIONS: Patients hospitalized with obesity may be prone to developing affective disorders that require in-hospital treatment, but the excess risk is modest. Severe obesity seems to be associated with other risk factors for mood disorders than those related to comorbid alcohol- or substance abuse.

Adolescent↗
PubMed2006

No association between the -399 C > T polymorphism of the neuropeptide Y gene and schizophrenia, unipolar depression or panic disorder in a Danish population.

OBJECTIVE: A polymorphism in the promoter region of the NPY gene at position -399 C > T was recently reported to be associated with schizophrenia in a Japanese population and with treatment refractory unipolar depression in a Swedish population. The objective of this study was to investigate potential associations between the polymorphism and three psychiatric disorders in a Danish population. METHOD: We investigated the occurrence of the polymorphism in patients with schizophrenia (n = 291), unipolar depression (n = 256) and panic disorder (n = 142) compared with controls (n = 716). RESULTS: We detected the polymorphism -399 C > T at a frequency of 48% in controls. No significant differences were found between genotype or allele frequencies in controls vs. the patient groups. CONCLUSION: The lack of association between the -399 C > T polymorphism and schizophrenia, unipolar depression or panic disorder, respectively, suggests that the polymorphism is not involved in the etiology of these disorders in the Danish population.

Adult↗
PubMed2006

Temporal changes in suicide rates for persons treated and not treated with antidepressants in Denmark during 1995-1999.

OBJECTIVE: To compare the temporal changes in suicide rate among patients treated with antidepressants with the change in suicide rate among persons who have not been treated with antidepressants during 1995-1999. METHOD: In a historic prospective national pharmacoepidemiological register linkage study by using four Danish registers we included 438,625 patients who had purchased antidepressants, and compared them with 1,199,057 population based control persons. The annual rate of suicide was estimated using Poisson regression analyses. RESULTS: The suicide rate decreased for persons treated with antidepressants as well as for persons not treated with antidepressants. The proportion of persons, who committed suicide and who had not been treated with antidepressants decreased. The reduction in suicide rate was more pronounced among persons treated with SSRIs or older antidepressants than among persons not treated with antidepressants. CONCLUSION: Several factors contribute to the decreasing suicide rate. The most pronounced decrease in suicide rate was found among persons treated with antidepressants.

Adolescent↗
PubMed2006

Treatment with antidepressants and lithium is associated with increased risk of treatment with antiparkinson drugs: a pharmacoepidemiological study.

OBJECTIVE: To estimate the risk for persons treated with antidepressants or lithium of subsequent treatment with antiparkinson drugs (APD). METHODS: The Danish national prescription database supplied data on all persons who received antidepressants, lithium, or antidiabetics (first control group). A second control group was included comprising persons from the general population. Outcome was purchase of APD and the study period was 1995 to 1999. RESULTS: In total, 1 293 789 persons were included. The rate ratio of treatment with APD after treatment with antidepressants was 2.27 (95% CI 2.14 to 2.42) for men and 1.50 (95% CI 1.43 to 1.58) for women. Figures for lithium were almost identical. CONCLUSION: Persons treated with antidepressants or lithium are at increased risk of subsequently treatment with APD, showing an association between anxiety/affective disorder and Parkinson's disease.

Antidepressive Agents↗
PubMed2006

The internalising and externalising dimensions of affective symptoms in depressed (unipolar) and bipolar patients.

OBJECTIVE: To analyse the internalising and externalising dimensions of affective states in depressed (unipolar) and bipolar patients approximately 2 years after discharge from psychiatric hospitals in Denmark. METHOD: The 42-item symptom scale based on the Beck Depression Inventory was used for the measurement of both the internalising dimension of affective symptoms (depression including suicidal ideas, anxiety and asthenia) and the externalising dimension (mania). To supplement the latter dimension, the WHO-5 questionnaire was included. These questionnaires were mailed to a large population of patients with depressive (unipolar) or bipolar disorders, representative of patients treated in hospital settings in Denmark, approximately 2 years after discharge from hospital. RESULTS: In total, 244 unipolars and 214 bipolars were included in the study. Mokken analysis showed that depressive (unipolar) patients could be measured more validly than bipolar patients on the internalising subscales of depression, anxiety and asthenia. On the externalising dimension of psychological well-being (WHO-5), both groups of patients could be validly measured. Approximately 2 years after discharge from hospital, around 36% of the unipolars and 19% of the bipolars had a moderate to severe depression. In a control group of healthy subjects, 4% had a moderate to severe depression. Less than 5% even in the bipolar group of patients were hypomanic. CONCLUSION: Approximately 2 years after discharge from psychiatric hospitals in Denmark, depressive (unipolar) patients scored significantly higher than bipolar patients on the internalising dimension and suicidal ideas, and significantly lower on the externalising dimension of psychological well-being.

Adult↗
PubMed2004

The predictive effect of episodes on the risk of recurrence in depressive and bipolar disorders - a life-long perspective.

OBJECTIVE: It is generally accepted that one of the most important predictors of recurrence in depressive and bipolar disorders is the number of previous episodes. However, very few studies have considered the individual tendency toward recurrence in analyses of the effect of the number of episodes on the risk of subsequent recurrence in affective disorder. METHOD: Frailty models were used to estimate the effect of the number of episodes on the rate of recurrence taking into account the individual frailty toward recurrence. The study base consisted of 406 patients, 186 patients with depressive disorder and 220 patients with bipolar disorder, who were admitted between 1959 and 1963 to the Psychiatric Hospital University of Zurich with an affective episode and followed up to 1997. RESULTS: The individual rate of subsequent recurrence was found to increase with the number of episodes even when the effect was adjusted for the individual frailty toward recurrence. The effect of episodes was the same in depressive and bipolar disorders and for men and women. CONCLUSION: It seems increasingly valid that in depressive and bipolar disorders, the risk of subsequent recurrence increases with the number of episodes.

Bipolar Disorder↗
PubMed2004

Does the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder?

OBJECTIVE: Several findings suggest that some patients with depressive or bipolar disorder may be at increased risk of developing dementia. The present study aimed to investigate whether the risk of developing dementia increases with the number of affective episodes in patients with depressive disorder and in patients with bipolar disorder. METHODS: This was a case register study including all hospital admissions with primary affective disorder in Denmark during 1970-99. The effect of the number of prior episodes leading to admission on the rate of readmission with a diagnosis of dementia following the first discharge after 1985 was estimated. A total of 18,726 patients with depressive disorder and 4248 patients with bipolar disorder were included in the study. RESULTS: The rate of a diagnosis of dementia on readmission was significantly related to the number of prior affective episodes leading to admission. On average, the rate of dementia tended to increase 13% with every episode leading to admission for patients with depressive disorder and 6% with every episode leading to admission for patients with bipolar disorder, when adjusted for differences in age and sex. CONCLUSION: On average, the risk of dementia seems to increase with the number of episodes in depressive and bipolar affective disorders.

Adult↗
PubMed2003

Does the impact of major stressful life events on the risk of developing depression change throughout life?

BACKGROUND: It is unclear whether there is an interaction of ageing on the association between major life events and onset of depression. METHOD: This was a population-based nested case-control study with linkage of the Danish Psychiatric Central Research Register and the Integrated Database for Longitudinal Labour Market Research. The study includes data on all admissions at psychiatric wards in Denmark from 1981 to 1998 and data on sociodemographic variables and death/suicide of first-degree relatives. RESULTS: A total of 13 006 patients who received a diagnosis of depression at the first ever admission at a psychiatric ward and a gender- and age-matched control group of 260 108 subjects were identified. A recent divorce and recent unemployment and suicide of a relative (mother, father, sibling, child, spouse) were associated with increased risk of being admitted for the first time ever at a psychiatric ward with a diagnosis of depression whereas death of a relative by causes other than suicide had no significant effect. In general, no interaction was found with age with any of the variables, totally, or for men or women, separately. CONCLUSIONS: The susceptibility to major life stressors does not seem to change throughout life.

Adult↗
PubMed2003

Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark.

A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly will also be presented. Antidepressants and antipsychotics are beyond the scope of the report, but due to the mood-stabilizing properties of at least some of the atypical antipsychotics, these agents will be brought into some focus in connection with the overall treatment guidelines for the different phases of bipolar disorder given at the end of this report.

Adolescent↗
PubMed2003

Affective disorders in neurological diseases: a case register-based study.

OBJECTIVE: To investigate the temporal relationships between a range of neurological diseases and affective disorders. METHOD: Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two control group diagnoses were followed for up to 21 years. The incidences of affective disorders in the different groups were compared with the control groups, using competing risks to consider the risk of affective disorder and the risk of death in the same analysis. RESULTS: We found an increased incidence of affective disorders in dementia, Parkinson's disease, epilepsy, stroke and intracerebral haemorrhage compared with control groups. The association was found to be the strongest for dementia and Parkinson's disease. In hospitalized patients, with incident multiple sclerosis, the incidence of affective disorder was lower than the incidence in the control groups. CONCLUSION: In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases).

Adolescent↗
PubMed2002

Enduring increased risk of developing depression and mania in patients with dementia.

OBJECTIVE: To investigate the time relation between dementia and major affective disorders (major depression and mania). METHODS: Register linkage study of the Danish Hospital Register and the Danish Psychiatric Central Research Register, to establish study cohorts of patients with dementia and control groups (osteoarthritis or diabetes) on first discharge from hospital. Follow up of cohorts was for up to 21 years. Hazard of death was allowed for by the use of competing risks models. RESULTS: Patients with dementia had an increased risk of being admitted to hospital for major depression or mania during the course of the illness. The incidence remained elevated throughout the rest of the patient's life. CONCLUSIONS: Patients with dementia have an increased risk of developing depression or mania. Proper treatment of affective disorders in patients with dementia is important in reducing suffering and costs.

Aged↗
PubMed2001

Increased risk of developing Parkinson's disease for patients with major affective disorder: a register study.

OBJECTIVE: To investigate whether patients with a diagnosis of affective disorder are at an increased risk of developing Parkinson's disease compared with medically ill control groups. METHOD: By linkage of public hospital registers from 1977 to 1993, three study cohorts were identified: patients with affective disorder episodes (mania or depression) and patients with osteoarthritis or diabetes. Time to the first diagnosis of Parkinson's disease was estimated with the use of survival analysis. RESULTS: A total of 164 385 patients entered the study base. The risk of being given a diagnosis of Parkinson's disease was significantly increased for patients with affective disorder, odds ratio 2.2 (CI 95% 1.7-2.8) compared with osteoarthritis, and depressive disorders, odds ratio 2.2 (CI 95% 1.7-2.9) compared with osteoarthritis. CONCLUSION: This study supports the hypothesis of a common aetiology for major affective disorder and Parkinson's disease.

Aged↗
PubMed2001

The hypothalamo-pituitary-adrenal axis in major affective disorder: a review.

This paper reviews studies of the hypothalamo-pituitary-adrenal (HPA)-axis activity in patients with affective disorders. It is concluded that, despite methodological drawbacks in most studies, dysregulation of the HPA axis seems to be a consistent finding in a proportion of patients with affective disorder. The HPA axis is a complex neuroendocrine network with multiple integrated levels of control, and it is likely that the dysregulation involves abnormalities at several sites within the axis. At present, it is not clear whether the abnormalities are related to the affective episodes only or to the disorder itself. There is a need for prospective studies of larger samples of patients to be followed during successive affective episodes with a combination of measurements of the HPA-axis activity and brain imaging.

Dexamethasone↗
PubMed1999

[The course of affective disorders--a registry study].

In recent years, studies of the risk of recurrence in affective disorder in relation to the number of prior episodes have given contradictory results. Survival analysis was used to calculate the rate of recurrence after successive episodes in a case register study including all hospital admissions with primary affective disorder in Denmark during 1971-1993. Totally, 20,350 first-admission patients were discharged with a diagnosis of affective disorder, depressive or manic/circular type. The rate of recurrence increased with the number of previous episodes in both unipolar and bipolar disorder. Initially, the two types of disorders followed markedly different courses, but later in the course of the illness the rate of recurrence was the same for the two disorders. The course of severe unipolar and bipolar disorder seems to be progressive in nature despite the effect of treatment.

Bipolar Disorder↗
PubMed1999

Recurrence in affective disorder: analyses with frailty models.

The risk of recurrence in affective disorder is influenced by the number of prior episodes and by a person's tendency toward recurrence. Newly developed frailty models were used to estimate the effect of the number of episodes on the rate of recurrence, taking into account individual frailty toward recurrence. The study base was the Danish psychiatric case register of all hospital admissions for primary affective disorder in Denmark during 1971-1993. A total of 20,350 first-admission patients were discharged with a diagnosis of major affective disorder. For women with unipolar disorder and for all kinds of patients with bipolar disorder, the rate of recurrence was affected by the number of prior episodes even when the effect was adjusted for individual frailty toward recurrence. No effect of episodes but a large effect of the frailty parameter was found for unipolar men. The authors concluded that the risk of recurrence seems to increase with the number of episodes of bipolar affective disorder in general and for women with unipolar disorder.

Age Distribution↗