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Objectives Previous Danish studies have shown that employees who "work with people" (ie, do person-related work) are at increased risk of hospitalization with a diagnosis of depression. However, these studies were purely register-based and consequently unable to point to factors underlying this elevated risk. This paper examines whether person-related work is associated with incident use of antidepressants, and whether this association is mediated by several work environment exposures. Methods Self-reported data from the Danish work environment cohort study in 2000 were linked with the use of antidepressants between 200 1-2006. We included 4958 respondents in our study after excluding those with severe depressive symptoms or use of antidepressants at baseline. Results Compared to employees doing non-person-related work, the use of antidepressants was increased statistically significantly for healthcare workers and statistically non-significantly for educational workers. The use of antidepressants was not elevated for social or customer service workers, or those doing "other" types of person-related work. The increased risks of antidepressant-use for healthcare and educational workers were attenuated when adjusted for emotional demands at work. Conclusions The results imply that healthcare and educational workers in Denmark are at increased risk of depression and that this risk is partly mediated by the high emotional demands of the work. [ABSTRACT FROM AUTHOR]

Background: It remains unclear how SSRIs and other antidepressants are associated with the risk of repeated suicide attempts. We aimed to analyse the association between redeemed antidepressant prescriptions and the risk of repeated suicide attempts, hypothesising that antidepressant treatment is associated with increased risk of repeated suicide attempts. Methods: The study was based on Danish register data and a validated cohort of 1842 suicide attempts. We used three Cox regression models (crude, adjusted and propensity score matched) to analyse the data; these models included both static and dynamic time-dependent factors. Results: 1842 individuals attempted suicide in the study period, with a total of 210 repeated attempts. Individuals redeeming antidepressant prescriptions were more likely to repeat a suicide attempt. All crude models showed all antidepressants to be significant risk factors (HR around 1.39), whereas all adjusted models showed all antidepressants to be insignificant risk factors. Conclusion: We found no significant increased risk of repeated suicide attempts in individuals redeeming a prescription for any antidepressant (or only SSRIs) when considering the individuals' baseline risk of repetition. This study is based on validated suicide attempts, register data, and strong epidemiology designs, but it still has some limitations, and the results should be replicated and confirmed in other studies. [ABSTRACT FROM AUTHOR]

Aim: To investigate the risk of depression in Danish women with PCOS compared to controls and possible mediators for depression in PCOS. National register-based study in Danish women with PCOS (PCOS Denmark, N = 25,203) and age-matched controls (N = 112,414). PCOS Odense University Hospital (PCOS OUH, N = 998) was a sub-cohort of women with PCOS with available clinical and biochemical results. The main study outcome was depression occurring after PCOS diagnosis. Depression was defined according to hospital ICD-10 diagnosis codes and/or inferred from filled medicine prescription of antidepressants. Diabetes, medical comorbidity, infertility, hormonal anti-contraception and low family income were entered as mediators in Cox regression analyses for depression. In PCOS OUH, PCOS characteristics (age, BMI, Ferriman-Gallwey score) were entered in Cox regression analyses. The median age at cohort entry was 28 (interquartile range (IQR) 23; 35) years. The median follow-up time to incident depression or censuring was 4.8 (IQR 2.2; 8.8) years in PCOS Denmark and 5.2 (IQR 2.4; 9.2) years in controls. Women with PCOS had a 40% increased risk of depression compared to controls (Hazard Ratio 1.42 (95% CI 1.38; 1.47). In regression analyses, diabetes, medical comorbidity, infertility, hormonal anticonception, and low family income were significant mediators of depression. Mediation analyses showed that the proportion of the association explained by diabetes was 12.5% (95% CI 10.4; 14.5). In PCOS OUH, BMI, waist and Ferriman-Gallwey score predicted development of depression. Conclusion: The risk of depression was increased in PCOS. Diabetes was an important mediator of depression in PCOS. [ABSTRACT FROM AUTHOR]

The study of medicine taking is controversial as it often reveals a discrepancy between healthcare professionals' advice and patients' actual behaviour. Qualitative researchers have examined depressed people's adherence to prescriptions of antidepressants by exploring the meaning they impute to the medicine and their use of the medicine in the wider context of their everyday lives. This paper contributes to this area of research by means of a prospective research study focussing on depressed patients' perspectives on taking medicine and how they change through time. The study included consecutive semi-structured interviews with 16 people four times during the year following an admission to hospital for depression. Data were collected in 2008–2009 in the Region of Southern Denmark. The study was based on an interactionist conception of social career and data were analysed thematically. Findings indicated that participants were confronted with recurrent challenges related to being depressed and taking medicine, and they learned how to manage these challenges in a post-admission career with two distinct stages: the basic restitution stage and the frustrated search stage. Medicine-taking depended on a number of career moving tensions and problems. The basic restitution stage was characterised by the participants' readiness to take medicine in accordance with healthcare professionals' prescriptions and advice. Half of the participants experienced being challenged by unacceptable prolonged mental, social, and/or physical distress, and they moved to the frustrated search stage, which was characterised by an alternative perspective on taking medicine that included increased self-regulation and less involvement of healthcare professionals and next of kin. Healthcare professionals played a very peripheral role in most participants' lives and unsatisfactory interactions often isolated participants and left them to solve their own problems. [ABSTRACT FROM AUTHOR]

Objectives We aimed to test the hypotheses that night-shift work is associated with an increased incidence of (i) redeemed prescriptions for psychotropic medicine and (ii) psychiatric hospital treatment due to mood, anxiety or stress-related disease. Moreover, we aimed to assess whether (iii) the effect of night-shift work on the rates of antidepressants differs from the effects on the rates of anxiolytics and (iv) the association between night-shift work and psychotropic medicine is affected by long working hours. Methods Full-time employees who participated in the Danish Labor Force Survey sometime in the period 2000–2013 (N=131 321) were followed for up to five years in national registers for redeemed prescriptions and psychiatric hospital treatment. The analyses were controlled for sex, age, weekly working hours, calendar time of the interview and socioeconomic status. Results We detected 15 826 cases of psychotropic drug use in 521 976 person-years at risk and 1480 cases of hospitalization in 636 673 person-years at risk. The rate ratio (RR) for psychotropic drugs was estimated to be 1.09 [99% confidence interval (CI) 1.02–1.16] for night-shift versus no night-shift work. The corresponding RR for psychiatric hospital treatment was 1.11 (95% CI 0.95–1.29). The odds of redeeming a prescription for antidepressants rather than anxiolytics was independent of night-shift work: 1.09 (95% CI 0.96–1.24), and we found no interaction effect between night-shift work and working hours (P=0.26). Conclusion As it appears in the general working population in Denmark, night-shift work is not an important predictor of mental ill health. [ABSTRACT FROM AUTHOR]

Objective: Studies restricted to live births may underestimate severe teratogenic effects. We address the limitation by including data from both prenatal and postnatal diagnoses of cardiac malformations. Design: Register‐based study. Setting: Denmark. Population: 364 012 singleton pregnancies from 2007 to 2014. Methods: We used data from five nationwide registries. Exposure to antidepressants was measured using redeemed prescriptions. Main outcome measures: Pregnancies with cardiac malformations that end in miscarriage, termination, stillbirth, postnatal death or cardiac surgery <1 year of birth were classified as severe cardiac malformations (SCM). Propensity scores with adjusted prevalence ratios (PRs) were calculated. Results: SCM were reported in 972 of 364 012 pregnancies overall and in 16 of 4105 exposed. For venlafaxine, the PR for SCM was 2.13 (95% confidence interval [CI] 0.89–5.13), 1.73 (95% CI 1.08–2.77) for other cardiac malformations, and there was a cluster of hypoplastic left heart syndromes (HLHS) (crude PR 17.4 [95% CI 6.41–47.2]), none of which ended in a live birth. For HLHS, the absolute risk increase was 4.4/1000 and the number needed to harm was 225. For selective serotonin reuptake inhibitors, the PRs were 1.09 (95% CI 0.52–2.30) and 1.38 (95% CI 1.00–1.92) for SCM and other cardiac malformations, respectively. Conclusions: Pregnancy exposure to venlafaxine is associated with an increased risk of severe cardiac malformations but with a low absolute risk. Potential mechanisms include direct effects or confounding by indication. Venlafaxine exposure is a marker for risk pregnancies for which fetal echocardiography may be considered. Exposure to venlafaxine is associated with an increased risk of cardiac malformations but with a low absolute risk. Exposure to venlafaxine is associated with an increased risk of cardiac malformations but with a low absolute risk. [ABSTRACT FROM AUTHOR]

Aims: To establish the prevalence of diabetes distress, perceived stress and depressive symptoms among adults with early‐onset Type 2 diabetes, and to examine their association with socio‐demographic and clinical characteristics. Methods: A cross‐sectional survey was performed among individuals with Type 2 diabetes aged 20‐45 years who were included in the Danish nationwide Danish Center for Strategic Research in Type 2 Diabetes cohort between 2010 and 2016. The survey assessed diabetes distress (20‐item Problem Areas in Diabetes Scale), perceived stress (10‐item Perceived Stress Scale) and depressive symptoms (10‐item short form of the Center for Epidemiological Studies Depression Scale Revised), as well as socio‐demographic characteristics. Clinical data were collected from national health registers. Results: In total, 216/460 (47%) individuals (48% women) with Type 2 diabetes completed the survey. The median (IQR) age was 42 (38–44) years and the diabetes duration was 5 (3–7) years. In total, 24% of respondents reported high diabetes distress (Problem Areas in Diabetes Scale ≥ 40), 46% reported high perceived stress (Perceived Stress Scale ≥ 18) and 41% reported elevated symptoms of depression (Center for Epidemiological Studies Depression Scale Revised ≥ 10). The prevalence of emotional problems was higher among women than men. Diabetes distress was higher among those prescribed non‐insulin glucose‐lowering drugs (vs. no glucose‐lowering drugs), but was not associated with other clinical or socio‐demographic characteristics. High perceived stress was associated with being unemployed and using antidepressant medication, and elevated depressive symptoms were associated with low education level, unemployment, living alone, having a psychiatric disorder and using antidepressant medication. Conclusion: We found a high prevalence of emotional problems among adults with early‐onset Type 2 diabetes in Denmark. Health care for this group should focus on both physical health and psychosocial circumstances and should also address general as well as diabetes‐specific emotional problems. What's new?: Adults with early‐onset Type 2 diabetes have an adverse risk factor profile. In Denmark, data on their psychosocial profile are needed to develop adequate health services.Almost half of 216 adults aged 20–45 years with Type 2 diabetes reported high levels of perceived stress and depressive symptoms, while a quarter reported high diabetes distress. The prevalence of emotional problems was higher among women and among some groups of lower socio‐economic status.Health services should be adapted to meet life‐stage specific needs in this group and to integrate psychosocial aspects into diabetes care. Gender‐specific interventions may be needed. [ABSTRACT FROM AUTHOR]

Background Data on drug utilisation patterns in nursing home populations is scarce. We aimed to describe drug use patterns in Danish nursing home residents. Methods We established a cohort of 5,179 individuals (63% women; median age of 84 years) admitted into 94 nursing homes across Denmark during 2015–2017. Data on prescription drug use and other census data were obtained from the nationwide Danish health registries. Results The total number of drug classes filled increased from a median of 6 drugs (interquartile range [IQR] 3–9) at 18–24 months before nursing home admission to a median of 8 drugs (IQR 6–11) just after admission, with the most common drug classes comprising paracetamol (61%), platelet inhibitors (41%), proton pump inhibitors (34%), statins (33%) and potassium supplements (31%). The incidence rate of new drug treatments increased from 21 new treatments/100 residents/month at 12–24 months before admission to a peak of 71 new treatments/100 residents/month in the month prior to admission, while it levelled off to about 34 new treatments/100 residents/month after 6–9 months. The drug classes primarily responsible for this peak were laxatives, antibiotics and analgesics. The largest absolute increases were seen for laxatives (53%), paracetamol (43%) and antidepressants (36%), all showing a marked increase up to and following admission. A high proportion of residents remained on therapy in the 3-year period following admission, with users of antidepressants and antidementia drugs being most persistent. Conclusion Nursing home admission is associated with an increase in use of both predominantly preventive and non-preventive drug classes. [ABSTRACT FROM AUTHOR]

Objective: To compare antidepressant utilization in individuals aged 5–19 years from the Scandinavian countries. Methods: A population‐based drug utilization study using publicly available data of antidepressant use from Denmark, Norway, and Sweden. Results: In the study period from 2007 to 2017, the proportion of antidepressant users increased markedly in Sweden (9.3–18.0/1000) compared to Norway (5.1–7.6/1000) and Denmark (9.3–7.5/1000). In 2017, the cumulated defined daily doses (DDD) of selective serotonin reuptake inhibitors were 5611/1000 inhabitants in Sweden, 2709/1000 in Denmark, and 1848/1000 in Norway. The use of 'other antidepressants' (ATC code N06AX) also increased in Sweden with a higher DDD in 2017 (497/1000) compared to Denmark (225/1000) and Norway (170/1000). The use of tricyclic antidepressants was generally low in 2017 with DDDs ranging between 30–42 per 1000. The proportion of antidepressant users was highest among 15‐ to 19‐year‐old individuals. Girls were more likely to receive treatment than boys, and the treated female/male ratios per 1000 were similar in Sweden (2.39), Denmark (2.44), and Norway (2.63). Conclusion: Even in highly comparable healthcare systems like the Scandinavian countries', variation in antidepressant use is considerable. Swedish children and adolescents have a markedly higher and still increasing use of antidepressants compared to Danish and Norwegian peers. [ABSTRACT FROM AUTHOR]

Aim: Few studies have evaluated how preadmission use of antidepressants affects outcomes in colorectal cancer (CRC) patients after they have undergone surgery. Therefore, our aim is to examine whether preadmission use of antidepressants increased the risk of complications and death in patients who underwent CRC surgery. Method: Using the Danish Colorectal Cancer Group Database we identified patients who underwent CRC surgery in Denmark from 2005 to 2012. We identified prescriptions for antidepressants redeemed within 1 year prior to surgery and categorized patients as current users (≤ 90 days), former users (91–365 days) and nonusers. All patients were followed from surgery to 30 days thereafter or to death. We calculated 30‐day rates of complications, intensive care unit (ICU) admission and mortality and compared these between users and nonusers using logistic and Cox regression adjusting for potential confounders. Results: Of 27 374 patients, 8.9% were current users and 3.0% were former users. Antidepressant users were older and had more comorbidity but a similar cancer stage. Compared with nonusers, current users had a higher risk of postoperative reoperation [adjusted odds ratio (aORs) = 1.15 (95% CI 1.02–1.30)], medical complications [aORs = 1.41 (95% CI 1.25–1.60)] and increased ICU admission rate [adjusted hazard ratio (aHR) = 1.32 (95% CI 1.21–1.45)]. The 30‐day mortality was 11.4% for current users, 9.1% for former users and 6.2% for nonusers [aHR = 1.34 (95% CI 1.17–1.53) for current vs nonusers]. Conclusion: Patients with preadmission use of antidepressants had a higher risk of complications and ICU admission, and higher 30‐day mortality following CRC surgery than nonusers. [ABSTRACT FROM AUTHOR]

Earlier it has been found that female Seventh-day Adventists (SDA) and Baptists have an increased incidence of psychiatric affective disorders, in contrast to findings that religious practice is associated with better health. In this study, we examined whether the increase in incidence is due to less use of prescribed antidepressants, sedatives and antipsychotics by members of these religious societies than by the general population. In a cohort study, we examined records of all drugs redeemed by 3121 SDA and 2888 Baptists and 29,817 age- and gender-matched members of the general population between 1995 and 2010 in the Danish Prescription Register and compared the prevalence and incidence of use of antidepressants, sedatives and antipsychotics. The prevalence of antidepressant use by women was lower in 1998 but no different from that in controls in 2003 and 2008; the prevalence of antidepressant use by men was higher in both 1998 and 2008 than in the Danish population. The incidence of antidepressant use was lower for female members in 1996-2000, but no difference was observed in the other periods. The prevalence and incidence of use of sedatives and antipsychotics did not consistently differ from those of the general population. The prevalence and incidence of use of antidepressants, sedatives and antipsychotics by female SDA and Baptists were not consistently lower than in the general Danish population. Our findings hence do not explain the increased incidence of psychiatric disorders among female members of these Danish religious societies. [ABSTRACT FROM AUTHOR]

This study explored how eight pregnant women diagnosed with depression managed the decision whether or not to take antidepressants during pregnancy. In total, 11 interviews were conducted and analysed by means of constructivist grounded theory. The major category constructed was Balancing risk, with two minor categories: Assessing depression and antidepressants and Evaluating the impact of significant others. The participants tried to make the safest decision, taking all aspects of their life into consideration. They described successful decision-making in the context of managing social norms that surround pregnancy, in a way that was acceptable to themselves, their significant others and healthcare professionals. [ABSTRACT FROM AUTHOR]

In response to recent calls for implementing mental health promotion (MHP) in Denmark, the Danish National Institute of Public Health undertook a perusal of existing MHP frameworks. While a small number of such frameworks exist, the Act-Belong-Commit campaign that originated in Western Australia, was the only comprehensive, population-wide program identified that had a strong evidence base, demonstrated success in implementation and universal principles of well-being. Following a successful funding application to the Ministry of Health, the National Institute for Public Health, is leading a partnership to implement the Act-Belong-Commit campaign in Denmark in 2015-2017. This article describes the Act-Belong-Commit campaign and its implementation in Australia and how the National Institute of Public Health plans to introduce the campaign into Denmark. It is hoped that our planning for Denmark will be helpful to other countries planning to adopt the Act-Belong-Commit campaign. [ABSTRACT FROM AUTHOR]

Objective Treatment of schizophrenia is frequently complicated by patients' ambivalence and lack of insight into the disease, occasionally warranting involuntary treatment. This study aims to describe involuntary treatment in Danish schizophrenia patients. Method Patients diagnosed with a lifetime ICD-10 F20 schizophrenia diagnosis and alive in the period 2004-2010 were identified in the Danish Psychiatric Central Research Register, and data were linked to The Registry of Coercive Measures in Psychiatric Treatment. Results Within the study period, a total of 18 599 admitted patients were identified, 3078 of which underwent involuntary treatment. The incidence rate for any involuntary treatment was 2.1 per in-patient year and 1.7 and 0.3 per in-patient year for rapid tranquilization and involuntary treatments, respectively. Somatic diseases comprised 34.5% of all involuntary treatments. Psychotropics comprised 56.9% with antipsychotics as the most common drug class (99.5%). Olanzapine was the most commonly used antipsychotic drug (33.2%). Treatment with depot injection and clozapine comprised only 13% and 4.8% of the antipsychotics used, respectively. Electroconvulsive therapy comprised 4.8% of all involuntary treatment. Conclusion Involuntary treatment involved a wide range of somatic treatment. Antipsychotic medicine was the most common psychotropic used. Involuntary treatment with depot antipsychotics and clozapine were rare. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the prevalence and patterns of exposure to antidepressants before, during and after pregnancy in a cohort including all pregnant women in Denmark between 1997 and 2010. Methods: We performed a retrospective cohort study including 912 322 pregnancies. Information was retrieved from the Danish Birth Registry and The Register of Medicinal Product Statistics to identify women redeeming an antidepressant prescription during pregnancy. Exposure periods were based on standard treatment doses and dispensed pack sizes. Results: We identified 19 740 pregnancies exposed to an antidepressant at some point during pregnancy. The rate of exposure increased from 0.2% in 1997 to 3.2% in 2010. We found that the rate of exposure was halved during the first 3 months of pregnancy. In contrast, we describe a clear increase in exposure after pregnancy among pre-delivery treatment-naïve women. Conclusions: In spite of uncertainty concerning antidepressants’ safety during pregnancy we find a 16-fold increase in exposure rates between 1997 and 2010. The rates describe a sharp decrease in exposure during pregnancy that is probably caused by physicians’ hesitation to prescribe antidepressants and women’s fear of unwanted effects on the unborn child. More studies are needed to clarify the consequences of antidepressant discontinuation during pregnancy. [ABSTRACT FROM AUTHOR]

Although the mental health consequences of domestic violence are well documented, empirical evidence is scarce regarding the mental health effects of violence in the workplace. Most studies have used data from small occupation-specific samples, limiting their generalizability. This article examines whether direct exposure to work-related violence is associated with clinically pertinent mental health problems, measured by purchases of psychotropics (antidepressants, anxiolytics, hypnotics), in a cross-occupational sample of 15,246 Danish employees free from using psychotropics at baseline. Self-reported data on work-related violence were merged with other data on purchases of medications through a national registry to estimate cause-specific hazard ratios during 3.6 years (1,325 days) of follow-up in the years 1996–2008. Outcomes were examined as competing risks, and analyses were adjusted for gender, age, cohabitation, education, income, social support from colleagues, social support from supervisor, and influence and quantitative demands at work. Work-related violence was associated with purchasing antidepressants alone (hazard ratio = 1.38, 95% confidence interval: 1.09, 1.75) or in combination with anxiolytics (hazard ratio = 1.74, 95% confidence interval: 1.13, 2.70) but not with purchasing anxiolytics or hypnotics only. The frequency of violent episodes and risk of caseness were unrelated. Work-related violence is associated with increased risk of clinically pertinent mental health problems. Reducing levels of work-related violence may help to prevent mental disorders in the working population. [ABSTRACT FROM PUBLISHER]

We evaluated factors associated with use of antidepressant medication subsequent to a diagnosis of breast cancer. We also evaluated the effect of participation in a cancer rehabilitation program on use of antidepressants. Material and methods. We conducted a register-based cohort study of 1 247 women with breast cancer diagnosed between 1998 and 2006 who attended a week-long rehabilitation program and a comparison group of 2 903 women who did not attend the program matched through the registers of the Danish Breast Cancer Cooperative Group. The associations between breast cancer-related, treatment-related, and sociodemographic factors and use of antidepressants were evaluated in multivariate Cox proportional hazard models separated on use of antidepressants before diagnosis of breast cancer. Results. The mean follow-up for the 4 150 women in the study was 3.3 years (5-95% range, 0.3-7.0 years) and 1 020 (25%) were users of antidepressants after diagnosis of breast cancer. Among women who had not used antidepressants before their breast cancer, the diagnosis of a new primary cancer increased the adjusted hazard ratio (HR) to 3.34 (95% CI, 1.50-7.76), and recurrence of breast cancer increased the HR for first use of antidepressants to 2.56 (95% CI, 1.86-3.52). Unemployment was associated significantly with use of antidepressants, whereas having no children living at home, lower income, and the number of tumor-positive axillary lymph nodes were of borderline significance. No effect of the rehabilitation program was observed on first use of antidepressants after breast cancer. Discussion. Diagnosis of a new cancer or recurrence of breast cancer considerably increased the rate of use of antidepressants. Sociodemographic rather than disease- or treatment-related characteristics at the time of diagnosis were associated with first use of antidepressants after a breast cancer diagnosis. [ABSTRACT FROM AUTHOR]

Background: Danish registry-based studies have found socio-economic differences in drug use. The extent to which the use of antidepressants differs between socio-economic groups is unknown. Aim: 1) to examine the association between socio-economic status (SES) and use of antidepressants 2) to evaluate the introduction of new types of antidepressants. Methods: A registry-based cross-sectional study linking information from administrative registries in North Jutland County, Denmark, 1995–99. Main outcome measures: 1) the prevalence proportion for use of antidepressants in different SES groups and by sex, and the estimated prevalence proportion ratio; 2) the proportion using the new drugs in different socio-economic groups through the study period. Results: Women used antidepressants more than twice as often as men with an increasing tendency for both men and women. The use of antidepressants was highest in persons outside the labour market. Among employees, the proportion using new types of antidepressants increased from 1% to 18%. High SES seemed to correlate to higher use of new antidepressants. The new antidepressants were introduced faster among men compared with women. Conclusion: The study showed differences in purchase of antidepressants in different SES groups. Furthermore, it showed faster introduction of new antidepressants among men and employees with high SES. [ABSTRACT FROM AUTHOR]

Background: the new antidepressants are generally effective and safe for older people, but may have serious side-effects. The use has been rapidly increasing, but focus on upper age groups has been limited. The pattern of antidepressant use as death approaches has never been analysed. Objective: to analyse the use of antidepressants among individuals aged 65 years and above with respect to time trends, age and proximity to death. Design: population-based prescription study. Setting: the County of Funen, Denmark, 1992-2004 (~470.000 inhabitants). Results: the 1-year prevalence of antidepressants increases steadily over time in all age groups. Among the 65+ year-olds it also increases with age and differs substantially between the youngest and the oldest. Very high prevalences are observed: 26.8% among females 85-89 years old and 17.5% among males 85 years and above in 2004. In all age groups the use antidepressants increases substantially with proximity to death in the last 3 years of life. In the last phase of life the use is independent of whether the patient dies at age 65 or 90 about 33% of females and 25% of males receive antidepressants in the last 6 months. Conclusions: the use of antidepressants among 65+ year-olds increases with age and proximity to death to very high levels. Future studies may clarify the problems and diagnoses giving rise to the use of antidepressants for such a large proportion of older people, and especially the problems giving rise to treatment as death approaches. [ABSTRACT FROM AUTHOR]

Antidepressant use in Denmark, as in many developed countries, has substantially increased during recent years, coinciding with a decreasing suicide rate. In a nationwide observational cohort study with linkage of registers of all prescribed antidepressants and recorded suicides in Denmark from 1995 to 2000, we investigated the relation between continued treatment with antidepressants and suicide in a population of all patients discharged from hospital psychiatry with a diagnosis of depressive disorder. Patients discharged from hospital psychiatry with a diagnosis of depressive disorder had a highly increased rate of suicide. Those who continued treatment with antidepressants had a decreased rate of suicide compared with those who purchased antidepressants once (rate ratio: 0.31, 95% confidence interval: 0.26-0.36). Further, the rate of suicide decreased consistently with the number of prescriptions. On individualized data from a cohort of patients with a known history of depressive disorder, continued antidepressant treatment was associated with reduced risk of suicide. [ABSTRACT FROM AUTHOR]

The article reports on the psychiatric outcome studies at the Psychiatric Research Unit in Denmark. The report covers the period from 1981 to 2006 in which a new generation of antidepressants with a new mechanism of action was developed. The report states that the scientific evidence obtained in the psychiatric outcome trials showed that antidepressants and antimanics help patients with moderate to severe affective disorders for whom psychotherapy is not a sufficient treatment.

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. [ABSTRACT FROM AUTHOR]

Background: A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment. Methods: A prospective follow-up study was performed in 5142 Danish employees, including 632 employees with and 4510 without a history of prolonged unemployment. Participants were drawn from a random 10% sample of the Danish population. Survey data on job insecurity were linked with register data on history of unemployment and dispensing of antidepressant medication between June 2000 and December 2003 retrieved from the Danish Medicinal Product Statistics. Respondents with major depression at baseline or antidepressant use in the 5 years preceding baseline were excluded. Results: Job insecurity predicted use of antidepressants after adjustment for sex, age, cohabitation, socioeconomic position and alcohol consumption (OR 1.43, 95% CI 1.09 to 1.88). The effect was attenuated after further adjustment for baseline depressive symptoms (OR 1.15, 95% CI 0.87 to 1.52). A history of prolonged unemployment predicted use of antidepressants in both models (OR 1.62, 95% CI 1.14 to 2.30 and OR 1.49, 95% CI 1.04 to 2.13, respectively) Compared with participants with neither job insecurity nor unemployment history, the OR for the joint effect of job insecurity and history of prolonged unemployment was substantially higher (OR 1.79, 95% CI 1.15 to 2.79) than the OR for job insecurity (OR 1.02) and unemployment history (OR 1.10) alone in the fully adjusted model. Conclusion: Job insecurity predicts incident use of antidepressants among Danish employees with a history of prolonged unemployment. [ABSTRACT FROM AUTHOR]