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• Tetracyclines have been proposed as candidate drugs for schizophrenia. • Potential long-term effects of doxycycline were explored using Danish Registry data. • 11,157 schizophrenia patients were analyzed, of which 718 redeemed a prescription of doxycycline. • The incidence of disability pension was selected as proxy measure of functioning. • Doxycycline prescription was associated with a lower incidence rate of disability pension. The brain-penetrant tetracycline antibiotics, minocycline and doxycycline, have been proposed as potential candidate drugs for treatment of schizophrenia, based on preclinical studies and clinical trials. A potential long-term beneficial effect of these antibiotics for schizophrenia patients has not been investigated. This study was designed to determine if redemption of doxycycline prescription in schizophrenia is associated with decreased incidence of disability pension, a proxy for long-term functioning. We performed a population-based cohort study with data from schizophrenia patients available through the Danish registers. Survival analysis models with time-varying covariates were constructed to assess incidence rate ratios (IRR) of disability pension after exposure to doxycycline or a non-brain penetrant tetracycline, defined as at least one filled prescription. The analysis was adjusted for age, sex, calendar year, parental psychiatric status and educational level. We used data from 11,157 individuals with schizophrenia (4,945 female and 6,212 male; average age 22.4 years old, standard deviation (std) 4.50). 718 of these were exposed to brain-penetrant doxycycline, and 1,498 individuals redeemed a prescription of one or more of the non-brain-penetrant tetracyclines. The average years at risk per person in this cohort was 4.9, and 2,901 individuals received disability pension in the follow-up period. There was a significantly lower incidence rate of disability pension in schizophrenia patients who had redeemed doxycycline compared to patients who did not redeem a prescription of any tetracycline antibiotics (Incidence rate ratio (IRR) 0.68; 95 % CI 0.56, 0.83). There was also a significant lower rate of disability pension in schizophrenia patients who redeemed doxycycline compared to individuals who redeemed a prescription of one of the non-brain penetrant tetracycline antibiotics (IRR 0.69 95 % CI 0.55, 0.87). In this observational study, doxycycline exposure is associated with a reduced incidence of disability pension. These data support further studies on the potential long term neuroprotective effects of doxycycline and level of functioning in schizophrenia patients. [ABSTRACT FROM AUTHOR]

The article discusses a study that investigated to what extent behavioral disorders with postpartum onset are early manifestations of an underlying bipolar affective disorder. Follow up results of women who had postpartum onset of bipolar symptoms showed that 14% of the women converted to bipolar diagnosis within the 15 year follow up period. This suggests that presentation of mental illness in early postpartum period is a marker of possible underlying bipolarity.

The article discusses the study investigating the risks and predictors of readmission for a mental disorder during the postpartum period. It is said that a cohort study has merged the data from the Danish Civil Registration System and the Danish Psychiatric Central Register. It includes 28, 124 women, in which 10,218 were mothers who were followed up from January 1, 1973 to June 30, 2005. Results show that mothers with mental disorders have lower readmision rates compared with nonmothers with mental disorders.

Background: Homelessness is an increasing societal problem in most high-income countries and often linked to mental illness and substance use disorders. However, there are few high-quality studies examining the risk of homelessness following discharge from in-patient psychiatric treatment. such information might be used as documentation for the need of structural changes to prevent homelessness in people with severe mental illness. We aimed to analyse the absolute and relative risk of homelessness following discharge from psychiatric wards in Denmark in the period from 2001 to 2015 and to identify high-risk diagnostic groups. Methods: We did a nationwide, register-based cohort study including people aged 18+ years discharged from psychiatric wards in Denmark between 1 January 2001 and 31 December 2015. We analysed associations between psychiatric diagnoses and the risk of homelessness using survival analysis. Results: A total of 126,848 psychiatric in-patients were included accounting for 94,835 person-years. The incidence of homelessness one year following discharge was 28.18 (95% CI 26.69–29.75) and 9.27 (95% CI 8.45–10.16) per 1000 person-years at risk in men and women, respectively. The one-year cumulative probability of first homelessness after discharge from psychiatric wards with a schizophrenia disorder was 1.54% (95% CI 1.25–1.88) in males and 0.60% (95% CI 0.40–0.87) in females. Substance use disorders increased the risk of homelessness after discharge with adjusted incidence rate ratios of 6.60 (95% CI 5.19–8.40) (men) and 13.06 (95% CI 9.31–18.33) (women), compared with depressive disorders. Schizophrenia increased the risk of homelessness after discharge by 1.91 (95% CI 1.29–2.83) and by 2.53 (95% CI 1.41–4.54) in men and women, respectively, also compared with depressive disorders. Prior history of homelessness was an important predictor for homelessness following discharge. Discussion: The first year following discharge from psychiatric wards is a high-risk period of homelessness, especially when having a substance use disorder or a prior history of homeless shelter contact. Schizophrenia was also an important predictor of homelessness. Improved efforts to prevent homelessness are needed. [ABSTRACT FROM AUTHOR]

Objective: Parental severe mental illness (SMI) increases the lifetime risk of mental and pediatric disorders in the offspring but little is known about specific disorders during early childhood. The primary aim was to investigate the incidence of mental and pediatric disorders among children 0-6 years old exposed to parental SMI, and secondarily to investigate the distribution of disorders on specific child age., Methods: A nationwide, register-based cohort study of 1,477,185 children born in Denmark between 1994.01.01 and 2016.12.31. Incidence rate ratios were calculated using Poisson regression analysis for any and specific mental and pediatric disorders., Results: IRR for any psychiatric disorder was elevated by a factor 2-5 among SMI offspring. Maternal schizophrenia resulted in the highest IRR = 5.23 (4.80-5.69) of any child psychiatric disorder. The risk of anxiety/OCD and attachment disorder among offspring exposed to parental, and in particular maternal, SMI was markedly raised with IRRs for anxiety/OCD between 7.59 and 17.02 and attachment disorders between 6.26 and 15.40. IRRs of mental disorders were highest at age 0-1 year and declined with age. IRR for any pediatric disorder was also elevated with IRRs between 1.01 and 1.28. Disorders of the digestive system and ill-defined symptoms were associated with the highest IRRs. Maternal (vs. paternal) SMI was associated with higher IRRs. IRRs declined slightly with child age., Conclusion: Children exposed to parental SMI are at increased risk of mental and pediatric disorders during early childhood, particularly anxiety/OCD and attachment disorders. If associations are estimates of a modifiable causal relationship, our results indicate a need for early intervention to promote mental and pediatric health among SMI offspring., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Psychiatric family history or a high autism polygenic risk score (PRS) have been separately linked to autism spectrum disorder (ASD) risk. The study aimed to simultaneously consider psychiatric family history and individual autism genetic liability (PRS) in autism risk. We performed a case-control study of all Denmark singleton births, May 1981-December 2005, in Denmark at their first birthday and a known mother. Cases were diagnosed with ASD before 2013 and controls comprised a random sample of 30,000 births without ASD, excluding persons with non-Denmark-born parents, missing ASD PRS, non-European ancestry. Adjusted odds ratios (aOR) were estimated for ASD by PRS decile and by psychiatric history in parents or full siblings (8 mutually-exclusive categories) using logistic regression. Adjusted ASD PRS z-score least-squares means were estimated by psychiatric family history category. ASD risk (11,339 ASD cases; 20,175 controls) from ASD PRS was not substantially altered after accounting for psychiatric family history (e.g., ASD PRS 10th decile aOR: 2.35 (95% CI 2.11-2.63) before vs 2.11 (95% CI 1.91-2.40) after adjustment) nor from psychiatric family history after accounting for ASD PRS (e.g., ASD family history aOR: 6.73 (95% CI 5.89-7.68) before vs 6.32 (95% CI 5.53-7.22) after adjustment). ASD risk from ASD PRS varied slightly by psychiatric family history. While ASD risk from psychiatric family history was not accounted for by ASD PRS and vice versa, risk overlap between the two factors will likely increase as measures of genetic risk improve. The two factors are best viewed as complementary measures of family-based autism risk. LAY SUMMARY: Autism risk from a history of mental disorders in the immediate family was not explained by a measure of individual genetic risk (autism polygenic risk score) and vice versa. That is, genetic risk did not appear to overlap family history risk. As genetic measures for autism improve then the overlap in autism risk from family history versus genetic factors will likely increase, but further study may be needed to fully determine the components of risk and how they are inter-related between these key family factors. Meanwhile, the two factors may be best viewed as complementary measures of autism family-based risk., (© 2021 International Society for Autism Research and Wiley Periodicals LLC.)

Objective: To study how often severe psychiatric disorders adversely affect a person's ability to be a parent, indicated by the child being placed in out-of-home care., Method: This study was conducted in 2013 as a prospective, register-based cohort study covering all first-born singletons in the entire Danish population born after 1982 (N = 782,092) and their parents. Rates of out-of-home placement of children with parents diagnosed with schizophrenia, bipolar disorder, or unipolar depression, according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 8th revision (ICD-8) and ICD, 10th revision (ICD-10), were analyzed. The rates were compared with those of children with parents from the general population., Results: A parental diagnosis of schizophrenia was the most prominent risk factor for children placed outside the home, with an accumulated risk for being placed in care at some point during childhood-40% for children with mothers with schizophrenia and 20% for children with fathers with schizophrenia. Children of mothers (incidence rate ratio [IRR] = 23.75; 95% CI, 20.94-26.93) and fathers (IRR = 7.85; 95% CI, 6.67-9.25) with a diagnosis of schizophrenia had the overall highest IRRs of placement in care. Having a mother with bipolar disorder was the second most prominent risk factor (IRR = 5.76; 95% CI, 4.50-7.36), followed by a maternal diagnosis of unipolar depression (IRR = 4.28; 95% CI, 3.73-4.90). Risks were especially high during the child's first year of life, indicating a critical period, especially for children with mothers with schizophrenia (IRR = 80.19; 95% CI, 68.09-94.43). Risks varied greatly with parents' socioeconomic factors in all diagnostic groups., Conclusions: Parental schizophrenia is a strong risk factor for placement of children in out-of-home care., (© Copyright 2015 Physicians Postgraduate Press, Inc.)