Suicidal behaviour and health care

Research questions:

This project aims to investigate:

• pathways to suicidal behaviour (suicide attempt and suicide)
• determinants of health care before and after a suicide attempt
• determinants of a poor prognosis following a suicide attempt in immigrant subgroups compared to the native population.

Immigrant subgroups are defined as refugees and other immigrants from different countries. Temporal and inter-country (Sweden versus Norway) differences in the mentioned associations will also be studied.

Project research design

Register-based cohort and case-control studies are conducted. For all individuals, retrospective and prospective data are linked.Outcome measures include suicidal behavior and specialized health care. Factors like social marginalization, specific mental disorders, health care and treatment are considered. Advanced statistical models are used.

This project will provide crucial knowledge by applying novel methodology taking individual differences in health care needs into consideration. This approach intends to provide a scientific knowledge base necessary to design optimal health care for immigrants with suicidal behaviour.

Participants

• Karolinska institutet
• Medical University Vienna
• University of Oslo

Publications

Amin R, Helgesson M, Runeson B, Tinghög P, Mehlum L, Qin P, Holmes EA, Mittendorfer-Rutz E. Suicide attempt and suicide in refugees in Sweden - a nationwide population-based cohort study. Psychological medicine 2019; 1-10

Amin R, Rahman S, Tinghög P, Helgesson M, Runeson B, Björkenstam E, Ping Q, Lars M, Holmes EA, Mittendorfer-Rutz E. Healthcare use before and after suicide attempt in refugees and Swedish-born individuals. Social psychiatry and psychiatric epidemiology 2020. https://link.springer.com/article/10.1007/s00127-020-01902-z External link.

Bjorkenstam E, Helgesson M, Amin R, Lange T, Mittendorfer-Rutz E. Mental disorders and suicidal behavior in refugees and Swedish-born individuals: is the association affected by work disability? Social psychiatry and psychiatric epidemiology 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395008/ External link.

Björkenstam E, Helgesson M, Amin R, Mittendorfer-Rutz E. Mental disorders, suicide attempt and suicide: differences in the association in refugees compared with Swedish-born individuals. The British journal of psychiatry: the journal of mental science 2019; 1-7

Niederkrotenthaler T, Mittendorfer-Rutz E, Mehlum L, Qin P, Björkenstam E. Previous suicide attempt and subsequent risk of re-attempt and suicide: Are there differences in immigrant subgroups compared to Swedish-born individuals? Journal of Affective Disorders 2020; https://www.sciencedirect.com/science/article/abs/pii/S0165032719326540 External link.

Amin R, Rahman S, Helgesson M, Björkenstam E, Runeson B, Tinghög P, Mehlum L, Qin P, Mittendorfer-Rutz E. Trajectories of antidepressant use before and after a suicide attempt among refugees and Swedish-born individuals: a cohort study. International Journal for Equity in Health. 2021 Jun 2;20(1):131. doi: 10.1186/s12939-021-01460-z. https://pubmed.ncbi.nlm.nih.gov/34078375/ External link.