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AbstractWe sought to investigate the risk of incident major depressive disorder (MDD) attributable to a range of sleep disorders in the Danish population. Data were obtained by linking longitudinal Danish population-based registers. A total of 65,739 individuals who had first onset of depression between 1995 and 2013 were selected as cases. For each case, a set of 20 controls of the same sex, birth month and year and who had not had depression by the date that the case was diagnosed were selected at random form the population (N = 1,307,580 in total). We examined whether there was an increased rate of prior sleep disorders in MDD cases compared to controls using conditional logistic regression. An increased risk of incident depression in cases was found for all sleep disorders analyzed. Highest incidence rate ratios (IRRs) were found for circadian rhythm disorders (IRR = 7.06 [2.78–17.91]) and insomnia of inorganic origin (IRR = 6.76 [4.37–10.46]). The lowest estimated IRR was for narcolepsy (IRR = 2.00 [1.26–3.17]). Those diagnosed with a sleep disorder in the last 6 months were at highest risk of developing depression compared to those with at least 1 year since diagnosis (3.10 vs. 2.36). Our results suggest that having any sleep disorder is a risk factor for incident depression. Depression screening should be considered for patients with sleep disorders, and where possible, long-term follow-up for mental health problems is advisable.

Background: In Denmark, it is a political goal that 95% of all young people should complete an upper secondary education. For some young people, this goal can be difficult to achieve. An association has been established between suicidal behaviour and school performance. Aim: We hypothesise that young people who have attempted suicide have a lower chance of finishing secondary education. Methods: We used Danish historical population registers to perform a longitudinal cohort design and extended Cox regression modelling to estimate crude and adjusted estimates of the effect of suicide attempt on secondary education. We used the birth cohorts 1983–1989, and all subjects were followed from birth until the end of 2011 ( n = 355,725). Results: For suicide attempters, the likelihood of completing secondary education was one-third of non-attempters (crude hazard ratio = 0.38). A part of the impact can be explained by confounding factors. Individuals with a suicide attempt at age 16–20 years or with multiple suicide attempts were most likely not to complete secondary education. Compared to mentally ill non-attempters, suicide attempters with mental illness were more likely not to finish secondary education. Conclusion: A suicide attempt is not necessarily causal for not finishing secondary education, but it is a marker, and it predicts an increased likelihood of not finishing secondary education. We need to identify individuals at risk for suicide attempts and subsequently provide the necessary support. Completing secondary education is important, as it provides better chances of employment, higher wages and more opportunities for individuals in the future.

Background: Immigrant populations in Western European countries have grown in their size and diversity, but little is known about risks of self-directed and externalised violence among second-generation immigrants. Aims: To compare risks for attempted suicides and violent offending among second-generation immigrants to Denmark according to parental region of origin versus the native Danish population. Methods: Data from interlinked national Danish registers were used ( N = 1,973,614). Parental origin outside Denmark was categorised thus: Asia, Africa, Middle East, Greenland, other Scandinavian countries, elsewhere in Europe and all other regions. We estimated gender-specific cumulative incidence and incidence rate ratios (IRRs) versus native Danes. Results: In virtually all subgroups of second-generation immigrants, risk was elevated for the two adverse outcomes in both genders. Females generally had greater elevations in attempted suicide risk, and males had greater elevations in violent offending risk. For attempted suicide, especially large IRRs were observed for males and females whose parents emigrated from Greenland; for violent offending, risks were particularly raised for males and females of Middle Eastern, Greenlandic and African origin. Adjustment for socioeconomic status partially explained these associations. Conclusion: Western European nations should develop preventive programmes tailored towards specific second-generation immigrant populations, with integrated approaches jointly tackling suicidality and violence.

BACKGROUND: Mental disorders account for a substantial proportion of the years lived with disability (YLDs) globally. These estimates have generally been calculated top down based on summary statistics. The aim for this study was to calculate YLDs and a novel related measure, Health Loss Proportion (HeLP), for 18 mental and substance use disorders, based on person-level register data (bottom up). METHODS: A cohort of 6 989 627 Danish residents (5·9% had a diagnosis of a mental or substance use disorder registered in the Danish Psychiatric Central Research Register) was investigated. YLDs (the duration of disease multiplied by a disability weight) were calculated for the disorder of interest and for comorbid mental and substance use disorders. HeLPs were estimated as YLDs associated with an index disorder and comorbid mental and substance use disorders divided by person-years at risk in persons with the index disorder. All analyses were adjusted for mental and substance use comorbidity using a multiplicative model of disability weights. FINDINGS: Major depressive disorder was the most prevalent disorder, although schizophrenia was the leading cause of YLDs in both sexes combined (YLDs 273·3 [95 % CI 232·3-313·6] per 100 000 person-years). People diagnosed with schizophrenia lost the equivalent of 73% (63-83%) of healthy life per year due to mental and substance use disorders, the largest HeLP of all mental and substance use disorders. Comorbidity of mental and substance use disorders accounted for 69-83% of HeLPs in people with either cannabis use disorders, other drug use disorder and ADHD. By contrast, comorbidity explained 11-23% of the HeLPs in people with autism spectrum disorders, conduct disorder, and schizophrenia. INTERPRETATION: Substantial variation in disability was observed across age, sex, and disorders. The new HeLP metric provides novel details of the contribution of comorbidity to the disability associated with mental and substance use disorders. FUNDING: The Danish National Research Foundation, Queensland Government Department of Health, European Union's Horizon 2020, Lundbeck Foundation, Stanley Medical Research Institute. TRANSLATION: For the Danish translation of the abstract see Supplementary Materials section.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files ; Schizophrenia is a debilitating psychiatric condition often associated with poor quality of life and decreased life expectancy. Lack of progress in improving treatment outcomes has been attributed to limited knowledge of the underlying biology, although large-scale genomic studies have begun to provide insights. We report a new genome-wide association study of schizophrenia (11,260 cases and 24,542 controls), and through meta-analysis with existing data we identify 50 novel associated loci and 145 loci in total. Through integrating genomic fine-mapping with brain expression and chromosome conformation data, we identify candidate causal genes within 33 loci. We also show for the first time that the common variant association signal is highly enriched among genes that are under strong selective pressures. These findings provide new insights into the biology and genetic architecture of schizophrenia, highlight the importance of mutation-intolerant genes and suggest a mechanism by which common risk variants persist in the population. ; European Union's Seventh Framework Programme Medical Research Council (MRC) Centre European Community's Seventh Framework Programme German Research Foundation (DFG) Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Munster National Health and Medical Research Council (NHMRC) Agencia Estatal de Investigacion (AEI) Xunta de Galicia Fondo Europeo de Desarrollo Regional (FEDER) Lundbeck Foundation Stanley Medical Research Institute, an advanced grant from the European Research Council Danish Strategic Research Council Aarhus University Wellcome Trust Juvenile Diabetes Research Foundation (JDRF) European Union National Institute for Health Research (NIHR) programme Chief Scientist Office of the Scottish government Health Directorates Scottish Funding Council National Institute of ...