Acta Psychiatrica Scandinavica最新文献

{"title":"The Prevalence of Obstructive Sleep Apnoea in Schizophrenia, Bipolar Disorder and Major Depressive Disorder: A Systematic Review With Meta-Analysis","authors":"Constanza Sommerhoff,&nbsp;Marta Bort,&nbsp;Michele De Prisco,&nbsp;Sofia Paolucci,&nbsp;Mireia Dalmases,&nbsp;Vincenzo Oliva,&nbsp;Eduard Vieta,&nbsp;Andrea Murru,&nbsp;Giovanna Fico","doi":"10.1111/acps.70119","DOIUrl":"10.1111/acps.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>People with severe mental illness (SMIs) are at an increased risk of morbidity and reduced life expectancy. Obstructive sleep apnoea (OSA), a prevalent but underdiagnosed condition in SMIs, may precipitate more physical health complications. This meta-analysis aimed to estimate the prevalence of OSA and assess its risk in SMIs populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis on studies reporting either diagnosis or high risk of OSA in bipolar disorder (BD), schizophrenia (SCZ), and major depressive disorder (MDD). Databases were searched through January 2026. Pooled prevalence of OSA was calculated through a single-group meta-analysis, while odds ratios (ORs) comparing SMIs and control groups were estimated by a two-group meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 47 articles were included in the meta-analysis. The pooled prevalence of OSA in SMIs was 41.2%, largely influenced by clinical and sleep-referral settings, with a 38.3% prevalence in SCZ, 38.2% in MDD and 35.6% in BD. Compared to healthy controls (HCs) without psychiatric diagnosis, participants with SMIs had significantly higher odds of being diagnosed with OSA (OR = 6.96; 95% CI = 2.48, 19.51; <i>k</i> = 2; <i>p</i>-value &lt; 0.001). High risk of OSA was present in 46.7% of SMI individuals. BD participants showed significantly higher excessive daytime sleepiness compared to HCs (SMD = 0.63; 95% CI = 0.28, 0.98; <i>k</i> = 2; <i>p</i>-value &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>People with SMIs have a high prevalence of OSA and are at an increased risk of OSA compared to the general population. These findings highlight the considerable burden of OSA in SMIs and support the need for systematic assessment within psychiatric care settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"322-341"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benzodiazepine Use and Mortality Risk: A Nationwide Cohort Study on New Benzodiazepine Users With a 5-Year Follow-Up","authors":"Hanna Särkilä,&nbsp;Heidi Taipale,&nbsp;Antti Tanskanen,&nbsp;Tero Taiminen,&nbsp;Reijo Sund,&nbsp;Terhi Kurko,&nbsp;Jarmo Hietala,&nbsp;Solja Niemelä","doi":"10.1111/acps.70121","DOIUrl":"10.1111/acps.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We aimed to investigate the risks of all-cause and cause-specific mortality associated with dose-dependent benzodiazepine and Z-drug (BZDR) use in the Finnish population initiating new BZDR use with five-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Study subjects were included if BZDR use had started in 2006 with no BZDR dispensing during the preceding years 2004–2005. The information drug dispensing was modeled with PRE2DUP method as time-varying measure updated at every dispensing and then divided into three dose categories which were low dose (&lt; 1.0 Defined Daily Doses [DDDs] per day), medium to high dose (1.0–&lt; 3.0 DDDs/day) and very high-dose (≥ 3.0 DDDs/day). Risk of mortality was studied with Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 48,124 incident BZDR users aged 18–65 years (44.4% male). During the 5-year follow-up, 2294 (4.9%) individuals died. Compared to non-use periods, BZDRs use was associated with increased mortality risk (adjusted Hazard Ratio HR 1.28, 95% Confidence Interval CI 1.16–1.41). Compared to the time periods when BZDRs were not used, both medium to high-dose use (aHR 1.58, 1.36–1.74) and very-high-dose use (aHR 2.68, 95% CI 2.20–3.26) were associated with an increased risk of all-cause mortality, whereas low dose use was not. The highest risk estimates were observed during very high-dose use and for potentially preventable deaths such as overdoses (aHR 6.18, 95% CI 3.77–10.12), suicides (aHR 4.46, 95% CI 2.79–7.13), and accidents (aHR 3.77, 95% CI 2.66–5.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Persons using BZDRs in very high doses are at a six-fold increased risk of overdose deaths compared to non-use, and those using BZDRs in medium to high doses are at a three-fold increased risk. In low doses, however, the risk of all-cause mortality was not elevated. The mortality risk strongly associates with higher doses and is often characterized by concomitant use of more than one BZDRs at the same time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"342-351"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148292621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the Danish Administrative Registers to Define Mental Disorders: Potential and Limitations of Using Different Data Sources.","authors":"Natalie C Momen, Xiaoqin Liu, Ole Köhler-Forsberg, Bodil Hammer Bech, Oleguer Plana-Ripoll","doi":"10.1111/acps.70145","DOIUrl":"https://doi.org/10.1111/acps.70145","url":null,"abstract":"<p><strong>Background: </strong>Although the Danish health registers provide rich data for epidemiological mental health research, the comparability of findings is hindered by different definitions of mental disorders across studies. We aimed to describe different approaches taken by researchers to define mental disorders using Danish register data and quantify the impact of selecting different definitions on estimates of prevalence and incidence.</p><p><strong>Method: </strong>We undertook a scoping review to identify the approaches to define mental disorders using Danish register data and produced a narrative synthesis. We compiled tables of potential definitions for any mental disorder and specific types of mental disorders using nationwide Danish registers. Using these definitions, we quantified (i) the number of individuals fulfilling each definition during 2018 and 2018-2022 and (ii) the estimated cumulative incidence.</p><p><strong>Results: </strong>Our search identified 2185 papers, 1155 of which used Danish register data to define mental disorders to describe the study population, an exposure, or an outcome. Our estimates of the number of individuals fulfilling each definition and the estimated cumulative incidences indicated considerable variation with the data sources and variables used to define mental disorders within the Danish national registers. For example, the cumulative incidence of any mental disorder at 80 years among females varied between 29.2% when only psychiatric unit patient register data were used and 62.1% when somatic patient, prescription, cause of death, and health services register data were added.</p><p><strong>Conclusion: </strong>The different data sources and variables used to define mental disorders can result in substantial variation in the numbers of identified cases. Studies should clearly document all variables and values used to define their disorders of interest, as well as describe the disorder they aim to capture, discussing the strengths and limitations of their approach and the likely impacts on the sensitivity and specificity of including or omitting data from other available registers.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiving and Work: Labour Market Outcomes in Spouses of Patients With a Mental Illness-A Danish Nationwide Matched Cohort Study.","authors":"Lisbeth Juhl Mikkelsen, Carsten Hjorthøj, Signe Sofie Nielsen, Michael E Benros, Anne Dorothee Müller, Merete Nordentoft, Anne Amalie Elgaard Thorup, Anne Ranning","doi":"10.1111/acps.70142","DOIUrl":"https://doi.org/10.1111/acps.70142","url":null,"abstract":"<p><strong>Objectives: </strong>To examine labour market outcomes among spouses of individuals with a hospital-recorded diagnosis of a mental disorder living with dependent children, compared with matched controls, and to assess whether these associations differ by sex.</p><p><strong>Methods: </strong>We conducted a nationwide, register-based matched cohort study using data from Danish population registers from 2010 to 2022. Cases were spouses cohabiting with an individual diagnosed with a mental disorder and with at least one child aged 0-17 years living at home at the index date. Controls were matched 1:10 on age, sex, and cohabitation status and had no partner with a registered mental disorder at the index date. Outcomes were taxable income, degree of employment (percentage of full-time employment), and receipt of sickness benefits, assessed from 5 years before to 5 years after the index date. Analyses used fixed-effects linear models and conditional fixed-effects logistic regression with both unadjusted and covariate-adjusted estimates, and sex-by-case status interactions were examined.</p><p><strong>Results: </strong>The study included 54,080 cases and 468,541 matched controls. Across the observation period, spouses of individuals with mental illness had persistently lower income and degree of employment and higher odds of receiving sickness benefits than controls. Five years after the index date, cases had a 16% lower annual income and a 12 percentage point lower degree of employment compared with controls. Odds of receiving sickness benefits increased markedly in the year following the partner's diagnosis. Sex-specific analyses showed that male spouses experienced larger relative income loss, whereas female spouses exhibited greater reductions in degree of employment and higher absolute levels of sickness benefit receipt.</p><p><strong>Conclusions: </strong>Spousal mental illness is associated with substantial and sustained labour market disadvantages in families with dependent children, even within a universal welfare system. The observed sex-specific patterns suggest that caregiving-related economic consequences are structured along sex-specific divisions of labour. These findings highlight the need to consider spouses in policy responses to mental illness.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide in Bipolar Disorder: A Differential Finding Needs a Differential Mechanism.","authors":"Alexis Demas","doi":"10.1111/acps.70143","DOIUrl":"https://doi.org/10.1111/acps.70143","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction in Rates of Stressful Life Events Preceding Depressive Episodes in the Course of Recurrent Major Depressive Disorder.","authors":"Sooyeon Min, Yoojin Song, Heon-Jeong Lee, Seunghee Won, Kyu Young Lee, Dong Yun Lee, Do Hoon Kim, Ji Hyun Baek, Kyoung-Sae Na, Eun-Jeong Joo, So Hee Lee, Ji-Woon Jeong, C Hyung Keun Park, Woojae Myung, So Young Yoo, Jaesub Park, Won-Hyung Kim, Moon-Soo Lee, Jeong Hun Yang, Jung Jae Lee, Young Tak Jo, Soo-Hee Choi, Hyunju Lee, Jaewook Han, Kenneth S Kendler, Sang Jin Rhee, Yong Min Ahn, Jonathan Flint","doi":"10.1111/acps.70141","DOIUrl":"https://doi.org/10.1111/acps.70141","url":null,"abstract":"<p><strong>Background: </strong>Stressful life events (SLEs) are a well-established etiologic risk factor for major depressive disorder (MDD). The kindling hypothesis proposes that their role diminishes as episodes recur, with illness becoming progressively autonomous from environmental triggers. It remains unclear whether this reflects true within-person change or a compositional shift-whereby more highly recurrent patients are those whose episodes were stress-independent from the outset.</p><p><strong>Methods: </strong>We analyzed data from life history calendars, a structured method for reconstructing lifetime sequences of depressive episodes and antecedent life events, from 5843 Korean women with recurrent MDD (≥ 2 lifetime episodes) contributing 17,338 episode observations (KOMOGEN-D), with replication in 708 Chinese women contributing 1905 episode observations (CONVERGE).</p><p><strong>Results: </strong>Consistent with the kindling hypothesis, the proportion of episodes preceded by any SLE declined substantially and monotonically across episode order, from 94.8% (95% CI, 94.2%-95.4%) at the first episode to 77.7% (95% CI, 71.2%-84.2%) at the seventh (OR per episode increase, 0.66; 95% CI, 0.62-0.71). Inter-episodic intervals shortened with episode order (β = -1.50 years; 95% CI, -1.61 to -1.38), indicating that episodes became more frequent. Within-individual analyses revealed that more participants had decreasing than increasing SLE counts across episodes, with more frequent transitions from SLE-associated to non-SLE-associated episodes than the reverse. Stratification by SLE type showed that independent SLEs decreased across episodes, whereas dependent SLEs increased. The main findings were replicated in CONVERGE, although some within-person transition analyses were limited by smaller sample size.</p><p><strong>Conclusions: </strong>Across two large cohorts collected in different cultural settings, SLE involvement preceding episodes decreased across episode order while the rate of recurrence accelerated, and within-person analyses supported stress-episode decoupling as an individual-level process. These findings provide some of the strongest evidence yet assembled that the course of recurrent MDD is consistent with the kindling hypothesis: episodes become progressively less dependent on external stressors, shifting toward a more autonomous illness. These results have direct implications for stratifying recurrence risk by episode stage and for identifying the point in the illness course at which preventive strategies should shift emphasis from targeting environmental stressors toward sustained pharmacological or psychological relapse prevention.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling Suicidal Ideation and Behaviors in a Global Cohort of Individuals at Clinical High-Risk for Psychosis: Multivariable Correlates and Subthreshold Psychotic Symptoms.","authors":"Stefano Damiani, Marika Orlandi, Umberto Provenzani, Elisa Bortolin, Margherita Rovida, Riccardo Stefanelli, Jean Addington, Luis Alameda, Celso Arango, Nicholas J K Breitborde, Matthew R Broome, Kristin S Cadenhead, Monica E Calkins, Ricardo E Carrion, Rolando I Castillo-Passi, Eric Yu Hai Chen, Jimmy Choi, Philippe Conus, Barbara A Cornblatt, Covadonga M Diaz-Caneja, Lauren M Ellman, Abigayle Fogarty, Pablo A Gaspar, Carla Gerber, Louise Birkedal Glenthøj, Leslie E Horton, Christy Lai Ming Hui, Joseph Kambeitz, Lana Kambeitz-Ilankovic, Matcheri S Keshavan, Minah Kim, Sung-Wan Kim, Nikolaos Koutsouleris, Zsuliet Kristof, Jun Soo Kwon, Kerstin Langbein, Daniel Mamah, Daniel H Mathalon, Vijay A Mittal, Josh Nguyen, Merete Nordentoft, Godfrey D Pearlson, Nora Penzel, Jesus Perez, Diana O Perkins, Albert R Powers, Jack Rogers, Fred W Sabb, Jason Schiffman, Jai L Shah, Steven M Silverstein, Stefan Smesny, William S Stone, Gregory P Strauss, Judy L Thompson, Rachel Upthegrove, Swapna Verma, Cassandra Wannan, Jijun Wang, Heather Wastler, Daniel H Wolf, Tianhong Zhang, Sylvain Bouix, Cheryl M Corcoran, Tina Kapur, Ofer Pasternak, Carrie E Bearden, Rene S Kahn, John M Kane, Patrick D McGorry, Barnaby Nelson, Martha E Shenton, Scott W Woods, Paolo Fusar-Poli","doi":"10.1111/acps.70138","DOIUrl":"https://doi.org/10.1111/acps.70138","url":null,"abstract":"<p><strong>Introduction: </strong>Suicidal ideation and behaviors (SIB) are common among individuals at clinical high risk for psychosis (CHR-P), but their relationship with the overall clinical profile remains unclear. This study aimed to identify sociodemographic/clinical factors associated with SIB in CHR-P individuals and to examine whether subthreshold psychotic symptom severity increases with suicidal risk.</p><p><strong>Methods: </strong>Data from the AMP SCZ initiative included 1443 CHR-P participants aged 12-30 years. SIB were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS). Three Elastic Net regression models examined associations between suicidal ideation severity, intensity, and behaviors using 54 variables spanning sociodemographics, general psychopathology, subthreshold psychotic symptoms, and socio-occupational functioning. Moreover, ANCOVA compared overall psychotic symptom severity across five groups defined by increasing severity on the C-SSRS.</p><p><strong>Results: </strong>Sixty-eight percent of participants reported lifetime suicidal ideation, and 26% reported previous suicidal behaviors. Model performance was modest but significant (cross-validated ideation severity: R² = 0.161, RMSE = 0.916; ideation intensity: R² = 0.193, RMSE = 0.898; suicidal behavior: accuracy = 0.685; AUC = 0.675; p < 0.001). Across all models, concurrent depressive symptoms, present/past diagnosis of depression, female sex at birth, cannabis use, visual/gustatory abnormalities, guilt, and lower role functioning were the most consistent correlates of SIB. Ideation was associated with lower disorganized communication expression and lower negative symptoms, whereas behaviors were associated with schizotypal personality disorder. Other core CHR-P symptoms, including Unusual Thoughts and Experiences, did not contribute to any model. ANCOVA (p < 0.001, partial η² = 0.041) indicated increasing overall subthreshold psychotic symptoms across the SIB spectrum.</p><p><strong>Conclusion: </strong>SIB in CHR-P individuals reflects a multidimensional clinical profile primarily outside of core psychosis-risk symptoms.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05905003.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol as a Foreseeable Suicide Risk Amplifier","authors":"Leo Sher","doi":"10.1111/acps.70112","DOIUrl":"10.1111/acps.70112","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 4","pages":"313-314"},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Intervention Following Detection of Incident Diabetes Within a Large Psychiatric Service System: A Chart Review Study","authors":"Pernille Kølbæk,&nbsp;Christopher Rohde,&nbsp;Maria Speed,&nbsp;Henrik Holm Thomsen,&nbsp;Søren Dinesen Østergaard","doi":"10.1111/acps.70114","DOIUrl":"10.1111/acps.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Individuals with mental illness have a markedly reduced life expectancy, partly due to a significantly increased risk of developing type 2 diabetes, driven by lifestyle factors and the adverse metabolic effects of psychotropic medications. This study examined whether abnormal laboratory values indicating incident diabetes, when ordered within psychiatric services, were followed by documented interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used electronic health record data from the Psychiatric Services of the Central Denmark Region and drew a random sample of patients with incident diabetes detected between 2019 and 2024. Incident diabetes was defined by the first laboratory value ordered by the psychiatric services indicating diabetes: glycated haemoglobin ≥ 48 mmol/mol, fasting plasma glucose ≥ 7.0 mmol/L, plasma glucose ≥ 11.1 mmol/L during a 2-h oral glucose tolerance test or random plasma glucose. Patients with pre-existing diabetes, identified through ICD-10 codes or antidiabetic medication history, were excluded. Manual chart review assessed whether incident diabetes was followed, within 3 months, by documented clinical intervention (such as referral, repeat testing, or medication initiation), or was merely acknowledged without further action. Descriptive statistics and adjusted logistic regression analysis were used to characterise the cohort and examine characteristics associated with lack of intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 416 patients with incident diabetes (57% male, median age 48 years [IQR: 35–59], 33% with schizophrenia or other psychotic disorders), only 37% received a clinical intervention. The most frequent intervention was referral to a general practitioner (27%), while antidiabetic medication was initiated in only 6% of those who received an intervention. The only characteristic associated with lack of clinical intervention was body mass index &lt; 25 kg/m² (adjusted odds ratio 3.82, 95% CI: 1.92–8.20).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that appropriate clinical intervention following detection of incident diabetes is lacking. This may inform future strategies to reduce metabolic and cardiovascular risks among individuals with mental illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 4","pages":"268-276"},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148147561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Glucagon-Like Peptide 1 Receptor Agonists and the Associated Risk of Hospitalisation in Bipolar Disorder, From a Nationwide Cohort, 2009–2024","authors":"Heidi Taipale,&nbsp;Mark Taylor,&nbsp;Markku Lähteenvuo,&nbsp;Ellenor Mittendorfer-Rutz,&nbsp;Antti Tanskanen,&nbsp;Jari Tiihonen","doi":"10.1111/acps.70120","DOIUrl":"10.1111/acps.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Diabetes, obesity and bipolar disorder often co-occur and may have shared pathophysiology. Glucagon-like peptide 1 receptor agonists (GLP-1RA) treat diabetes and obesity but their impact on bipolar disorder is unknown. In this era of stagnated pharmacotherapy, we examined psychiatric hospitalisation and absence from work due to sick leave as potential measures of relapse in people diagnosed with bipolar disorder who were also prescribed antidiabetic medications, including GLP-1RA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study cohort was derived from the National Swedish Registers and included all people with a diagnosis of bipolar disorder who used any antidiabetic medication, between the years 2009 and 2024. GLP-1RA individually and as a group were compared with non-use of GLP-1RA, and directly with other second-line antidiabetic medications. A within-individual design was utilised for all comparisons to reduce confounding. The main outcome was psychiatric hospitalisation for any reason, with secondary outcomes being psychiatric hospitalisation after a relapse of bipolar disorder, and sick leave due to psychiatric reasons. Within-individual stratified Cox models with adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>14,694 people were included in the study, of whom 5200 used GLP-1RA. Semaglutide was associated with a 21% (aHR 0.79, 95% CI 0.69–0.91) lower risk of psychiatric hospitalisation compared with non-use of GLP-1RA in that same individual. Liraglutide and dulaglutide were not specifically associated with a lower hospitalisation risk. Semaglutide was also linked to a 17% (aHR 0.83, 95% CI 0.69–0.99) lower risk of relapse of bipolar disorder. Absences from work due to sick leave were not significantly associated with the specific antidiabetic medications studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In people with both bipolar disorder and diabetes and/or obesity, the use of semaglutide was linked to lower rates of psychiatric hospitalisation compared with time periods when GLP-1RA were not used by that individual. Liraglutide and dulaglutide were not associated with reduced psychiatric hospitalisation, implying this is not a class effect. This finding with semaglutide should be further tested in a randomised controlled trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 4","pages":"305-312"},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148292638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}