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Annette Erlangsen

Annette Erlangsen
Danish Research Institute for Suicide Prevention · Copenhagen Research Centre For Mental Health

PhD

About

154
Publications
39,990
Reads
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6,057
Citations
Citations since 2017
97 Research Items
4961 Citations
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Introduction
My research interests are within suicide prevention. Using register data of Denmark and other Scandinavian countries, I have focused on studies of suicide risks related to stressful life-events and among marginalized groups, older adults and people with chronic disorders. I am also responsible for RCTs assessing effects of e-heath tools. Lately, I have initiated research projects in alliance with volunteer organisations and Danish railway companies.
Additional affiliations
September 2018 - present
Australian National University
Position
  • Researcher
August 2010 - present
Danish Research Institute for Suicide Prevention
Position
  • Professor (Associate)
August 2007 - present
Johns Hopkins Bloomberg School of Public Health
Position
  • Professor (Associate)

Publications

Publications (154)
Article
Full-text available
Introduction Benzodiazepines and non-benzodiazepines have been linked to a variety of adverse effects including addiction. Long term use of these drugs has been associated with an increased risk of suicide. Objectives We assessed if individuals in treatment with non-benzodiazepine (n-BZD) and benzodiazepine (BZD) had higher rates of suicide when c...
Article
Full-text available
Introduction Sleep disorders and psychiatric disease are closely related, and psychiatric diseases are associated with elevated suicide risks. Yet, the association between sleep disorders and suicide remains to be assessed using a consistent measure of sleep disorders. Objectives The aim of this study was to examine whether people with a hospital-...
Article
Full-text available
Introduction Melatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts. Objectives We aimed to investigate whether individuals in treatment with melatonin had higher rates of suic...
Article
Full-text available
Objective: To provide the first estimates of the risk of suicide after bereavement by the suicide of any first-degree relative and the proportion of suicides in Denmark attributable to suicide bereavement. Methods: We conducted a nationwide nested case-control study defining cases as all Danish-born individuals who died by suicide in Denmark bet...
Article
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Abstract: Research has shown that people bereaved by suicide have an increased risk of mental health problems, suicidality and associated stigma, as well as higher rates of sick leave and increased rates of receiving disability pensions. Peer-led suicide bereavement support groups are perceived to enhance people’s recovery by enabling shared experi...
Article
Full-text available
Background Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods We identified suicide data from official pu...
Article
Full-text available
Background: Several smaller, community-based studies have suggested a link between sleep disorders and dementia with a focus on sleep as a modifiable risk factor for dementia. Studies on neurodegenerative diseases are prone to reverse causation, and few studies have examined the association with long follow-up time. Our aim was to explore the poss...
Article
Study objectives: Melatonin is often prescribed to patients with sleep disorders who are known to have elevated suicide risks. Yet, melatonin's association to suicidal behavior remains to be examined. We investigated whether individuals prescribed melatonin had higher rates of suicide and suicide attempts when compared to individuals who were not...
Article
Objective: The aim of this study was to: (1) determine the proportion of callers to a national helpline for suicide prevention who were evaluated to be at risk of suicide; (2) identify characteristics associated with being at risk; (3) determine the level of suicidal ideation among callers, as measured by a clinical scale, and compared to the gene...
Preprint
Full-text available
Background: Non-suicidal self-injury (NSSI) is a growing healthcare problem. Individuals with NSSI have an increased risk of suicidality. Because of stigma, they may self-injure in secret, which means they often seek help when events have escalated to suicidal ideation or a mental disorder. Previous studies have shown that interventions delivered v...
Article
Full-text available
Objectives: The aim of this study was to analyze whether individuals reporting exposure to workplace bullying had a higher risk of suicidal behavior, including both suicide attempt and death by suicide, than those not reporting such exposure. Methods: Using a prospective cohort study design, we linked data from nine Danish questionnaire-based su...
Article
Background: Poor school performance is linked to higher risks of self-harm. The association might be explained through genetic liabilities for depression or educational attainment. We investigated the association between school performance and self-harm in a population-based sample while assessing the potential influence of polygenic risk scores (...
Article
Background: Mood stabilisers are the main treatment for bipolar disorder. However, it is uncertain which drugs have the best outcomes. Aims: To investigate whether rates of suicide, self-harm and psychiatric hospital admission in individuals with bipolar disorder differ between mood stabilisers. Method: A cohort design was applied to people ag...
Article
Full-text available
Background Traumatic brain injury (TBI) can cause long-lasting sequelae that may increase the risk of suicidal or criminal behaviour, but large-scale longitudinal studies are lacking on the link between TBI and events of suicide attempt and violent crime. This study examined the incidence of suicide attempt and violent crime following hospital cont...
Article
Study objectives Sleep disorders are related to mental disorders. Yet few studies have examined their association with suicide. We examined whether males and females diagnosed with sleep disorders had higher rates of suicide than individuals not diagnosed with sleep disorders. Methods In a cohort study, nationwide data on all males and females age...
Article
Background Suicidal behaviour runs in families, but the nature of transgenerational concordance needs elucidation. The aim of this study was to examine parent-to-child transmission by investigating whether presence and nature of parental suicidal behaviour was associated with suicidal behaviour in children. Methods We did a retrospective, nationwi...
Article
Objective There are concerns that asylum-seekers are at increased risk of suicide attempt and suicide mortality. Yet, largescale nationwide studies are limited. Our aim was to examine whether asylum-seekers in Denmark had higher rates of suicide attempt and suicide when compared to the general population. Methods A retrospective cohort design was...
Article
Background: Reviews of camera surveillance systems have demonstrated ambivalent behaviors among people who die by railway suicide. Yet, only few preventive measures have been evaluated. Aims: We aimed to review incidents of suicidal behavior at a Danish railway station, install preventive measures, and monitor subsequent calls to a telephone helpli...
Article
Objective: To estimate national direct hospital costs associated with treatment of self-harm and to analyze whether costs differ with respect to demographic and clinical characteristics. Methods: A cohort design was applied to register-data on all people living in Denmark (5.8 million inhabitants) from Jan 1, 2012 to Dec 31, 2016. Self-harm pres...
Article
Objective: The aim of this study was to estimate the association between self-reported perceived danger during deployment, measured as combat exposure or witnessing the consequences of war, and post-deployment suicide attempts among military personnel. Furthermore, the effect of post-deployment symptoms of posttraumatic stress disorder (PTSD) and/o...
Article
Full-text available
Background Suicide is a leading cause of death worldwide, and non-fatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genom...
Article
Objective: The majority of individuals with suicidal ideation do not receive help, and every year close to 800,000 people die by suicide. This study aimed to investigate the effectiveness of a guided internet-based self-help program compared to a waiting list control group in reducing suicidal ideation. Methods: In a randomized controlled trial, 4...
Article
Objective: Lyme borreliosis is a tick-borne infectious disease that may confer an increased risk of mental disorders, but previous studies have been hampered by methodological limitations, including small sample sizes. The authors used a nationwide retrospective cohort study design to examine rates of mental disorders following Lyme borreliosis....
Article
Aims We aimed to analyze whether people with substance-induced psychosis (SIP), both those who convert and do not convert to schizophrenia, have higher all-cause and cause-specific mortality when compared to the general population. Design Prospective cohort study. Setting Nationwide Danish registers. Participants/Cases We included all people bor...
Article
Introduction Sleep disorders and psychiatric disease are closely related, and psychiatric diseases are associated with elevated suicide risks. Yet, it is not clear if sleep disorders are associated with suicide as previous studies were limited by self-reported measures. The aim of this study was to examine whether people with a hospital-diagnosis o...
Article
Full-text available
Background Safety planning-type interventions (SPTIs) for patients at risk of suicide are often used in clinical practice, but it is unclear whether these interventions are effective. Aims This article reports on a meta-analysis of studies that have evaluated the effectiveness of SPTIs in reducing suicidal behaviour and ideation. Method We search...
Article
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Summary Background The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. Methods We sourced real-time s...
Article
Background The association between suicide attempts (SAs) in parents and children is unclear, and risk indicators for intergenerational transmission remain undocumented. We aimed to assess this association, considering the child's developmental period at the time of parents' attempted suicide, and the parental relation. Methods Using a prospective...
Article
Objective The loss of a friend or family member to suicide, i.e., surviving suicide, can be devastating. Yet, little is known regarding the support received by survivors of suicide. We aimed to examine the characteristics of survivors of suicide who sought counseling from a Danish volunteer organization. Method Data on all users of the Danish Netw...
Article
Full-text available
Background: The suicide rate in first week after psychiatric discharge is alarmingly high. Although a risk assessment prior to discharge is standard praxis, it can be difficult to take into consideration the obstacles that patient will meet once discharged. A follow-up-visit during the first week after discharge is an opportunity to reevaluate whet...
Article
Full-text available
PurposeThe aim of this study was to examine the relation of mental, physical, and social wellbeing measures to death by suicide and self-harm (SH).Methods Using a cohort design, questionnaire data on 266,324 responders aged ≥ 45 years, living in NSW, Australia were linked to hospital and death databases during 2006–2017. Adjusted incidence rate rat...
Article
Full-text available
Background: The treatment of depression is a main strategy for suicide prevention in older adults. We aimed to calculate suicide rates by antidepressant prescription patterns in persons aged ≥ 75 years. A further aim was to estimate the contribution of antidepressants to the change in suicide rates over time. Methods: Swedish residents aged ≥ 75 ye...
Article
Full-text available
Importance There is limited evidence supporting an association of autism spectrum disorder (ASD) with suicidality and the risk factors for suicide attempt and suicide among people with ASD. Existing research highlights the need for national cohort studies. Objectives To analyze whether people with ASD have higher rates of suicide attempt and suici...
Chapter
The association between somatic disorders and suicidal behaviour has been examined in many studies. Despite large variation in quality and study design, recent studies have improved our knowledge substantially, not only regarding the extent of risk but also factors influencing the risk. Most studies have been conducted in European countries, the US...
Preprint
Full-text available
Suicide is a leading cause of death worldwide and non-fatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both are known to have a substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. We conducted a genome-wide...
Article
Objective Little is known about people who have been exposed to a suicide attempt by someone they know. The purpose of this study was to examine how many people have been exposed to a suicide attempt by someone they knew and whether the exposure was associated with general well‐being and suicidal ideation. Method A population‐based online survey w...
Article
Objective To assess associations between physical, mental, and social well‐being and suicide and self‐harm in a community‐based sample of older adults. Methods Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006–2009 were linked to hospital and cause‐of‐death da...
Article
Full-text available
Background: An increasing number of qualitative research articles have reported on relatives' experiences of providing care for individuals displaying suicidal behaviour. To contribute more fully to theory and practice, these reported experiences must be synthesized. Objectives: To identify original qualitative studies of relatives' experiences...
Preprint
Full-text available
ABSTRACT Aim: To present a protocol for the analysis of the prospective association between workplace bullying and suicidal behaviour. Method: The analyses will be carried out on a sample of 98,330 participants (64% women, n=62,582) taken from a pooled dataset of nine Danish questionnaire-based surveys (2004-2014) including self-reported measures...
Article
Full-text available
Family studies have shown an aggregation of suicidal behavior in families. Yet, molecular studies are needed to identify loci accounting for genetic heritability. We conducted a genome-wide association study and estimated single nucleotide polymorphisms (SNP) heritability for a suicide attempt. In a case-cohort study, national data on all individua...
Article
Full-text available
Background: This paper outlines the need for a health systems approach and rapid response strategy for gathering information necessary for policy decisions during pandemics and similar crises. It suggests a new framework for assessing the phases of the pandemic. Method: The paper draws its information and conclusions from a rapid synthesis and tran...
Article
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Aim: To summarise commonalities and variations in the mental health response to COVID-19 across different sites and countries, with a view to better understanding key steps not only in crisis management, but for future systemic reform of mental health care. Method: We conducted a Rapid Synthesis and Translation Process of lessons learned from an in...
Article
Objective Over recent decades, intense efforts to address suicides in psychiatric admitted people have been initiated. The aim was to calculate suicide rates, rate ratios, population attributable risks (PAR) and trends among people admitted to or recently discharged from psychiatric wards. Methods Using a cohort design, we obtained nationwide regi...
Article
Full-text available
Background: The loss of a loved one to suicide can be a devastating experience that can have negative long-term effects on the social life and physical and mental health of the bereaved person. Worldwide, an estimated 237 million older adults have experienced suicide bereavement. As assumed in critical psychology, “the conduct of everyday life” ref...
Article
Objective: To explore different stakeholder perspectives on the MYPLAN app for suicide prevention safety planning. Methods: The study was a comparative analysis of four focus groups with Danish MYPLAN stakeholders, young users, adult users, relatives, and clinicians. The focus groups were audio recorded, transcribed, and subjected to a thematic...
Article
Full-text available
Objective: To identify empirical studies of older adults (≥60) bereaved by the loss of a significant other to suicide. Methods: A systematic literature search in CINAHL, Embase, Medline, PsycINFO, and SCOPUS. The inclusion criteria were empirical studies investigating people bereaved by suicide at age ≥60 published in English or a Nordic language....
Article
Background: Few qualitative studies have focused on clinicians’ perspectives regarding treatment of suicidal people. Despite limited evidence and imperfect risk-assessment tools, the psychosocial therapy at the Danish suicide prevention clinics has been linked to reductions in numbers of repeated self-harm, deaths by suicide, and other causes. This...
Article
Click here to view the Letter to the Editor by Aubin et al.
Article
Objective: To compare suicide rates of people in prison and the general population in the Nordic countries. Methods: Data on deaths by suicide and person-years for people in prison and the general population were obtained for the Nordic countries during 2000–2016. Age-standardized rate ratios were calculated. Results: The suicide rate in the Nordic...
Article
Full-text available
Background Studies conducted in the UK and in Ireland have reported increased rates of self-harm in adolescent females from around the time of the 2008 economic recession and through periods of subsequent national austerity programme implementation. It is not known if incidence rates have increased similarly in other Western European countries duri...
Chapter
Suicide is often the outcome of a personal crisis; yet many conditions, both societal and individual, are established predictors of suicide. It remains a major public health problem worldwide, although rates of suicide vary substantially across nations. The highest rates are reported in Russia and East European countries. This chapter summarizes th...
Article
Full-text available
Objective Self-poisoning with non-opioid analgesics presents a growing challenge to health care providers. We aimed to assess the impact of an 18-year age restriction of OTC sales and a pack size restriction of non-opioid analgesics sold OTC in pharmacies on hospital-treated poisonings and poisoning severity measured using biomarkers. Methods We a...
Article
Objective: To assess the association between specific heart diseases and suicide. Design: Nationwide retrospective cohort study. Participants: 7 298 002 individuals (3 640 632 males and 3 657 370 females) aged >15 years and living in Denmark during 1980-2016. Main outcome measures: Incidence rate ratios (IRR) with 95% confidence intervals. I...
Article
Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, r...
Article
Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, r...
Article
Full-text available
Background People belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using unique national data from two countries, we investigated whether individuals entering a same-sex marriage (SSM), a proxy group of sexual minority individuals, had higher suicide rate...
Article
Background: Systematic reviews have consistently shown that individuals with mental disorders have an increased risk of premature mortality. Traditionally, this evidence has been based on relative risks or crude estimates of reduced life expectancy. The aim of this study was to compile a comprehensive analysis of mortality-related health metrics a...
Article
Full-text available
Suicide is a devastating public health problem, afflicting individuals, families, and societies. Fortunately, continuous striving by the World Health Organization to strengthen suicide prevention efforts is paying off. The annual number of suicide deaths decreased from 1 million to 800,000 worldwide during recent decades. A gloomy exception to this...
Article
Background: Persons diagnosed with attention-deficit hyperactivity disorder (ADHD) have been found to have an increased risk of suicidal behaviour, but the pathway remains to be thoroughly explored.AimsTo determine whether persons with ADHD are more likely to present with suicidal behaviour (i.e. suicide attempts and deaths by suicide) if they hav...
Article
Suicide is a major public health problem and there is a paucity of knowledge about the particular needs of people bereaved by suicide late in life. This study protocol describes a co-operative inquiry designed to collaboratively explore the needs for psychosocial support for this group and to use ‘action circles’ to develop and test psychosocial in...
Poster
Full-text available
I presented my PhD protocol on a poster at the 5th Horatio Festival of Psychiatric Nursing in Copenhagen May 2019.
Article
Full-text available
Background: The effect of safety planning for people in suicidal crisis is not yet determined, but using safety plans to mitigate acute psychological crisis is regarded as best practice. Between 2016 and 2017, Australian and Danish stakeholders were involved in revising and updating the Danish MYPLAN mobile phone safety plan and translating the app...
Article
Full-text available
Background Suicide accounts for more than 800,000 annual deaths worldwide. Some of these deaths may be preventable by timely identification of individuals at risk and effective intervention. General practitioners (GPs) may have the potential to play an important role in this process. Aim The present study aimed to assess the frequency of primary h...
Article
Background: Although most mental disorders have their onset in early life, the mental health needs of young people are often not addressed adequately. Open Dialogue is a need-adapted approach that mobilizes psychosocial resources in a crisis struck person’s social network. Open Dialogue is organised as a series of network meetings and seeks to prom...
Article
Background: People with schizophrenia have an increased risk of premature mortality compared to the general population. We aimed to quantify which types of causes of death contributed to the excess mortality, and to examine whether there has been an increase in the excess mortality among persons with schizophrenia in the period 1995 to 2015. Meth...
Article
Background: Evidence links infections to mental disorders and suicidal behavior. However, knowledge is sparse regarding less severe infections, anti-infective treatment, and deliberate self-harm. Using nationwide Danish longitudinal registers, we estimated associations between infections treated with anti-infective agents and infections requiring...
Article
Full-text available
Background and aims Almost 20% of the adult population suffers from chronic pain. Chronic pain may be linked to an elevated mortality; however, results from previous studies are inconsistent. Some studies find similar mortality levels in chronic pain patients and pain-free controls while other studies show elevated mortality levels among chronic pa...
Preprint
BACKGROUND The efficacy of safety planning for people in suicidal crisis is not yet determined but using safety plans to mitigate acute psychological crisis is regarded ‘best practice’. In 2016-17, Australian and Danish key stakeholders were systematically involved in revising and translating the Danish MYPLAN mobile phone safety plan app into a cu...
Article
Importance Traumatic brain injuries (TBIs) can have serious long-term consequences, including psychiatric disorders. However, few studies have assessed the association between TBI and risk of suicide. Objective To examine the association between TBI and subsequent suicide. Design, Setting, and Participants Retrospective cohort study using nationw...