Trine Munk-Olsen

Aarhus University | AU · National Centre for Integrated Register-based Research "CIRRAU"

Importance: Approximately one-half of women treated for affective disorders discontinue antidepressant use during pregnancy, yet this discontinuation could lead to relapse post partum. Objective: To investigate the associations between longitudinal antidepressant fill trajectories during pregnancy and postpartum psychiatric outcomes. Design, se...

Background Doxycycline and minocycline are brain-penetrant tetracycline antibiotics, which recently gained interest because of their immunomodulatory and neuroprotective properties. Observational studies have suggested that exposure to these drugs may decrease the risk to develop schizophrenia, but results are inconsistent. The aim of this study wa...

Attention Deficit Hyperactivity Disorder (ADHD) medication is increasingly being used during pregnancy. Concerns have been raised as to whether ADHD medication has long-term adverse effects on the offspring. The authors investigated whether in utero exposure to ADHD medication was associated with adverse long-term neurodevelopmental and growth outc...

Objective: To determine the association between continued antidepressant use in pregnancy and postpartum psychiatric visits for eating (ED) or mood/anxiety disorders in women with preexisting ED. Method: Using Danish health registry data (1998-2015), we identified 3529 pregnancies in women with ED prepregnancy: (i) 564 with continued antidepress...

Importance The direct and indirect implications of the COVID-19 pandemic have been associated with the mental health of children and adolescents, but it is uncertain whether these implications have been associated with changes in prescribing and diagnosis patterns. Objective To examine psychotropic medication use and rates of psychiatric disorders...

Background Depressive episodes during pregnancy are widely investigated but it is still unknown whether pregnancy is a high-risk period compared to the pre-pregnancy period. Therefore, we aimed to investigate the incidence and recurrence of depressive episodes before, during, and after pregnancy. Methods In the current population-based registry st...

Postpartum depression (PPD) is a serious condition associated with potentially tragic outcomes, and in an ideal world PPDs should be prevented. Risk prediction models have been developed in psychiatry estimating an individual’s probability of developing a specific condition, and recently a few models have also emerged within the field of PPD resear...

Importance: Current evidence on the association between family history of psychiatric disorders and postpartum depression is inconsistent; family studies have identified familial risk of postpartum depression, whereas systematic reviews and umbrella reviews, compiling all risk factors for postpartum depression, often have not. Objective: To inve...

Importance An increasing number of individuals fill antipsychotic prescriptions during pregnancy, and concerns have been raised about prenatal antipsychotic exposure on neurodevelopmental outcomes. Objective To examine whether maternal prescription fill for antipsychotics during pregnancy was associated with performance in standardized tests among...

Background Childbirth may be a traumatic experience and vulnerability to posttraumatic stress disorder (PTSD) may increase the risk of postpartum depression (PPD). We investigated whether genetic vulnerability to PTSD as measured by polygenic score (PGS) increases the risk of PPD and whether a predisposition to PTSD in PPD cases exceeds that of maj...

Background Postpartum depression (PPD) is the most common postpartum psychiatric disorder, affecting 11–15% of new mothers, and initiatives towards early identification and treatment are essential due to detrimental consequences. Family history of psychiatric disorders is a risk factor for developing psychiatric episodes outside the postpartum peri...

Objective: Prenatal antidepressant use is widespread. Observational studies have investigated the neonatal effects of prenatal antidepressant exposure with inconclusive results. We aimed to comprehensively investigate the associations between prenatal antidepressant exposure and the most commonly studied adverse neonatal outcomes: preterm birth, b...

Background Women prescribed antidepressants face the dilemma of whether or not to continue their treatment during pregnancy. Currently, limited evidence is available on the efficacy of continuing versus discontinuing antidepressant treatment during pregnancy to aid their decision. We aimed to estimate whether antidepressant discontinuation before o...

Purpose: Perinatal mental health disorders affect a significant number of women with debilitating and potentially life-threatening consequences. Researchers in Nordic countries have access to high quality, population-based data sources and the possibility to link data, and are thus uniquely positioned to fill current evidence gaps. We aimed to rev...

Background Self-harm in pregnancy or the year after birth (‘perinatal self-harm’) is clinically important, yet prevalence rates, temporal trends and risk factors are unclear. Methods A cohort study of 679 881 mothers (1 172 191 pregnancies) was conducted using Danish population register data-linkage. Hospital treatment for self-harm during pregnan...

This population-based cohort study examines the risk of persistent pulmonary hypertension among newborns in Denmark after antidepressant exposure in utero.

Information on neurodevelopmental effects of antenatal exposure to antipsychotics is limited to 10 studies, all examining children up to 5 years of age or less. The paper aimed to investigate the association between in utero exposure to antipsychotics and psychiatric outcomes in children using Danish nationwide registers. In total, 9011 liveborn si...

Background Researchers have long investigated a hypothesized interaction between genetic risk and stressful life events in the etiology of depression, but studies on the topic have yielded inconsistent results. Methods We conducted a genome-wide environment interaction study in 18,532 patients with depression from hospital-based settings and 20,18...

Depression is associated with general medical conditions (GMCs), but it is not known if treatment-resistant depression (TRD) affects GMC risk and vice versa. We estimated bidirectional associations between TRD and GMCs (prior and subsequent). All individuals aged 18–69 years, born and living in Denmark, with a first-time prescription for an antidep...

Researchers have long investigated a hypothesized interaction between genetic risk and stressful life events in the etiology of depression, but studies on the topic have yielded inconsistent results. We conducted a genome-wide environment interaction study in 18,532 depression cases from hospital-based settings and 20,184 population-representative...

Background: For women, the perinatal period confers an increased risk of severe psychiatric disorders, but similar evidence for fathers is lacking. We examined rates of first-time and recurrent psychiatric disorders in men before and after becoming fathers. Methods: A descriptive prospective study design was applied using information from the Da...

Background: In this study, we examined the relationship between polygenic liability for depression and number of stressful life events (SLEs) as risk factors for early-onset depression treated in inpatient, outpatient or emergency room settings at psychiatric hospitals in Denmark. Methods: Data were drawn from the iPSYCH2012 case-cohort sample,...

Background Several national guidelines include recommendations for a minimum duration of antidepressant treatment, but these vary from 4–9 months after remission. We aimed to investigate whether there is an optimal minimum duration of antidepressant treatment to reduce relapse risk. Methods A Danish population-based cohort study among 89,442 adult...

To investigate the association between intrauterine antidepressant exposure and offspring affective disorders over an 18-year follow-up period using Danish national registers. We included 42,988 singletons born during 1998–2011 and followed-up until 2016, death, emigration, or date of first affective disorder diagnosis. Children were categorised in...

Objective: Psychiatric disorders are an established risk factor for divorce or separation. Despite the fact that 10%-15% of new mothers experience postpartum psychiatric episodes (PPEs), no previous studies have investigated the effects of PPEs on the probability of divorce in these new families. Therefore, this study aimed to investigate and quant...

Aims To assess the association between different stages of maternal depression and injury risk in offspring aged 0–10 years. Methods Population‐based cohort study of all live‐born children in Denmark from 1 January 1997 until 31 December 2013 (n = 1,064,387). Main outcome measure was emergency department contacts with a main diagnosis of injury co...

Background Maternal depression has been linked to adverse outcomes in the offspring. Existing literature is mainly based on parental reports, which can be an unreliable source when the parent has depression. Aim To explore if maternal depression was associated with daily health complaints and low self-assessed health (SAH) in the offspring. Desig...

Background Depression is associated with excess mortality, but it is not known how treatment-resistance influences life expectancy. We estimated cause-specific excess mortality and Life Years Lost (LYL) in patients with treatment-resistant depression (TRD). Methods The population included all individuals born and living in Denmark who redeemed the...

Background Depression is one of the leading causes of premature workforce exit in many Western countries, but little is known about the extent to which treatment-resistance reduces number of work-years. We compared the risk of premature workforce exit among patients with treatment-resistant depression (TRD) relative to non-TRD patients and estimate...

Background: Psychiatric patients have an increased risk of general medical conditions and mortality, but no study has systematically explored these outcomes among women with mental disorders following childbirth (postpartum psychiatric disorders: PPD). Therefore, we aimed to investigate the risk of subsequent general medical conditions and mortali...

Background Research in schizophrenia and pregnancy has traditionally been conducted in small samples. More recently, secondary analysis of routine healthcare data has facilitated access to data on large numbers of women with schizophrenia. Aims To discuss four scientific advances using data from Canada, Denmark and the UK from population-level hea...

Objective Major depression and asthma frequently co-occur, suggesting shared genetic vulnerability between these two disorders. We aimed to determine whether a higher genetic liability for major depression was associated with increased childhood asthma risk, and if so, whether such an association differed by sex of the child. Methods We conducted...

Objective: Reviews on child outcomes following in utero antidepressant exposure have focused on short-term outcomes. However, several recent individual studies reported on adverse physical, neurodevelopmental, and psychiatric outcomes beyond infancy and early childhood. The objective of this systematic review was to establish the long-term effects...

Using prescription drugs during pregnancy is challenging and approached with caution. In this study, we present population-based information on prescription patterns of benzodiazepines and benzodiazepine-related drugs in the peripartum period. A population-based study of 1,154,817 pregnancies between 1997 and 2015 in Denmark, of which 205,406 (17.8...

Study question: Are women with a history of first-onset postpartum psychiatric disorders after their first liveborn delivery less likely to have a subsequent live birth? Summary answer: Women with incident postpartum psychiatric disorders are less likely to go on to have further children. What is known already: Women are particularly vulnerabl...

Objective: There is limited information on the longitudinal disease course after first-onset postpartum psychosis (PP). Some women will experience severe affective episodes outside the postpartum period, while for other women their vulnerability to mania and psychosis may be restricted to the postpartum period. This meta-analysis estimates the ris...

Background: Individuals with schizophrenia often develop diabetes, but little is known about their risk of diabetic complications. We aimed to study incidence of registered diabetic complications and subsequent mortality in individuals with schizophrenia and diabetes compared to individuals with diabetes only. Methods: We conducted a cohort stud...

Purpose Antidepressants are the mainstay of pharmacological treatment for nonpsychotic mental disorders in the perinatal period. However, little is known about the indications for antidepressant use during pregnancy. We aimed to examine the treatment indications of antidepressant prescriptions redeemed by pregnant women and to investigate whether t...

Postpartum psychiatric disorders are heritable, but how genetic liability varies by other significant risk factors is unknown. We aimed to (1) estimate associations of genetic risk scores (GRS) for major depression (MD), bipolar disorder (BD), and schizophrenia (SCZ) with postpartum psychiatric disorders, (2) examine differences by prior psychiatri...

Introduction: Factors that influence antidepressant (AD) prescription and use during pregnancy are multiple including, in particular, the balance between the potential risk of untreated depression and the potential risk of AD treatment. Surveillance of temporal trends of AD use might identify areas requiring further research. We studied the use of...

Background: Suicidal ideation due to abortion has been used to justify restrictive US abortion policies. Much research examining abortion and mental health has relied on self-report, has had low participation rates, and did not consider confounding factors. In the present study, we used data that do not rely on self-report and are not affected by...

Postpartum mental disorders (PPMDs) are serious conditions ranging in prevalence, incidence, and severity. The disorders are mainly observed in women who are primiparous,¹ and mothers with a history of PPMDs are understandably concerned about risk of recurrence after successive deliveries. In this study, we aimed to (1) examine the risk of a mental...

Objective: To investigate whether intrauterine exposure to maternal asthma or asthma exacerbations increases the risk of attention-deficit/hyperactivity disorder (ADHD). Methods: Using Danish register data, this cohort study comprised of 961,202 live singletons born in Denmark during 1997-2012. Children were followed to a maximum of 20.0 years f...

Background Women suffering from first onset postpartum mental disorders (PPMD) have a highly elevated risk of suicide. The current study aimed to: (1) describe the risk of self-harm among women with PPMD and (2) investigate the extent to which self-harm is associated with later suicide. Methods We conducted a register-based cohort study linking na...

Childhood infection has been proposed as an important etiologic factor for schizophrenia. However, it is unclear to what extent the association between childhood infection and schizophrenia is confounded by parental socioeconomic status and mental illness, and childhood adversity, and whether the association is explained by familial liability for i...

The recent conceptualisation of bipolar disorder as a neuroprogressive illness has highlighted the potential importance of prevention and early intervention in high-risk populations. Undiagnosed bipolar disorder early in the disease course is associated with adverse clinical outcomes and impaired functioning for patients, which in turn has economic...

Poor school performance and risk of not completing primary education have been observed in children born of mothers with severe psychiatric disorders (eg, schizophrenia) at the time of conception¹ and of mothers with mental disorders with specific onset during pregnancy and postpartum.²,3 It is, however, unknown whether the specific timing of onset...

Objective Examine the overall incidence of medically treated depression in Denmark among individuals 15‐44 years old, and estimate the 5‐year cumulative incidence of psychiatric hospital care among individuals treated first in non‐hospital based care. Methods We followed all individuals born in Denmark between 1969 and 1998 from age 15 or 2006 (wh...

Background: Depression is a common mental illness worldwide. The offspring of a mother with depression has higher risk of developing mental and physical illness. Aim: This study aimed to investigate the association between the timing of maternal depression and the use of primary health care for the offspring. Design and setting: A population-b...

In Reply We are happy to respond to Sullins and Harrison regarding our findings that having an abortion is not associated with increased likelihood of antidepressant use among women in Denmark.¹ They raised 2 issues. One involved using receipt of an antidepressant prescription as an indicator of depression. They noted the articles we cited as indic...

Background: Excess mortality in individuals with severe mental illness (SMI) is often explained by physical comorbidity and suboptimal healthcare. Cancer is a prevalent cause of death, and tumour stage at diagnosis is a strong predictor of mortality. We aimed to study cancer incidence, disease stage at diagnosis and subsequent mortality in individ...

Background: Concerns about teratogenicity and maternal and offspring complications restrict the use of lithium during pregnancy for the treatment of mood disorders. We aimed to investigate the association between in-utero lithium exposure and risk of pregnancy complications, delivery outcomes, neonatal morbidity, and congenital malformations. Met...

Importance The repercussions of abortion for mental health have been used to justify state policies that limit access to abortion in the United States. Much earlier research has relied on self-report of abortion or mental health conditions or on convenience samples. This study uses data that rely on neither. Objective To examine whether first-trim...

Objective: Postpartum psychiatric disorders are common and morbid complications of pregnancy. The authors sought to evaluate how family history of psychiatric disorders is associated with postpartum psychiatric disorders in proband mothers with and without a prior psychiatric history by assessing degree of relationship, type of disorder, and sex o...

Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These disorders can include postpartum depression and anxiety, which are relatively common, and the rare but more severe postpartum psychosis. In addition, other PPDs can include obsessive...

Objectives Little is known about risk of custody loss or out‐of‐home placement among children whose mothers experience postpartum mental disorders, and whether this risk differs from that of children whose mothers had earlier onset of their mental disorder. Methods National Danish registers comprising 1 868 467 births (1982–2012) were used to dete...

Background Schizophrenia constitutes a high risk of morbidity and mortality from physical illness. Individuals with comorbid schizophrenia and diabetes mellitus have been found to have a three- to four-fold higher rate of death than the general population, which may be explained by a higher rate of diabetic complications. We aimed to study incidenc...

Background: Depression is a common and potentially debilitating illness worldwide. Attendance to routine childcare appointments is a key point of interest in the effort to improve the health and care for families facing depression. Aim: To evaluate the association between maternal depression and offspring non-attendance to the Danish childcare a...

Purpose: Prescription drug use during pregnancy has increased during the past decades. However, little is known about prescription drug use for high-risk pregnancies. We aimed to estimate the prevalence of redeemed prescriptions in Danish pregnant women with and without previous psychiatric history. Methods: A Danish population-based descriptive...

Purpose: Antidepressant use during pregnancy has been increasing in recent years. We evaluated whether in utero exposure to antidepressants increased the risk of childhood cancer. Methods: This population-based cohort study using national registers in Denmark comprised 915 128 liveborn singletons during 1998-2012. We categorised children into th...

Objective: Previous studies evaluating the association between early childhood adversities and eating disorders have yielded conflicting results. The aim of this study is to examine the association between a range of adversities and risk of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS) in 495,244...

Background: Offspring of parents with severe mental illness (SMI: schizophrenia, bipolar disorder or major depressive disorder) have an increased risk of developing mental disorder themselves. In childhood they may have neurodevelopmental delays, cognitive deficits and social adversities. We aimed to investigate if these individuals are more at ri...

Background: There is increasing interest in the possible link between maternal hypothyroidism in the perinatal period and childhood asthma risk. We explored this in the present study while accounting for the timing of hypothyroidism diagnosis. Further, we evaluated whether the risk was moderated by thyroid hormone treatment during pregnancy. Meth...

Background: Trauma histories may increase risk of perinatal psychiatric episodes. We designed an epidemiological population-based cohort study to explore if adverse childhood experiences (ACE) in girls increases risk of later postpartum psychiatric episodes. Methods: Using Danish registers, we identified women born in Denmark between January 198...

Background Depression ranges among the most impairing mental disorders worldwide and early detection is a global health priority. Little is known about the association between non-affective mental disorders in childhood/adolescence and later depression. Methods Nationwide register-based prospective cohort study, estimating cumulative incidences an...

Background The postpartum period is well-known risk period for the first onset of autoimmune thyroid disorders (AITDs) as well as first onset of psychiatric disorders. These two disorders are some of the most prevalent medical conditions postpartum, often misdiagnosed and disabling if left untreated. Our study was designed to explore the possible b...

Objective To investigate the association between in utero exposure to antidepressants and risk of psychiatric disorders. Design Population based cohort study. Setting Danish national registers. Participants 905 383 liveborn singletons born during 1998-2012 in Denmark and followed from birth until July 2014, death, emigration, or date of first ps...

Background Lithium is challenging to dose during pregnancy.AimsTo provide guidance for dosing lithium during pregnancy.Method Retrospective observational cohort study. Data on lithium blood level measurements (n= 1101), the daily lithium dose, dosing alterations/frequency and creatinine blood levels were obtained from 113 pregnancies of women recei...

Correspondence to: The National Center for Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Denmark. Tel.: +45 8716 5749.

Objective: To examine 5-year trajectories of psychiatrist-treated late-life major depressive disorder (MDD), and evaluate whether previous vascular pathology is associated with more severe trajectories of late-life MDD. Methods: Data were obtained from nationally representative civil, psychiatric, hospital, and prescription registers in Denmark....

Background Severe and uncontrolled asthma during pregnancy has been linked to several unfavorable perinatal outcomes. However, current knowledge on the association between the severity and control of maternal asthma and offspring asthma is sparse. Objective We sought to investigate the extent to which offspring asthma is influenced by maternal ast...