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Late-adolescent risk factors for suicide and self-harm in middle-aged men: explorative prospective population-based study.

Journal article
Authors Jenny Nyberg
Sara Gustavsson
Maria A I Åberg
Hans-Georg Kuhn
Margda Waern
Published in The British journal of psychiatry : the journal of mental science
Pages 1-7
ISSN 1472-1465
Publication year 2019
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Neuroscience and Physiology
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 1-7
Language en
Links dx.doi.org/10.1192/bjp.2019.243
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Psychiatry, Basic Medicine

Abstract

Recent reports show alarmingly high rates of suicide in middle-aged men, yet there are few long-term prospective studies that focus on suicidal behaviour in men in this age group.To prospectively explore associations of potential risk factors at age 18 with suicide and self-harm in middle-aged men.A population-based Swedish longitudinal cohort study of male conscripts with no history of self-harm at enlistment in 1968-1989 (n = 987 583). Conscription examinations included measures of cognitive performance, stress resilience, psychiatric diagnoses, body mass index (BMI), cardiovascular fitness and muscle strength. Suicides and self-harm at age 45-65 years were identified in the National Hospital Register and Swedish Cause of Death Register. Risks were calculated using Cox proportional hazards models.Low stress resilience (cause-specific hazard ratio CHR = 2.31, 95% CI 1.95-2.74), low cognitive ability (CHR = 2.01, 95% CI 1.71-2.37) as well as psychiatric disorders and low cardiovascular fitness in late adolescence were associated with increased risk for suicide in middle-aged men. Similar risk estimates were obtained for self-harm. In addition, high and low BMI as well as low muscle strength were associated with increased risk of self-harm. Associations also remained significant after exclusion of men with self-harm before age 45.This prospective study provides life-course perspective support that psychological and physical characteristics in late adolescence may have long-lasting consequences for suicidal behaviour in middle-aged men, a very large population at heightened risk of suicide.

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