Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder.

Importance: Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption.

Objective: To test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual.

Design, Setting, And Participants: This cohort study was an observational study conducted nationwide in Sweden using data from January 2006 to December 2023.

Comparative Effectiveness of Antipsychotics in Patients With Schizophrenia Spectrum Disorder.

Importance: Antipsychotics are the cornerstone of maintenance treatment in schizophrenia spectrum disorders, but it is unclear which agents should be prioritized by prescribers.

Objective: To investigate the clinical effectiveness of antipsychotics, including recent market entries, in comparison with oral olanzapine in relapse and treatment failure prevention among individuals with schizophrenia spectrum disorder.

Design, Setting, And Participants: This comparative effectiveness research study with a within-individual analysis included data from Swedish health care registers of inpatient and specialized outpatient care, sickness absence, and disability pensions among all individuals aged 16 to 65 years who were diagnosed with schizophrenia spectrum disorder from January 1, 2006, to December 31, 2021, including an incident cohort and a prevalent cohort.

Dosing levels of antipsychotics and mood stabilizers in bipolar disorder: A Nationwide cohort study on relapse risk and treatment safety.

Background: Finding effective treatment regimens for bipolar disorder is challenging, as many patients suffer from significant symptoms despite treatment. This study investigated the risk of relapse (psychiatric hospitalization) and treatment safety (non-psychiatric hospitalization) associated with different doses of antipsychotics and mood stabilizers in persons with bipolar disorder.

Methods: Individuals aged 15-65 with bipolar disorder were identified from Finnish national health registers in 1996-2018.

Characteristics of high-dose benzodiazepine use: nationwide cohort study on new benzodiazepine users with 5-year follow-up.

Background: A nationwide register-based cohort study from Finland including 48 124 incident benzodiazepines and related drug (BZDR) users aged 18-65 years who initiated use in 2006 and were not dispensed BZDRs during 2004-2005. The follow-up was 5 years or until death, whichever occurred first.

Aims: To investigate sociodemographic and clinical factors associated with high-dose use of BZDRs (i.

Trajectories of work disability among individuals with anxiety-, mood/affective-, or stress-related disorders in a primary healthcare setting.

Background: Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors.

Methods: The study population included working-age individuals, aged 22-62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304).

Cause-specific mortality in treatment-resistant major depression: Population-based cohort study.

Background: Limited evidence-base on long-term prognosis of treatment-resistant major depression (TRD) is a barrier to clinical decision-making. Therefore, the purpose of this study was to establish cause-specific mortality in TRD compared to non-TRD major depression.

Method: We identified all individuals with a diagnosis of major depression (MDD) who were treated with an antidepressant aged 15 to 65 years during 2004-2016 in Finland.

High Burden of Ileus and Pneumonia in Clozapine-Treated Individuals With Schizophrenia: A Finnish 25-Year Follow-Up Register Study.

Objective: The authors used longitudinal biobank data with up to 25 years of follow-up on over 2,600 clozapine users to derive reliable estimates of the real-world burden of clozapine adverse drug events (ADEs).

Methods: A total of 2,659 participants in the FinnGen biobank project had a schizophrenia diagnosis and clozapine purchases with longitudinal electronic health record follow-up for up to 25 years after clozapine initiation. Diseases and health-related events enriched during clozapine use were identified, adjusting for disease severity.

Pneumonia Risk, Antipsychotic Dosing, and Anticholinergic Burden in Schizophrenia.

Importance: Antipsychotic drugs (particularly clozapine) have been associated with pneumonia in observational studies. Despite studies of the associations between antipsychotic use and incident pneumonia, it remains unclear to what degree antipsychotic use is associated with increased risk of pneumonia, whether dose-response associations exist, and what agents are specifically associated with incident pneumonia.

Objective: To estimate pneumonia risk associated with specific antipsychotics and examine whether polytherapy, dosing, and receptor binding properties are associated with pneumonia in patients with schizophrenia.

Dopamine D2 receptor antagonism of antipsychotics and the risk of death due to choking.

The risk of fatal choking for people with schizophrenia and associations with antipsychotic medication are largely unknown. Therefore, we calculated the choking-related standardized mortality ratio for schizophrenia relative to the general population (SMR). We also computed adjusted hazard ratios (aHR) of choking-related mortality for antipsychotics in a nationwide cohort of patients with schizophrenia (N = 59,916).

Cardiovascular mortality in bipolar disorder: Population-based cohort study.

Background: Limited evidence base on cause-specific excess cardiovascular disease (CVD) mortality in bipolar disorder (BD) is a barrier to developing preventive interventions aimed at reducing the persistent mortality gap in BD.

Objective: To investigate cause-specific CVD mortality in BD.

Methods: We identified all individuals aged 15+ years during 2004-2018 with a diagnosis of BD using Finnish nationwide routine data.

The role of mating effort and co-residence history in step-grandparental investment.

The prevalence of divorce in both parental and grandparental generations has led to a rise in the number of children who now have families that include both biological and step-grandparents. Despite the thorough examination of biological grandparents' contributions in the recent literature, there remains a scarcity of studies focusing on the investment of step-grandparents. Using population-based data from a sample of 2494 parents in Germany, we assessed grandparental investment through financial support and assistance with childcare of grandparents ( = 4238) and step-grandparents ( = 486).

Changes in Resources and Volunteering: A Longitudinal Study of Active Engagement Among Older Europeans.

Background And Objectives: Volunteering is an important dimension of successful aging. Although prior studies have found that personal resources such as health and financial situations are associated with volunteering, there is a lack of research exploring the relationship between resource changes and volunteering. Here, we investigated whether changes in individuals' resources were associated with volunteer engagement among older Europeans.

Is Transition to Retirement Associated With Volunteering? Longitudinal Evidence from Europe.

Studies have shown that retired older adults are more likely to volunteer than their working counterparts. However, whether the transition to retirement is associated with increased volunteering frequency and whether this varies according to material and time resources of participants is unclear. We used four waves of data from the longitudinal Survey of Health, Ageing and Retirement in Europe, collected between 2011-2018 across 19 countries ( = 12,400 person-observations from 6200 individuals over 50).

Long-term persistence of the risk of agranulocytosis with clozapine compared with other antipsychotics: a nationwide cohort and case-control study in Finland.

Background: Agranulocytosis is a life-threatening side-effect of clozapine, the only approved drug for treatment-resistant schizophrenia. The long-term profile of this complication has not yet been well established. Here we aim to describe the risk of clozapine-induced agranulocytosis over the long term.

Antipsychotic Use and Risk of Breast Cancer in Women With Severe Mental Illness: Replication of a Nationwide Nested Case-Control Database Study.

Background And Hypothesis: Breast cancer is more prevalent in women with severe mental illness than in the general population, and use of prolactin-increasing antipsychotics may be a contributing factor.

Study Design: A nested case-control study was conducted using the Swedish nationwide registers (inpatient/outpatient care, sickness absence, disability pension, prescribed drugs, cancers). All women aged 18-85 years with schizophrenia/schizoaffective/other nonaffective psychotic disorder/bipolar disorder and breast cancer (cases) were matched for age, primary psychiatric diagnosis, and disease duration with five women without cancer (controls).

Antipsychotic medications and sleep problems in patients with schizophrenia.

Background: Sleep problems are common and related to a worse quality of life in patients with schizophrenia. Almost all patients with schizophrenia use antipsychotic medications, which usually increase sleep. Still, the differences in subjective sleep outcomes between different antipsychotic medications are not entirely clear.

Long-term benzodiazepine use and risk of labor market marginalization in Finland: A cohort study with 5-year follow-up.

Background: Benzodiazepines and related drugs (BZDRs) are widely used in the treatment of anxiety and sleep disorders, but cognitive adverse effects have been reported in long-term use, and these may increase the risk of labor market marginalization (LMM). The aim of this study was to investigate whether the risk of LMM is associated with new long-term BZDR use compared to short-term use.

Methods: This register-based nationwide cohort study from Finland included 37,703 incident BZDR users aged 18-60 years who initiated BZDR use in 2006.

Antipsychotic Use and Psychiatric Hospitalization in First-Episode Non-affective Psychosis and Cannabis Use Disorder: A Swedish Nationwide Cohort Study.

Background And Hypothesis: There is a paucity of research on treatment outcomes of patients with psychosis and cannabis use disorder (CUD). We aimed to compare the effectiveness of antipsychotics in reducing the risk of hospitalization in patients with first-episode psychosis (FEP) and co-occurring CUD.

Study Design: We utilized a nationwide Swedish cohort of patients with longitudinal register data from the year 2006 to 2021.

Investment by maternal grandmother buffers children against the impacts of adverse early life experiences.

Exogenous shocks during sensitive periods of development can have long-lasting effects on adult phenotypes including behavior, survival and reproduction. Cooperative breeding, such as grandparental care in humans and some other mammal species, is believed to have evolved partly in order to cope with challenging environments. Nevertheless, studies addressing whether grandparental investment can buffer the development of grandchildren from multiple adversities early in life are few and have provided mixed results, perhaps owing to difficulties drawing causal inferences from non-experimental data.

Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes.

Importance: Individuals with attention-deficit/hyperactivity disorder (ADHD) often have comorbid psychiatric conditions. Relatively little is known about how specific ADHD medications are associated with overall treatment outcomes among these patients.

Objective: To investigate the association of the use of specific ADHD medications with hospitalization outcomes and work disability among adolescents and adults with ADHD.

Development and Validation of a Machine Learning-Based Model of Mortality Risk in First-Episode Psychosis.

Importance: There is an absence of mortality risk assessment tools in first-episode psychosis (FEP) that could enable personalized interventions.

Objective: To examine the feasibility of machine learning (ML) in discerning mortality risk in FEP and to assess whether such risk predictions can inform pharmacotherapy choices.

Design, Setting, And Participants: In this prognostic study, Swedish nationwide cohort data (from July 1, 2006, to December 31, 2021) were harnessed for model development and validation.

Efficacy and effectiveness of antipsychotics in schizophrenia: network meta-analyses combining evidence from randomised controlled trials and real-world data.

Background: There is debate about the generalisability of results from randomised clinical trials (RCTs) to real-world settings. Studying outcomes of treatments for schizophrenia can shed light on this issue and inform treatment guidelines. We therefore compared the efficacy and effectiveness of antipsychotics for relapse prevention in schizophrenia and estimated overall treatment effects using all available RCT and real-world evidence.