@article{ref1,
title="Mental disorders, suicide attempt and suicide: differences in the association in refugees compared with Swedish-born individuals",
journal="British journal of psychiatry",
year="2019",
author="Björkenstam, Emma and Helgesson, Magnus and Amin, Ridwanul and Mittendorfer-Rutz, Ellenor",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Mental disorders are associated with an elevated risk for suicide attempt and suicide. Whether the strength of the associations also holds for refugees is unclear. AIMS: To examine the relationship between specific mental disorders and suicide attempt and suicide in refugees and Swedish-born individuals. <br><br>METHOD: This longitudinal cohort study included 5 083 447 individuals aged 16-64 years, residing in Sweden in 2004, where 196 757 were refugees. Mental disorders were defined as having a diagnosis in psychiatric care during 2000-2004. Estimates of risk of suicide attempt and suicide were calculated as hazard ratios with 95% confidence intervals. Adjustments were made for important confounding factors, including history of attempt. The reference group comprised Swedish-born individuals without mental disorders. <br><br>RESULTS: Rates for suicide attempt in individuals with a mental disorder were lower in refugees compared with Swedish-born individuals (480 v. 850 per 100 000 person-years, respectively). This pattern was true for most specific disorders: compared with the reference group, among refugees, multivariable-adjusted hazard ratios for suicide attempt ranged from 3.0 (anxiety) to 7.4 (substance misuse), and among Swedish-born individuals, from 4.9 (stress-related disorder) to 9.3 (substance misuse). For schizophrenia, bipolar disorder and personality disorder, estimates for suicide attempt were comparable between refugees and Swedish-born individuals. Similar patterns were seen for suicide. <br><br>CONCLUSIONS: For most mental disorders, refugees were less likely to be admitted to hospital for suicide attempt or die by suicide compared with Swedish-born individuals. Further research on risk and protective factors for suicide attempt and suicide among refugees with mental disorders is warranted. DECLARATION OF INTEREST: None.<p /> <p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.2019.215",
url="http://dx.doi.org/10.1192/bjp.2019.215"
}