@article{ref1,
title="Late-adolescent risk factors for suicide and self-harm in middle-aged men: explorative prospective population-based study",
journal="British journal of psychiatry",
year="2019",
author="Nyberg, Jenny and Gustavsson, Sara and Åberg, Maria A. I. and Kuhn, H. Georg and Waern, Margda",
volume="ePub",
number="ePub",
pages="1-7",
abstract="BACKGROUND: 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. AIMS: To prospectively explore associations of potential risk factors at age 18 with suicide and self-harm in middle-aged men. <br><br>METHOD: 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. <br><br>RESULTS: 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. <br><br>CONCLUSIONS: 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.<p /> <p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.2019.243",
url="http://dx.doi.org/10.1192/bjp.2019.243"
}