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OBJECTIVE To examine risk of unnatural death among people diagnosed with diabetes irrespective of disease type. RESEARCH DESIGN AND METHODS We conducted a matched cohort study of the entire Swedish population using interlinked national registers. From the National Diabetes Register we identified 252,191 people diagnosed with diabetes (type 1 or 2) during 1996-2009. Each cohort member was matched for age, sex, and county of birth to five unaffected individuals randomly sampled from the Total Population Register. Mortality was examined with complete ascertainment, and risk ratios (RRs) for all unnatural deaths and for specific causes (suicide, accident, homicide, and iatrogenic effects) were estimated using conditional fixed-effects Poisson regression. RESULTS Risk of any unnatural death was elevated versus the general population: 77.3 versus 32.1 per 10,000 (RR 2.2 [95% CI 2.1-2.4]), and these deaths occurred at a younger age in the diabetes cohort. Risk was increased for suicide (RR 3.4 [95% CI 3.0-3.8]), accident (RR 2.0 [95% CI 1.9-2.1]), homicide (RR 3.1 [95% CI 1.6-6.1]), and iatrogenic effects (RR 2.4 [95% CI 1.9-3.2]). It was greatly elevated for fatal poisoning from a variety of agents, including psychotropic drugs and "other and unspecified medication," as well as narcotics, alcohol, and carbon monoxide. Almost 9% of all fatal poisoning cases in the diabetes cohort were identified as overdoses of insulin or oral hypoglycemic drugs. CONCLUSIONS Various causes of unnatural death, in particular deliberate and accidental poisonings, occur more frequently among diabetic patients. Before preventive strategies can be implemented, a deeper understanding of the risk factors and causal mechanisms explaining the marked elevations in risk is needed. [ABSTRACT FROM AUTHOR]

The article discusses a population-based cohort study which determined the effect of low birth weight with increased risk for adult schizophrenia or other adult mental illnesses. In the population-based cohort research conducted in Sweden and Denmark, two phases of analyses were made using the Stata version 10 software and the SAS version 9.1 software. Results show that birth weight is somehow linked with adult mental disorder.

Currently there is a lack of strong epidemiological evidence for violent offending and intelligence quotient (IQ) level as predictors of suicide risk among people with schizophrenia. We interlinked several Swedish routinely collected national registers, including the Hospital Discharge, Crime, Conscript, Migration and Cause of Death Registers, to identify 13,804 patients admitted at least twice with a schizophrenia diagnosis during 1973-2004. All deaths by specific cause were ascertained and suicides identified, and rate ratios were estimated using Poisson regression models with adjustment for age and period effects. There were 871 suicides: 6.3% of the cohort. Almost 80% of these cases were aged 20-39 years, and 80% occurred within 10 years of second discharge, with almost a quarter taking place within a year. The following risk factors were identified: younger age, 15-19 versus 40 years and older (rate ratio 3.18, 95% confidence interval 1.82-5.56), male sex (rate ratio 1.37, 1.18-1.59) and history of violent offending (rate ratio 1.45, 1.21-1.73). Intelligence quotient data were unavailable for women, but in men, lower IQ appeared protective compared to those of average or higher levels of intelligence (rate ratio 0.71, 0.58-0.86). Further stratified analyses to identify effect modification indicated that the elevated risk associated with past violent offending was restricted to males, and specifically to those with a lower IQ. Further research is needed to identify additional risk and protective factors for suicide that may be unique to people diagnosed with schizophrenia, and also other modifiers of the increased risk linked with violent offending., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Context: Since national risk reduction campaigns have been conducted, sudden infant death syndrome (SIDS) has become increasingly concentrated among disadvantaged families, including those affected by mental illness. However, causal mechanisms specific to this group are poorly understood., Objectives: To estimate relative risk and compare risk factor prevalence in infants with and without parental psychiatric inpatient history, and to explore effect modification after the 1992 Swedish risk reduction campaign., Design: National birth cohort. Parental psychiatric admissions, maternal prenatal smoking, obstetric and social risk factors, and cause-specific infant death were ascertained via linkage between national registers., Setting: The Swedish population, 1978 through 2004., Participants: All singleton live births (N = 2.5 million)., Main Outcome Measure: Incidence of SIDS., Results: Risk of SIDS was higher with a history of parental inpatient care, especially if both parents were admitted with any mental illness (odds ratio, 6.8; 95% confidence interval, 4.7-10.0), or if the mother (6.5; 4.9-8.7) or both parents (9.5; 5.5-16.4) had an alcohol/drug disorder. A 2-fold higher risk was also seen if the mother or father was admitted with any psychiatric illness other than alcohol or other drug disorders. Elevated risk persisted even if the last maternal inpatient episode had occurred 5 or more years before the infant's birth. After the national campaign, risk factor prevalence (especially maternal antenatal smoking) remained high in this population, and relative risks therefore increased. During 1992 through 2004, smoking and individual social adversity measures jointly accounted for approximately half the excess risk linked with maternal psychiatric inpatient history, whereas the confounding effects of obstetric factors were minimal., Conclusions: Tailored approaches are needed to ensure that standard safety advice is effectively communicated to these vulnerable families. In particular, mentally ill pregnant women should be encouraged and better supported to stop smoking. Families with 2 affected parents require particularly strong support. A clearer understanding is needed as to why high risk factor prevalence persists among these parents.