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Strömsten, Lotta M. J., PhD
Alternative names
Publications (10 of 18) Show all publications
Idenfors, H., Strömsten, L. & Salander Renberg, E. (2019). Are non-psychiatric hospitalisations before self-harm associated with an increased risk for suicide among young people?. Journal of Psychosomatic Research, 120, 96-101
Open this publication in new window or tab >>Are non-psychiatric hospitalisations before self-harm associated with an increased risk for suicide among young people?
2019 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 120, p. 96-101Article in journal (Refereed) Published
Abstract [en]

Objective: This study aimed to investigate any increased risk for suicide in young people with admission for self-harm and if the risk is further increased due to somatic inpatient admissions before a first act of self-harm.

Methods: This register study included 16,235 cases in the ages 16–24, with a first admission for self-harm, and 32,465 matched controls. All admissions and diagnoses were recorded from the year preceding cases first admission for self-harm. Subjects were followed until death or end of study, registering the cause of death for all deceased. Group differences were analysed using survival analysis with death by suicide as primary outcome.

Results: In cases with a previous somatic admission, the risk for death by suicide during the study period was higher than in cases without a somatic admission (457 and 316 suicides per 100,000 people and year, respectively, p = 0.01). For cases with a somatic admission, the hazard ratio was 1.43 (95% confidence interval 1.04–1.98) compared with those without somatic admissions (controlled for age, sex and psychiatric admission). Survival of cases with a previous somatic admission compared with those without was 98.4% versus 99.2% after the first year, 97.8% versus 98.9% after the second year, and 95.5% versus 96.9% after the tenth year.

Conclusions: This study suggests that admission for physical illness before self-harm is associated with a higher risk for suicide among young people, and that their contact with healthcare due to physical problems could provide an opportunity to detect suicide risk.

Keywords
Suicide, Young people, Self-harm, Case-control, Register study, Somatic disorders, Suicide risk, Suicide attempt
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:umu:diva-120696 (URN)10.1016/j.jpsychores.2019.02.013 (DOI)000464627300014 ()30929715 (PubMedID)
Note

Originally included in thesis in manuscript form

Available from: 2016-05-18 Created: 2016-05-18 Last updated: 2019-05-27Bibliographically approved
Beckman, K., Lindh, Å., Waern, M., Strömsten, L. M. J., Salander Renberg, E., Runesson, B. & Dahlin, M. (2019). Impulsive suicide attempts among young people: a prospective multicentre cohort study in Sweden. Journal of Affective Disorders, 243, 421-426
Open this publication in new window or tab >>Impulsive suicide attempts among young people: a prospective multicentre cohort study in Sweden
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2019 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 243, p. 421-426Article in journal (Refereed) Published
Abstract [en]

Background: We aimed to compare the prevalence of impulsive suicide attempts (ISA) among young adults and those over 25 who present at hospital in connection with attempted suicide. We also aimed to identify factors associated with ISA in young adults and to assess medical severity as well as the probability of repeated suicide attempts in this age group.

Method: A prospective multicentre cohort study included hospital known cases of suicide attempt (N = 666). The prevalence of ISA was compared between young adults (18-25) and adults aged > 26. We used logistic regression models to identify factors associated with ISA, associations of ISA with high medical severity and prediction of new fatal or non-fatal suicide attempts within 6 months.

Results: 43.7% of the young patients had made an ISA, and 30.2% among those aged > 26 (p = 0.001). Among the young, substance use disorder was associated with ISA; crude odds ratio (OR) 2.0 (1.0-4.2), and adjusted OR 2.1 (0.99-4.4). Affective disorder and unemployment/sickness absence implied lower odds of ISA. ISA resulted in injuries of high medical severity as often as more planned attempts and non-fatal or fatal repetition within 6 months was equally common (30%) in both groups.

Limitations: The study was set in psychiatric emergency services, which limits the generalizability.

Conclusions: Clinicians should acknowledge that suicide attempts among youth often occur without previous planning and may result in medically severe injuries. The probability of new fatal or non-fatal suicide attempts should be kept in mind also after an impulsive suicide attempt.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Suicide, Young, Suicide attempt, Cohort study, Mental illness
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:umu:diva-151956 (URN)10.1016/j.jad.2018.09.070 (DOI)000446860300055 ()30268958 (PubMedID)
Funder
Swedish Research Council, 521-2011-299Stockholm County CouncilVästerbotten County Council, ALFVLL-549931
Available from: 2018-09-19 Created: 2018-09-19 Last updated: 2019-10-16Bibliographically approved
Strömsten, L. M. J., Wiktorsson, S., Waern, M., Lindh, Å., Jokinen, J., Salander-Renberg, E. & Runesson, B. (2019). Interpersonal violence is differentially associated with repeated suicidal behavior in men, women and different age groups. In: : . Paper presented at 30th IASP World Congress. Londonderry, UK
Open this publication in new window or tab >>Interpersonal violence is differentially associated with repeated suicidal behavior in men, women and different age groups
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2019 (English)Conference paper, Oral presentation only (Refereed)
Place, publisher, year, edition, pages
Londonderry, UK: , 2019
Keywords
Suicide, interpersonal violence
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:umu:diva-163510 (URN)
Conference
30th IASP World Congress
Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2019-10-03Bibliographically approved
Strömsten, L. M. J. (2017). Katastrofövning med Google Apps. In: : . Paper presented at Universitetspedagogiska konferensen 2017 - Undervisning i praktiken.
Open this publication in new window or tab >>Katastrofövning med Google Apps
2017 (Swedish)Conference paper, Oral presentation only (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-151957 (URN)
Conference
Universitetspedagogiska konferensen 2017 - Undervisning i praktiken
Available from: 2018-09-19 Created: 2018-09-19 Last updated: 2018-10-01
Idenfors, H., Strömsten, L. M. J. & Salander Renberg, E. (2016). Are Non-Psychiatric Hospitalisations Before Self-Harm Associated with Increased Risk of Unnatural Deaths Among Young People?. Journal of Psychosomatic Research, 85, 66-67
Open this publication in new window or tab >>Are Non-Psychiatric Hospitalisations Before Self-Harm Associated with Increased Risk of Unnatural Deaths Among Young People?
2016 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 85, p. 66-67Article in journal, Meeting abstract (Other academic) Published
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-123985 (URN)10.1016/j.jpsychores.2016.03.163 (DOI)000377627200046 ()
Note

Meeting Abstract: 37

Available from: 2016-08-19 Created: 2016-07-07 Last updated: 2018-06-07Bibliographically approved
Jonsson, F., San Sebastian, M., Stromsten, L. M. J., Hammarstrom, A. & Gustafsson, P. E. (2016). Life Course Pathways of Adversities Linking Adolescent Socioeconomic Circumstances and Functional Somatic Symptoms in Mid-Adulthood: A Path Analysis Study. PLoS ONE, 11(5), Article ID e0155963.
Open this publication in new window or tab >>Life Course Pathways of Adversities Linking Adolescent Socioeconomic Circumstances and Functional Somatic Symptoms in Mid-Adulthood: A Path Analysis Study
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 5, article id e0155963Article in journal (Refereed) Published
Abstract [en]

While research examining the health impact of early socioeconomic conditions suggests that effects may exist independently of or jointly with adult socioeconomic position, studies exploring other potential pathways are few. Following a chain of risk life course model, this prospective study seeks to examine whether pathways of occupational class as well as material and social adversities across the life course link socioeconomic disadvantage in adolescent to functional somatic symptoms in mid-adulthood. Applying path analysis, a multiple mediator model was assessed using prospective data collected during 26 years through the Northern Swedish Cohort. The sample contained 987 individuals residing in the municipality of Lulea, Sweden, who participated in questionnaire surveys at age 16, 21, 30 and 42. Socioeconomic conditions (high/low) in adolescence (age 16) were operationalized using the occupation of the parents, while occupational class in adulthood (manual/nonmanual) was measured using the participant's own occupation at age 21 and 30. The adversity measurements were constructed as separate age specific parcels at age 21 and 30. Social adversity included items pertaining to stressful life events that could potentially harm salient relationships, while material adversity was operationalized using items concerning unfavorable financial and material circumstances. Functional somatic symptoms at age 42 was a summary measure of self-reported physical symptoms, palpitation and sleeping difficulties that had occurred during the last 12 months. An association between socioeconomic conditions at age 16 and functional somatic symptoms at age 42 (r = 0.068) which was partially explained by people's own occupational class at age 21 and then material as well as social adversity at age 30 was revealed. Rather than proposing a direct and independent health effect of the socioeconomic conditions of the family, the present study suggests that growing up in an unfavorable socioeconomic environment might be a source for a chain of adverse material and social living situations, which in turn affects adult health.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-123074 (URN)10.1371/journal.pone.0155963 (DOI)000376880200041 ()27214206 (PubMedID)
Available from: 2016-06-27 Created: 2016-06-27 Last updated: 2018-11-12Bibliographically approved
Idenfors, H., Strömsten, L. M. . & Salander Renberg, E. (2016). Non-psychiatric inpatient care preceding admission for self-harm in young people. Journal of Psychosomatic Research, 88, 8-13
Open this publication in new window or tab >>Non-psychiatric inpatient care preceding admission for self-harm in young people
2016 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 88, p. 8-13Article in journal (Refereed) Published
Abstract [en]

Objective

Many young people contact health services before they harm themselves intentionally. However, they often seek care for non-suicidal or non-psychiatric causes despite having suicidal thoughts. We investigated the non-psychiatric hospital diagnoses received by young people during the year before their first admission to hospital for self-harm.

Methods

From a national register, we selected people who were hospitalised for an episode of self-harm during the period 1999-2009, at which time they were aged 16 to 24. We compared them with matched controls regarding the probability for being admitted with different diagnoses during the year preceding the self-harm admission.

Results

The study included 48,705 young people (16,235 cases and 32,470 controls). Those admitted for self-harm were more likely than controls to have been hospitalised for non-psychiatric reasons, which included symptomatic diagnoses such as abdominal pain, syncope/collapse, unspecified convulsions, and chest pain. Certain chronic somatic illnesses were also overrepresented, such as epilepsy, diabetes mellitus type 1, and asthma.

Conclusions

Symptomatic diagnoses were more common in those who had been admitted for self-harm. It is possible that psychiatric problems could have been the cause of the symptoms in some of these admissions where no underlying illness could be found, and if this was not uncovered it might lead to a delay in suicide risk assessment. For several chronic illnesses, when admitted to hospital, a psychiatric evaluation might be indicated.

Keywords
Case-control, Register study, Self-harm, Somatic disorders, Suicide attempt, Young people
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:umu:diva-120695 (URN)10.1016/j.jpsychores.2016.06.011 (DOI)000381841600002 ()27521645 (PubMedID)
Note

Originally included in thesis in manuscript form.

Available from: 2016-05-18 Created: 2016-05-18 Last updated: 2018-06-07Bibliographically approved
Jonsson, F., San Sebastian, M., Strömsten, L. M. J., Hammarström, A. & Gustafsson, P. E. (2016). Paths of adversity linking adolescent socioeconomic conditions to adult functional somatic symptoms. In: : . OXFORD UNIV PRESS, 26
Open this publication in new window or tab >>Paths of adversity linking adolescent socioeconomic conditions to adult functional somatic symptoms
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2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-134281 (URN)10.1093/eurpub/ckw170.055 (DOI)000398600402140 ()
Note

Supplement 1

Available from: 2017-05-12 Created: 2017-05-12 Last updated: 2018-06-09
Semb, O., Strömsten, L. M., Fransson, P., Henningsson, M. & Sundbom, E. (2012). Shame and post-traumatic distress. In: : . Paper presented at The 28th ISTSS Annual Meeting, Los Angeles..
Open this publication in new window or tab >>Shame and post-traumatic distress
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2012 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-140412 (URN)
Conference
The 28th ISTSS Annual Meeting, Los Angeles.
Available from: 2017-10-10 Created: 2017-10-10 Last updated: 2018-09-19
Sundbom, E., Henningsson, M., Fransson, P., Semb, O. & Strömsten, L. (2011). Betydelse av tidig kontakt och behandling av våldsdrabbade brottsoffer: en prospektiv longitudinell studie. Umeå: Umeå universitet
Open this publication in new window or tab >>Betydelse av tidig kontakt och behandling av våldsdrabbade brottsoffer: en prospektiv longitudinell studie
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2011 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. p. 28
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-42803 (URN)
Available from: 2011-04-15 Created: 2011-04-13 Last updated: 2018-06-08Bibliographically approved
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