Our latest publications

• Bukten, Anne; Mehlum, Lars; Fazel, Seena; Lokdam, Nicoline Toresen; Tverborgvik, Torill & Skurtveit, Svetlana Ondrasova [Show all 12 contributors for this article] (2026). Sociodemographic, Criminological and Clinical Determinants in Suicide After Release From Prison: A 23‐Year National Cohort Study. Acta Psychiatrica Scandinavica. ISSN 0001-690X. doi: 10.1111/acps.70148. Full text in Research Archive Show summary

  ABSTRACT Background Suicide risk is elevated after prison release, but population‐level evidence on temporal risk patterns and associated factors remains limited. We aimed to describe characteristics of individuals who die by suicide after release from Norwegian prisons, compare their suicide mortality with the general population, and examine risk factors over time. Material and Methods Data from the Norwegian Prison Release Study (nPRIS), including all people in prison in Norway (2000–2022), were linked to the Norwegian Cause of Death Registry, the Norwegian Prison Registry, the Norwegian Patient Registry, and Statistics Norway. We calculated crude mortality rates (CMR) per 100,000 person‐years, standardized mortality ratios (SMR), annual age‐standardized years of life lost rate (ASYR), and Cox proportional hazards models. Results From 2000 to 2022, 1183 suicides (9.1% of all deaths; CMR 81; 95% CI 76–85) occurred after release (90% male). The SMR was higher in women (SMR 8.64; 95% CI 7.17–10.34) than men (SMR 3.98; 95% CI 3.76–4.22). In multivariable models (2009–2022; n  = 57,034; 516 suicides), strong independent associations with suicide 6 months post‐release included self‐harm (adjusted HR [aHR] 4.76; 95% CI 2.60–8.72), severe mental illness (aHR 1.95; 95% CI 1.16–3.27), release from high‐security prisons (aHR 1.93; 95% CI 1.12–3.33), and pretrial detention (aHR 1.82; 95% CI 1.06–3.13). Conclusions Suicide risk is substantially and persistently elevated relative to the general population, peaks immediately after release, and is concentrated among people with prior self‐harm, severe mental illness, and those released from high‐security settings.

• Sterri, Njål Herman E.; Lockertsen, Øyvind; Husum, Tonje Lossius; Lockertsen, Veronica; Siqveland, Johan & Senneseth, Mette (2026). Antecedents to episodes involving aggression and coercion in in-patient mental health settings: scoping review. BJPsych Open. 12(6), p. 1–12. doi: 10.1192/bjo.2026.12123. Full text in Research Archive Show summary

  Background Preventing episodes involving aggression and reducing coercive measures are important goals in in-patient mental health settings. Antecedents may provide insight into how episodes are described to develop. However, most studies reflect staff perspectives, and often describe and temporally specify antecedents inconsistently. Aims This scoping review mapped reported antecedents to episodes involving aggression and episodes involving coercive measures, and identified which appeared shared or specific to either phenomenon. Method This review followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidance, and included 39 studies from systematic searches across Ovid Medline, APA PsycINFO and Scopus. Reported antecedents were extracted, standardised and mapped to six analytical domains. Results The review mapped 240 antecedents, many of which appeared shared across the phenomena. Patient studies emphasised experiences of restrictive care, loss of autonomy and poor interaction quality. Staff studies emphasised immediate, observable situations related to risk management, such as patient aggression, denied requests and interpersonal conflict. Most studies did not specify the temporal boundaries of antecedents. Conclusions The perspectives represented in studies and the ways antecedents are conceptualised influence which antecedents become visible in the literature. Overlapping antecedents indicate that episodes involving aggression and episodes involving coercive measures are often described as part of the same escalation process, although patient and staff studies seem to highlight different stages. Prevention efforts therefore require attention to the entire trajectory, and to the point at which staff perceive intervention as necessary. Future studies should incorporate both perspectives, prioritise patient involvement, and more clearly define and temporally specify antecedents.

• Essletzbichler, Amy Gaglia; Bierman, Miriam; Skuza, Magdalena; Češková, Natálie & Tørmoen, Anita Johanna (2026). Case study: The DBT implementation journey of dialectical behaviour therapy in five European countries. Borderline Personality Disorder and Emotion Dysregulation. 13(1). doi: 10.1186/s40479-026-00359-x. Full text in Research Archive Show summary

  Abstract Background This paper is a narrative review of the implementation trajectories Dialectical Behaviour Therapy in five countries, the UK, Germany Norway, Poland, and the Czech Republic in Europe over the past 30 years. The aim of this comparison is to identify common and divergent systems levels facilitators and hindrances of DBT implementation. Methods DBT experts in each respective country were asked to provide a narrative account of their country’s implementation journey. Histories were then considered in accordance with existing DBT implementation frameworks. Results Common themes emerged such as the importance national guidelines on evidence-based treatment shape implementation, university affiliations promote dissemination, implementation and research activities, national societies help to create standards. Conclusion There are common DBT implementation trajectories that exist across geography and nationally specific mental health care systems. The discussion of the refining of national DBT practices based on emerging literature and the importance of outcomes of implementation such as therapists’ behaviour or client related outcome data adds to existing information.

• Mohn, Christine (2026). Kronisk smerte og selvmordsatferd – overlappende fysiologiske prosesser som forklaring. Suicidologi. ISSN 1501-6994. 31(2), p. 12–17. doi: 10.5617/suicidologi.13636. Full text in Research Archive Show summary

  Kroniske smertetilstander er forbundet med økt risiko for selvmordsatferd. Begge disse tilstandene kjennetegnes også av symptomer på psykiske lidelser, spesielt depresjon, sosial isolasjon og ensomhet, og disse faktorene kan forsterke hverandre gjensidig. Kronisk smerte, depresjonslidelser og ensomhet kjennetegnes dessuten av delvis overlappende nevrofysiologisk aktivitet i de samme hjerneområdene – det limbiske system og ventromediale prefrontal cortex. Videre kan det fysisk smertefulle i tiden før et selvmord korrespondere med det klassiske suicidologiske begrepet psychache. Det overlappende nevrobiologiske grunnlaget for fenomenene fysisk smerte, psykiske plager og sosial utstøtelse kan forklares evolusjonistisk, og hvis disse tilstandene vedvarer, kan selvmord oppleves som en måte å unnslippe det sammensatte lidelsesbildet.

• Mohn, Christine; Haga, Egil; Nilsson, Hanne Sofie Wernø & Mehlum, Lars (2026). Who notices suicide prevention media campaigns? Demographic characteristics and attitudes to suicide and help-seeking. Psychiatry Research Communications. 6(4). doi: 10.1016/j.psycom.2026.100285. Full text in Research Archive Show summary

  Public media campaigns have the potential to reach large numbers of people with suicide prevention messages. However, relatively few individuals among the exposed population report being aware of the campaigns when they occur. Those who notice these campaigns may differ from those who do not in key variables relevant for suicide prevention interventions. In this study, we compare the demographic characteristics and attitudes to suicide and help-seeking in these two groups. In 2022 and 2023, three regional uniform suicide prevention media campaigns were carried out in Mid-, West- and South-Norway. Before and after each campaign, sex- and age-representative samples of the population completed surveys of demographic variables and attitudes to suicide and help-seeking. Among the 3234 participants, n = 644 (20%) reported having noticed the campaign, and n = 2590 (80%) did not. In the campaign awareness group, there were significantly fewer members in the 30-39 age bracket and more members in the 70-79 age bracket than among the non-aware group. Moreover, the campaign awareness group had a higher proportion of people with MA level education, in retirement, and who had family members or friends who had died by suicide or attempted suicide. In this group, there was also slightly higher preparedness to help a suicidal person. The effect sizes were small. Logistic regression analyses revealed not belonging to the 30-39 age bracket and having family/friends with suicidal behaviour as significant predictors of campaign awareness.

• Feng, Xin; Sigurdardottir, Fjola Dögg Hugberg; Arnardottir, Erna Sif; Dammen, Toril; Einvik, Gunnar & Korkalainen, Henri [Show all 15 contributors for this article] (2026). Association of major adverse cardiovascular events with the apnea-hypopnea index, desaturation severity parameters, and cardiac troponins in participants of the Akershus Sleep APnea cohort. Sleep. ISSN 0161-8105. 49(8). doi: 10.1093/sleep/zsag013. Full text in Research Archive Show summary

  Study Objectives: To examine the prognostic value of the apnea-hypopnea index (AHI), desaturation severity parameters, and cardiac troponins alone and combined for major cardiovascular events (MACEs). Methods: MACE data were retrieved in 2021 from the Norwegian Patient Registry for 518 participants in the Akershus Sleep APnea (ASAP) cohort. Baseline polysomnography and fasting blood samples were collected between June 2006 and January 2008. Desaturation duration (DesDur) and severity (DesSev) were calculated using Automatic Blood Oxygen Saturation Analysis software. Cox regression models estimated hazard ratios (HRs) for MACE. Predictive properties of combining troponins and obstructive sleep apnea severity were calculated by comparing established clinical thresholds for cardiac troponin I (cTnI) and T (cTnT) with AHI clinical thresholds of ≥15 and ≥30, respectively. Results: High AHI, DesDur, DesSev, cTnI, and cTnT were associated with increased MACE risk. However, only cTnI independently predicted MACE after adjustment (HR: 1.74, 95% CI: 1.32–2.29). The HR for MACE was 2.68 (95% CI: 1.03–6.97) in patients with both high cTnI and AHI ≥30 events/h. Conclusion: In this 15-year follow-up, cTnI was independently associated with risk of MACE, whereas the AHI, desaturation parameters, and cTnT were not independent predictors. cTnI, especially when combined with AHI, was a stronger MACE predictor than cTnT. Provided our findings are validated in clinical obstructive sleep apnea populations, the measurement of cTnI may be considered for cardiovascular risk stratification.

• Stangeland, Tormod; Hanssen-Bauer, Ketil & Siqveland, Johan (2026). Prediction of Suicide Attempts Among Adolescents in Acute Mental Health Crisis. Archives of Suicide Research. ISSN 1381-1118. doi: 10.1080/13811118.2026.2714308. Full text in Research Archive
• Klungsøyr, Ole; Røssberg, Jan Ivar; Papageorgiou, Constantinos; Evensen, Julie Horgen; Løvgren, André & Malkomsen, Anders [Show all 10 contributors for this article] (2026). Personalized and optimal treatment estimated by a value search method in a randomized clinical trial with psychodynamic versus cognitive behavioral therapy for depression. Psychotherapy Research. ISSN 1050-3307. doi: 10.1080/10503307.2026.2682995. Full text in Research Archive
• Solberg, Amalie Christine; Ottesen, Akiah Astral; Barrett, Elizabeth Ann; Mork, Erlend; Qin, Ping & Melle, Ingrid (2026). Characteristics of self-harm in patients with first episode psychosis. Psychiatry Research. ISSN 0165-1781. 364, p. 117278–117278. doi: 10.1016/j.psychres.2026.117278. Full text in Research Archive
• Dibaj, Iselin Solerød; Galfalvy, Hanga; Tørmoen, Anita Johanna; Haga, Egil & Mehlum, Lars (2026). Does Dialectical Behaviour Therapy for adolescents affect suicidal ideation and use of coping skills in adulthood? A 12.4-years follow-up study of a Randomized Trial using Ecological Momentary Assessment. Behaviour Research and Therapy. ISSN 0005-7967. 203. doi: 10.1016/j.brat.2026.105091. Full text in Research Archive
• Bukten, Anne; Mehlum, Lars; Lokdam, Nicoline Toresen; Tverborgvik, Torill & Stavseth, Marianne Riksheim (2026). Rates, Timing and Correlates of Suicide in Norwegian Prisons: A 23-Year National Cohort Study. Archives of Suicide Research. ISSN 1381-1118. doi: 10.1080/13811118.2026.2680205. Full text in Research Archive
• Furnes, Desire; Mehlum, Lars; Walby, Fredrik Andreas; Fredriksen, Kristin J; Ødegaard, Ketil Joachim & Gjestad, Rolf (2026). Predicting suicide in patients who have received acute psychiatric inpatient treatment - the longitudinal and prospective SIPEA study. Journal of Psychiatric Research. ISSN 0022-3956. 195, p. 257–263. doi: 10.1016/j.jpsychires.2026.01.053. Full text in Research Archive Show summary

  Suicidality (suicidal ideation and -plans (SI) and deliberate self-harm (DSH)), has been extensively studied in different patient populations. Fewer studies have examined predictors of suicide within an extensive longitudinal frame, which is problematic since findings from studies including participants with non-lethal suicidal behavior are not easily generalizable to patients that complete suicide. We aimed to address this gap by examining demographic and clinical factors as predictors of suicide in a longitudinal prospective cohort study of 7,000 consecutively admitted patients. Mean observation time was 4.1 years. Male gender, more frequent admissions during the follow-up period, and having SI, DSH and substance-induced psychosis at the final admission before suicide, directly predicted shorter time to suicide. Shorter time to suicide was indirectly predicted by borderline personality disorder (BPD) via DSH and by psychotic depression and neurotic disorders via SI. In contrast, longer time to suicide was indirectly predicted by substance-induced psychosis and psychotic disorders via reduced probability of SI and DSH at the final admission. Patients diagnosed with BPD had more frequent admissions and higher levels of SI and DSH across admissions, which predicted shorter time to suicide via increased risk of DSH at the final admission. Similarly, patients diagnosed with neurotic disorders had a higher level of SI and DSH across admissions, with shorter time to suicide via SI and DSH at the final admission. Findings suggest different pathways to suicide for different clinical subgroups, and this is discussed in relation to current theoretical models that emphasize suicide as a transdiagnostic phenomenon.

• Mehlum, Lars; Dibaj, Iselin Solerød; Haga, Egil; Helle, Sofie Egidius; Morken, Katharina Teresa Enehaug & Klungsøyr, Ole [Show all 7 contributors for this article] (2026). Adult life outcomes for adolescents 12.4 years after dialectical behavior therapy - a randomized clinical trial. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-025-02856-w. Full text in Research Archive Show summary

  Adolescents with suicidal and self-harming behavior run significant risk for suicide. Outcomes in adult life after specialized treatment for this population are unknown. We examined adult life outcomes in adolescents with recurrent suicidal and self-harming behavior and borderline features having participated in a randomized trial of dialectical behavior therapy (DBT-A) or enhanced usual care (EUC). Of the original 77 study participants, 61 (79%) were followed-up at a mean age of 28 years, an average of 12.4 years post-baseline. Primary outcomes were frequency of self-harm episodes and levels of suicidal ideation and depressive symptoms over the follow-up intervals. Secondary outcomes were borderline symptoms, psychiatric morbidity, occupational and psychosocial functioning. Self-harm frequency was consistently lower throughout the 12.4 year follow-up period in participants who had received DBT-A, although differences were not statistically significant at the final follow-up. Whereas suicide attempts were infrequent in both groups, self-harm episodes were more than twice as common in the EUC group compared to the DBT-A group with a mean difference of 90 episodes per person from baseline to 12.4 years follow-up. DBT-A was associated with significantly stronger reductions in suicidal ideation, depressive and borderline symptoms at end of treatment but differences tapered off until not statistically significant at the final follow-up. There were no significant trend differences in current psychiatric morbidity, self-reported depressive symptoms and global functioning. This first study of adult life outcomes of specialized psychosocial interventions for adolescents with recurrent suicidal and self-harming behavior and borderline features suggests that adolescents may have a realistic hope of sustained recovery as adults.

• Mohn, Christine; Haga, Egil; Nilsson, Hanne Sofie Wenø & Mehlum, Lars (2026). Changes in Attitudes After Suicide Prevention Media Campaigns in Three Norwegian Regions. Archives of Suicide Research. ISSN 1381-1118. doi: 10.1080/13811118.2026.2624605. Full text in Research Archive
• Torgersen, Kristin Stensland; Dammen, Toril; Klungsøyr, Ole; Wilberg, Theresa; Bringager, Christine Bull & Evensen, Julie Horgen [Show all 11 contributors for this article] (2026). Improvement and deterioration trajectories in psychotherapy for depression: results from an RCT with cognitive behavioural and psychodynamic therapy. Nordic Journal of Psychiatry. ISSN 0803-9488. doi: 10.1080/08039488.2026.2648291. Full text in Research Archive
• Isham, Aleksandra Eriksen & Dritschel, Barbara (2026). Sad reflections of positive past selves: reduced emotional benefit of positive central life events during depression. Current Psychology. ISSN 1046-1310. 45(5). doi: 10.1007/s12144-025-08922-5. Full text in Research Archive Show summary

  Positive central life events are positive past events that are perceived to be central to one’s identity. These events are thought to have important self-enhancing functions, such as promoting wellbeing, self-esteem, and positive emotions in healthy individuals. Research on how individuals with depression respond to positive central life events is scarce. However, evidence from studies examining responses to positive memories more broadly, suggests that individuals with depression respond differently to positive memories than individuals with no history of depression. These findings raise the question of whether individuals with depression may not benefit from positive central life events in the same way as healthy individuals. The current study aimed to address this question by investigating how individuals with past or current depression respond to positive central life events compared to individuals who have never been depressed. We asked never-depressed individuals, individuals with past depression, and individuals with current depression to report two positive life events that they viewed as central to their identity. Participants rated the intensity of happiness, intensity of sadness, brooding, and self-incongruency experienced in response to each event. Individuals with current depression reported less intense happiness, and greater self-incongruency when thinking about their positive central life events, compared to individuals without a depression history. Individuals with past depression did not differ from never-depressed individuals on any of the outcome measures. These findings suggest that dampened happiness and reduced ability to relate to positive central life events may reflect a concomitant phenomenon of current depressive episode rather than a lasting vulnerability in individuals with past depression. However, further research is needed to confirm this possibility. This includes studies investigating how individuals with past and current depression respond to positive central life events that are retrieved spontaneously in everyday life. Future studies should also address whether the impairment may become more persistent with a higher number of past depressive episodes. In addition, due to the largely female university sample in the present study, there is a need to confirm the results in non-students and other genders.

• Matsumoto, Noboru; Fujino, Masahiro; Sekine, Hana; Yoshida, Eri; Watson, Lynn Ann & Isham, Aleksandra Eriksen [Show all 7 contributors for this article] (2026). Shinshu mindful study: can mindfulness training change the retrieval mode of autobiographical memory? Memory. ISSN 0965-8211. 34(4), p. 432–432. doi: 10.1080/09658211.2026.2628213. Full text in Research Archive Show summary

  Researchers have suggested that interoception can trigger the retrieval of autobiographical memories or influence the subjective sense of retrieval mode (e.g., involuntary or voluntary). This study examined whether four sessions of mindfulness training, aimed at improving interoceptive processing over eight weeks, can alter autobiographical memory retrieval and perceived retrieval mode in a community sample. 26 participants in the mindfulness group and 30 participants in the waitlist control group completed the study (Mage = 34.80 ± 12.68). In the mindfulness group, participants showed a decrease in perceived retrieval suddenness and an increase in perceived retrieval effort for involuntary memories, and an increase in perceived generative retrieval for voluntary memories. Retrieval latency, frequency, and memory specificity did not change with training. Although heart rate acceleration was observed immediately before memory responses judged as being directly retrieved, this physiological response remained unchanged with training. Reported interoceptive sensibility and dispositional mindfulness increased significantly in the mindfulness group over time, but these changes did not predict changes in retrieval mode variables. The results suggest that mindfulness training leads to more deliberate, effortful memory retrieval, but changes in interoceptive processing may not support changes in retrieval. Clinical implications for reducing intrusive memory and its emotional impact are discussed.

• Neupane, Sudan Prasad; Onyeka, Ifeoma Nkeiruka; Bull, Vibeke Hervik & Daray, Federico M. (2026). Associations between diseases of the mouth and mental disorders: A scoping review of longitudinal studies. Neurobiology of Disease. ISSN 0969-9961. 220. doi: 10.1016/j.nbd.2026.107285. Full text in Research Archive Show summary

  Background Mental disorders and oral health conditions frequently co-occur. We mapped and critically reviewed the literature on longitudinal associations between oral health conditions and mental disorders. Method MEDLINE, Embase and PsycInfo were searched for longitudinal studies published during the last 25 years. Two reviewers independently screened, reviewed full-text and extracted data before synthesizing the evidence. Associations between oral and mental disorders were illustrated as Sankey diagrams. The review protocol was pre-registered (https://osf.io/vrpu9). Findings From 165 included studies, we identified 118 studies investigating 35 independent associations between 16 oral exposures and 12 mental disorder outcomes. Another 42 studies investigated 32 associations between 17 mental disorder exposures and 14 oral outcomes. Five studies reported bidirectional associations. Most reports linked tooth loss to Alzheimer's disease/other dementias (18 studies) and cognitive impairment (15 studies), with periodontitis linked to Alzheimer's disease/other dementias (16 studies). Conversely, depression (10 studies), dementia (6 studies) and sleep disorder (5 studies) were attributed to temporomandibular disorders (TMD; 10 studies), periodontitis (8 studies) and caries (7 studies) outcomes. Depressive and anxiety disorders were linked bidirectionally with TMD and eating disorders. Interpretation Prevention and early management of oral and mental disorders may mitigate their reciprocal risk, thereby lowering the overall disease burden.

• Walby, Fredrik A & Tørmoen, Anita Johanna (2025). Selvmordsproblematikk og selvskading hos barn og ungdom. Psykisk oppvekst Rådet for psykisk helse. doi: https:/psykiskhelse.no/psykiskoppvekst/utviklingsarenaer-og-overganger/selvmordsproblematikk-og-selvskading-hos-barn-og-ungdom/. Full text in Research Archive
• Sudmann, Thea Melsen; Jeber, Anne Kathinka; Brækhus, Anne; Klungsøyr, Ole; Rowe, Fiona J. & Jørstad, Øystein Kalsnes (2025). The impact of different spectacle designs on the European visual field requirements for driving. Journal of optometry. ISSN 1888-4296. 19(1). doi: 10.1016/j.optom.2025.100582. Full text in Research Archive Show summary

  Purpose Spectacles can obstruct the peripheral visual field (VF) and interfere with formal requirements for driving. The European VF standards can be assessed with perimetry using the European Driving Test (EDT). This study aimed to evaluate the impact of different spectacles on the EDT, and their compliance with the European VF standards for driving. Methods This cross-sectional study included 30 participants (15 males and 15 females) with normal VF. Participants underwent binocular EDT perimetry with three different spectacles. The number of missed test points were recorded and the vertex distance (VD), pupillary distance, and eye dominance were measured. Statistical comparisons were conducted using a generalized linear mixed model, with significance set at p < 0.05. Results Peripheral VF loss was observed in 11 (37 %) participants (10 males) with spectacle B and in six (20 %) participants (five males) with spectacle C, whereas only one participant had a single missed test point with spectacle A. Participants with spectacle-related VF loss had significantly greater VD than those without. Moreover, there were a higher number of missed test points on the side of the dominant eye. Conclusions Spectacles with thin frames and temples had a negligible impact on the peripheral VF, whereas thicker frames and temples could compromise compliance with the VF standards. VF loss was associated with greater VD, which can explain why male participants exhibited more artefacts. These findings emphasize the need to consider spectacle design in fitness-to-drive assessments with perimetry and raise awareness of potential VF restrictions associated with certain eyewear.

• Skei-Larssen, Emma; Grimholt, Tine Kristin & Qin, Ping (2025). Risk of deliberate self-harm and suicide in children bereaved from parental death by specific natural and external causes – A national study. Journal of Affective Disorders. ISSN 0165-0327. 397. doi: 10.1016/j.jad.2025.120984. Full text in Research Archive Show summary

  Objective Losing a parent in childhood can significantly impact the child, yet little research examines how cause of parental death may affect children differently. This study aims to investigate risks of deliberate self-harm (DSH) and suicide in bereaved children by parental cause of death. Method Data from Norwegian population registers were interlinked to investigate exposure to parental death from specific causes and risks of DSH and suicide via a nested case-control design. Children under the age of 35 who were treated for DSH (n = 20,180) or died by suicide (n = 5039) constituted the cases and were compared with population controls of 20 per case matched by gender and age. Conditional logistic regression models were used to assess the risk. Results In the study population, 9.7 % of the DSH cases and 13.1 % of the suicide cases lost a parent. The risk of DSH was increased for bereaved children [OR = 1.54, 95 %CI 1.46–1.62], with the highest risk associated with parental death caused by mental diseases [2.84, 2.34–3.44], followed by accidental poisoning and suicide. The risk of suicide was significantly increased for bereaved children after parental death [1.28, 1.17–1.40], with the highest risk associated with parental death caused by homicide [4.68, 2.18–10.02], followed by suicide and accidental poisoning. No gender interactions or gender-of-deceased interactions was detected. Conclusion Parental-bereaved children are at significantly increased risk of DSH and suicide in early life, but the risk differ by parental cause of death. This underscores the importance of psychosocial and familial support for children following a parental loss.

• Melby, Linde; Høyen, Karina Sagmo; Prestmo, Astrid; Vaaler, Arne Einar; Kvithyld, Tuva Prestmo & Galynker, Igor [Show all 9 contributors for this article] (2025). Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study. European psychiatry. ISSN 0924-9338. 68(1). doi: 10.1192/j.eurpsy.2025.10030. Full text in Research Archive
• Calkova, Tereza; Vaskinn, Anja; Mørch-Johnsen, Lynn Egeland; Smelror, Runar; Jørgensen, Kjetil Nordbø & Wortinger, Laura Anne [Show all 18 contributors for this article] (2025). Early versus adult onset of schizophrenia: an examination of premorbid and current IQ. Schizophrenia Research: Cognition. 43, p. 100397–100397. doi: 10.1016/j.scog.2025.100397. Full text in Research Archive Show summary

  Background Cognitive deficits are core findings in schizophrenia, but whether the severity of impairments is related to the age of onset remains unclear. We hypothesized that early onset schizophrenia (EOS; onset before age 19) is associated with lower IQ compared to adult-onset schizophrenia (AOS; onset from age 19). Methods We included 99 adult patients with EOS (age of onset: 15.3 ± 2.8 years), 282 adult patients with AOS (age of onset: 26.5 ± 7.4 years), and 863 adult healthy controls (HC). We assessed current IQ with Wechsler Abbreviated Scale of Intelligence (WASI) and estimated premorbid IQ with National Adult Reading Test (NART). Results Both patient groups had lower current IQ than HC ( p < 0.001). Full-scale ( p = 0.004), performance ( p = 0.003) and verbal ( p = 0.011) current IQ were significantly lower in EOS than in AOS, with 5 IQ units difference for all three measures. EOS and AOS did not differ in premorbid IQ, but EOS showed a steeper IQ decline from premorbid levels than AOS (11.4 vs. 8 IQ units, respectively, p = 0.013). Conclusion EOS had lower current IQ than AOS, but did not differ in premorbid IQ, suggesting a larger decline from premorbid IQ levels. This could imply different neurodevelopmental processes underlying cognitive dysfunction related to age of onset in schizophrenia, underscoring the necessity for further inquiry into the mechanisms driving this decline and strategies for its prevention.

• Stangeland, Tormod; Hanssen-Bauer, Ketil; Lynum, Linn Ingunn; Nedberge, Karen Margrethe Walaas & Siqveland, Johan (2025). Assessing the Lethality of Suicide Attempts: Adding Chance of Rescue to Medical Severity. Suicide and Life-Threatening Behaviour. ISSN 0363-0234. 55(5), p. e70058–e70058. doi: 10.1111/sltb.70058. Full text in Research Archive Show summary

  ABSTRACT Introduction Emphasis on medical severity when assessing the lethality of suicide attempts may overlook important contextual factors. We examined if distinguishing between medical severity and chance of rescue improves evaluation and understanding of suicidal mental states. Methods Seventy adolescent inpatients with a recent suicide attempt were interviewed with the Suicide Intent Scale, and clinicians rated the Risk‐Rescue Rating Scale, which provides separate ratings for medical severity (Risk) and chance of rescue (Rescue). They also completed the Interpersonal Needs Questionnaire and Fearlessness about Death scale. Results The lethality components Risk and Rescue were uncorrelated ( r  = −0.02). However, Rescue was significantly negatively correlated with suicidal intent ( r  = −0.46), fearlessness about death ( r  = −0.29), and unmet interpersonal needs ( r  = −0.28), while Risk was only correlated with suicidal intent ( r  = 0.29). In a hierarchical regression model, Rescue was the strongest predictor of suicidal intent. Conclusion Rescue factors, more than medical severity factors, were consistently related to our measures of suicidal mental state. Including the rescue component in lethality assessments may improve both the accuracy of clinical evaluations and our understanding of adolescents' mental state during suicidal crisis.

• Holgersen, Katrine Høyer; Hasselberg, Nina; Siqveland, Johan & Ruud, Torleif (2025). Effect of crisis resolution team treatment on crisis experience and crisis coping: a multicenter pre-post study in Norway. BMC Psychiatry. 25(1). doi: 10.1186/s12888-025-07491-y. Full text in Research Archive Show summary

  Abstract Background Crisis resolution teams (CRTs) have been established in several high-income countries to improve access to mental health services and to prevent unnecessary inpatient admissions. General crisis theory is one of the foundations underpinning the development of CRTs. However, little research has been conducted on what characterises the situations leading to contact with these services and the crisis reactions during CRT care. This study aimed to describe characteristics and situations leading to contact with CRTs and to explore and predict possible changes in crisis experience and coping after CRT treatment. Methods Participants of this Norwegian multicentre pre-post study included 546 CRT service users of 25 CRTs. No control group was included. The present study builds on data collected from service users and team workers. The main outcome variables were change in patient-reported crisis experience and crisis coping from start to end of treatment. We performed descriptive analysis of affected life domains, and linear mixed modelling to analyse how outcomes were associated with patients’ characteristics and treatment. Results At treatment initiation, service users reported high scores of crisis experience and coping difficulties. Several life domains were affected, particularly emotional-life domains, such as mental illness, suicide risk, and loneliness. Lower levels of crisis experience, and enhanced coping abilities were observed within a timeframe of eight weeks or less. Although the current study design cannot rule out a specific causal relationship, recovery was nevertheless associated with service satisfaction, practical support, medication management, and quick access to help. Psychiatric symptoms at start, previous mental illness, and collaboration with wards were negatively related to a favourable outcome. Conclusions CRT service users reported high levels of crisis experience and low levels of coping at treatment initiation. CRT treatment was associated with a decrease in severity and improvement in coping, although more severe mental health problems at the start were negatively related to recovery.

• Haylom, Fesehatsion Aferwerki & Neupane, Sudan Prasad (2025). Prevalence of Depression and Associated Factors Among Adult Eritreans in Norway. International Journal of Social Psychiatry. ISSN 0020-7640. doi: 10.1177/00207640251384523. Full text in Research Archive Show summary

  Background: The higher rates of depression among immigrant populations are often attributed to socioeconomic disadvantage, adverse life events and other pre-migration circumstances and challenges with reintegration process. We aimed to determine the prevalence of depression and examine the associated factors among Eritrean immigrants living in Oslo and surrounding areas. Method: A convenience sample of 243 adult Eritreans, 114 women and 129 men, aged 35.7 ( SD 9.7) years were enrolled. A battery of structured instruments was administered to assess the sociodemographic, psychiatric, and acculturation-related variables, including the screening of depressive symptoms using the Center for Epidemiological studies-Depression scale (CES-D) and major depression (recent 2-weeks and 12 months) using the Major Depression Inventory (MDI). Statistical analyses were conducted using χ 2 -tests, Student’s t -tests, and logistic regression. Results: The prevalence rates of past week depressive symptoms, current and 12 months’ depression in the sample were 0.8%, 1.2% and 16.9% respectively. Factors associated with 12-month depression were increasing age, longer duration of stay since migration, presence of PTSD symptoms and higher number of adverse life events experienced. PTSD symptoms (OR = 4.2 (95% CI: 1.9 to 9.3, p  < .001) and the number of adverse life events (OR = 1.05 (95% CI: 1.01 to 1.1, p <  .001) were identified as independent correlates of 12-month depression. Conclusion: Every 6th Eritrean in our sample was found to screen positive for 12-month depression, with almost 15% participants reporting that life was not worth living. The study findings call for targeted programmes to address poor mental health among this group of immigrants.

• Daray, Federico Manuel; Grendas, Leando Nicolás; Neupane, Sudan Prasad; Chiapella, Luciana Carla; Fisher, Prudence W. & Gould, Madelyn S. [Show all 10 contributors for this article] (2025). Prediction of fatal and non-fatal suicide attempts by the Columbia Suicide Severity Rating Scale (C-SSRS): systematic review and meta-analysis. British Journal of Psychiatry. ISSN 0007-1250. doi: 10.1192/bjp.2025.10316. Full text in Research Archive Show summary

  Background The Columbia Suicide Severity Rating Scale (C-SSRS) is a predominant tool for screening and scoring suicidal ideation and behaviour to identify individuals at risk. No meta-analysis has examined its predictive significance. Aims To evaluate the C-SSRS assessment of suicidal ideation and suicidal behaviour as predictors of future fatal and non-fatal suicide attempts. Method A systematic search of Medline, PsycInfo, Embase, and Health and Psychosocial Instruments databases was conducted from January 2008 to February 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study was registered in PROSPERO (CRD42022361944). Two independent reviewers screened and extracted data, and assessed the risk of bias. Pooled odds ratios were calculated using random-effects models, and heterogeneity was assessed with the I 2 statistic. Publication bias was evaluated with Egger’s test and funnel plots. Results The search identified 1071 unique records, of which 28 studies met inclusion criteria. The meta-analysis included 27 studies with independent samples. Suicidal behaviour (pooled odds ratio 3.14, 95% CI 1.86–5.31) and suicide attempts (pooled odds ratio 2.78, 95% CI 1.82–4.24) were predictors of future non-fatal suicide attempts. Suicidal ideation severity (odds ratio 1.46/point, 95% CI 1.28–1.77) was a stronger predictor of future non-fatal suicide attempts than suicideal ideation intensity (odds ratio 1.11/point, 95% CI 1.04–1.18). Two studies linked higher suicidal ideation severity and a history of suicidal behaviour with an increased risk of fatal suicide attempts, though meta-analysis was not feasible for only two studies. Conclusions Suicidal behaviour, suicide attempts and to a lesser extent suicidal ideation, identified using the C-SSRS, predicted future non-fatal suicide attempts. These findings support the use of the C-SSRS to detect individuals at higher-risk requiring enhanced preventive interventions.

• Mauland, Erik Klepsland & Neupane, Sudan Prasad (2025). The Influence of Psychological Stress and Stress‐Related Disorders in the Treatment Outcome of Periodontitis: A Systematic Review and Meta‐Analysis. Journal of Clinical Periodontology. ISSN 0303-6979. 52(12), p. 1760–1778. doi: 10.1111/jcpe.70022. Full text in Research Archive Show summary

  Background and Objective In humans 16 years and above with periodontitis (Population), how do psychological stress and stress‐related disorders (PSRD; Exposure) compared to those without PSRD (Comparison) affect clinical attachment level (CAL) upon periodontitis treatment (Outcome), as observed in experimental studies or descriptive pre–post studies (Study design)? Methods Five major databases were searched for pre–post studies, descriptive cohort and quasi‐experimental or randomised controlled trials (RCTs). For meta‐analysis, mean differences in CAL and bleeding on probing (BOP) were pooled with random‐effects models. Risk of bias, study quality and certainty of evidence were assessed. Results Thirteen studies (eight prospective, two retrospective, two quasi‐experimental and one pilot RCT) with 1610 participants were identified. PSRD (measured as stress in nine studies, depression in three studies and anxiety in one study) showed a negative influence on periodontitis treatment (steps 1 + 2: eight studies, steps 1 + 2 + 3 or 4: four studies, step 4: one study) outcomes. Meta‐analysis of steps 1 + 2 treatment results revealed that patients with PSRD (exposure: stress)—compared to those without—had smaller reductions in CAL (three studies; n  = 170; weighted mean difference (WMD) = 0.78 mm; p  = 0.01) and probing pocket depth (PPD; three studies; n  = 170; WMD = 1.02 mm; p  = 0.04) following periodontitis treatment in studies. Conclusion PSRD adversely affected periodontitis treatment outcomes, particularly concerning CAL and PPD, even though our confidence in the effect estimate is limited in the case of CAL and very low in the case of PPD. This conclusion, based on small treatment cohorts and quasi‐experimental studies following steps 1 + 2 of periodontitis treatment over a 3–6‐month period, warrants validation through rigorously designed studies.

• Mohn, Christine; Olsson, Anna-Karin; Olsson-Tall, Maivor; Hjärthag, Fredrik; Härd, Iris van Dijk & Helldin, Lars (2025). Neurocognitive function in schizophrenia spectrum disorders: A 20-year prospective study of a community sample. Schizophrenia Research: Cognition. 43. doi: 10.1016/j.scog.2025.100393. Full text in Research Archive
• Grimstad, Kristoffer; Sørensen, Håkon; Vaskinn, Anja; Mohn, Hanne Christine; Glastad, Stine Holmstul & Andreassen, Ole [Show all 11 contributors for this article] (2025). Subjective cognition in schizophrenia and bipolar disorder: Investigation of group differences and associations with objective cognition and clinical characteristics using a novel measure of subjective cognition. Schizophrenia Research: Cognition. 40. doi: 10.1016/j.scog.2025.100345. Full text in Research Archive
• Dibaj, Iselin Solerød; Tørmoen, Anita Johanna; Klungsøyr, Ole; Morken, Katharina Teresa Enehaug; Haga, Egil & Dymbe, Kine Johansen [Show all 7 contributors for this article] (2025). Early remission of deliberate self-harm predicts emotion regulation capacity in adulthood: 12.4 years follow-up of a randomized controlled trial of adolescents with repeated self-harm and borderline features. European Child and Adolescent Psychiatry. ISSN 1018-8827. p. 1–12. doi: 10.1007/s00787-024-02602-8. Full text in Research Archive Show summary

  Emotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: “Treatment for Adolescents with Deliberate Self-harm”; http://ClinicalTrials.gov/;NCT00675129

• Aardal, Vilde Eika; Hol, Caroline; Rønneberg, Anne; Neupane, Sudan Prasad & Willumsen, Tiril (2025). Who requires dental treatment under general anesthesia due to pain and severe dental anxiety? Findings from panoramic X-ray images and anamnesis. Acta Odontologica Scandinavica. ISSN 0001-6357. 84, p. 78–85. doi: 10.2340/aos.v84.42895. Full text in Research Archive
• Hughes, Carla Louise; Liu, Baopeng & Qin, Ping (2025). Socioeconomic, demographic, and occupational risk factors for suicide amongst males: a systematic review and meta-analysis. Journal of Affective Disorders. ISSN 0165-0327. 391. doi: 10.1016/j.jad.2025.119986. Full text in Research Archive Show summary

  Background Suicide mortality remains a serious public health issue amongst adult males, yet there is a lack of comprehensive reviews addressing suicide risk with occupation and socioeconomic status in this selected population. This systematic review and meta-analysis synthesises data drawn from multiple countries, with the purpose of highlighting how these societal factors contribute to male suicide. Methods Using PRISMA reporting guidelines, a systematic search was conducted across MEDLINE, Embase, PsycINFO, Scopus, and Web of Science for English-language studies published 1993 to 2023. Studies reporting individual-level data on employment, income, education, marital status and occupation associated with suicide of male adults were included. A total of 53 studies with data from 23 countries met the inclusion criteria. Results Meta-analyses revealed the pooled prevalence of key risk factors in male suicide decedents were often unemployed (18.4 %), had a low education (40.5 %), never married (33.7 %), divorced (13.4 %), or widowed (7.3 %). The associated pooled risk ratios demonstrated elevated risks for suicide: 1.84 (95 % CI: 1.44–2.36) for unemployment, 2.27 (1.84–2.81) for being separated/divorced, and 2.69 (1.52–4.77) for low income. Occupational classifications revealed increased risks for suicide amongst males in skilled agricultural work (RR 1.90, 1.59–2.17) and craft and related trades workers (RR 1.56, 1.16–2.10). Meanwhile, being managers and clerical support workers presented to be protective against suicide in males. Conclusion Male suicide is closely linked to personal socioeconomic status and type of occupation. These findings highlight the importance of informed social policies and suicide prevention initiatives targeting males with socioeconomic and occupational disadvantages.

• Solberg, Amalie; Ottesen, Akiah; Barrett, Elizabeth Ann; Kristiansen, Ida; Mork, Erlend & Qin, Ping [Show all 7 contributors for this article] (2025). Trajectories of suicidal behavior and their clinical correlates in the early phases of schizophrenia spectrum disorders. Psychiatry Research. ISSN 0165-1781. 347. doi: 10.1016/j.psychres.2025.116409. Full text in Research Archive Show summary

  Background Many risk factors for suicidal behavior (SB) in schizophrenia spectrum disorders (SSD) are present before the onset of psychosis or are associated with specific phases of illness. We aim to investigate the trajectories of SB from before the onset of psychosis until the first start of treatment in patients with first-episode psychosis (FEP). Method A total of 252 patients with first-episode SSD were recruited, out of which 224 had complete SB data. They participated in clinical interviews and self-report questionnaires during their first treatment. We assessed SB in three time periods: Before the onset of psychosis, during untreated psychosis, and at treatment start (study baseline). We used K-mean cluster analyses to identify trajectories of SB over these periods. Results Four trajectories of SB were identified: persistent low/no SB (n = 114, 51 % of 224), increasing mild/moderate SB (n = 54, 24 %), severe SB during untreated psychosis (n = 25, 11 %), severe persistent SB (n = 31, 14 %). With “persistent low/no SB” as a reference group, all other groups had significantly more depressive symptoms at baseline. The duration of untreated psychosis was significantly longer in the group with “severe SB during untreated psychosis”. Clinical insight subscale scores differed between the trajectory groups. Also, the “severe persistent SB” group reported more emotional abuse and total childhood trauma than the “increasing mild/moderate SB” group. Conclusion Our findings suggest the presence of different pathways to SB in FEP. More knowledge about these pathways can support the development of tailored preventive strategies in this patient group.

• Torgalsbøen, Anne-Kari; Mohn, Christine; Larøi, Frank & Czajkowski, Nikolai Olavi (2025). Longitudinal recovery and self-efficacy in first-episode schizophrenia: insights from a 10-year follow-up study. Frontiers in Psychiatry. p. 01–09. doi: 10.3389/fpsyt2025.1588349. Full text in Research Archive Show summary

  Background: Research on clinical recovery rates in first-episode schizophrenia has yielded inconsistent results due to varying definitions of recovery and methodological differences. The longitudinal trajectory of recovery—whether rates improve, decline, or remain stable—remains unclear. Schizophrenia significantly impacts young lives, making it crucial to examine self-efficacy, the belief in one’s ability to manage adversity, and its relationship with clinical recovery. Methods: The Oslo Schizophrenia Recovery study`s repeated assessment design, including twelve clinical evaluations over ten years, is ideal for studying longitudinal recovery. Self-efficacy was measured using the General Perceived Self-Efficacy scale, with data analyzed through linear multilevel models. Twenty-eight well-defined first-episode schizophrenia patients were assessed yearly, using a strict recovery definition (two years of full symptom remission and adequate social/role functioning), with 79% of patients retained from baseline. Results: Recovery rates improved and remained stable, suggesting better outcomes than previously reported. Of the participants, 50% achieved clinical recovery. Recovered individuals showed a sharp increase in self-efficacy within the first year, while non-recovered patients exhibited gradual improvement. The interaction between recovery status and time revealed distinct self-efficacy trajectories, particularly in the first post-onset year. Conclusions: A significant proportion of first-episode schizophrenia patients can achieve clinical recovery. While these positive outcomes are noteworthy, it is important to recognize that recovery paths can vary widely among individuals. Since people with schizophrenia are concerned about their chances of recovery, the results must be shared with patients and their families. While the causal relationship between self-efficacy and recovery remains unclear, they likely influence each other.

• Dibaj, Iselin Solerød; Neupane, Sudan Prasad & Mehlum, Lars (2025). Brief, pragmatic measure of emotion dysregulation in young people – a preliminary validation of the BER-5. Borderline Personality Disorder and Emotion Dysregulation. 12. doi: 10.1186/s40479-025-00285-4. Full text in Research Archive Show summary

  Background Emotion dysregulation is a transdiagnostic construct associated with mental health problems, including self-harm and borderline personality disorder (BPD). Although often targeted in clinical practice, the majority of psychometric assessment instruments of emotion dysregulation are developed for research purposes, and there is a need for an adapted version to be used in a clinical screening setting. The main aim of this study was to examine psychometric properties of a brief, pragmatic measure of emotion dysregulation, the Brief Emotion Regulation Scale − 5 items (BER-5). Methods The sample consisted of 60 young adults (mean age 28.1 years) who participated in a 12.4 years follow-up study of an RCT of Dialectical Behaviour Therapy’s long-term effect. Cronbach’s alpha was used to calculate internal consistency. Concurrent and convergent validity were examined using Spearman’s correlation in comparison with other measures, and logistic regression as well as area under the curve to examine its ability in terms of differentiating between BPD diagnosis and trait levels. Optimal cut-off points were explored using Receiver Operating Curves. Results Our results indicated adequate internal consistency both in adolescence and in young adulthood, as well as high convergence with a gold-standard measure of emotion dysregulation, and moderate convergence with symptom measures of anxiety and depression. BER-5 was able to differentiate between participants with no BPD from subthreshold or full BPD diagnosis in adulthood, and a cut-off score of 5 was found optimal in terms of sensitivity and specificity in identifying individuals with BPD. Conclusions The BER-5 is a brief, pragmatic measure of emotion dysregulation with good psychometric properties and is potentially a useful screening tool for clinicians working in specialized health care settings.

• Belanger, Sissel Marguerite; Christiansen, Solveig Tobie Glestad; Kalseth, Jorid; Kaspersen, Silje Lill; Erlangsen, Annette & Reneflot, Anne [Show all 8 contributors for this article] (2025). Utilization of mental health care among people bereaved by suicide in Norway: A trajectory analysis. Journal of Psychiatric Research. ISSN 0022-3956. 185, p. 130–137. doi: 10.1016/j.jpsychires.2025.03.036. Full text in Research Archive Show summary

  Background: Losing a loved one to suicide is an extremely stressful event that is associated with mental health issues. However, little is known about the health care utilization of those bereaved by suicide. Identifying distinct trajectories of mental health care utilization can help reveal gaps in service provision, barriers to access, and opportunities for targeted interventions. Aims: To uncover distinct patterns of mental health care utilization in association with suicide bereavement and explore sociodemographic factors and subsequent suicide risk associated with these patterns. Method: We analyzed Norwegian population-wide registry data on mental health care utilization at three different levels among 14 781 adults bereaved by suicide from 2010 to 2019 using group-based multi-trajectory modeling to identify groups with distinct mental health care utilization trajectories. Socio-demographic differences between trajectory groups were analyzed in multinomial logistic regression models and the associated risk of suicide was obtained with cox proportional hazards regression models. Results: We identified four distinct trajectories of mental health care utilization. Two distinct groups of individuals bereaved by suicide either rarely contacted mental health care providers (“Low”) or only consulted with general practitioners only ("GP only"). In the latter group, the utilization rate increased post-bereavement. One group of bereaved ("Acute increase") increased their mental health care utilization significantly after the loss, while another group ("High") consistently had a high utilization rate. These groups differed with respect to kinship to the deceased and sociodemographic factors. Individuals in the “GP only” and “High” group had significantly higher risk of suicide when compared to those in the “Low” group. Conclusions: Individuals bereaved by suicide exhibited diverse patterns of mental health care utilization, reflecting a broad spectrum of needs and responses to loss.

• Hughes, Carla Louise & Hermansen, Åsmund (2025). Payment problems and suicide: life under financial strain. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948241312375. Full text in Research Archive Show summary

  Aims: Suicide deaths are often linked to impulsivity during moments of crisis, such as financial difficulties, relationship breakdowns and poor health. For individuals experiencing financial problems, risk factors for suicide can commonly include circumstances surrounding payment problems, including unemployment, divorce, low education and low income mediated by debt. Methods: In this study, we investigate the impact of payment problems on suicide in Norway using a spline-based parametric survival analysis, with suicide as the outcome variable. With access to high quality Norwegian register data and unique information on payment problems, defined as deductions in wages or benefits, we investigated suicide amongst the entire adult Norwegian population over an 11-year period (2008–2018). Results: We found that the prevalence of payment problems among the Norwegian population between 2009 and 2018 was associated with a higher risk of suicide for both males and females. Despite the greater proportion of suicide occurring amongst males both globally and in Norway, we found that women experiencing financial hardship had a relatively higher suicide risk when adjusted for demographic variables than their male counterparts. Conclusions: These findings highlight the need for stronger protections for individuals struggling with financial difficulties and emphasise the importance of further research on the relationship between payment problems and suicide, with the aim of informing and enhancing national suicide prevention strategies.

• Krishnamoorthy, Sadhvi; Armstrong, Gregory; Ross, Victoria; Reifels, Lennart; Purdon, Hayley & Francis, Jillian [Show all 51 contributors for this article] (2025). Towards development of guidelines for harnessing implementation science for suicide prevention: an international Delphi expert consensus study. BMJ Public Health. 3(1). doi: 10.1136/bmjph-2024-001206. Full text in Research Archive
• Myhre, Martin Øverlien; Walby, Fredrik Andreas; Klungsøyr, Ole; Bramness, Jørgen Gustav & Mehlum, Lars (2025). Factors associated with self-harm in patients with substance use disorders who died by suicide: national hybrid questionnaire registry study. British Journal of Psychiatry. ISSN 0007-1250. p. 1–7. doi: 10.1192/bjp.2025.22. Full text in Research Archive Show summary

  Background - Self-harm, self-poisoning or self-injury, irrespective of the motivation, is a central risk factor for suicide. Still, there is limited knowledge of self-harm among patients with substance use disorders (SUDs) who die by suicide. <p> <p>Aims We aimed to describe the prevalence of a history of self-harm and identify the factors associated with self-harm, comparing individuals who died by suicide with and without SUDs. <p> <p>Method - We used data from the Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services, which is based on a national linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry, to identify individuals who died by suicide within 1 year after last contact with mental health or substance use services (n=1140). A questionnaire was retrieved for 1041 (91.3%) of these individuals. We used least absolute shrinkage and selection operator (LASSO) regression to select variables and compared patients with and without SUDs. Conditional selective inference was used to improve 90% confidence intervals and p-values. <p> <p>Results - The prevalence of self-harm was 55% in patients with SUDs and 52.6% in patients without SUDs. Suicidal ideation (odds ratio 2.98 (95% CI 1.74–5.10)) emerged as a factor shared with patients without SUDs, while personality disorders (odds ratio 1.96 (1.12–3.40)) and a history of violence (odds ratio 1.86 (1.20–2.87)) were unique factors for patients with SUDs. <p> <p>Conclusions - Ahistory of self-harm is prevalent in patients with SUDs who die by suicide and is associated with suicidal ideation, a history of violence and personality disorders in patients with SUDs.

• Sveen, Carl-Aksel; Pedersen, Geir; Wilberg, Theresa & Kvarstein, Elfrida Hartveit (2025). The societal costs of avoidant personality disorder. Personality and Mental Health. ISSN 1932-8621. 19(1). doi: 10.1002/pmh.1644. Full text in Research Archive Show summary

  The study aims to estimate the societal costs of avoidant personality disorder (AvPD). Cross-sectional data on AvPD patients during 2017–2020 were retrieved from the quality register of the Norwegian Network for Personality Disorders. Cost estimations were based on a bottom-up approach, using a structured interview covering the 6-month period prior to initial assessment. Unit costs were retrieved from public records. The human capital approach was used to calculate productivity losses. Diagnoses were determined according to DSM-5 by semi-structured diagnostic interviews (SCID-5-PD). Mean societal costs were €19,378 for the total group (N = 410). The subgroup with a single diagnosis (n = 270) incurred €18,818, whereas the subgroup with at least one comorbid PD (n = 140) incurred €20,458. The difference between the two subgroups was not statistically significant. The largest cost component was productivity loss (69%), whereas health service costs constituted 31%. The main contributors to societal costs from the health service cost components were inpatient treatment (18%) and individual outpatient treatment (11%). In conclusion, societal costs for AvPD patients were high, on the same level as borderline PD, schizotypal PD, and schizophrenia, and higher than anxiety disorders, depression, and rheumatoid arthritis. In the future, development of effective AvPD treatment programs enhancing personality functioning and workforce participation is important in order reduce the cost of illness.

• Mohn, Hanne Christine; Haga, Egil; Nilsson, Hanne Sofie Wernø; Pirkis, Jane & Mehlum, Lars (2025). Predictors of not wanting to seek help or information for suicide thoughts. BMC Psychiatry. 25. doi: 10.1186/s12888-025-06985-z. Full text in Research Archive Show summary

  Background Approximately half of all individuals who die by suicide in Norway do not seek contact with specialist mental health services during the year before death. Here we aim to report the demographic characteristics and attitudes to suicide, mental ill health, and help-seeking in people who do not wish to seek help or information for suicide thoughts. Moreover, we identify the strongest predictors of non-help-seeking intentions. Methods A population sample (N = 3251) from the Mid- and West- Norway regions participated in an online survey of attitudes to suicide and help-seeking for mental ill health. The sample was recruited from the regional population that later was exposed to a media suicide prevention campaign. Of these, 167 individuals stated that they would not seek help or information if they were to get suicide thoughts. Results The group of people who would not seek help or information for suicide thoughts, were more likely to be male, aged between 40 and 49 years, not being retired, or having experienced suicide or suicide attempts among family or friends, compared to the group that stated their help-seeking intentions. Moreover, they were more likely to report more negative attitudes to suicide (e.g., believing it can’t be prevented, or that it should not be talked about), mental illness (e.g., wanting to hide depression, or wanting to sort out problems on their own), and help-seeking (e.g., feeling inferior if seeking professional help, or not being confident in getting help) as well as lower levels of support from family or friends. Stepwise logistic regression analyses identified male sex, not being confident in getting professional help for suicide thoughts, not being able to talk to family or friends about problems, and not wanting to disclose having depression, as the statistically significant predictors of not wanting to seek help or information, explaining 28% of the variance. Conclusions We conclude that these factors should be targeted in future suicide prevention efforts in Norway. In particular, the strongest predictor (Not being confident in getting professional care for suicide thoughts), should be addressed.

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• Aakhus, Eivind; Bergsholm, Per; Bigseth, Therese Torgersen; Bystad, Martin Kragnes; Coman, Alina & Folstad, Rikke Lise [Show all 16 contributors for this article] (2026). ECT og andre nevrostimulerende behandlingssmetoder. Forlaget aldring og helse. ISBN 9788284700205. 196 p. Full text in Research Archive

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• Torstein, Garcia de Presno, & Haga, Egil (2026). No One to Lose – Workplace: A Brief Training to increase Employees’ Confidence in Responding to Suicide Risk. Full text in Research Archive Show summary

  Background: Workplaces can play a crucial role in suicide prevention — colleagues are often the first to notice when something’s off. “No One to Lose – Workplace” is a short, team-based training program developed to increase the employees’ confidence in responding to possible suicide risk. The program mixes short films with guided group discussions. Organizations receive some initial guidance by phone but run the sessions themselves, making it a flexible option that fits into everyday work routines. Method: A total of 20 organizations with approximately 800 employees were offered the training. The employees were invited to participate in anonymous online surveys before and after the training, and N=399 and N=197 responded to the pre- and post-tests, respectively. Participants rated their confidence (on a 1–10 scale) on recognizing suicide risk, talking directly and offering support to a person with suicidal thoughts. We compared confidence levels before and after the training, using independent samples t-tests. Additionally, implementation was assessed in terms of completion rates, teamwork, and leadership involvement. Results: Most participants completed the training, joined the discussions, and many managers took part. Overall, scores increased towards higher confidence in the posttest, and most markedly with regards to talking openly about suicide and knowing how to offer support. Qualitative feedback was overwhelmingly positive — participants highlighted the program’s relevance, practicality, and impact on reducing stigma. Some wanted more time, clearer crisis routines, and extra tools. Many also expressed interests in further training. Conclusion: A short team-based program can strengthen employees’ confidence in responding to suicide risk — especially by encouraging open dialogue and supportive action. Manager participation and collective reflection seem to boost the effect. While self-report data and the lack of a control group limit causal conclusions, the findings suggest that simple, discussion-based training can make workplaces more prepared to prevent suicide.

• Mohn, Christine; Haga, Egil; Nilsson, Hanne Sofie Wernø; Silviken, Anne & Mehlum, Lars (2026). Post-media campaign changes in attitudes to suicide and help-seeking in the indigenous Sami and majority Norwegian population in North-Norway. Full text in Research Archive
• Myhre, Martin Øverlien; Walby, Fredrik A; Sjåfjell, Tommy Lunde; Bramness, Jørgen Gustav & Mehlum, Lars (2026). Preliminary Service Recommendations to Prevent Suicide in Patients with Substance Use Disorders. Full text in Research Archive
• Myhre, Martin Øverlien & Sjåfjell, Tommy Lunde (2026). Ikke glem alkoholen. doi: https:/www.dagensmedisin.no/alkohol-psykisk-helse-rus/ikke-glem-alkoholen/731071. Full text in Research Archive
• Mehlum, Lars & Dibaj, Iselin Solerød (2026). Effective Treatment of Adolescents With Suicidal and Self-Harming Behaviors: What Are the Knowledge Gaps? Journal of the American Academy of Child and Adolescent Psychiatry. ISSN 0890-8567. doi: 10.1016/j.jaac.2026.04.010. Full text in Research Archive
• Bukten, Anne; Mehlum, Lars; Fazel, Seena; Lokdam, Nicoline Toresen; Skurtveit, Svetlana Ondrasova & Ericson, Øystein Bruun [Show all 11 contributors for this article] (2026). Risikofaktorer for selvmord under fengsling og etter løslatelse. Full text in Research Archive
• Bukten, Anne; Mehlum, Lars; Fazel, Seena; Lokdam, Nicoline Toresen; Tverborgvik, Torill & Skurtveit, Svetlana Ondrasova [Show all 12 contributors for this article] (2026). Psykisk helse i fengsel. Risikofaktorer for selvmord under fengsling og etter løslatelse. doi: https:/www.fagligforum.no/event/rus-og-psykisk-helse-2026/. Full text in Research Archive
• Walby, Fredrik A (2026). Lessons learned from The Norwegian Surveillance System for Suicide in Mental Health and Substance Misuse Services and implications for the revised national guidelines for suicide prevention. doi: https:/www.iasp.info/wp-content/uploads/2025-IASP-Abstract-Book-Vienna.pdf. Full text in Research Archive Show summary

  The Norwegian Surveillance System for Suicide in Mental Health and Substance Misuse Services (NoSS) systematically collects data regarding suicide among people who have been in contact with secondary mental health and substance misuse services in the 12 months preceding death. The NoSS is based on The National Confidential Inquiry into Suicide and Safety in Mental Health in the UK and adapted for Norway using a hybrid registry design. The aim of this presentation is 1) to describe the design of the NoSS including information security issues, 2) to provide an overview of main findings and 3) to discuss how available data has been used in the newly revised national preventive guidelines in Norway. The NoSS is well received among clinicians and authorities and has a coverage of above 92 % of all suicides in connection with care. Findings for the years 2010 – 2023 show that 46% of all people who died by suicide had contact with secondary mental health- and substance misuse services in the year preceding death, 38% had contact in the last 90 days. In adult mental health suicide rates were 111 (females) and 245 (males) per 100 000, and further increased 3.7 times among those with at least one inpatient admission. Post-discharge clustering was significant. More than half had a psychiatric history lasting more than 5 years, about half had a history of substance misuse and 66% of females and 48% of males had a history of deliberate self-harm. Recent adverse life events were known in about 40 % and only 25 % were employed. 46 % had depressive symptoms at last contact but only 25 % had known suicidal ideation. Both immediate and long-term suicide risk were generally rated as low. In substance misuse services the suicide rates were 190 (females) and 202 (males) per 100 / 100 000. Trajectory analyses show that most suicides had short and fragmented contact with any service during the 12 months before death. The findings from the NoSS have informed Norwegian practice guidelines including a deemphasis on the focus of suicide risk assessments and specific recommendations for post discharge follow up. Future research-based developments in health services aim at quality improvement as well as early interventions to target social difficulties and functioning seems necessary. Learning objective: Understand how systematic surveillance of suicides in large health-care organizations can assist in strengthening system-level approaches to suicide prevention in high-risk groups

• Bukten, Anne; Mehlum, Lars; Lokdam, Nicoline Toresen; Fazel, Seena; Tverborgvik, Torill & Skurtveit, Svetlana Ondrasova [Show all 12 contributors for this article] (2025). Suicides among people in prison. Full text in Research Archive
• Tørmoen, Anita Johanna & Bertelsen, Tone Enge (2025). DBT-PTSD-ferdighetsbasert eksponeringsterapi ved kompleks PTSD med dissosiasjon. Full text in Research Archive
• Tørmoen, Anita Johanna & Bertelsen, Tone Enge (2025). DBT-PTSD – erfaringer med ferdighetsassistert eksponering for pasienter med selvmordsatferd og dissosiasjon. Full text in Research Archive
• Skei-Larssen, Emma; Grimholt, Tine Kristin & Qin, Ping (2025). Risk of deliberate self-harm and suicide in young offspring bereaved from parental death by specific natural and external causes – a national study. Full text in Research Archive
• Larsen, Kim Sverre; Stangeland, Tormod & Qin, Ping (2025). Submitted Staff Reactions to Suicidal Acts of Patients in Mental Health Services. Full text in Research Archive
• Qin, Ping (2025). Suicide and other cause-specific mortality following non-fatal self-harm: a national cohort study. Full text in Research Archive
• Kizilaslan, Busenur & Qin, Ping (2025). Beyond the Surface: Understanding Self-Harm Subgroups through Latent Class Analysis of Hospital-treated Patients and Their Prospective Health Outcomes. Full text in Research Archive
• Qin, Ping (2025). Suicide risk in bereaved children and parents – findings from Norwegian registries. Full text in Research Archive
• Qin, Ping (2025). Understanding high-risk groups for suicide and suicidal behavior. Full text in Research Archive
• Qin, Ping (2025). Suicide and associated factors following hospital presentation for non-fatal deliberate self-harm: a national cohort study. Full text in Research Archive
• Myhre, Martin Øverlien (2025). Atferdsaktivering for depresjon: Workshop. Full text in Research Archive
• Myhre, Martin Øverlien (2025). Rus og selvskade. Full text in Research Archive
• Myhre, Martin Øverlien (2025). Personer med rusmiddelbrukslidelser: Den glemte risikogruppen? Full text in Research Archive
• Tørmoen, Anita Johanna; Mehlum, Lars; Ødegård, Kristoffer Bele; Stornes, Marthe & Kvalstad, Gjertrud (2025). The fairy tale of DBT in Norway - from a clinical trail to a large-scale training program. Full text in Research Archive
• Dibaj, Iselin Solerød; Tørmoen, Anita Johanna; Klungsøyr, Ole; Haga, Egil; Morken, Katharina Teresa Enehaug & Dymbe, Kine Johansen [Show all 7 contributors for this article] (2025). Remisjon av selvskading hos ungdommer predikerte bedre emosjonsregulering i voksen alder. Suicidologi. ISSN 1501-6994. 30(1). doi: 10.5617/suicidologi.12350. Full text in Research Archive Show summary

  Emotion regulation capacity, which is critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals, whereas deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH], which peaks in adolescence. Dialectical behaviour therapy for adolescents [DBT-A] has previously been shown to effectively induce DSH remission in adolescents. The present study aimed to investigate whether such remission was associated with reduced ED in adulthood, and whether this effect was mediated by reductions in dysfunctional coping. The design was a prospective longterm follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents with borderline personality features and repeated self-harm. The original sample consisted of 77 adolescents, of which 61 were assessed in adulthood, 12.4 years later. The results showed that there was a direct effect of DSH remission one year after treatment on adult ED, although this effect was not mediated by changes in coping. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood, and highlights the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED.

• Isham, Aleksandra Eriksen & Lorentzen, Kari Evelin Arellano (2025). Ansattes erfaringer med tvang. In Olesen, Esben Søndergaard Bruun; Wiik, Cornelia H.B. & Ødegaard, Anna (Ed.), Tvang og grenser i barne- og ungdomspsykiatrien. Universitetsforlaget. ISSN 9788215067346. p. 67–79. Full text in Research Archive Show summary

  Når barn og unge blir utsatt for tvang i psykisk helsevern, er det ofte med mål om å beskytte og hjelpe. Men hvordan oppleves det å bli holdt fast, stengt inne eller tvunget til å spise? Tvang og grenser i barne- og ungdomspsykiatrien tar leseren med inn i barne- og ungdomspsykiatriens mest krevende rom - der omsorg, makt og grenser møtes. Gjennom sterke fortellinger fra unge med egne erfaringer, refleksjoner fra ansatte i helsevesenet og innsiktsfull fagkunnskap utforsker boken hvordan tvang brukes, forstås og oppleves. Den stiller de vanskelige spørsmålene: Når er tvang nødvendig? Når er den lovlig? Og hvordan kan vi bedre forstå og ivareta de som rammes? Boken er skrevet som en del av et forskningsprosjekt ledet av Nordlandsforskning i samarbeid med Mental Helse Ungdom og er et viktig bidrag til åpenhet og kunnskap om psykisk helse og barns rettigheter. Selv om tvang er tillatt ved 18 avdelinger i Norge, finnes det lite forskning på feltet. Boken bidrar med ny kunnskap og skal gjøre informasjon om tvang lett tilgjengelig og forståelig - særlig for barn og unge, men også for studenter, fagfolk, pårørende og alle som vil forstå mer om bruk av tvang i psykisk helsevern.

• Isham, Aleksandra Eriksen; Watson, Lynn Ann; Bohn, Annette; Jørgensen, Carsten René & Mehlum, Lars (2025). Narrativ identitet og BPD-trekk, selvskade og suicidalitet i ungdomsårene. Full text in Research Archive
• Torstein, Garcia de Presno, & Haga, Egil (2025). Ingen å miste – arbeidsliv. Kan kollegastøtte ved selvmordsfare gi bedre hjelpeferdigheter? Full text in Research Archive
• Haga, Egil (2025). Mediekampanjer for forebygging av selvmord. Erfaringer og resultater. Full text in Research Archive
• Klungsøyr, Ole & Sexton, Joseph (2025). Kan vi bli SMARTere? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(12). doi: 10.4045/tidsskr.25.0326. Full text in Research Archive
• Isham, Aleksandra Eriksen; Watson, Lynn Ann; Sørensen, Alexander Leonard Birk; Bohn, Annette; Jørgensen, Carsten René & Mehlum, Lars (2025). Disruptions in narrative identity and vulnerability for BPD, self-harm, and suicidality during adolescence: are they associated? Full text in Research Archive
• Isham, Aleksandra Eriksen; Sørensen, Alexander Leonard Birk; Mehlum, Lars; Bohn, Annette; Jørgensen, Carsten René & Watson, Lynn Ann (2025). Involuntary autobiographical memories: are they linked to BPD, self-harm, and suicide vulnerability in adolescents? Full text in Research Archive
• Isham, Aleksandra Eriksen; Watson, Lynn Ann; Bohn, Annette; Jørgensen, Carsten René & Mehlum, Lars (2025). Involuntary autobiographical memories: a potential vulnerability factor for the emergence of BPD during adolescence? Full text in Research Archive
• Isham, Aleksandra Eriksen (2025). Borderline Personality Disorder: Memory and Identity in Adolescence (BOLD MINDS). Full text in Research Archive
• Isham, Aleksandra Eriksen (2025). Borderline Personality Disorder and Autobiographical Memory: Do memories play a role in the development of borderline personality disorder? doi: https:/www.psychologytoday.com/us/blog/days-gone-by/202507/borderline-personality-disorder-and-autobiographical-memory. Full text in Research Archive
• Helle, Sofie Egidius; Neupane, Sudan Prasad & Mehlum, Lars (2025). Pharmacotherapy in Randomized Controlled Studies of Psychotherapy for Adolescents With Borderline Personality Pathology: A Systematic Scoping Review. Full text in Research Archive
• Isham, Aleksandra Eriksen (2025). Emosjonelt ustabil personlighetsforstyrrelse, villet egenskade og suicidalitet i ungdomsårene: Spiller selvbiografisk hukommelse en rolle? Suicidologi. ISSN 1501-6994. 30(1), p. 78–83. doi: 10.5617/suicidologi.12358. Full text in Research Archive
• Høstmælingen, Andreas Teisner; Bækkelund, Harald; Coldevin, Marit; Hagen, Roger; Herheim, Åste & Holmén, Aina [Show all 10 contributors for this article] (2025). Hvem er psykologene til for? Tidsskrift for Norsk psykologforening (Psykologtidsskriftet). ISSN 0332-6470. Full text in Research Archive
• Neupane, Sudan Prasad; Helle, Sofie Egidius & Mehlum, Lars (2025). Psychopharmacotherapy for adolescents with self-harming behavior in the absence of documented effect. doi: 10.1007/s00787-025-02659-z. Full text in Research Archive
• Hughes, Carla Louise & Qin, Ping (2025). Suicide risk in relation to socioeconomic disadvantage and related occupational stressors in males of middle- and old age - a contextual effect. Full text in Research Archive
• Walby, Fredrik A & Myhre, Martin Øverlien (2025). Selvmord, villet egenskade og selvmordstanker. In Gonzalez, Marianne Thorsen (Eds.), Psykiske lidelser - faglig forståelse og terapeutisk tilnærming. Sykepleiefaglige og flerfaglige perspektiver.. Gyldendal Norsk Forlag A/S. ISSN 9788205590106. p. 211–224. Full text in Research Archive
• Haga, Egil; Mohn, Hanne Christine; Nilsson, Hanne Sofie Wernø & Mehlum, Lars (2025). Increasing intention to seek help for suicidal ideation and depression through a media campaign. Full text in Research Archive
• Hughes, Carla Louise; Hermansen, Åsmund; Belanger, Sissel Marguerite; Stene-Larsen, Kim; Haraldsen, Stian & Rønhovde, Henning Hope (2025). Ny selvmordsforskning: – Kvinner som ender i en slik situasjon, er veldig sårbare. [Internet]. https://www.nrk.no/buskerud/flere-kvinner-enn-menn-tar-livet. Full text in Research Archive
• Qin, Ping (2025). Risk Factors for Suicidal Behavior and Prevention Challenges. Full text in Research Archive
• Hughes, Carla Louise & Skjeldal, Eskil (2025). Kan betalingsproblemer påvirke selvmordsrisiko? [Internet]. https://erfaringskompetanse.no/arkiv/kan-betalingsproblemer-. Full text in Research Archive
• Qin, Ping (2025). Recent methodological developments in epidemiological suicide research. Full text in Research Archive
• Qin, Ping (2025). Follow-up Care and Support For Self-Harming Patients in the Real World. Full text in Research Archive
• Jelin, Elma; Ellingsen-Dalskau, Lina Harvold; Hanssen-Bauer, Ketil; Siqveland, Johan; Isham, Aleksandra Eriksen & Nyland, Camilla Skau [Show all 7 contributors for this article] (2025). Patient Experience Measurement in Mental Health and Substance Dependence inpatient care: Development of Short Versions of Validated Questionnaires Through Importance Ranking and Psychometric testing. Full text in Research Archive
• Iversen, Hilde Karin Hestad; Kjøllesdal, Marte Karoline Råberg; Nyland, Camilla Skau; Skudal, Kjersti Eeg; Hanssen-Bauer, Ketil & Isham, Aleksandra Eriksen [Show all 8 contributors for this article] (2025). Towards more inclusive patient experience surveys: Applying a standardised TRAPD-based approach for translating and adapting measures for Polish-speaking inpatients in psychiatric and substance dependence care in Norway (PRQMs-MAS*). Full text in Research Archive
• Hughes, Carla Louise; Hermansen, Åsmund & Kvalnes, Pål Arne (2025). Selvmord i Norge: Kvinner mest utsatt om de får betalingsproblemer. [Internet]. www.oslomet.no. Full text in Research Archive
• Hughes, Carla Louise; Kvalnes, Pål Arne & Hermansen, Åsmund (2025). Overraskende funn om kvinner og selvmord. [Internet]. www.forskning.no. Full text in Research Archive
• Øien-Ødegaard, Carine; Johannessen, Pia Myklebust; Belanger, Sissel Marguerite; Reneflot, Anne & Stene-Larsen, Kim (2026). Selvmord uten kontakt med psykisk helsevern eller tverrfaglig spsesialisert rusbehandling : kjennetegn og muligheter for forebygging. Folkehelseinstituttet. ISSN 9788284066011. Full text in Research Archive Show summary

  Formålet med denne rapporten er å kartlegge selvmord blant personer som ikke var i kontakt med psykisk helsevern eller tverrfaglig spesialisert rusbehandling (PHV/TSB) det siste året før dødsfallet, og å identifisere arenaer der disse personene potensielt kan nås med forebyggende tiltak. Rapporten fokuserer primært på menn, da de er overrepresentert i selvmordsstatistikken og i mindre grad oppsøker helsehjelp for psykiske lidelser og plager. Videre har de som dør ved bruk av skytevåpen lavest kontakt med PHV/TSB sammenlignet med de som dør av selvmord ved andre metoder. Selvmord med skytevåpen er mest utbredt blant menn. En stor andel menn som dør av selvmord utenfor PHV/TSB er samboer eller ektefelle. Det er likevel noen tendenser til flere selvmord blant enslige. Mange er i arbeid, men en betydelig andel mottar ytelser fra NAV. Funnene tyder også på at ensomhet og tilgang til skytevåpen er andre viktige områder for forebyggende innsats særlig blant eldre menn. Det finnes ingen enkeltarena eller enkeltstående tiltak som vil nå alle som dør i selvmord uten å ha vært i kontakt med spesialisthelsetjenesten det siste leveåret. Rapporten fremhever primærhelsetjenesten, arbeidsplassen, studentsamskipnaden, familievernkontorene, helsestasjonen, og NAV som viktige mulige arenaer for selvmordsforebyggende arbeid.

• Sveen, Carl-Aksel & Kvarstein, Elfrida Hartveit (2026). The societal costs of personality disorders: Cost estimates and variations associated with diagnostic categories and severity. Universitetet i Oslo. ISSN 9788234808739. Full text in Research Archive Show summary

  This thesis, within clinical psychology and health economics, examines the societal costs of personality disorders (PDs) in Norway. The aims were to estimate the societal costs associated with the full range of DSM-5 PDs, provide the first explicit estimate for avoidant PD, and investigate whether specific PD categories or dimensional measures of personality pathology severity were associated with variations in societal costs. It is based on cross-sectional data (2017–2020) from the Norwegian Network for Personality Disorders, a multicenter treatment and research collaboration within specialist mental health services. Resource use, including healthcare utilization and productivity losses before assessment, was estimated using a societal cost-of-illness approach. Regression analyses examined the independent contributions of PD diagnoses and dimensional measures of personality pathology while controlling for common comorbid mental disorders. PDs were associated with substantial societal costs, comparable to those reported for schizophrenia and higher than those for anxiety and depressive disorders. Productivity losses accounted for about two-thirds of total costs, largely reflecting that up to 80% of patients were outside the workforce. Costs associated with avoidant PD were similar to those observed across DSM-5 PDs. Neither specific PD categories nor dimensional measures of severity were independently associated with overall societal costs, suggesting that the economic burden is largely related to impaired functioning shared across treatment-seeking patients rather than to diagnostic subtype or differences in severity. Beyond economic consequences, PDs are associated with profound psychological distress, impaired functioning, and reduced quality of life. The findings highlight the need for effective treatment across the full spectrum of PDs and interventions that improve occupational functioning, thereby alleviating patients' suffering while reducing societal costs.

• Sudmann, Thea Melsen; Jørstad, Øystein Kalsnes; Klungsøyr, Ole & Brækhus, Anne (2026). A Study of the European Visual Field Standards for Driving: Cross-Country Practices, Spectacle Frame Effects, and Correlation with Driving Ability. Universitetet i Oslo. ISSN 9788234808326. Full text in Research Archive Show summary

  Visual field measurements with perimetry may cause unnecessary withdrawal of driving privileges Across Europe, drivers who may not meet the visual requirements for driving should undergo assessment by an ophthalmic specialist. Accurate assessment of the visual field requires standardized perimetry. However, the European Commission Directive 2009/113/EC does not specify which perimetry algorithm should be used or how results should be interpreted in terms of pass–fail criteria for driving eligibility. This lack of guidance risks inconsistent standards and unequal assessment practices between countries. In Norway, legislation advises on the use of the Esterman test. This perimetry test has been criticised for not having a sufficient correlation to actual driving skills. This thesis A Study of the European Visual Field Standards for Driving: Cross-Country Practices, Spectacle Frame Effects, and Correlation with Driving Ability aimed to investigate how the European Commission directive 2009/113/EC is enforced in member states, to investigate how a new perimetry program called European Driving Test (EDT) would be affected if participants performed the test wearing different spectacle designs and finally, how well visual field loss measured with the EDT corresponded to actual driving skills, to establish evidence based passed-failed-criteria. Findings from the studies show that the same visual field loss may cause loss of driving privileges in one country but not another, that certain spectacle frames cause visual field obstructions that alone might conflict with driving privileges, and that even with the new EDT test, perimetry is unfit for predicting driving eligibility and should not be used alone in determinations on fitness to drive in individuals with visual field loss. Instead, the thesis advocates for individual assessments, including practical driving assessments.

• Walby, Fredrik A; Astrup, Helene; Myhre, Martin Øverlien & Belanger, Sissel Marguerite (2025). Nasjonalt kartleggingssystem for selvmord i psykisk helsevern og tverrfaglig spesialisert rusbehandling: Selvmord under Covid-19-pandemien. Universitetet i Oslo. Full text in Research Archive
• Lunde, Ketil Berge; Qin, Ping; Mehlum, Lars & Melle, Ingrid (2025). Deliberate Self-Harm (DSH) in Young Adults: Patient Characteristics, Follow-Up Psychiatric Care, and Repetition Risk in Norwegian Public Healthcare. Universitetet i Oslo. Full text in Research Archive Show summary

  Deliberate self-harm (DSH), defined as intentional self-injury or poisoning regardless of intent, is a severe consequence of psychological distress and/or mental illness. It is associated with a range of adverse outcomes; most prominently, suicide. A large proportion of patients who present to hospitals with DSH are young adults 18–35 years old. Efforts to improve followup care for these patients are crucial and should be informed by a solid understanding of patient’s characteristics, current treatment provision, and prospective outcomes. Young adults with hospital-presented DSH represent a highly heterogeneous group. Therefore, it is important to enhance our understanding of the heterogeneity of risk factors in this population as well as how clinical factors such as specific psychiatric morbidities and previous DSH influence both treatment provision and prospective outcomes. Accordingly, the aims of this thesis were: 1) to explore independent and interactive associations of a broad range of sociodemographic and health-related factors with hospitalpresented DSH; 2) to investigate rates of, and factors associated with, direct transferal to psychiatric inpatient services following somatic treatment of DSH; and 3) to describe followup psychiatric care within the first week of discharge from general hospital management of DSH, and its association with DSH relapse within three, six, and 12 months. The thesis comprises three self-contained studies and uses data from national longitudinal registers. Acute somatic treatments of DSH in young adults aged 18–35 years were identified in the Norwegian Patient Registry (NPR). Individual-level data on socioeconomic background and medical treatment were interlinked across registers via an encrypted personal identifier. Paper I was a nested case-control study examining socioeconomic and sick-leaverelated risk factors for DSH. Study cases were young adults with an index episode of hospitalpresented DSH within the study period of 2008–2013. These study cases were compared with age- and gender-matched controls derived from a 25% random sample of all Norwegian residents with no record of hospital-presented DSH at the time. We found that low education, current sick leave due to psychiatric disorders, and being divorced had the greatest effects. Subgroup analyses revealed an association between education and sick leave in which the two subgroups with the highest risk were young adults with low education and young adults with high education and recorded sick leave. Paper II used a retrospective cohort design to examine clinical and sociodemographic correlates of admissions to a psychiatric inpatient unit on the same day of discharge from the general hospital. The cohort included all episodes of hospital-treated DSH in young adult patients within the study period of 2008–2018. We found that 21.4% of these episode patients were directly transferred to psychiatric inpatient services after discharge from a general hospital. Prominent correlates of such transferal or admission were a history of psychiatric treatment and recorded diagnoses of psychotic, mood or personality disorders at a general hospital when DSH occurred. When adjusted for other factors, previous DSH presentations were inversely associated with psychiatric inpatient admissions. Paper III also used a retrospective cohort design, which included all young adults with a hospital-presented DSH within the study period of 2010–2017. The status of follow-up psychiatric care within seven days after discharge from a general hospital was categorized as no follow-up, outpatient attendance, or inpatient admission. The outcome of the study was repetition of hospital-presented DSH within three, six, and 12 months; and observed confounders were adjusted using inverse probability of treatment weighting. We found that 37.2% of these patients received follow-up psychiatric care within seven days of discharge from DSH somatic treatment (17.3% psychiatric outpatient attendance; 19.9% inpatient admissions). Those who received psychiatric follow-up were more likely to have a recorded psychiatric morbidity and were also shown to have a high crude risk of repeated DSH. When adjusting for observed psychiatric confounders and sociodemographic status, this risk was attenuated but remained significant for inpatient admissions. Additional analyses indicated that the increased risks associated with inpatient admissions were confined to certain subgroups: those aged 18– 24 years, those without a recorded mood disorder, and first-time DSH presenters. Overall, this thesis has shown that young adults with hospital-presented DSH often had low education or a history of sick leave. Furthermore, follow-up psychiatric care was most likely provided to those with the most complex and severe psychiatric symptoms and with a high risk of relapse. This was especially prominent among those who were psychiatrically hospitalized, which likely explains the high risk of repeated DSH associated with psychiatric inpatient admissions. Interestingly, although young adults with previous DSH had high psychiatric admission rates, the association between previous DSH and psychiatric inpatient admission reversed in adjusted analyses. Moreover, the increased risk associated with psychiatric inpatient admission was largely confined to certain subgroups of patients with no or limited prior contact with psychiatric services, namely those aged 18–24 years, those without a recorded mood disorder, and first-time DSH presenters. As we were less likely to capture differences in the baseline risk of DSH in these subgroups, this indicates that unmeasured confounders largely explained the risk of DSH relapse associated with inpatient admissions. Finally, young adults who presented to a hospital with DSH faced a multitude of adversities in addition to psychiatric morbidity, including socioeconomic disadvantage and sick leave from work. Although distinct risk factor configurations were found, difficulties in the occupational domain were prominent risk factors for DSH, underscoring the importance of coordinated follow-up from both healthcare services and social services in the DSH aftermath.

• Dibaj, Iselin Solerød; Mehlum, Lars & Tørmoen, Anita Johanna (2025). Long-term change in adolescents treated for deliberate self-harm and borderline features: Exploring the role of emotion dysregulation. Universitetet i Oslo. ISSN 9788234806247. Full text in Research Archive Show summary

  Deliberate self-harm (DSH) peaks during adolescence and is associated with an increased risk of future suicide attempts and mental health problems. DSH can effectively be treated in adolescents, however, the long-term effects of such treatment in adulthood remained unknown when this study was conducted. To date, the treatment that has received the most empirical support in DSH treatment is Dialectical behaviour therapy for adolescents (DBT-A). The main aim of this PhD thesis was to examine adult life outcomes after DBT-A, both when it came to DSH as well as other outcomes, including suicidal ideation, and emotion regulation ability. The specific papers focused on treatment effects, response trajectories, and mechanisms of change. The study was a follow-up study of an RCT conducted 12 years earlier, comparing DBT-A with usual care for adolescents with repetitive DSH and features of borderline personality disorder. The sample was examined with structured interviews and self-report questionnaires at baseline, 1-, 3- and 12-years follow-up. At the final follow-up, participants also reported data through Ecological Momentary Assessment, by receiving short questionnaires six times daily on their phones over a week. DBT-A was associated with earlier and more robust reduction of DSH, however the difference between the groups diminished over time, and DSH was rarely reported in adulthood across the whole sample. As adults, the majority were either working or studying, and suicide attempts were rare. Moreover, DBT-A was associated with less suicidal ideation in adulthood. DBT-A participants also reported lower negative affect after having used coping skills in their daily life. Finally, remission of DSH one year after treatment was associated with better emotion regulation ability in adulthood. Overall, the findings in this thesis highlight the importance of early targeted intervention and suggest an optimistic long-term prognosis for adolescents who are treated for DSH, extending beyond symptom remission.

• Myhre, Martin Øverlien; Mehlum, Lars; Walby, Fredrik A & Bramness, Jørgen Gustav (2025). Service Utilisation and Clinical Characteristics of People with Substance Use Disorders Who Died by Suicide. A National Consecutive Case Series. Universitetet i Oslo. ISSN 9788234806759. Full text in Research Archive Show summary

  Substance use disorders are a well-known risk factor for suicide. Still, we have limited knowledge to guide prevention strategies within services. The aim of this thesis was to describe the clinical characteristics and service utilisation of patients with substance use disorders (SUD) who died by suicide within one year after contact with services for substance use or mental health. Materials from the Norwegian Surveillance System for Suicide (NoSS) were used. Paper I and II used a national registry linkage including all people who died by suicide or undetermined intent from the Norwegian Cause of Death Registry, who were registered with contact in substance use or mental health services in the Norwegian Patient Registry. Paper III included in addition nationally representative data from a clinical questionnaire filled in by clinicians who were in direct contact with patients during their last treatment contact before their death; these data were linked with the mentioned registry linkage. The studies included all patients within the NoSS who were registered with a SUD diagnosis in the NPR in the last year before their suicide. In the study reported in Paper I, we examined past-year service contact trajectories, identifying brief contact trajectories as the most prevalent. In the study reported in Paper II, we analysed the association between the number of weeks from the last contact to suicide and comorbid mental disorders, finding that patients with comorbid psychosis or bipolar disorder, or personality disorders died fewer weeks after their last contact with services. In the study reported in Paper III, we reported on the prevalence of a history of previous self-harm and examined the factors associated with such a history. A history of self-harm was present in 53 % of patients who later died by suicide, and such a history was associated with suicidal ideation at the last contact, personality disorder, a history of violent behavior and more than two admissions in the last year. These findings can inform clinical care and service development that are better adapted common characteristics, which in turn could contribute to improving patient safety and potentially saving lives.

• Graff, Ingvild Eide; Ellingsen, Christian Lycke; Gravensteen, Ida Kathrine; Johansen, Ingrid Hjulstad; Kirkhorn, Kari & Lexander, Hågen Vatshelle [Show all 11 contributors for this article] (2025). Utredning av hvordan mørketall ved selvmord kan reduseres. Folkehelseinstituttet. ISSN 9788284064970. Full text in Research Archive Show summary

  Ekspertgruppen har evaluert dagens praksis for hvordan informasjon om dødsårsak og dødsmåte blir formidlet til Dødsårsaksregisteret (DÅR) etter en persons død. Dette inkluderer opplysninger fra dødsmeldingen, dialog med lege, og fra obduksjonsrapport når det er aktuelt. Målet for ekspertgruppen har vært å identifisere og vurdere tiltak som kan bedre forekomsttallene for selvmord. Gruppens mandat har vært å foreslå endringer i dagens system slik at kvaliteten på informasjon om selvmord bedres, og at graden av mørketallene når det gjelder antall selvmord i Norge, kan reduseres. Dette er en del av arbeidet med å forebygge selvmord og er i tråd med regjeringens handlingsplan for 2020-2025. Overgangen fra dødsmelding på papir til digital dødsmelding startet i 2018, og fra 01.01.2022 ble det obligatorisk for leger å melde inn dødsfall elektronisk. I løpet av 2022 kom 98 % av dødsmeldingene digitalt inn til DÅR. Dette ga raskere tilgang til opplysninger om dødsårsak, bedre lesbarhet og tryggere lagring av data. Det virker som om dette systemet fungerer godt, og det rapporteres ikke om tekniske vanskeligheter fra leger som benytter systemene. Dødsmeldingen sendes automatisk til relevante myndigheter. Det er likevel en utfordring at det for de fleste leger går lang tid mellom hver gang de fyller ut en dødsmelding, og at de svært sjeldent er i befatning med selvmord. Ved dødsfall utenfor institusjon har legen ofte lite informasjon tilgjengelig i vurderingen av dødsårsak og dødsmåte. Det er derfor en risiko for at dødsfallet kodes feil. Hvert år publiseres statistikk over dødsårsaker, inkludert selvmord, fra året før. Det er flere feilkilder ved innmelding av et dødsfall som kan påvirke forekomsttallene av selvmord. Dødsmeldinger kan være dårlig eller mangelfullt utfylt, slik at det ikke kommer frem at det er et selvmord. Legen kan oppgi en feil, men plausibel dødsårsak på dødsmeldingen, eller det kan være oppgitt korrekt skadediagnose, men feil dødsmåte. Noen ganger benyttes koder for dødsårsak og dødsmåte som gir lite informasjon om den underliggende dødsårsaken. I Norge er omtrent 29 % av dødsfallene kodet med en slik lite informativ kode (såkalt skrotkode), og det er sannsynlig at en del av mørketallene for selvmord befinner seg blant disse skrotkodene. Ekspertgruppen har derfor foreslått tiltak som gruppen mener vil bedre kvaliteten på kodene for dødsårsak og dødsmåte i Norge, og dermed bidra til å ta ned mørketallene ved selvmord. Ekspertgruppens ti foreslåtte tiltak for å ta ned mørketallene ved selvmord er: • Automatisk involvering av fastlege når en dødsmelding er sendt inn til DÅR • Elektronisk kommunikasjon mellom DÅR og fastlegen når DÅR skal innhente tilleggsopplysninger • Inkludering av unaturlige dødsfall og rusrelaterte dødsfall i en lignende prosess som for dødsfall i veitrafikken (2020) • Betydelig økning i kapasitet og kompetanse i de rettspatologiske fagmiljøene • Gjennomføring av et forsknings- og utviklingsprosjekt for å undersøke andelen selvmord blant eldre • Forbedring av det digitale skjemaet for dødsmeldingen • Honorering for arbeid med dødsmelding, innhenting av tilleggsopplysninger, og rekvirering av obduksjon (HELFO sats) • Arrangering av årlige møter mellom rettsmedisinere, andre leger og kodere i DÅR • Påminnelse til rettspatologiavdelingene om å sette rettsmedisinsk kommisjon og DÅR som kopimottakere når de oppretter sak • Revurdering av finansieringsordningen for obduksjoner Ekspertgruppen har også anbefalt ytterligere syv tiltak, og har vurdert ni tiltak som er omtalt, men som gruppen ikke anbefaler. Ekspertgruppen anbefaler ikke at det igangsettes en utredning av coroner eller medical examiner ordning etter modell fra England i denne omgang. Ekspertgruppen oppfordrer til at tiltakene iverksettes noenlunde samlet dersom det er mulig. Det vil lette evalueringen av om tiltakene samlet sett har virket.

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