Seasonality of Suicide and Airborne Allergens

描述（由申请人提供）：引言：这是对我们先前申请的广泛修订，更好地利用了丹麦纵向登记的机会，并为我们提供了强大的能力来检验我们高度新颖的假设，即空气过敏原和过敏与自杀相关。时间和地形聚类的问题已经得到解决，设计的重点已经收紧，并给出了更多的细节分析。研究背景：自杀的季节性高峰在春季一直被报道，但其起源却知之甚少。受益于自然实验（春季树木花粉的突然增加），并考虑到过敏性致敏的高患病率（40-50%），我们提出，春季树木花粉的大量释放，通过炎症介质，通过影响过敏，抑郁和自杀的个体，提高了自杀的相对风险。本研究的目的是：1）确认过敏原峰和自杀峰之间的关系（使用生态方法和广义线性模型，使我们能够解决地理和时间聚集问题），2）估计过敏和自杀之间的预测关联，并调整之前描述的与自杀相关的变量并与之相互作用，例如诊断情绪障碍，既往自杀企图，以及其他与自杀风险相关的人口统计学/社会经济学变量，使用嵌套病例对照设计和条件Logistic回归模型，以及3）使用条件Logistic回归模型估计春季过敏和春季花粉高峰期自杀与心境障碍史相互作用之间的预测关联。次要目的是具体分析个人和家庭中过敏和情绪障碍与自杀企图之间的预测关联，评估与人口统计学和社会经济因素的相互作用，并估计（抗过敏和精神病）药物的保护作用与风险升高作用。意义：这项研究准备确定一个潜在的新的自杀脆弱性，即，过敏性致敏，和一个潜在的新的触发因素，空气过敏原暴露，并在此过程中，复制先前报道的性别特异性过敏和情绪障碍之间的关系，在个人和家庭。在流行病学上，结合临床研究和实验室工作，确认过敏原和过敏与自杀有关，有望改善自杀的预测和预防。

DESCRIPTION (provided by applicant): Introduction: This is an extensive revision of our prior application which makes better use of the opportunities of the Danish longitudinal registers and gives us a robust power for testing our highly novel hypothesis that aeroallergens and allergy are associated with suicide. Issues of temporal and topographic clustering have been addressed, the focus of the design has been tightened and more details are given regarding the analysis. Background: Seasonal peaks of suicide in spring have been consistently reported but the origin is poorly understood. Benefiting from a natural experiment (the abrupt rise of tree-pollen in spring), and considering the high prevalence of allergic sensitization (40-50%), we proposed that the massive release of tree-pollen in spring, via mediators of inflammation, elevates the relative risk for suicide, by affecting individuals with vulnerability for allergies, depression, and suicide. The aims of the study are 1) to confirm the relationship between allergen peaks and suicide peaks (using an ecologic approach and a generalized linear model allowing us to address geographic and temporal clustering), 2) to estimate a predictive association between allergy and suicide, with adjustment for and interaction with variables previously described to be related to suicide, such as diagnosis of mood disorders, prior suicide attempts, and other demographic /socioeconomic variables related to suicide risk, using a nested case control design and conditional logistic regression models , and 3) to estimate the predictive association between spring allergy, and spring suicide during peak tree-pollen periods in interaction with history of mood disorders using conditional logistic regression models. Secondary aims are to analyze specifically the predictive association between allergy and mood disorders and suicidal attempts in individuals and families, to evaluate interactions with demographic and socioeconomic factors, and to estimate protective versus risk elevating effects of (anti-allergy and psychotropic) medications. Implications: The study is poised to identify a potential novel vulnerability for suicide, i.e., allergic sensitization, and a potential novel trigger, aeroallergen exposure, and, in the process, to replicate the previously reported gender-specific relationship between allergy and mood disorders, in individuals and families. Confirming that allergens and allergy are related to suicide epidemiologically, in conjunction with clinical research and laboratory work, is expected to improve prediction and prevention of suicide.