Seasonality of Suicide and Airborne Allergens

描述（由申请人提供）：简介：这是对我们之前申请的广泛修订，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力量来测试我们高度新颖的假设，即空气过敏原和过敏与自杀有关。解决了时间和地形聚类的问题，加强了设计的重点，并给出了有关分析的更多细节。背景：春季自杀的季节性高峰一直有报道，但其起源却知之甚少。得益于自然实验（春季树花粉的突然增加），并考虑到过敏致敏的高患病率（40-50%），我们提出，春季树花粉的大量释放，通过炎症介质，通过影响过敏、抑郁和自杀易感性的个体，提高了自杀的相对风险。本研究的目的是1)确认过敏原峰值和自杀峰值之间的关系（使用生态学方法和广义线性模型，允许我们解决地理和时间聚类问题），2)通过调整先前描述的与自杀相关的变量并与之相互作用，估计过敏和自杀之间的预测性关联，例如情绪障碍的诊断，先前的自杀企图，以及其他与自杀风险相关的人口/社会经济变量，采用嵌套病例对照设计和条件逻辑回归模型；3)使用条件逻辑回归模型估计春季过敏和春季自杀在花粉高峰期与情绪障碍史的交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与情绪障碍和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，并评估（抗过敏和精神药物）药物的保护作用与风险升高作用。意义：该研究准备确定一个潜在的新的自杀易感性，即过敏致敏，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，复制先前报道的个体和家庭中过敏和情绪障碍之间的性别特定关系。在流行病学上确认过敏原和过敏与自杀有关，结合临床研究和实验室工作，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.