{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:13:13Z","timestamp":1793412793988,"version":"4.5.0"},"reference-count":59,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"Importance<\/jats:title>Traumatic events have been associated with elevated risks of psychiatric disorders, while the contributions of familial factors to these associations remain less clear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine the contribution of familial factors to long-term incidence trajectories of psychiatric disorders following potentially traumatic events.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study evaluated 3 separate cohorts of individuals residing in Sweden who were free of previous diagnosed psychiatric disorders when first exposed to assault (n\u2009=\u200949\u202f957), injury (n\u2009=\u2009555\u202f314), or bereavement (n\u2009=\u2009321\u202f263) from January 1987 to December 2013, together with their unexposed full siblings, and 10 age-, sex-, and birthplace-matched unexposed individuals (per exposed individual). Cohorts were created from the Swedish Total Population Register linked to health and population registers. Data were analyzed from March 2022 to April 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Potentially traumatic events, including various types of assault, injuries, and bereavement (death of a child or of a spouse or partner), were ascertained from the Swedish national registers.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Incident psychiatric disorders were ascertained from the Swedish Patient Register. Flexible parametric and Cox models were used to estimate associations of potentially traumatic events with incident psychiatric disorders after multivariable adjustment.<\/jats:p><\/jats:sec>Results<\/jats:title>The median (IQR) age at exposure to assault, injury, and bereavement was 22 (18-31), 19 (8-40), and 60 (51-68) years, respectively. During a median (IQR) follow-up of 4.9 (2.2-8.2), 9.1 (4.1-15.6), and 8.1 (3.4-14.8) years, the incidence rates of any psychiatric disorder were 38.1, 13.9, and 9.0 per 1000 person-years for the exposed groups of the 3 cohorts, respectively. Elevated risk of any psychiatric disorder was observed during the first year after exposure to any assault (hazard ratio [HR], 4.55; 95% CI, 4.34-4.77), injury (HR, 3.31; 95% CI,3.23-3.38), or bereavement (HR, 2.81; 95% CI, 2.72-2.91) and thereafter (assault HR, 2.50; 95% CI, 2.43-2.56; injury HR, 1.69; 95% CI, 1.68-1.70; bereavement HR, 1.42; 95% CI, 1.40-1.44). Comparable associations were obtained in sibling comparison (first year: assault HR, 3.70; 95% CI, 3.37-4.05; injury HR, 2.98; 95% CI, 2.85-3.12; bereavement HR, 2.72; 95% CI, 2.54-2.91; thereafter: assault HR, 1.93; 95% CI, 1.84-2.02; injury HR, 1.51; 95% CI, 1.48-1.53; bereavement HR, 1.35; 95% CI, 1.31-1.38). The risk elevation varied somewhat by type of traumatic events and psychiatric disorders, with the greatest HR noted for posttraumatic stress disorder after sexual assault (sibling comparison HR, 4.52; 95% CI, 3.56-5.73 during entire follow-up period).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, the long-term risk elevation of psychiatric disorders after potentially traumatic events was largely independent of familial factors. The risk elevation observed immediately after these events motivates early clinical surveillance and mental health services for these vulnerable populations.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2023.5156","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T17:47:07Z","timestamp":1705513627000},"page":"374","source":"Crossref","is-referenced-by-count":25,"title":["Incidence Trajectories of Psychiatric Disorders After Assault, Injury, and Bereavement"],"prefix":"10.1001","volume":"81","author":[{"given":"Yufeng","family":"Chen","sequence":"first","affiliation":[{"name":"Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"},{"name":"Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Shen","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China"},{"name":"Institute for Advanced Study, Tongji University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Lichtenstein","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimie L.","family":"Gradus","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts"},{"name":"Department of Psychiatry, Boston University School of Public Health, Boston, Massachusetts"},{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip K.","family":"Arnberg","sequence":"additional","affiliation":[{"name":"National Centre for Disaster Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet"},{"name":"School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M.","family":"D\u2019Onofrio","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet"},{"name":"Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Song","sequence":"additional","affiliation":[{"name":"Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland"},{"name":"West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unnur A.","family":"Valdimarsdottir","sequence":"additional","affiliation":[{"name":"Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"},{"name":"Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland"},{"name":"Department of Epidemiology, Harvard T. 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