Contact with primary health care prior to suicide is common even in the final month before death. The findings presented in this study highlight the importance of placing suicide prevention strategies and interventions within the primary health care setting.

Reneflot A, Evensen M. Unemployment and psychological distress among young adults in the Nordic countries: A review of the literature This article reviews Nordic research, published from 1995 and onwards, on the relationship between unemployment and mental health among young adults. Cross-sectional, longitudinal and time-series studies are included. Cross-sectional studies show that the unemployed experience more mental health problems than the non-unemployed. Leaving unemployment is associated with increased well-being. Economic problems, feelings of shame and poor social support increase the likelihood of psychological distress. The longitudinal studies show that unemployment increases the risk of psychological distress and attempted suicide, after initial mental health status and confounding factors are accounted for. The relationship remains significant when time-invariant characteristics of the individuals are controlled for. The time-series studies found no relationship between unemployment and suicide, but levels of psychological distress were found to vary with changes in the labour market. This relationship remained significant after excluding the non-employed, indicating that unemployment trends have effects beyond those directly associated with unemployment.

The alarmingly high prevalence of DUD among young patients with severe mental disorders should encourage preventive efforts to reduce illicit drug use in the adolescent population.

Background Self-report data on mental distress indicate a deterioration of population mental health in many countries during the COVID-19 pandemic. A Norwegian epidemiological diagnostic psychiatric interview survey was conducted from January to September 2020, allowing for comparison of mental disorder and suicidal ideation prevalence from before through different pandemic periods. Prevalence of suicide deaths were compared between 2020 and 2014–2018. Methods Participants from the Trøndelag Health Study (HUNT) in Trondheim were recruited through repeated probability sampling. Using the Composite International Diagnostic Interview (CIDI 5.0) ( n = 2154), current prevalence of mental disorders and suicidal ideation was examined in repeated cross-sectional analyzes. Data on suicide deaths was retrieved from the Norwegian Cause of Death Registry and compared for the months March to May in 2014–2018 and 2020. Findings Prevalence of current mental disorders decreased significantly from the pre-pandemic period (January 28th to March 11th 2020; 15•3% (95% CI 12•4–18•8)) to the first pandemic period (March 12th – May 31st; 8•7% (6•8–11•0)). Prevalences were similar between the pre-pandemic period and the interim (June 1st July 31st; 14•2% (11•4–17•5)) and second periods (August 1st-September 18th; 11•9% (9•0–15•6)). No significant differences were observed in suicidal ideation or in suicide deaths. Interpretation Except for a decrease in mental disorders in the first pandemic period, the findings suggest stable levels of mental disorders, suicidal ideation and suicide deaths during the first six months of the COVID-19 pandemic compared to pre-pandemic levels. Potential methodological and contextual explanations of these findings compared with findings from other studies are discussed. Funding None.