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Increased Incidence Rate of Trauma- and Stressor-related Disorders in Denmark After the Breivik Attacks in Norway

Hansen, Bertel T.a,b; Dinesen, Peter T.a; Østergaard, Søren D.c,d

doi: 10.1097/EDE.0000000000000705
Descriptive Epidemiology

Background: On 22 July 2011, Anders Breivik killed 77 adults and children in Norway. Having recently documented increases in the incidence of trauma- and stressor-related disorders in Denmark after the 9/11 attacks, we hypothesized that the Breivik attacks—due to their geographic proximity—would be followed by even larger increases in Denmark.

Methods: Using population-based data from the Danish Psychiatric Central Research Register (1995–2012), we conducted an intervention analysis of the change in the incidence of trauma- and stressor-related disorders after the Breivik attacks.

Results: The incidence rate increased by 16% over the following 1½ years after the Breivik attacks, corresponding to 2736 additional cases. In comparison, 9/11 was followed by a 4% increase. We also present evidence of a subsequent surge in incidence stimulated by media attention.

Conclusion: This study bolsters previous findings on extra-national consequences of terrorism and indicates that geographic proximity and media coverage may exacerbate effects.

Supplemental Digital Content is available in the text.

From the aDepartment of Political Science, University of Copenhagen, Copenhagen, Denmark; bDepartment of Political Science, Stanford University, Stanford, CA; cDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark; and dPsychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.

Submitted December 23, 2016; accepted June 27, 2017.

This work was support by grants 2011_01_0609 and CF14-0703 from the Carlsberg Foundation. S.D.Ø. was supported by grant R165-2013–15320 from the Lundbeck Foundation. The funders had no influence on the following: design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

The authors report no conflicts of interest.

Availability of data and code for replication: Data and code for replication are available in eAppendix 2 and eAppendix 3, respectively.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com).

Correspondence: Søren D. Østergaard, Psychosis Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Skovagervej 2, 8240 Risskov, Denmark. E-mail: soeoes@rm.dk.

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