Speaker  Spotlight:
Erkki Isometsä, M.D., Ph.D.
 
Erkki Isometsä, MD, PhD, is a Professor of Psychiatry at the University of Helsinki, Finland. He started research in the national psychological autopsy study of the National Suicide Prevention Project in Finland and the WHO/Euro Study of Parasuicide Helsinki site, thereafter serving in 1997-2004 as the Head of the Mood Disorders and Suicide Research Unit at the National Public Health Institute.
 
More recently, his research has focused on the general population and clinical epidemiology of mood disorders, their risk factors, illness mechanisms, course, outcome, treatment, and associated disability and suicidal behavior.
 
He has led major longitudinal research projects, including the Vantaa Depression Study (VDS), the Vantaa Primary Care Depression Study (PC-VDS), and the Jorvi Bipolar Study (JoBS). His current research includes register-based national studies of suicide, and clinical risk factors studies of suicidal behavior in mood disorders. He leads clinical trials, studies of neurocognition and emotional processing, and experience sampling and mobile monitoring of mood disorders and suicidal behavior.
 
Professor Isometsä chairs the national Finnish depression treatment guidelines and is a member of the bipolar and suicide prevention guideline task forces. He served as the Secretary & Treasurer the International Academy of Suicide Research (IASR) in 2011-14, and is Finland’s country representative in the International Association for Suicide Prevention (IASP).
 
He is active in International Society for Bipolar Disorders (ISBD), and the European College of Neuropsychopharmacology (ECNP), and has other expert roles including memberships in editorial boards.
 
By May 2018, he had authored or co-authored 230 original studies, plus 134 reviews, textbook chapters, or editorials; in the Scopus, his publications had been cited 10 814 times (h-index 55). In 2014, he was granted the Nordic Prize in Medicine.

Suicide in Mood Disorders: 
Importance of Temporal Variation in Risk

Abstract (243 words)

 
The usefulness of traditional risk factors for suicide, such as mental disorders, has been recently debated. Meta-analyses have found the potency of such factors quite weak. This is puzzling, given that in psychological autopsy studies almost all suicides have suffered from mental disorders preceding their death, and that cohorts of psychiatric patients with mental disorders have high suicide mortality.
 
In a plenary talk focusing on suicide in mood disorders, professor Isometsä argues, that the perceived weakness of mental disorder constructs as risk factors for suicide is largely a consequence of the limitations of study designs commonly applied in suicide research. In particular, lack of information on time-related factors is crucial, when investigating episodic illnesses.
 
Temporal variations in risk of suicide have been found remarkable in postdisharge studies, and among psychiatric patients with mood disorders, incidence of suicide attempts has been found up to 120-fold during bipolar mixed states, and 60-fold during major depressive episodes compared with euthymic periods. Impact of temporal variations in suicide risk can be demonstrated, if temporal variations in clinical states and timing of suicidal acts are both investigated in a longitudinal design using life chart methodology.
 
Isometsä suggests, that future research on suicide risk in mood disorders needs to clarify the causal pathways through which the effects of numerous distal and proximal risk factors are intertwined with the marked impact of mood states. These may involve both modifying risk when high-risk illness states are present, or influencing their duration.