Vulnerable Populations | Research at the EPiCSS group

Mental disorders are prevalent across all population groups but there are also known high risk groups. We aim to add knowledge about mental health and its determinants in known risk groups such as migrants and sexual and gender minorities. We also focus on physical health and social outcomes among offspring of individuals with mental illness.

Research projects

Periscope - a Pan-European Response to the ImpactS of COVID-19 and future Pandemics and Epidemics

Project contact: Christina Dalman

Periscope is a large-scale research project that involves a consortium of 32 European institutions to investigate the implications of COVID-19 in a broad way, which include the socio-economic impacts, the health impacts and the impacts on the health systems. Karolinska Institutet is the lead of the project work with mental health impacts and will focus on exploring levels of mental health and service consumption across EU-countries

Bridging Barriers to mental health support for newly arrived minors (TINA-Tidiga Insatser NyAnlända)

Project contact: Christina Dalman

Data show that a lower proportion of newly arrived minors receive early intervention for mental distress in the first line mental health service compared to Swedish-born. This project aims at facilitating newly arrived children and youth to seek, and receive, appropriate help at an early stage, since we know that early interventions yields better results

The project is financed by the Swedish Research Council (2019-2024). 


Project contact: Anna-Clara Hollander, James Kirkbride

We investigate the role of migrant status on the risk of developing psychiatric outcomes using register and linked cohort data. We are particularly interested in understanding the social and economic determinants of variation in risk between the Swedish-born population, migrants, refugees and the children of migrants. We have previously shown that refugees have a risk of psychotic disorders in excess of other migrants from similar regions of origin.

Our current research focus on psychosis, suicide and substance use disorders in particular, and their individual and contextual determinants.

Young Adults

Project contact: Kyriaki Kosidou, Andreas Lundin

Psychiatric service use has increased sharply in Sweden and in other developed countries, particularly among young people. The reasons for the increases in service use might be higher prevalence of mental health problems, but also lower stigmatization of mental disorders, broader conceptualization of mental disorder and a lowering of the threshold for help-seeking in younger age groups. It could also be that contextual factors such as difficulties faced by young people in establishing themselves to the labor market and adult life contribute to their increased need of support and mental health care.

This project examines reasons for the increasing psychiatric service use of young people in Sweden in a thorough matter, using a combination of register-data, self-reported data from questionnaires including answers to open-ended questions.


Trends in levels of self-reported psychological distress among individuals who seek psychiatric services over eight years: a comparison between age groups in three population surveys in Stockholm County.
Kosidou K, Lundin A, Lewis G, Fredlund P, Dal H, Dalman C
BMC Psychiatry 2017 10;17(1):345

Mental health service use, depression, panic disorder and life events among Swedish young adults in 2000 and 2010: a repeated cross-sectional population study in Stockholm County, Sweden.
Lundin A, Forsell Y, Dalman C
Epidemiol Psychiatr Sci 2018 10;27(5):510-518

Discriminant validity of the 12-item version of the general health questionnaire in a Swedish case-control study.
Lundin A, Åhs J, Åsbring N, Kosidou K, Dal H, Tinghög P, et al
Nord J Psychiatry 2017 Apr;71(3):171-179

Children of Parents with Mental Illness

Project contact: Kyriaki Kosidou

It has been known previously that the offspring of parents with mental disorders have higher risk of developing mental disorders themselves. However, whether or not they also have higher risk for physical ill-health health and negative social outcomes is less known.

In this project, we seek to determine the association between parental mental disorders with physical health outcomes (i.e. immune-related disorders), injuries, and placement for out-of-home care among the offspring. We are also interested in finding out if these associations might be mediated by other factors, such as childhood adversity.

Sexual and gender minorities

Project contact: Kyriaki Kosidou

Sexual and gender minority status is associated with risk for mental ill-health but with differential associations for different minority groups. In a number of studies, we explore associations of sexual minority status with mental health problems. We also examine the occurrence of gender incongruence in the general population and associations with mental health.


Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population?
Björkenstam C, Björkenstam E, Andersson G, Cochran S, Kosidou K
J Sex Med 2017 03;14(3):396-403

Suicide in married couples in Sweden: Is the risk greater in same-sex couples?
Björkenstam C, Andersson G, Dalman C, Cochran S, Kosidou K
Eur. J. Epidemiol. 2016 07;31(7):685-90

Self-reported suicide ideation and attempts, and medical care for intentional self-harm in lesbians, gays and bisexuals in Sweden.
Björkenstam C, Kosidou K, Björkenstam E, Dalman C, Andersson G, Cochran S
J Epidemiol Community Health 2016 Sep;70(9):895-901