Donghao Lu

Donghao Lu

Senior Lecturer | Docent
Visiting address: Nobels väg 13, 17177 Stockholm
Postal address: C6 Institutet för miljömedicin, C6 Integrativ epidemiologi Lu, 171 77 Stockholm
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About me

Research

  • My research program is to study women’s mental health over the life course and to bridge the gap between Obstetrics/Gynecology and Psychiatry. Leveraging international large-scale population-based cohorts, I aim to understand the underlying biological mechanisms affecting women’s mental health and potential health consequences. My current main research topics are:

    1) Risk factors and health consequences of reproductive mood disorders or sex-specific mental disorders, including:

    ° premenstrual disorders (premenstrual syndrome and premenstrual dysphoric disorder)

    ° perinatal depression (prenatal and postnatal depression)

    ° perimenopausal depression and menopausal symptoms

    ° other maternal mental disorders occurred during and after pregnancy
    2) Sex disparity in mental health



    Grants:

    My research work is supported by the European Research Council (ERC), Swedish Research Council (VR), Swedish Research Council for Health, Working Life, and Welfare (Forte), China Scholarship Council, and Karolinska Institutet Strategic Research Area in Epidemiology and Biostatistics (SFOepi), Faculty Board, Board of Doctoral Education, and Research Fund.


    Contributions to Science:

    1) Early life origins and risk factors of premenstrual disorders

    Premenstrual disorders are typically diagnosed in women in their 20s/30s, but my research has shown that the symptoms often begin during adolescence. In fact, in a sample of young women in the US, I found that approximately 70% of premenstrual disorders had onset before the age of 20. However, little was known about the factors in early life that may predispose these women to the onset of premenstrual disorders during adolescence. Through my studies, I have identified several important risk factors for premenstrual disorders developed later in life, including early menarche or pubertal development, adverse childhood experiences, childhood overweight or obesity, and childhood asthma or food allergy. These findings have significantly contributed to the understanding of the early life origins of the pathophysiology of premenstrual disorders.

    1. Lu D, Aleknaviciute J, Bjarnason R, Tamimi RM, Valdimarsdóttir UA, Bertone-Johnson ER. Pubertal development and risk of premenstrual disorders in young adulthood. Hum Reprod. 2021 May 30, 36(2):455-464. PMID: 33289027
    2. Yang Q, Þórðardóttir EB, Hauksdóttir A, Aspelund T, Jakobsdóttir J, Halldorsdottir T, Tomasson G, Rúnarsdóttir H, Danielsdottir HB, Bertone-Johnson ER, Sjölander A, Fang F, Lu D#, Valdimarsdóttir UA#. Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11, 973 women. BMC Med. 2022 Feb 21, 20(1):60. PMID: 35184745
    3. Lu D, Aleknaviciute J, Kamperman AM, Tamimi RM, Ludvigsson JF, Valdimarsdóttir UA, Bertone-Johnson ER. Association Between Childhood Body Size and Premenstrual Disorders in Young Adulthood. JAMA Netw Open. 2022 Mar 1, 5(3):e221256. PMID: 35258576
    4. Yang Y, Gong T, Camargo CA, Valdimarsdóttir UA, Bertone-Johnson E, Lu D. Childhood asthma, allergies, and risk of premenstrual disorders in young adulthood. Nature Mental Health. 2023. DOI 10.1038/s44220-023-00066-4

    2) Health impact of premenstrual disorders

    Although premenstrual symptoms are restricted to the days before menstruation, the chronic and cyclic condition may translate to a profound impact on the long-term quality of life. However, there is a lack of prospective data to understand the health consequences of premenstrual disorders. My research is the first to demonstrate that patients with premenstrual disorders are at increased risk of subsequent suicidal behavior, accidents, perinatal depression, early menopause and severe menopause symptoms, sick leave, premature death, and eventually contribute to the sex gap in mental health. We also found that use of hormonal contraceptives, particularly combined products, may reduce the rates of suicidal behaviors among women with premenstrual disorders.

    1. Yang Q, Sjölander A, Li Y, Viktorin A, Bertone-Johnson ER, Ye W, Fang F, Valdimarsdóttir UA#, Lu D#. Clinical indications of premenstrual disorders and subsequent risk of injury: a population-based cohort study in Sweden. BMC Med. 2021, 19(1):119. PMID: 34034729
    2. Yang Q, Bränn E, Bertone-Johnson E, Sjölander A, Fang F, Öberg S, Valdimarsdóttir UA, Lu D. The bidirectional association between premenstrual disorders and perinatal depression: a nationwide register-based study. PLoS Med. 2024, 21(3):e1004363. PMID: 38547436, The Conversation, BBC News
    3. Yang Y, Valdimarsdóttir UA, Manson JE, Sievert LL, Harlow BL, Eliassen AH, Bertone-Johnson ER#, Lu D#. Premenstrual Disorders, Timing of Menopause, and Severity of Vasomotor Symptoms. JAMA Netw Open. 2023, 6(9):e2334545. PMID: 37725375, CNN News
    4. Yang Q, Lagerberg T, Sjölander A, Bertone-Johnson ER, Fang F, Ye W, Chang Z, Valdimarsdóttir UA#, Lu D#. Use of hormonal contraceptives and antidepressants and risks of suicidal behavior and accidents among women with premenstrual disorders: a nationwide cohort study. BMC Med. 2022, 20(1):482. PMID: 36522649
    5. Yang Y, Bränn E, Zhou J, Wei D, Bergstedt J, Fang F, Valdimarsdóttir UA, Bertone-Johnson E, Lu D. Premenstrual disorders and risk of cardiovascular diseases. Nat Cardiovasc Res. 2025 Aug;4(8):1001-1010. PMID: 40646267
    6. Li Y, Jiang J, Halldorsdottir T, Zhu H, Bertone-Johnson E, Valdimarsdóttir UA, Zhou X, Zhang W#, Lu D#. Premenstrual disorders and gender differences in adolescent mental health. J Affect Disord. 2023, 340:930-937. PMID: 37543115
    7. Opatowski M, Valdimarsdóttir UA, Oberg AS, Bertone-Johnson ER, Lu D. Mortality Risk Among Women With Premenstrual Disorders in Sweden. JAMA Netw Open. 2024, 7(5):e2413394. PMID: 38805225
    8. Yu H, Yang Y, Hysaj E, Nevriana A, Hägg S, Valdimarsdóttir UA, Bertone-Johnson E, Lu D. Premenstrual disorders and risk of sick leave and unemployment: a prospective cohort study of 15 857 women in Sweden. BMJ Ment Health. 2025, 28(1):e301550. PMID: 40623861


    3) Health impact of perinatal depression

    Maternity care typically prioritizes pregnancy outcomes, often sidelining women’s mental well-being. Perinatal depression affects as many as 10-20% of women giving birth worldwide. In contrast to the common belief that perinatal depression is self-resolving, many cases can last for months or even longer, particularly if left untreated. However, prospective data are lacking to illustrate whether women with perinatal depression may confront enduring health consequences. My research is among the first to demonstrate that patients with perinatal depression are at increased risks of subsequent suicidal behavior, autoimmune disease, cardiovascular disease, and mortality.

    1. Bränn E, Shen Q, Lu D. Perinatal depression and its health impact. BMJ, 2024, 384:p2777.PMID: 38195147
    2. Hagatulah N, Bränn E, Oberg AS, Valdimarsdóttir UA, Shen Q#, Lu D#. Perinatal depression and risk of mortality: nationwide, register based study in Sweden. BMJ, 2024, 384:e075462. PMID: 38199643, FORTE News, New York Times
    3. Bränn E, Chen Y, Song H, László KD, D'Onofrio BM, Hysaj E, Almqvist C, Larsson H, Lichtenstein P, Valdimarsdottir UA, Lu D. Bidirectional association between autoimmune disease and perinatal depression: a nationwide study with sibling comparison. Mol Psychiatry. 2024. PMID: 38191927, U.S. News
    4. Yu H, Shen Q, Bränn E, Yang Y, Oberg AS, Valdimarsdóttir UA, Lu D. Perinatal Depression and Risk of Suicidal Behavior. JAMA Netw Open, 2024, 7(1):e2350897. PMID: 38194232, New York Times
    5. Lu D, Valdimarsdóttir UA, Wei D, Chen Y, Andreassen O, Fang F, László KD, Bränn E. Perinatal depression and risk of maternal cardiovascular disease: a nationwide Swedish study. Eur Heart J, 2024. PMID: 38889798

Teaching

Articles

All other publications

Grants

  • Swedish Research Council
    1 January 2025 - 31 December 2027
    Around 4% of middle-aged women have breast implants, the large majority for cosmetic reasons. There are rising concerns for adverse health effects of breast implants, yet comprehensive research efforts are needed to determine if the indicated health risks are preexisting or caused by the procedure itself. Therefore, the aim of the BRISK study is to leverage unique Swedish population-based data to determine risks of mental disorders, autoimmune disease, chronic fatigue, and other medical conditions among women with cosmetic breast implants. In this three-year project, we will identify 29 011 women with cosmetic breast implants through the Breast Implant Quality Register (operated 2014-22) and ongoing mammography studies (identified 2008-21), as well as ~5 000 women undergoing permanent removal of breast implants (1997-2022). By record linkage to the population-based Patient, Primary Care- and Prescription Registers, we will compare the rates of the studied health risks of women with breast implants to that of their full sisters and an age- and region matched cohort of women. We will assess pre-surgery rates of these conditions and take them into account when assessing post-surgery rates. Solid evidence on major health outcomes of breast implant surgery is currently lacking, leaving women considering this surgery option largely uninformed on long-term health effects. The BRISK study will provide valuable evidence for this patient group and health care policy worldwide.
  • Swedish Research Council
    1 January 2025 - 31 December 2028
    The MoodMAP project targets the challenge of diagnosing and treating reproductive mood disorders (RMDs), such as premenstrual disorder and postpartum depression, which significantly affect women’s health and contribute to the mental health gender gap. Emerging evidence including our own indicate that these disorders, linked to hormonal changes, may be influenced by genetic predisposition, chronic inflammation, and metabolic dysfunction. Our goals are to uncover new biomarkers, understand the biological underpinnings of women’s susceptibility to mood disorders, and improve strategies for diagnosis, prevention, and treatment. Utilizing data from three Nordic cohorts, the project will:1) integrate genomic, inflammatory proteomic, and metabolomic data to map RMDs’ molecular architecture
    2) identify functional and causal biomarkers through hormone-manipulated cell data and epidemiological methods
    3) predict clinical prognosis using multi-omics data and machine learning.By studying RMDs in concert, MoodMAP aims to reveal the biological basis of female vulnerability to mood disorders, employing advanced omics techniques and state-of-the-art design and analytic methods. The research team is experienced and interdisciplinary in nature, with specific milestones mapped out for each aim over five years. This project is poised to transform our understanding of RMDs, enhancing diagnostic and therapeutic approaches and ultimately addressing the gender gap in mental health.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2025 - 31 December 2027
    Research problem and specific questions: Approximately 4% of middle-aged women in Sweden have breast implants, the large majority (~80%) for cosmetic reasons. At the same time there are rising concerns for adverse health effects, including reports of multiple adverse symptoms (‘breast implant illness’) as well as some psychiatric- and autoimmune conditions among women with breast implants. Yet, comprehensive research efforts are still needed to determine if these risks are preexisting or caused by the procedure itself. Therefore, the aim of the BRISK study is to leverage unique Swedish population-based data sources to determine pre- and post- implant procedure risks of: 1) mental disorders and psychotropic drug use
    2) autoimmune and chronic fatigue conditions
    3) sick-leave and disability pension among women with cosmetic breast implants. Data and method: We will identify 28 835 women with cosmetic breast implants through the Breast Implant Register (BRIMP
    N=20 779 operated 2014-22) and ongoing mammography studies (N=8 056 with breast implants, identified 2008-21). By record linkage to the population-based Patient, Primary Care- and Prescription Medicines Registers, and Databases for Health Insurance and Labor Market, we will compare the rates of psychiatric- and autoimmune conditions as well as sick leave and disability pension among women with breast implants to that of their full sisters and an age- and region matched cohort of women (1:10 unexposed women). We will assess pre-surgery rates of these conditions and take them into account when assessing the post-surgery rates of the studied health outcomes.Societal relevance and utilization: Solid evidence on major health outcomes associated with breast implant surgery is currently lacking, leaving women considering this surgery option largely uninformed on long-term health effects. This comprehensive investigation will provide valuable information for health care policy and the growing population of women with breast implants. Plan for project realization:  We seek three years of funding for a post-doc, record linkages, database management and presentation of the results to stakeholders and the scientific community. Implementation of record linkages and preliminary analyses will be completed during the first year (2025), statistical analyses during the second year (2026), and publication of three scientific papers in leading international scientific journals by the end of the third year (2027).
  • Develop a comprehensive roadmap to address premature deaths shadowing reproductive mood disorders
    Karolinska Institutet KID
    1 January 2024 - 31 December 2027
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2024 - 31 December 2026
    Research problem and specific questionsSex/gender differences in mental health among adolescents and young adults (AYAs) are well documented. Yet, the driving forces are poorly understood. Premenstrual disorders (PMDs) are common yet under-investigated mental/behavioral conditions emerging during adolescence, with a significant psychosocial impact on young women. Our recent work based on cross-sectional data revealed that the higher prevalence rates of depression and anxiety in adolescent girls than boys did not emerge until menarche and were almost fully attributable to PMDs. However, prospective data are urgently needed to demonstrate the causal relations between PMDs and mental ill-health in young women, and subsequently the contribution to the sex disparities in AYAs mental health.Data and methodsLeveraging the nationwide Swedish register data and two large prospective cohorts (the LifeGene and CATSS), this proposal aims to develop a strategy roadmap for future interventions reducing mental health sex/gender disparities among AYAs through novel prevention programs for PMDs. Specifically, we aim to: 1) assess the association of PMDs and subsequent risks of depression and anxiety using population and sibling analyses
    2) quantify the mediating role of PMDs in the sex differences in mental health and suicidal behavior using mediation analysis
    and 3) determine modifiable childhood causal risk factors for PMDs using Mendelian randomization (MR) analysis.Plan for project realizationThe research team consists of multidisciplinary experts from epidemiology, OB/GYN, psychology/psychiatry, and genetics from Iceland, Sweden, and the US. The applicant has extensive experience in conducting cutting-edge studies on women´s mental health, particularly among AYAs, using registers and large population-based cohorts with advanced methods integrating omics data. One full-time PhD student and 70% of a postdoc will be financed to implement the projects over 3 years under the applicant´s supervision. RelevanceMental ill-health is the leading cause of disease burden among AYAs in Sweden and the sex/gender disparity is alarmingly concerning. However, very limited progress has been implemented so far. Through this program, we will fill an important knowledge gap in the contribution of PMDs to the sex/gender disparities in AYAs mental health, and provide innovative guidelines for future interventions targeted to reduce such disparities.
  • Prenatal antidepressant treatment: from maternal serum signature to fetal brain response to ADHD risk and resilience
    Karolinska Institutet Research Incubator Fellow Postdoc Project Grants with an Interdisciplinary Focus
    1 January 2024 - 31 December 2026
  • Reproductive mood disorders: a neglected determinant of sex/gender disparities in health
    Karolinska Institutet Strategic Research Area in Epidemiology and Biostatistics
    1 October 2023 - 31 December 2026
  • Swedish Research Council
    1 January 2021 - 31 December 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2021 - 31 December 2024
  • Swedish Research Council
    1 July 2018 - 31 December 2020

Employments

  • Senior Lecturer, Institute of Environmental Medicine, Karolinska Institutet, 2025-
  • Associate Professor (Docent), IMM, Karolinska Institutet, 2023-
  • Assistant Professor, Institute of Environmental Medicine, Karolinska Institutet, 2021-2025

Degrees and Education

  • Docent, Karolinska Institutet, 2023
  • Degree Of Doctor Of Philosophy, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 2017

Leadership and responsibility assignments

  • Research team leader, Research Group Leader, IMM, Karolinska Institutet, 2023-

Visiting research fellowships

  • Research Fellow, Harvard TH Chan School of Public Health, 2018-2022
  • Research Fellow, Harvard Medical School, 2018-2020
  • Postdoc Fellow, University of Iceland, 2017-2018

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