What is Bipolar mood disorder? Bipolar disorders, formerly called manic depression, are brain disorders that cause unusual mood swings which include emotional highs (mania or hypomania) and lows (depression).

These mood swings can affect daily functioning, sleep, energy, activity, judgment, behaviour and the ability to think clearly.

Episodes of mood swings may occur rarely or multiple times a year.

Diagnosis:

There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, irritable, or energized behaviour (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes. People can experience both manic and depressive symptoms in the same episode. This kind of episode is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while, at the same, time feeling extremely energized.

Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during a woman’s pregnancy or following childbirth.
Definitions Manic episode:

A manic episode is a period of at least one week when a person is very high spirited or irritable in an extreme way most of the day for most days, has more energy than usual and experiences at least three of the following, showing a change in behaviour: The changes are significant and clear to friends and family. Symptoms are severe enough to cause dysfunction and problems with work, family or social activities and responsibilities. Symptoms of a manic episode may require a person to get hospital care to stay safe. The average age for a first manic episode is 18, but it can start anytime from early childhood to later adulthood.

Hypomanic episode:

A hypomanic episode is similar to a manic episode but the symptoms are less severe and need only last for four days in a row. Hypomanic symptoms do not lead to the major problems that mania often causes and the person is still able to function.

Major Depressive Episode:

A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
What causes BMD? Researchers are studying the possible causes of bipolar disorder. Most agree that there is no single cause and it is likely that many factors contribute to a person’s chance of having the illness.

Risk factors

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:
Complications Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
Co-occurring conditions If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:
Treatment Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a doctor is the first step.

Mental health care providers usually diagnose bipolar disorder based on a person’s symptoms, lifetime history, experiences, and, in some cases, family history. Accurate diagnosis in youth is particularly important.

Medications

Certain medications can help manage symptoms of bipolar disorder. Some people may need to try several different medications and work with their health care provider before finding medications that work best.

Medications generally used to treat bipolar disorder include mood stabilizers and second-generation (“atypical”) antipsychotics. Treatment plans may also include medications that target sleep or anxiety. Health care providers often prescribe antidepressant medication to treat depressive episodes in bipolar disorder, combining the antidepressant with a mood stabilizer to prevent triggering a manic episode.

People taking medication should: Avoid stopping a medication without talking to a health care provider first. Suddenly stopping a medication may lead to a “rebound” or worsening of bipolar disorder symptoms

Psychotherapy

Psychotherapy can be an effective part of the treatment plan for people with bipolar disorder. Psychotherapy is a term for a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behaviours. It can provide support, education, and guidance to people with bipolar disorder and their families.

Other Treatment Options

Some people may find other treatments helpful in managing their bipolar symptoms, including:
  1. Electroconvulsive Therapy (ECT): ECT is a brain stimulation procedure that can help people get relief from severe symptoms of bipolar disorder. With modern ECT, a person usually goes through a series of treatment sessions over several weeks. ECT is delivered under general anaesthesia and is safe. It can be effective in treating severe depressive and manic episodes, which occur most often when medication and psychotherapy are not effective or are not safe for a particular patient. ECT can also be effective when a rapid response is needed, as in the case of suicide risk or catatonia (a state of unresponsiveness).

  2. Regular Exercise: Regular aerobic exercise, such as jogging, brisk walking, swimming, or bicycling, helps with depression and anxiety, promotes better sleep, and is healthy for your heart and brain. There is also some evidence that anaerobic exercise such as weightlifting, yoga, and Pilates can be helpful. Check with your health care provider before you start a new exercise regimen.

  3. Keeping a Life Chart: Even with proper treatment, mood changes can occur. Treatment is more effective when a patient and health care provider work together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help patients and health care providers track and treat bipolar disorder over time. Patients can easily share data collected via smartphone apps – including self-reports, self- ratings, and activity data – with their health care providers and therapists.
When to get emergency help

Suicidal thoughts and behaviour are common among people with bipolar disorder. If you have thoughts of hurting yourself, call your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

Living with bipolar disorder can be challenging, but there are ways to help make it easier for yourself, a friend, or a loved one.
Prevention There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.

If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:
Alzheimer’s Disease Forgetting things is a normal part of getting older and something we will all experience. However, when forgetfulness starts to disrupt a person’s lifestyle or change their normal behaviour, it can sometimes be a symptom of Alzheimer’s disease (AD).

Receiving a diagnosis and experiencing the first symptoms of AD can be a distressing and difficult situation for both the person with the disease as well as for the carer. However, it is important to stay positive and realise that with proper information, treatment, planning and routines, living with AD can be manageable.

Alzheimer’s disease (AD) is a progressive illness that causes cell changes in the parts of the brain that deal with memory, language, perception and behaviour. Initial symptoms of AD include difficulty remembering, misplacing objects and a lack of concentration. Emotional symptoms such as moodiness, restlessness or depression are also common, and behavioural disturbances such as agitation and aggression can also become increasingly noticeable. Unlike the forgetfulness typical of old age, Alzheimer’s is a disease that can be diagnosed by a doctor using both physiological and cognitive tests, as well as brain imaging techniques.

As the disease progresses, the diagnosed person and his/her carer will find handling the activities of daily living more and more difficult. Having more information is essential for coping with the disease, as it will help to know what to expect and how to prepare for changes in lifestyle.

How common is AD?
Dementia is an umbrella term for a number of mental disorder that affects memory, thought processes and behaviour. AD is the most common type of dementia. Worldwide, around 50 million people have dementia, and there are nearly 10 million new cases every year.

What is the cause of AD?
The actual cause of AD has not yet been found. Current knowledge indicates that a progressive loss of brain cells is related to the formation of abnormal ‘plaques’ of insoluble protein fragments in and around the cells. Another characteristic sign of AD is the presence of ‘tangles’ within the brain cells, formed by abnormal twists of tau, a vital protein in healthy cells. Although these formations may be harmless by themselves, they may activate some kind of defence mechanism in the body that causes cell degeneration in the affected areas. In fact, it is highly likely that AD is not caused by any single factor, but by a number of factors that affect each person differently.

Dementia may be associated with Huntington’s disease, Parkinson’s disease or certain infectious diseases. Damage to the brain from physical trauma, metabolic disorders, or toxins may also influence development of the disease.

How does AD affect the brain?
Alzheimer’s disease causes cell damage in brain cells with eventual total loss of the affected cells. This damage occurs in parts of the brain that control memory, thought and language. It is a progressive disease, which means that as more brain cells become affected over time, more symptoms will appear.

Who is affected?
Getting older appears to be the most decisive cause of AD, but other factors such as gender and genes may also increase the risk of developing the disease. In the majority of cases (95%), the disease develops in people aged 65 years and older, which means that as people live longer and longer, the number of people with the disease will increase.

The disease occurs across ethnic groups, social class and gender, although it is slightly more common in women.

A small percentage of people develop the disease at an earlier age; between 35 and 60 years of age. With this ‘early-onset’ AD, there is thought to be a link with genetics, as cases tend to cluster within certain families.

Getting a diagnosis
AD is diagnosed by a doctor using both physiological and cognitive tests, as well as brain imaging techniques in certain cases. Symptoms for the different forms of dementia may be very similar to those of AD, so careful attention to symptoms described by family members will help to get an accurate diagnosis and early. During the diagnosis and afterwards, those involved will need both physical and emotional support from relatives and friends. Whether or not the final diagnosis is AD, getting a professional opinion and the treatment needed will help all involved to cope.

What changes will take place? Alzheimer’s disease affects people in different ways at different stages. The first symptoms that are usually noticed are memory loss and forgetfulness. As time goes on, other abilities may be affected which vary from person to person. From a clinical point of view, the symptoms of AD can be divided into three main categories:

Cognitive: Symptoms that affect the ability to understand, memory and language

Changes in cognition:
Often the first signs of AD, cognitive symptoms are those that affect non-emotional mental processes such as reasoning, memory and judgment. In the early stages, the person with the disease may be aware of a decline in their cognitive abilities, which can lead to depression and/or anxiety.

Cognitive symptoms include: The symptoms of Alzheimer’s will affect both the person diagnosed with AD and the people around them by posing challenges to everyday life. That’s why it’s important to seek and adhere to treatment as soon as possible and start to create ways of making life easier. The value of any improvement in symptoms will have a positive effect on quality of life for all concerned.

Behavioural: Symptoms that affect mood and behaviour

Changes in behaviour:
One of the most distressing aspects of AD for family and carers are the changes in behaviour, which occur as the disease affects different parts of the brain. When someone you love behaves in an unusual way or appears to change personality, it can be very difficult to come to terms with.

Behavioural symptoms include: Many of these behavioural changes will appear to affect the person’s overall personality, which can be particularly distressing for family and friends. Some people with the disease may eventually become very aggressive and appear unkind and accusatory. Often these symptoms can be relieved with treatment. It is essential to remember that it is the disease that is causing these changes; the person inside is still the same and is not behaving this way on purpose. Despite thesecomplicated symptoms, the ability to express feelings is often impaired in patients with AD. Someone with AD might still be able to share joy, anger, fear and most importantly love.

Functional: Symptoms that affect the ability to perform daily activities

Changes in ability to function:
AD will also cause difficulties in the way the person with the disease functions in terms of performing basic daily activities. Undertaking tasks such as personal grooming and household chores will therefore become increasingly demanding for the individual with AD, as a result, there will be an increased need for care.

Functional symptoms include: Some of these difficulties are associated with memory problems; the person might simply forget to take care of everyday practical tasks. There may also be a problem with understanding the order in which chores are performed. Over time, the disease may also affect the patient’s ability to move in a coordinated way and many daily activities may become physically awkward.
How is Alzheimer’s treated? There is currently no cure for Alzheimer’s disease. However, there are several treatments that can ease or slow the development of certain symptoms. Even small improvements in specific symptoms can have a great effect on the ability to undertake everyday activities. An early diagnosis means that treatment can be started as soon as possible, helping to improve the quality of everyday life for both the individual with the disease and those around them.

What are the medical treatments?

Medical treatment for AD falls into two main categories: How are these medical treatments taken?

These treatments are taken orally as tablets and can be easily taken every day at home. It is essential to stick to the prescribed dose and keep in contact with the doctor to get the best effects of treatment. As the person taking the medication may suffer from memory problems, it is important that someone else checks that the medication is being taken regularly and according to the instructions. A journal can help keep track of treatment given.

Getting the right dose

It is normal for a person to be started on a low dose of medication that is then gradually increased by their doctor until the required level or ‘maintenance dose’ is reached. A minimum period, during which cognitive, functional and behavioural status is monitored, should elapse before a decision regarding the efficacy of the treatment is made. Response to the treatment should not be judged on the basis of monitoring change in only one of the above domains, as symptoms vary from person to person, so does the response to these treatments.

What about alternative treatments?

Substances such as Ginkgo biloba and Vitamin E are thought by some people to have some value in treating AD. However, it is essential that all options are discussed with your doctor before taking any alternative medications, as there maybe interactions with the prescribed medicines.

Treating symptoms associated with AD

Other medical treatments may also be prescribed to alleviate symptoms associated with the disease such as anxiety and depression. These treatments may help by improving specific symptoms and helping to retain and/or increase the quality of life for the person with AD and carer.
What kind of care is needed? Initially, it may be possible for the person with AD to retain a fairly independent life. As time goes on and more symptoms develop, it may become necessary for another person to help with certain issues such as medication, financial matters and daily activities. Eventually the person with the disease may require full-time care, which will be difficult for one person to cope with.

The type of care will also change over time. Initially, the person may need assistance with remembering details such as names, dates, words, directions, and where things have been placed. Daily activities such as cooking, cleaning and shopping may also require assistance, as may washing and grooming. Changes in behaviour such as increased aggression or irritability can make caring more and more difficult. As symptoms progress the physical side of the illness becomes apparent and help may be needed with walking, toileting and other activities. At this point, outside help may be required. Eventually a residential home where the person with AD can receive around-the-clock care may be the best option.

Medical professionals and care workers can help identify what type of help is necessary and available for each individual situation and may be able to provide contact details. In addition, Alzheimer’s disease/Dementia associations and help-groups often offer this kind of information.

Providing care

Throughout the illness, the carer of the person with AD may face his or her own emotional and physical challenges as the disease symptoms progress. It may help to have some outside support; carers should try and recognise their own limits and feel able to ask for as much help as they need, in the form of home visits from professionals or respite care in a day centre or nursing home. Sharing problems, seeking advice and making time for individual needs will help the carer to manage the range of emotions that may accompany the task of caring.

What legal issues should be dealt with?

From a legal point of view, it is helpful if the person with AD and their family make arrangements such as a will, appointment of a power of attorney and other issues early on. This will ensure that the individual with the disease has as much authority over their future as possible, while they retain their independence.
Where can more information be found? Refer to the website under resources for important local contact information on organisations that have information about the disease and support groups as well as services available in your area. Across the globe, there are many associations that can help with information and support for those affected by Alzheimer’s disease. Alzheimer’s Disease International is an umbrella organisation of Alzheimer’s associations around the world.
What is depression? Depression is a severely disabling condition that has a profound effect on all aspects of a sufferer's life. In a World Health Organisation (WHO) report from 2015, the proportion of the global population with depression is estimated to be 4.4%. Suicide accounted for close to 1.5% of all deaths worldwide, bringing it into the top 20 leading causes of death. Suicide occurs throughout the lifespan and was the second leading cause of death amoung 15-29 year olds globally. In South Africa, the percentage of the population with depression and anxiety disorders, was 4.6%. Depression is ranked by the WHO as the single largest contributor to global disability (7.5% of all years lived with disability). Depression is also a major contributor to suicide deaths, which number close to 800 000 per year. 1

Prevalence rates vary by age, peaking in older adulthood (above 7.5% among females aged 55-74 years, and above 5.5% among males). Depression also occurs in children and adolescents below the age of 15 years, but at a lower level than older groups. 1

Depression impacts on the mood or feelings of affected persons: symptoms range in terms of their severity (from mild to severe) and duration (from months to years) These disorders are diagnosable health conditions, and are distinct from feelings of sadness, stress or fear that anyone can experience from time to time in their lives. Depression can be long lasting or recurrent, substantially impairing an individual's ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide 1. Depression is an illness that can seriously impair all aspects of a person's life, including personal relationships, performance at work and enjoyment of activities. 2

Cognitive dysfunction (impaired concentration, memory, decision making) is a common feature of depression that can be easily identified in patients with depression, but it often overlooked and may persist once other symptoms have resolved. Symptoms of cognitive dysfunction are predicative of poor outcome if they are not fully treated and are associated with marked effects on the patients work performance.
Symptoms
Diagnosis According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), five or more of the symptoms must be present during the same 2 week time period that represents changes in functioning. At least one symptom is either a depressed mood or loss of interest. 4
Treatment The best treatment for depression is usually a combination of pharmacotherapy and psychotherapy.
What can you expect Most people with moderate or severe depression benefit from antidepressants, but not everybody does. You may respond to 1 antidepressant but not to another, and you may need to try 2 or more treatments before you find one that works for you. When you start taking antidepressants, you should see your GP or specialist every week or 2 for at least 4 weeks to assess how well they're working. If they're working, you'll need to continue taking them for at least 6 months after your symptoms have eased. If you have had episodes of depression in the past, you may need to continue to take antidepressants for up to 5 years or more. Antidepressants are not addictive, but you may get some withdrawal symptoms if you stop taking them suddenly or you miss a dose. It's very important to take your antidepressants as prescribed, even if you start to feel better. If you stop taking them too soon, your depression could return. 5
What is schizophrenia? Schizophrenia is a brain illness that appears in many different forms involving thoughts, emotions, senses, behaviour and movement 1.

Schizophrenia is not a 'split/multiple personality' 3 , nor is it a result of a bad upbringing, weakness or laziness.

The illness begins in the late teens to mid-30's. Women have a slightly later onset (average age late-twenties) than men (early to mid-twenties) 1.

There are no racial or gender differences 1,3.
What causes schizophrenia? We don't know the exact cause of schizophrenia. It seems there are a number of factors that may combine to cause the illness 1.

These factors include:
What are the symptoms of schizophrenia? Some symptoms may come and go while others may always be there. They may also vary in severity over the course of the illness.

Positive symptoms 2: Negative symptoms 2:
How can I get help?
How can I stay well?
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When you sign up to receive the MySupport newsletter via the website (or on paper e.g. on a congress) we collect your name, email address, profession, country, zip code, place of practice. We will also register information on whether you consent to receive news letters from Lundbeck.

We process this personal data for the purpose of direct marketing, i.e. providing you with e-mail newsletters if you have consented to.

We ask you about your profession to ensure you are an HCP because the content of the e-mails (which contain solely non-promotional material) are most relevant for this segment and because local legislation and industry guidelines may require is to do so .

The legal basis is your consent.
When you use the MySupport website we collect personal data via cookies such as type of browser, your IP-address, including your network location and information about your computer. Necessary cookies: Necessary cookies help make a website usable by enabling basic functions like page navigation and access to secure areas of the website. The website cannot function properly without these cookies.
Functional cookies: Functional cookies enable a website to remember information that changes the way the website behaves or looks, like your preferred language or the region that you are in.
Statistics cookies: Statistic cookies help website owners to understand how visitors interact with websites by collecting and reporting information.
Marketing cookies: Marketing cookies are used to track visitors across websites. The intention is to display ads that are relevant and engaging for the individual user and thereby more valuable for publishers and third-party advertisers.
 
The legal basis is consent.
The legal basis for necessary cookies is Lundbeck's legitimate interest in providing the website and functionalities to users.
 

When we collect personal data directly from you when you sign up to receive the MySupport newsletter, you provide the personal data voluntarily. You are not obligated to provide the information to us. The consequences of not providing the personal data are that we cannot send you our newsletter.

When we collect personal data via cookies, the source is your device.

Recipients of personal data

Lundbeck uses data processors (IT service providers and hosting services) in relation to the website. These third party provides will be obligated to safeguard the confidentiality of your data and to take adequate technical and organizational measures to protect your data against accidental or unlawful destruction, loss or alteration, unauthorized disclosure or abuse, or other unlawful processing.

For cookies, please see our cookie policy for more information.

Storage of Data (Data Retention)

Lundbeck will keep your personal data only for as long as reasonably necessary for the purposes for which it was collected or received or to comply with any applicable legal or ethical reporting or document retention requirements.

Your rights as a data subject

Lundbeck has taken all necessary and adequate steps to protect your personal data and ensure your rights as a data subject.
You have certain rights described below. Please note that limitations may apply to your ability to exercise these rights, for example, when your right to obtain the information is found to be overwritten by essential considerations of private interests.

Right of access
You have the right to request access to the personal data Lundbeck processes about you.
Lundbeck must provide a copy of the personal data undergoing processing as a starting point free of charge or by electronic means, if the request has been submitted in a commonly used electronic form.

Right to rectification
You have the right to rectification of inaccurate personal data concerning you, including completion of incomplete personal data.
Right to erasure (right to be forgotten)
You have the right to the erasure of the personal data concerning you.

Right to restriction
You have the right to restrict Lundbeck's processing of personal data concerning you.

Right to data portability
Where processing is based on a consent or a contract and the processing is carried out by automated means, you have the right to receive the personal data concerning you in a structured, commonly used and machine-readable format. You have the right to transmit this personal data to a third party without hindrance from Lundbeck, if technically possible.

Object

You have the right to object, on grounds relating to your particular situation, at any time to processing of personal data concerning you which is based on legitimate interests as legal basis for the processing, including profiling based on this provision. Where you have exercised this right to object, Lundbeck must no longer process the personal data unless Lundbeck demonstrates compelling legitimate grounds for the processing, which override your interests, rights and freedoms, or if processing is necessary for the establishment, exercise or defence of legal claims.

Where your personal data are processed for direct marketing purposes, you have the right to object at any time to processing of personal data concerning you for such marketing, which includes profiling to the extent that it is related to such direct marketing. Where you object to processing for direct marketing purposes, Lundbeck must no longer process the personal data for such purposes.

If processing of your personal data is based on your consent, you may withdraw your consent at any time. Please note that this does not affect Lundbeck's processing of your personal data prior to the withdrawal of your consent.
If you want to exercise any of your rights as described above or have any question to that, please contact the Lundbeck Data Protection Officer (see contact information below)

Lundbeck Data Protection Officer

If you have any questions regarding Lundbeck processing of personal data, please contact the Lundbeck Data Protection Officer:

H. Lundbeck A/S
Attn: Data protection officer
Ottiliavej 9
2500 Valby
Denmark
 

Email address: dataprivacy@lundbeck.com

If you contact our Data Protection Officer, H. Lundbeck A/S will process the personal data you provide us with in your request with the purpose of processing and responding to your request. Please read our privacy notification regarding this processing activity on Lundbeck.com.

2. Direct communication

Any questions, comments, suggestions, etc. that you may forward or transmit via the website will - to the fullest extent permitted by applicable law - become and remain the property of Lundbeck and will be treated as non-confidential, non-proprietary information that Lundbeck may use at its own discretion.

3. Disclaimer of liability

Lundbeck ensures that reasonable care is being taken to ensure that the website content is accurate and up-to-date, but all information is provided ‘as is' and Lundbeck makes no warranties or representations of any kind as to accuracy, sequence, timeliness or completeness of the website content and may at any time at its sole discretion change or replace the information on the website and discontinue distributing the site without prior notice. The website may contain information on diseases and treatments: this information is intended for general guidance only and must never be a substitute for advice provided by a doctor or other qualified healthcare professional. To the extent permitted by mandatory law, Lundbeck shall not be liable for any direct, incidental, consequential, indirect or punitive damages arising out of access to or use of any content on this site, including viruses, regardless of the accuracy or completeness of any such content. If you suspect you have a health problem, we strongly recommend that you contact your physician.

4. Links to other websites

The website may contain links to third party websites. Lundbeck disclaims any control over, relationship with, or endorsement of these sites and shall not be liable for any damages or injuries arising from the content of such sites. Links to other websites are provided only as a convenience and Lundbeck encourages that you read these third party websites' Terms of Use and Privacy Statements.

5. Intellectual property rights

The content of the website is subject to copyright protection and other intellectual property rights. The company names, trade names, logos and all product names are trademarks owned by Lundbeck. Any misuse of these trademarks is expressly forbidden. The content of the website may not be copied other than for personal and non-commercial use, with all copyright or other proprietary notices retained. Except as expressly provided above, it is not permitted to copy, display, download, modify, reproduce or retransmit any information on this website without the express written consent of Lundbeck.

6. Children

This website is not intended or designed to attract children under the age of 18 years. We do not knowingly collect personally identifiable data from any person we know to be under the age of 18 years.

7. Governing law and venue

This disclaimer and the contents of this site shall be governed and interpreted by Danish law without regard to its conflict of law rules. Any dispute arising out of or in relation to this disclaimer shall, if it cannot be solved amicably, be decided exclusively by the Danish Courts in Copenhagen, Denmark.

8. Changes and questions

Any changes to this document will be communicated promptly on this page. If you have any further questions regarding this document or the website in general, please do not hesitate to contact us.

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