uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Ekselius, L
Alternative names
Publications (10 of 114) Show all publications
Folke, F., Hursti, T., Kanter, J. W., Arinell, H., Tungström, S., Söderberg, P. & Ekselius, L. (2018). Exploring the relationship between activities and emotional experience using a diary in a mental health inpatient setting.. International Journal of Mental Health Nursing, 27(1), 276-286
Open this publication in new window or tab >>Exploring the relationship between activities and emotional experience using a diary in a mental health inpatient setting.
Show others...
2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 276-286Article in journal (Refereed) Published
Abstract [en]

Mental health inpatient milieus have repeatedly been found to be associated with passivity, social disengagement, and low levels of interaction with staff. However, little is known about patients' experiences related to different ward activities. In the present study, we aimed to study the reports of activities and associated experiences of patients admitted to acute psychiatric inpatient wards. Disengaged, inactive, and solitary activities were hypothesized to be associated with less reward and more distress than their counterparts. We also aimed to investigate if such activities predicted distress, and if they were associated with clinical severity. Participants (n = 102) recorded their activities along with concurrent ratings of reward and distress in a structured 1-day diary, and nurses provided clinical severity ratings. On average, 3.74 of the 11 hours assessed (34%) were spent doing nothing, only 0.88 hours (8%) were spent with staff, and most of the time was spent in solitude. Doing nothing, being alone, and passivity were associated with the greatest levels of distress and lowest levels of reward, whereas informal socializing demonstrated the opposite pattern. Distress was not predicted by activity or reward when adjusting for baseline distress. Clinical severity was not associated with the amount of time spent alone or the experience of reward during activity. In conclusion, the risk for passivity and social disengagement during admission prevails. This activity pattern could have detrimental emotional consequences and warrants action, but more studies are needed to determine if activity actually precedes emotional experience.

Keywords
activity, diary, hospitalized, mental health inpatient, reward
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-330226 (URN)10.1111/inm.12318 (DOI)000419717100027 ()28220616 (PubMedID)
Available from: 2017-09-28 Created: 2017-09-28 Last updated: 2018-02-14Bibliographically approved
Tillman, K. K., Hakelius, M., Höijer, J., Ramklint, M., Ekselius, L., Nowinski, D. & Papadopoulos, F. (2018). Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts. Journal of the American Academy of Child and Adolescent Psychiatry, 57(11), 876-883
Open this publication in new window or tab >>Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts
Show others...
2018 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 57, no 11, p. 876-883Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Children with orofacial clefts (OFC) may have an increased risk of poor mental health. This study aimed to investigate the risk of psychiatric diagnoses in individuals with OFC, stratified by cleft type.

METHOD: A nationwide register-based cohort of all individuals born with nonsyndromic OFC in Sweden between 1973 and 2012 (n = 7,842) was compared to a matched cohort (n = 78,409) as well as to their unaffected siblings (n = 9,637). The risk of psychiatric diagnoses, suicide attempts, and suicides was examined by crude and adjusted Cox regression models. Effect modification by sex was investigated with interaction terms in the models.

RESULTS: Children with cleft lip (CL) had a significantly higher risk of any psychiatric disorder, intellectual disability, and language disorders; children with cleft lip and palate (CLP) had, in addition, an increased risk of autism spectrum disorder (ASD). Children with cleft palate only (CPO) had risk increases for the same diagnoses as children with CL and CLP, but with higher hazard ratios, and also for psychotic disorders, attention-deficit/hyperactivity disorder (ADHD), and other behavioral or emotional disorders in childhood. Sex stratification indicated higher risk increases among females in CL and CLP but not in CPO. Siblings without OFC were less likely to be diagnosed with any psychiatric disorder, intellectual disability, language disorder, ASD, or ADHD compared to their siblings with OFC.

CONCLUSION: Children with nonsyndromic clefts had a significantly higher risk of neurodevelopmental disorders. This risk is unlikely to be explained by familial influences such as inherited genetic or shared environmental factors.

Keywords
epidemiology, neurodevelopmental disorders, nonsyndromic clefts, psychiatric comorbidity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-368474 (URN)10.1016/j.jaac.2018.06.024 (DOI)000453802900013 ()30392629 (PubMedID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2019-01-16Bibliographically approved
Edvinsson, D. & Ekselius, L. (2018). Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A 6-Year Prospective Naturalistic Study. Journal of Clinical Psychopharmacology, 38(4), 370-375
Open this publication in new window or tab >>Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A 6-Year Prospective Naturalistic Study
2018 (English)In: Journal of Clinical Psychopharmacology, ISSN 0271-0749, E-ISSN 1533-712X, Vol. 38, no 4, p. 370-375Article in journal (Refereed) Published
Abstract [en]

Background: Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder typically treated with stimulants and atomoxetine. Data on long-term tolerability and safety of such pharmacological treatment in subjects diagnosed in adulthood are limited.

Methods: A cohort of adults diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria was followed-up on an average of 6 years after first evaluation. Of 168 adults, 112 (67%) who initiated medication were available for follow-up. Data were obtained from patient record data, self-report forms, and a telephone interview.

Results: Of the 112 participants assessed, 57 (51%) were still on treatment with methylphenidate (MPH) at follow-up and 55 (49%) had discontinued. The 3 leading reasons for discontinuing treatment with MPH were lack of effect (29%), elevated mood or hypomania (11%), and losing contact with the prescribing physician (9%). The most common adverse effects in subjects still on treatment with MPH were decreased appetite (28%), dry mouth (24%), anxiousness/restlessness and increased pulse frequency (19% each), decreased sexual desire (17%), and perspiration (15%). Subjects still on treatment reported increased quality of life, a higher level of functioning, and a greater understanding of their way of functioning from those being close compared with nonmedicated subjects.

Conclusions: The high attrition rate underscores the need for further research to identify possible modes to increase retention to treatment. Those diagnosed with ADHD and on long-term treatment with stimulants experience mild and tolerable adverse effects.

National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-327891 (URN)10.1097/JCP.0000000000000917 (DOI)000438053700016 ()29927781 (PubMedID)
Note

Title in dissertation reference list: Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder

Available from: 2017-08-11 Created: 2017-08-11 Last updated: 2018-09-24Bibliographically approved
Salberg, J., Folke, F., Ekselius, L. & Öster, C. (2018). Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences. International Journal of Mental Health Nursing, 27(5), 1401-1410
Open this publication in new window or tab >>Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences
2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 5, p. 1401-1410Article in journal (Refereed) Published
Abstract [en]

A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care.

Keywords
behavioural activation, evaluation, group intervention, mental health care, nursing
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:uu:diva-364165 (URN)10.1111/inm.12439 (DOI)000443391700009 ()29446512 (PubMedID)
Available from: 2018-10-29 Created: 2018-10-29 Last updated: 2018-11-16Bibliographically approved
Volgsten, H., Schmidt, L., Skoog Svanberg, A., Ekselius, L. & Sundström Poromaa, I. (2018). Psychiatric disorders in women and men up to five years after undergoing assisted reproductive technology treatment: a prospective cohort study. Human Fertility, 1-6
Open this publication in new window or tab >>Psychiatric disorders in women and men up to five years after undergoing assisted reproductive technology treatment: a prospective cohort study
Show others...
2018 (English)In: Human Fertility, ISSN 1464-7273, E-ISSN 1742-8149, p. 1-6Article in journal (Refereed) Epub ahead of print
Abstract [en]

This is a prospective cohort study with the objective to describe psychiatric disorders, such as any mood and anxiety disorders, in both women and men five years after assisted reproductive technology (ART). The Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), was used as the diagnostic tool to evaluate psychiatric disorders. Logistic regression analysis was used to calculate odds ratios (ORs) and confidence interval (CI) for factors associated with psychiatric disorders at the follow-up. Overall, 278 (63.3%) women and 183 (41.7%) men filled in and returned the questionnaire. Approximately 11.5% of women and 5.5% of men fulfilled the criteria for any psychiatric diagnosis. Of these, any mood disorder was present in 9.4% of women and 4.4% of men. The major risk factor for mood or anxiety disorders at follow-up was mood or anxiety disorders at the time of the index ART. Mood disorders were not more common in women who remained childless after ART. In conclusion, these findings indicate that psychiatric disorders at five years follow-up after ART are less common than at the baseline assessment in conjunction with the ART.

Keywords
Assisted reproductive technology, cohort study, depression, follow-up, infertility, psychiatric disorders
National Category
Psychiatry Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-351123 (URN)10.1080/14647273.2018.1474279 (DOI)29768933 (PubMedID)
Available from: 2018-05-19 Created: 2018-05-19 Last updated: 2018-09-12Bibliographically approved
Edvinsson, D. & Ekselius, L. (2018). Six-Year Outcome in Subjects Diagnosed with Attention-Deficit/Hyperactivity Disorder as Adults. European Archives of Psychiatry and Clinical Neuroscience, 268(4), 337-347
Open this publication in new window or tab >>Six-Year Outcome in Subjects Diagnosed with Attention-Deficit/Hyperactivity Disorder as Adults
2018 (English)In: European Archives of Psychiatry and Clinical Neuroscience, ISSN 0940-1334, E-ISSN 1433-8491, Vol. 268, no 4, p. 337-347Article in journal (Refereed) Published
Abstract [en]

There are very few studies on the long-term outcome in subjects diagnosed with ADHD as adults. The objective of the present study was to assess this and relate the outcome to whether there was current medication or not and to other potential predictors of favourable outcome. A prospective clinical cohort of adults diagnosed with ADHD according to DSM-IV criteria was followed-up on an average of 6 years after first evaluation (n = 124; mean age 42 years, 51% males). ADHD symptom trajectories were assessed as well as medication, global functioning, disability, health-related quality of life, and alcohol and drug consumption at follow-up. Ninety percent of those diagnosed were initially treated pharmacologically and half of them discontinued treatment. One-third reported remission, defined as not fulfilling any ADHD subtype and a GAF-value last year ≥ 70, which was not affected by comorbidity at baseline. Current medication was not associated with remission. Subjects evaluated and first diagnosed with ADHD as adults are functionally improved at follow-up 6 years later despite a high percentage of psychiatric comorbidity at baseline. Half dropped out of medication, and there was no difference in ADHD remission between subjects with on-going medication at follow-up or subjects without medication, although current medication was related to a higher degree of self-reported global improvement.

National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-327890 (URN)10.1007/s00406-017-0850-6. (DOI)000432412500003 ()29143159 (PubMedID)
Funder
Swedish Research Council
Available from: 2017-08-11 Created: 2017-08-11 Last updated: 2018-07-30Bibliographically approved
Kouros, I., Hörberg, N., Ekselius, L. & Ramklint, M. (2018). Wender Utah Rating Scale-25 (WURS-25): psychometric properties and diagnostic accuracy of the Swedish translation. Upsala Journal of Medical Sciences
Open this publication in new window or tab >>Wender Utah Rating Scale-25 (WURS-25): psychometric properties and diagnostic accuracy of the Swedish translation
2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967Article in journal (Refereed) Epub ahead of print
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-372661 (URN)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-08
Kask, J., Ramklint, M., Kolia, N., Panagiotakos, D., Ekbom, A., Ekselius, L. & Papadopoulos, F. C. (2017). Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients. Psychological Medicine, 47(8), 1489-1499
Open this publication in new window or tab >>Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients
Show others...
2017 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 47, no 8, p. 1489-1499Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Anorexia nervosa (AN) is a psychiatric disorder with high mortality.

METHOD: A retrospective register study of 609 males who received hospitalized care for AN in Sweden between 1973 and 2010 was performed. The standardized mortality ratios (SMRs) and Cox regression-derived hazard ratios (HRs) were calculated as measures of mortality. The incidence rate ratios (IRRs) were calculated to compare the mortality rates in patients with AN and controls both with and without psychiatric diagnoses.

RESULTS: The SMR for all causes of death was 4.1 [95% confidence interval (CI) 3.1-5.3]. For those patients with psychiatric co-morbidities, the SMR for all causes of death was 9.1 (95% CI 6.6-12.2), and for those without psychiatric co-morbidity, the SMR was 1.6 (95% CI 0.9-2.7). For the group of patients with alcohol use disorder, the SMR for natural causes of death was 11.5 (95% CI 5.0-22.7), and that for unnatural causes was 35.5 (95% CI 17.7-63.5). The HRs confirmed the increased mortality for AN patients with psychiatric co-morbidities, even after adjusting for confounders. The IRRs revealed no significant difference in mortality patterns between the AN patients with psychiatric co-morbidity and the controls with psychiatric diagnoses, with the exceptions of alcohol use disorder and neurotic, stress-related and somatoform disorders, which seemed to confer a negative synergistic effect on mortality.

CONCLUSION: Mortality in male AN patients was significantly elevated compared with the general population among only the patients with psychiatric co-morbidities. Specifically, the presence of alcohol and other substance use disorders was associated with more profound excess mortality.

Keywords
Anorexia nervosa, eating disorders, males
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-318530 (URN)10.1017/S0033291717000034 (DOI)000401293800014 ()28162109 (PubMedID)
Funder
Swedish Society of Medicine, SLS-253101 SLS-230421
Available from: 2017-03-25 Created: 2017-03-25 Last updated: 2018-09-17Bibliographically approved
Björkenstam, E., Ekselius, L., Burström, B., Kosidou, K. & Björkenstam, C. (2017). Association between childhood adversity and a diagnosis of personality disorder in young adulthood: a cohort study of 107,287 individuals in Stockholm County. European Journal of Epidemiology, 32(8), 721-731
Open this publication in new window or tab >>Association between childhood adversity and a diagnosis of personality disorder in young adulthood: a cohort study of 107,287 individuals in Stockholm County
Show others...
2017 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 32, no 8, p. 721-731Article in journal (Refereed) Published
Abstract [en]

Childhood adversity (CA) may increase the risk for later developing of personality disorder (PD). However, less is known about the association between cumulative CA and PD, and the role of childhood psychopathology and school performance. The current study examined the relationship between a range of CAs and a diagnosis of PD in young adulthood, and the roles of childhood psychopathology and school performance in this relationship. All individuals born in Stockholm County 1987-1991 (n = 107,287) constituted our cohort. Seven CAs were measured between birth and age 14: familial death, parental criminality, parental substance abuse and psychiatric morbidity, parental separation and/or single-parent household, household public assistance and residential instability. Individuals were followed from their 18th birthday until they were diagnosed with PD or until end of follow-up (December 31st 2011). Adjusted estimates of risk of PD were calculated as hazard ratios (HR) with 95% confidence intervals (CI). Associations were observed between cumulative CA and PD. During the follow-up 770 individuals (0.7%) were diagnosed with PD. Individuals exposed to 3+ CAs had the highest risks of being diagnosed with PD (HR 3.0, 95% CI 2.4-3.7). Childhood psychopathology and low school grades further increased the risk of PD among individuals exposed to CA. Cumulative CA is strongly associated with a diagnosis of PD in young adulthood. Our findings indicate that special attention should be given in schools and health services to children exposed to adversities to prevent decline in school performance, and to detect vulnerable individuals that may be on negative life-course trajectories.

Place, publisher, year, edition, pages
SPRINGER, 2017
Keywords
Childhood adversity, Personality disorder, Epidemiology, Cohort, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-335716 (URN)10.1007/s10654-017-0264-9 (DOI)000410179400009 ()28560537 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2017-12-11Bibliographically approved
Edvinsson, Å., Skalkidou, A., Hellgren, C., Gingnell, M., Ekselius, L., Willebrand, M. & Sundström Poromaa, I. (2017). Different patterns of attentional bias in antenatal and postpartum depression. Brain and Behavior, 7(11), Article ID e00844.
Open this publication in new window or tab >>Different patterns of attentional bias in antenatal and postpartum depression
Show others...
2017 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 7, no 11, article id e00844Article in journal (Refereed) Published
Abstract [en]

BackgroundBiased information processing in attention, memory, and interpretation is proposed to be central cognitive alterations in patients with major depressive disorder, but studies in women with peripartum depression are scarce. Because of the many similarities with depression in nonperipartum states as regards symptom profile and risk factors, we hypothesized that women with antenatal and postpartum depression would display attentional bias to negatively and positively valenced words. MethodsOne hundred and seventy-seven pregnant and 157 postpartum women were included. Among these, 40 suffered from antenatal depressive disorder and 33 from postpartum depressive disorder. An emotional Stroop task with neutral, positive, negative, and negatively valenced obstetric words was used. ResultsNo significant difference in emotional interference scores was noted between women with antenatal depression and nondepressed pregnant women. In contrast, women with postpartum depression displayed shorter reaction times to both positive (p=.028) and negative (p=.022) stimuli, compared with neutral words. Pregnant women on antidepressant treatment displayed longer reaction times to negatively valenced obstetric words in comparison with untreated depressed women (p=.012), and a trend toward greater interference in comparison with controls (p=.061). ConclusionsIn contrast with the hypothesis, we found no evidence of attentional bias to emotionally valenced stimuli in women with untreated peripartum depression. However, the shorter reaction times to emotional stimuli in women with postpartum depression may indicate emotional numbing, which in turn, is a functional impairment that may have repercussions for child development and well-being. Our findings emphasize the need to identify and treat women with postpartum depression at the earliest possible time point to ensure swift recovery and support for the family.

Keywords
antenatal depression, attentional bias, emotional Stroop, postpartum depression, pregnancy, women
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychiatry
Identifiers
urn:nbn:se:uu:diva-342913 (URN)10.1002/brb3.844 (DOI)000416063200009 ()29201545 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-12-05Bibliographically approved
Organisations

Search in DiVA

Show all publications