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Alaie, I., Philipson, A., Ssegonja, R., Hagberg, L., Feldman, I., Sampaio, F., . . . Jonsson, U. (2019). Uppsala Longitudinal Adolescent Depression Study (ULADS). BMJ Open, 9(3), Article ID e024939.
Open this publication in new window or tab >>Uppsala Longitudinal Adolescent Depression Study (ULADS)
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 3, article id e024939Article in journal (Refereed) Published
Abstract [en]

Purpose: To present the Uppsala Longitudinal Adolescent Depression Study, initiated in Uppsala, Sweden, in the early 1990s. The initial aim of this epidemiological investigation was to study the prevalence, characteristics and correlates of adolescent depression, and has subsequently expanded to include a broad range of social, economic and health-related long-term outcomes and cost-of-illness analyses.

Participants: The source population was first-year students (aged 16-17) in upper-secondary schools in Uppsala during 1991-1992, of which 2300 (93%) were screened for depression. Adolescents with positive screening and sex/age-matched peers were invited to a comprehensive assessment. A total of 631 adolescents (78% females) completed this assessment, and 409 subsequently completed a 15year follow-up assessment. At both occasions, extensive information was collected on mental disorders, personality and psychosocial situation. Detailed social, economic and health-related data from 1993 onwards have recently been obtained from the Swedish national registries for 576 of the original participants and an age-matched reference population (N=200 000).

Findings to date: The adolescent lifetime prevalence of a major depressive episode was estimated to be 11.4%. Recurrence in young adulthood was reported by the majority, with a particularly poor prognosis for those with a persistent depressive disorder or multiple somatic symptoms. Adolescent depression was also associated with an increased risk of other adversities in adulthood, including additional mental health conditions, low educational attainment and problems related to intimate relationships.

Future plans: Longitudinal studies of adolescent depression are rare and must be responsibly managed and utilised. We therefore intend to follow the cohort continuously by means of registries. Currently, the participants are approaching mid-adulthood. At this stage, we are focusing on the overall long-term burden of adolescent depression. For this purpose, the research group has incorporated expertise in health economics. We would also welcome extended collaboration with researchers managing similar datasets.

National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-389609 (URN)10.1136/bmjopen-2018-024939 (DOI)000471144900167 ()30826765 (PubMedID)
Funder
Swedish Research Council, 2014-10092Forte, Swedish Research Council for Health, Working Life and WelfareStiftelsen Söderström - Königska sjukhemmet
Available from: 2019-07-22 Created: 2019-07-22 Last updated: 2019-07-22Bibliographically approved
Motilla Hoppe, J., Frick, A., Åhs, F., Linnman, C., Appel, L., Jonasson, M., . . . Furmark, T. (2018). Association between amygdala neurokinin-1 receptor availability and anxiety-related personality traits. Translational Psychiatry, 8(1), 168
Open this publication in new window or tab >>Association between amygdala neurokinin-1 receptor availability and anxiety-related personality traits
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2018 (English)In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 8, no 1, p. 168-Article in journal (Refereed) Published
Abstract [en]

Animal studies indicate that substance P (SP) and its preferred neurokinin-1 (NK1) receptor modulate stress and anxiety-related behavior. Alterations in the SP-NK1 system have also been observed in human anxiety disorders, yet little is known about the relation between this system and individual differences in personality traits associated with anxiety propensity and approach-avoidance behavior, including trait anxiety, neuroticism, and extraversion. Exploring this relation could provide important insights into the neurobiological underpinnings of human anxiety and the etiology of anxiety disorders, as anxious traits are associated with increased susceptibility to develop psychopathological conditions. Here we examined the relationship between central NK1 receptor availability and self-rated measures of trait anxiety, neuroticism, and extraversion. The amygdala was chosen as the primary region of interest since this structure has been suggested to mediate the effect of the SP-NK1 system on anxiety. Anxious traits and NK1 receptor availability, determined with positron emission tomography and the radiotracer [11C]GR205171, were measured in 17 healthy individuals. Voxel-wise analyses showed a significant positive correlation between bilateral amygdala NK1 receptor availability and trait anxiety, and a trend in similar direction was observed for neuroticism. Conversely, extraversion was found to be negatively associated with amygdala NK1 receptor availability. Extraversion also correlated negatively with the NK1 measure in the cuneus/precuneus and fusiform gyrus according to exploratory whole-brain analyses. In conclusion, our findings indicate that amygdala NK1 receptor availability is associated with anxiety-related personality traits in healthy subjects, consistent with a modulatory role for the SP-NK1 system in human anxiety.

National Category
Pedagogy
Identifiers
urn:nbn:se:uu:diva-358759 (URN)10.1038/s41398-018-0163-1 (DOI)000443079700001 ()
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-12-10Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2017). Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage and treatment effects of anxiety-, depression and insomnia symptoms. European Journal of Integrative Medicine, 16, 15-21
Open this publication in new window or tab >>Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage and treatment effects of anxiety-, depression and insomnia symptoms
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2017 (English)In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 16, p. 15-21Article in journal (Refereed) Published
Abstract [en]

Introduction: The interest in non-pharmacological interventions for insomnia disorder has increased. The aim was to assess the immediate treatment effects of auricular acupuncture (AA) and cognitive behavioural therapy for insomnia (CBT-i) regarding discontinuation of hypnotic usage and symptoms of anxiety, depression and insomnia.

Method: Prospective randomised controlled study. Fifty-seven participants (mean age 61 years (SD 8.6)) with insomnia disorder and long-term use of non-benzodiazepine hypnotics received group-treatment with AA or CBT-i. Pre- and post-treatment measures included symptoms of anxiety, depression and insomnia via self-report questionnaires: Hospital Anxiety and Depression scale (HAD-A, HAD-D) and Insomnia Severity Index (ISI). Other sleep parameters and hypnotic consumption were measured with a sleep diary. Linear mixed models were performed to examine treatment effect over time within and between the groups.

Results: Seventy-one percent of the AA participants and 84% of the CBT-i participants managed to discontinue their hypnotic drug consumption post-treatment. Symptoms of anxiety and depression decreased within the AA group (HAD-A (p < 0.05), HAD-D (p < 0.05)) and insomnia symptoms decreased within the CBT-i group (ISI (p < 0.001)). The only between-group difference occurred in ISI (p < 0.001), in favour of CBT-i. According to the within-group sleep diary results, the CBT-i group went to bed later (p < 0.001), fell asleep quicker (p < 0.05), increased their sleep efficiency (p < 0.001) and self-rated sleep quality (p < 0.05) post-treatment.

Conclusions: Both groups ended/maintained low hypnotic drug consumption post-treatment. Short-term reductions occurred in the AA group in anxiety and depression symptoms and in the CBT-i group regarding insomnia symptoms.

Keywords
Auricular acupuncture, Cognitive behavioural therapy, Hypnotic consumption, Anxiety Insomnia Depression
National Category
Medical and Health Sciences Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-319923 (URN)10.1016/j.eujim.2017.10.002 (DOI)000417392500003 ()
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2018-03-08Bibliographically approved
Päären, A., Bohman, H., von Knorring, L., Olsson, G., von Knorring, A.-L. & Jonsson, U. (2017). Early risk factors for adult bipolar disorder in adolescents with mood disorders: a 15-year follow-up of a community sample. Paper presented at 19th Annual Conference of the International-Society-for-Bipolar-Disorders, MAY 04-07, 2017, Washington, DC. Bipolar Disorders, 19(S1), 63-63
Open this publication in new window or tab >>Early risk factors for adult bipolar disorder in adolescents with mood disorders: a 15-year follow-up of a community sample
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2017 (English)In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 19, no S1, p. 63-63Article in journal, Meeting abstract (Other academic) Published
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-331816 (URN)10.1111/bdi.12479 (DOI)000401266200142 ()
Conference
19th Annual Conference of the International-Society-for-Bipolar-Disorders, MAY 04-07, 2017, Washington, DC
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-10-18Bibliographically approved
Holm, J., Brus, O., Båve, U., Landen, M., Lundberg, J., Nordanskog, P., . . . Nordenskjöld, A. (2017). Improvement of cycloid psychosis following electroconvulsive therapy. Nordic Journal of Psychiatry, 71(6), 405-410
Open this publication in new window or tab >>Improvement of cycloid psychosis following electroconvulsive therapy
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2017 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 71, no 6, p. 405-410Article in journal (Refereed) Published
Abstract [en]

Background: The treatment of choice for cycloid psychosis has traditionally been electroconvulsive therapy (ECT), but there is a lack of studies on its effectiveness.

Aims: The primary aim of this register study was to determine the rates of remission and response after ECT for cycloid psychosis. The secondary aim was to examine possible predictors of outcome.

Methods: Data were obtained from the National Quality Register for ECT in Sweden. The study population was patients (n=42) who received ECT for acute polymorphic psychotic disorder without symptoms of schizophrenia or for cycloid psychosis between 2011-2015 in 13 hospitals. Remission and response rates were calculated using Clinical Global Impression-Severity (CGI-S) and -Improvement scores, respectively. Variables with possible predictive value were tested using Chi-square and Fisher's exact test.

Results: The response rate was 90.5%. The remission rate was 45.2%. Of 42 patients, 40 improved their CGI-S score after ECT (p<0.001). The mean number of ECT treatments was 2.5 for non-responders and 7.0 for responders (p=0.010). The mean number of ECT treatments did not differ significantly between remitters and non-remitters (7.2 vs 6.1, p=0.31). None of the other investigated potential predictors was statistically significantly associated with outcome.

Conclusions: ECT is an effective treatment for cycloid psychosis. Future studies need to compare the outcome of ECT to that of other treatment strategies. Clinical implications: The high response rate with ECT indicates that cycloid psychosis is a clinically useful diagnosis.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2017
Keywords
Cycloid psychosis, electroconvulsive therapy, treatment outcome, acute polymorphic disorder without symptoms of schizophrenia
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-333426 (URN)10.1080/08039488.2017.1306579 (DOI)000406723800001 ()28367711 (PubMedID)
Funder
Swedish Research Council, 523-2013-2982Swedish Foundation for Strategic Research , KF10-0039
Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2017-11-13Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2017). Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia. Complementary Therapies in Clinical Practice, 28, 220-226
Open this publication in new window or tab >>Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia
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2017 (English)In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 28, p. 220-226Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to objectively examine how sleep patterns were affected in a short- and long-term perspective after auricular acupuncture (AA) and cognitive behavioral therapy for insomnia (CBT-i). Sixty participants with insomnia disorders (men/women 9/51; mean age of 60.5 years, (SD 9.4)), were randomized to group treatment with AA or CBT-i. Actigraphy recordings were made at baseline, post-treatment and 6-month follow-up. The CBT-i group reduced their time in bed, their actual sleeping time, their sleep latency and their actual time awake. The AA group slept longer, increased their time in bed and decreased their sleep latency post-treatment. The between-groups results differed in wake-up time, rising, time in bed, actual sleep time and actual wake time. The differences were not maintained six months later. In accordance with previous findings the results support the notion that the objective sleep time does not necessarily affect the subjective perception of insomnia.

Keywords
Actigraphy, Auricular acupuncture, Cognitive-behavioral therapy, Insomnia disorder, Non-pharmacological, Treatment
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-320044 (URN)10.1016/j.ctcp.2017.06.006 (DOI)000407722900030 ()28779933 (PubMedID)
Funder
Ekhaga Foundation, 2011 59
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2017-11-21Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2016). A randomised controlled trial of auricular acupuncture and cognitive behavioural therapy for insomnia: a short-term self-assessment. Paper presented at 23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY. Journal of Sleep Research, 25, 213-213
Open this publication in new window or tab >>A randomised controlled trial of auricular acupuncture and cognitive behavioural therapy for insomnia: a short-term self-assessment
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2016 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 213-213Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-309494 (URN)000383445201008 ()
Conference
23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY
Available from: 2016-12-05 Created: 2016-12-05 Last updated: 2017-04-18Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2016). Auricular acupuncture and cognitive behavioural therapy for insomnia - a randomised controlled study. Paper presented at 23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY. Journal of Sleep Research, 25, 214-214
Open this publication in new window or tab >>Auricular acupuncture and cognitive behavioural therapy for insomnia - a randomised controlled study
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2016 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 214-214Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-309495 (URN)000383445201011 ()
Conference
23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY
Available from: 2016-12-05 Created: 2016-12-05 Last updated: 2017-04-18Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2016). Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia: A Randomised Controlled Study. Sleep Disorders, 2016, Article ID 7057282.
Open this publication in new window or tab >>Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia: A Randomised Controlled Study
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2016 (English)In: Sleep Disorders, ISSN 2090-3545, E-ISSN 2090-3553, Vol. 2016, article id 7057282Article in journal (Refereed) Published
Abstract [en]

Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i). However CBT-i may not suit everyone. Auricular acupuncture (AA) is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4), with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression scale (HAD), were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2016
Keywords
non-pharmacological, sleep disorder, treatment, auricular acupuncture, cognitive-behavioural therapy, insomnia
National Category
Medical and Health Sciences Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-292961 (URN)10.1155/2016/7057282 (DOI)
Funder
Ekhaga Foundation, 2011 59
Available from: 2016-05-11 Created: 2016-05-11 Last updated: 2017-11-30Bibliographically approved
Danielsson, K., Markström, A., Broman, J.-E., von Knorring, L. & Jansson-Fröjmark, M. (2016). Delayed sleep phase disorder in a Swedish cohort of adolescents and young adults: Prevalence and associated factors. Chronobiology International, 33(10), 1331-1339
Open this publication in new window or tab >>Delayed sleep phase disorder in a Swedish cohort of adolescents and young adults: Prevalence and associated factors
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2016 (English)In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, no 10, p. 1331-1339Article in journal (Refereed) Published
Abstract [en]

A delayed sleep-wake and circadian rhythm often occurs during puberty. While some individuals only develop a delayed sleep phase (DSP), others will fulfill the criteria for the diagnosis of delayed sleep phase disorder (DSPD). All previous studies have however not separated DSP from DSPD, and, as a result, the prevalence and associated factors are largely unknown for the two conditions individually. We estimated the prevalence of DSP and DSPD in a Swedish cohort of adolescents and young adults. We also investigated associated factors in the two conditions relative to each other and individuals with no delayed sleep phase. A questionnaire regarding sleep patterns, demographics, substance use/abuse, and symptoms of depression, anxiety, worry, and rumination was sent to 1000 randomly selected participants (16–26 years of age) in Uppsala, Sweden (response rate = 68%). DSP was defined as a late sleep onset and a preferred late wake up time. The DSPD diagnosis was further operationalized according to the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5) criteria including insomnia or excessive sleepiness, distress or dysfunction caused by the delayed sleep phase and that the sleep problem had been evident for 3 months. DSP occurred at a frequency of 4.6% and DSPD at a frequency of 4% in the investigated cohort. DSP was more common in males and was associated with not attending educational activity or work, having shift work, nicotine and alcohol use and less rumination. DSPD was equally common in males and females and was associated with not attending educational activity or work and with elevated levels of anxiety. Both DSP and DSPD appear to be common in adolescents and young adults in this Swedish cohort. No educational activity or work was associated with both DSP and DSPD. However, there were also apparent differences between the two groups in shift work, substance use and mental health, relative to persons with no delayed sleep phase. Thus, it seems reasonable to assess DSP and DSPD as distinct entities in future studies.

Keywords
delayed sleep phase, delayed sleep phase disorder, associated factors, occupational status, shift work, substance use/abuse.
National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-298762 (URN)10.1080/07420528.2016.1217002 (DOI)000388746800003 ()27537980 (PubMedID)
Available from: 2016-07-28 Created: 2016-07-07 Last updated: 2018-01-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9984-1691

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