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Jansson, Lennart
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Publications (7 of 7) Show all publications
Nehlin, C. G., Grönbladh, L., Fredriksson, A. & Jansson, L. (2013). Alcohol and Drug Use, Smoking, and Gambling Among Psychiatric Outpatients: A 1-Year Prevalence Study. Substance Abuse, 34(2), 162-168
Open this publication in new window or tab >>Alcohol and Drug Use, Smoking, and Gambling Among Psychiatric Outpatients: A 1-Year Prevalence Study
2013 (English)In: Substance Abuse, ISSN 0889-7077, E-ISSN 1573-6733, Vol. 34, no 2, p. 162-168Article in journal (Refereed) Published
Abstract [en]

Background and Aims: Studies of alcohol habits in general psychiatric populations are scarce. The objective was to investigate alcohol and drug use, smoking, and gambling in a clinical sample of psychiatric outpatients. A further aim was to study age and gender differences in the rates of these habits. Methods: Data were collected among psychiatric outpatients with mainly mood (47%) and anxiety (35%) disorders. A questionnaire package was distributed, including AUDIT (Alcohol Use Disorders Identification Test), DUDIT (Drug Use Disorders Identification Test), tobacco items, and gambling items. Two major drinking categories were formed: Nonhazardous alcohol use (NH) and Alcohol use above hazardous levels (AH). Results: In total, 2160 patients (65% females) responded to the questionnaire package. The AH rate was high among psychiatric outpatients (28.4%), particularly among young females (46.6%). Young female patients also reported a high prevalence of problematic drug use (13.8%). Problematic drug use, daily smoking, and problematic gambling were frequent. The unhealthy habits were linked to AH. Conclusions: Alcohol and drug use, smoking, and gambling are all highly prevalent among psychiatric outpatients. Young females are in particular need of attention. Interventions should be tailored for co-occurring psychiatric disorders and applied within routine psychiatric care.

Keywords
Alcohol and drug use, smoking habits, gambling habits, psychiatric patients
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-200366 (URN)10.1080/08897077.2012.728991 (DOI)000317742700015 ()
Available from: 2013-05-27 Created: 2013-05-27 Last updated: 2017-12-06Bibliographically approved
Nehlin Gordh, C., Grönbladh, L., Fredriksson, A. & Jansson, L. (2012). Brief alcohol intervention in a psychiatric outpatient setting: A randomized controlled study. Addiction Science & Clinical Practice, 7(23)
Open this publication in new window or tab >>Brief alcohol intervention in a psychiatric outpatient setting: A randomized controlled study
2012 (English)In: Addiction Science & Clinical Practice, ISSN 1940-0640, Vol. 7, no 23Article in journal (Refereed) Published
Abstract [en]

Background:Although brief alcohol intervention (BI) is widely studied, studies from psychiatric outpatient settings are rare. The aim of this study was to investigate the effects of two variants of BI in psychiatric outpatients. By using clinical psychiatric staff to perform the interventions, we sought to collect information of the usefulness of BI in the clinical setting.

Methods: Psychiatric outpatients with Alcohol Use Disorders Identification Test (AUDIT) scores indicating hazardous or harmful drinking were invited to participate in the study. The outpatients were randomized to minimal (assessment, feedback, and an informational leaflet) or BI (personalized advice added). Measurements were performed at baseline and at six and 12 months after the intervention. The primary outcome was change in AUDIT score at the 12-month follow-up.

Results: In all, 150 patients were enrolled and received either a minimal intervention (n = 68) or BI (n = 82). At 12 months, there was a small reduction in AUDIT score in both groups, with no significant differences in outcome between groups. At 12-month follow-up, 21% of participants had improved from a hazardous AUDIT score level to a nonhazardous level, and 8% had improved from a harmful level to a hazardous level (8%).

Conclusions: Brief alcohol interventions may result in a reduction of AUDIT score to a small extent in psychiatric patients with hazardous or harmful alcohol use. Results suggest that BI may be of some value in the psychiatric outpatient setting. Still, more profound forms of alcohol interventions with risky-drinking psychiatric patients need elaboration.

Keywords
Brief intervention, alcohol intervention, hazardous alcohol use, harmful alcohol use, psychiatric outpatients
National Category
Medical and Health Sciences
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-179328 (URN)10.1186/1940-0640-7-23 (DOI)
Available from: 2012-08-13 Created: 2012-08-13 Last updated: 2013-03-14Bibliographically approved
Nehlin, C., Fredriksson, A. & Jansson, L. (2012). Brief alcohol screening in a clinical psychiatric population: Special attention needed. Drug and Alcohol Review, 31(4), 538-543
Open this publication in new window or tab >>Brief alcohol screening in a clinical psychiatric population: Special attention needed
2012 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 31, no 4, p. 538-543Article in journal (Refereed) Published
Abstract [en]

Introduction and aims: Abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) and single-item screeners show promising results but have not previously been investigated in a clinical psychiatric setting. The aim of the present study was to investigate the capacity of three brief screening methods to detect hazardous drinking in a psychiatric treatment-seeking population.

Design and methods: Data was collected from consecutive patients (n = 1811) visiting a general psychiatric clinic. The screening capacity of the Heavy Episodic Drinking (HED) screener, AUDIT item # 3 (AUDIT-3) and the three consumption items of AUDIT (AUDIT-C) was compared to the result of the full 10-item AUDIT with cut-off points 6 for females and 8 for males.

Results: The HED screener and AUDIT-3 with recommended cut-offs captured low rates of hazardous drinkers when compared to the full AUDIT. Lowering the cut-offs created rates far above those of the full AUDIT. AUDIT-C with recommended cut-off limits categorised nearly the same rates of males as the full AUDIT but much higher rates of females. Raising the cut-off for females approached the detection rate of AUDIT-C closely to that of the full AUDIT.

Discussion and conclusions:The findings of this study suggest that the HED screener is not sensitive enough in the clinical psychiatric setting. When designing alcohol screening measures to be used all over health care organisations, special attention should be paid to psychiatric patients. If a somewhat more extensive screening tool is used, the full AUDIT is recommended.

Keywords
alcohol screening method, psychiatric patient, hazardous alcohol use, assessment
National Category
Medical and Health Sciences
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-168843 (URN)10.1111/j.1465-3362.2011.00333.x (DOI)000304817800024 ()
Available from: 2012-02-16 Created: 2012-02-16 Last updated: 2017-12-07Bibliographically approved
Nehlin, C., Fredriksson, A., Grönbladh, L. & Jansson, L. (2012). Three hours of training improve psychiatric staff’s self-perceived knowledge and attitudes toward problem-drinking patients. Drug and Alcohol Review, 31(4), 544-549
Open this publication in new window or tab >>Three hours of training improve psychiatric staff’s self-perceived knowledge and attitudes toward problem-drinking patients
2012 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 31, no 4, p. 544-549Article in journal (Refereed) Published
Abstract [en]

Introduction and aims

Staff attitudes are an important factor in the successful implementation of systematic alcohol strategies and policies.  The forms and extent of training needed to improve therapeutic attitude among psychiatric staff to problem drinking are unclear. The aim of the investigation was to study the knowledge and attitudes of psychiatric staff toward problem drinking patients. A further aim was to investigate whether a short three-hour training is sufficient to improve knowledge and therapeutic attitude toward problem drinking.

Design and methods

A tailored training model for psychiatric staff (non-physicians) was carried out at a medium size university clinic. Participants were medical (nurses and psychiatric aides) and non-medical staff (psychologists and social workers). The training consisted of a two-hour workshop and a one-hour follow-up session. Knowledge and attitudes were measured at baseline and follow-up by a questionnaire including vignettes assessment and the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ).

Results

In total, 115 persons completed the questionnaire (follow-up rate 83.5 %). The distribution was even (50 % for the medical and 50 % for the non-medical staff). After training, the non-medical staff estimated vignette case severity higher than before. Both staff groups estimated their capacity to help a patient with complex problems higher after training. Role adequacy was higher in both subgroups after training.  Medical staff scored Work satisfaction higher after the training. 

Discussion and conclusions

Three hours of tailored training for psychiatric staff improve their knowledge and therapeutic attitude to problem drinking patients.

 

Keywords
training effect, staff attitude, psychiatric staff, alcohol training
National Category
Medical and Health Sciences
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-168846 (URN)10.1111/j.1465-3362.2011.00373.x (DOI)000304817800025 ()
Available from: 2012-02-16 Created: 2012-02-16 Last updated: 2017-12-07Bibliographically approved
Reinius, H., Jonsson, L., Gustafsson, S., Sundbom, M., Duvernoy, O., Pelosi, P., . . . Fredén, F. (2009). Prevention of atelectasis in morbidly obese patients during general anesthesia and paralysis: a computerized tomography study. Anesthesiology, 111(5), 979-987
Open this publication in new window or tab >>Prevention of atelectasis in morbidly obese patients during general anesthesia and paralysis: a computerized tomography study
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2009 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 111, no 5, p. 979-987Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Morbidly obese patients show impaired pulmonary function during anesthesia and paralysis, partly due to formation of atelectasis. This study analyzed the effect of general anesthesia and three different ventilatory strategies to reduce the amount of atelectasis and improve respiratory function. METHODS: Thirty patients (body mass index 45 +/- 4 kg/m) scheduled for gastric bypass surgery were prospectively randomized into three groups: (1) positive end-expiratory pressure of 10 cm H2O (PEEP), (2) a recruitment maneuver with 55 cm H2O for 10 s followed by zero end-expiratory pressure, (3) a recruitment maneuver followed by PEEP. Transverse lung computerized tomography scans and blood gas analysis were recorded: awake, 5 min after induction of anesthesia and paralysis at zero end-expiratory pressure, and 5 min and 20 min after intervention. In addition, spiral computerized tomography scans were performed at two occasions in 23 of the patients. RESULTS: After induction of anesthesia, atelectasis increased from 1 +/- 0.5% to 11 +/- 6% of total lung volume (P < 0.0001). End-expiratory lung volume decreased from 1,387 +/- 581 ml to 697 +/- 157 ml (P = 0.0014). A recruitment maneuver + PEEP reduced atelectasis to 3 +/- 4% (P = 0.0002), increased end-expiratory lung volume and increased Pao2/Fio2 from 266 +/- 70 mmHg to 412 +/- 99 mmHg (P < 0.0001). PEEP alone did not reduce the amount of atelectasis or improve oxygenation. A recruitment maneuver + zero end-expiratory pressure had a transient positive effect on respiratory function. All values are presented as mean +/- SD. CONCLUSIONS: A recruitment maneuver followed by PEEP reduced atelectasis and improved oxygenation in morbidly obese patients, whereas PEEP or a recruitment maneuver alone did not.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-113069 (URN)10.1097/ALN.0b013e3181b87edb (DOI)000271172500009 ()19809292 (PubMedID)
Available from: 2010-01-25 Created: 2010-01-25 Last updated: 2017-12-12Bibliographically approved
Lundin, T. & Jansson, L. (2007). Traumatic impact of a fire disaster on survivors: A 25-year follow-up of the 1978 hotel fire in Borås, Sweden. Nordic Journal of Psychiatry, 61(6), 479-485
Open this publication in new window or tab >>Traumatic impact of a fire disaster on survivors: A 25-year follow-up of the 1978 hotel fire in Borås, Sweden
2007 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 6, p. 479-485Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to investigate the long-term psychological and mental health outcomes among survivors of a disastrous hotel fire. A 25-year follow-up investigation among adolescent and young adult survivors of a fire disaster was conducted in Boras, Sweden. A self-evaluation questionnaire and four self-rating scales - the IES-22, PTSS-10, GHQ-28 and SoC - were sent by mail to the participants. The results from the self-reported data showed low levels of psychiatric illness. Moreover, the respondents reported a low level of traumatic stress symptoms. More than 50% of the participants stated that the fire had a determining effect on their lives. Sixteen (21.3%) respondents indicated that the fire still had an impact on their daily lives. Differences between men and women were reported in most of the self-rating scales. The results indicate that a traumatizing experience (such as a fire disaster) still had a small effect on psychological health in a long-term perspective.

Keywords
bereavement, fire disaster, follow-up study, post-traumatic stress disorder
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-14522 (URN)10.1080/08039480701773329 (DOI)000252768000012 ()18236316 (PubMedID)
Available from: 2008-01-30 Created: 2008-01-30 Last updated: 2017-12-11Bibliographically approved
Jansson, L., Wennström, E. & Wiesel, F.-A. (2005). The Need of Support and Service Questionnaire (NSSQ): a brief scale to assess needs in clients with long-term mental disabilities. Nordic Journal of Psychiatry, 59(6), 465-472
Open this publication in new window or tab >>The Need of Support and Service Questionnaire (NSSQ): a brief scale to assess needs in clients with long-term mental disabilities
2005 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, no 6, p. 465-472Article in journal (Refereed) Published
Abstract [en]

We present the Need of Support and Service Questionnaire (NSSQ), a new instrument developed to provide professionals in psychiatric care and community social services with a tool to assess needs of support and service in mentally disabled clients. The final version of the instrument was designed after comments from professionals in psychiatric care, community social services, and the clients and their relatives. A reliability study (test-retest, n=77), inter-rater (n=69) and a validity study (n=529) were performed. In the validity study, comparisons were done with the Camberwell Assessment of Need (CAN) scale, the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS). The test-retest and inter-rater reliability were 0.86 and 0.76, respectively. The percentage of agreement on the individual items ranged from 83.1% to 100.0% (test-retest) and 76.8% to 100.0% (inter-rater reliability). The corresponding kappa coefficients ranged from 0.63 to 1.00 (test-retest) and 0.33 to 1.00 (inter-rater reliability). The comparison between NSSQ and CAN items demonstrated high sensitivity and specificity as well as satisfactory likelihood ratios (LRs). The correlations between GAF and SOFAS scores and the number of needs of support, number of needs of service and the total number of needs of support and service were -0.49, -0.32 and -0.47, and -0.48, -0.26 and -0.45, respectively. All correlations were statistically significant (P<0.01). The results demonstrated that the psychometric characteristics of the NSSQ were satisfactory. Moreover, professionals without any formal training easily used it.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-92768 (URN)10.1080/08039480500360716 (DOI)16316899 (PubMedID)
Available from: 2005-03-30 Created: 2005-03-30 Last updated: 2017-12-14Bibliographically approved
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