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Olsson, Gunilla
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Publications (10 of 12) Show all publications
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
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
Päären, A., Bohman, H., von Knorring, L., Olsson, G., von Knorring, A.-L. & Jonsson, U. (2014). Early risk factors for adult bipolar disorder in adolescents with mood disorders: A 15-year follow-up of a community sample. BMC Psychiatry, 14(1), 363
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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2014 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 14, no 1, p. 363-Article in journal (Refereed) Published
Abstract [en]

Background:  We aimed to outline the early risk factors for adult bipolar disorder (BPD) in adolescents with mood disorders.

Methods: Adolescents (16-17 years old) with mood disorders (n=287; 90 participants with hypomania spectrum episodes and 197 with major depressive disorder [MDD]) were identified from a community sample. Fifteen years later (at 30-33 years of age), mood episodes were assessed (n=194). The risk of developing BPD (n=22), compared with MDD (n=104) or no mood episodes in adulthood (n=68), was estimated via logistic regression. Adolescent mood symptoms, non-mood disorders, and family characteristics were assessed as potential risk factors.

Results: Among the adolescents with mood disorders, a family history of BPD was the strongest predictor of developing BPD compared with having no mood episodes in adulthood (OR=5.94; 95% CI=1.11-31.73), whereas disruptive disorders significantly increased the risk of developing BPD compared with developing MDD (OR=2.94; CI=1.06-8.12). The risk that adolescents with MDD would develop adult BPD, versus having no mood episodes in adulthood, was elevated among those with an early disruptive disorder (OR=3.62; CI=1.09-12.07) or multiple somatic symptoms (OR=6.60; CI=1.70-25.67). Only disruptive disorders significantly predicted adult BPD among adolescents with MDD versus continued MDD in adulthood (OR=3.59; CI=1.17-10.97). Only a few adolescents with hypomania spectrum episodes continued to have BPD as adults, and anxiety disorders appeared to increase this risk.

Conclusions: Although most of the identified potential risk factors are likely general predictors of continued mood disorders, disruptive disorders emerged as specific predictors of developing adult BPD among adolescents with MDD.

Keywords
adolescent mood disorders, bipolar disorder, predictors, long-term follow-up assessment
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-239832 (URN)10.1186/s12888-014-0363-z (DOI)000348156400001 ()25539591 (PubMedID)
Projects
adolescents with mood disorders: A 15-year follow-up of a community sample
Available from: 2015-01-02 Created: 2015-01-02 Last updated: 2017-12-05Bibliographically approved
Päären, A., Bohman, H., von Knorring, A.-L., von Knorring, L., Olsson, G. & Jonsson, U. (2014). Hypomania spectrum disorder in adolescence: a 15-year follow-up of non-mood morbidity in adulthood. BMC Psychiatry, 14, 9
Open this publication in new window or tab >>Hypomania spectrum disorder in adolescence: a 15-year follow-up of non-mood morbidity in adulthood
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2014 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 14, p. 9-Article in journal (Refereed) Published
Abstract [en]

Background:

We investigated whether adolescents with hypomania spectrum episodes have an excess risk of mental and physical morbidity in adulthood, as compared with adolescents exclusively reporting major depressive disorder (MDD) and controls without a history of adolescent mood disorders.

Methods:

A community sample of adolescents (N = 2 300) in the town of Uppsala, Sweden, was screened for depressive symptoms. Both participants with positive screening and matched controls (in total 631) were diagnostically interviewed. Ninety participants reported hypomania spectrum episodes (40 full-syndromal, 18 with brief episode, and 32 subsyndromal), while another 197 fulfilled the criteria for MDD without a history of a hypomania spectrum episode. A follow up after 15 years included a blinded diagnostic interview, a self-assessment of personality disorders, and national register data on prescription drugs and health services use. The participation rate at the follow-up interview was 71% (64/90) for the hypomania spectrum group, and 65.9% (130/197) for the MDD group. Multiple imputation was used to handle missing data.

Results:

The outcomes of the hypomania spectrum group and the MDD group were similar regarding subsequent non-mood Axis I disorders in adulthood (present in 53 vs. 57%). A personality disorder was reported by 29% of the hypomania spectrum group and by 20% of the MDD group, but a statistically significant difference was reached only for obsessive-compulsive personality disorder (24 vs. 14%). In both groups, the risk of Axis I disorders and personality disorders in adulthood correlated with continuation of mood disorder. Prescription drugs and health service use in adulthood was similar in the two groups. Compared with adolescents without mood disorders, both groups had a higher subsequent risk of psychiatric morbidity, used more mental health care, and received more psychotropic drugs.

Conclusions:

Although adolescents with hypomania spectrum episodes and adolescents with MDD do not differ substantially in health outcomes, both groups are at increased risk for subsequent mental health problems. Thus, it is important to identify and treat children and adolescents with mood disorders, and carefully follow the continuing course.

Keywords
Adolescence, Hypomania spectrum, Follow up, Comorbidity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-218944 (URN)10.1186/1471-244X-14-9 (DOI)000330075000002 ()
Available from: 2014-02-27 Created: 2014-02-20 Last updated: 2017-12-05Bibliographically approved
Päären, A., von Knorring, A.-L., Olsson, G., von Knorring, L., Bohman, H. & Jonsson, U. (2013). Hypomania spectrum disorders from adolescence to adulthood: A 15-year follow-up of a community sample. Journal of Affective Disorders, 145(2), 190-199
Open this publication in new window or tab >>Hypomania spectrum disorders from adolescence to adulthood: A 15-year follow-up of a community sample
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2013 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 145, no 2, p. 190-199Article in journal (Refereed) Published
Abstract [en]

Background: There is a lack of scientific knowledge about the broader spectrum of hypomania in adolescence and the course over time. To investigate this, we used longitudinal data spanning from adolescence to age 31 years.

Method: A community sample of adolescents (N=2300) was screened for depressive symptoms. Adolescents (16-17 years) with a positive screening and matched controls were interviewed with a structured diagnostic interview. A blinded follow-up assessment was conducted 15 years later, with a structured diagnostic interview covering the age span 19-31 years. Questions about treatment and family history were included.

Results: Ninety adolescents (16-17 years) with a lifetime hypomania spectrum episode (3.9% of the total sample) were identified: 40 with fullsyndromal, 18 with brief-episode (<4 day), and 32 with subsyndromal (1-2 main symptoms and 1-2 additional symptoms) hypomania. The hypomania symptoms reported by the fullsyndromal and the brief-episode groups were similar, whereas the subsyndromal group per definition reported fewer symptoms. Of the 90 adolescents with a hypomania spectrum episode, 64 (71%) participated in the follow-up interview. Mania in adulthood was reported by 2 (3%), hypomania by an additional 4 (6%), and major depression by 38 (59%). Incidence of mood episodes in adulthood did not differ between the subgroups of hypomania spectrum.

Limitations: 29% of the participants with hypomania spectrum were lost to follow-up.

Conclusion: The results indicate that only a small proportion of adolescents with hypomania spectrum episodes continue to have (hypo)mania in adulthood. Thus, maintenance or prophylactic treatment does not seem warranted for this group.

Keywords
Child and adolescent hypomania, Mood disorders, Long-term follow-up
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-196000 (URN)10.1016/j.jad.2012.07.031 (DOI)000314092100007 ()
Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2017-12-06Bibliographically approved
Kristjansdottir, J., Olsson, G. I., Sundelin, C. & Naessén, T. (2013). Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception: A descriptive study. European journal of contraception & reproductive health care, 18(5), 343-354
Open this publication in new window or tab >>Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception: A descriptive study
2013 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 5, p. 343-354Article in journal (Refereed) Published
Abstract [en]

Objectives To study seasonal variations in self-rated health and depressive symptoms in adolescent girls and possible differences in reported health with regard to use of medications. Method The SF-36 questionnaire was completed by 1250 girls with a mean age of 17 years, who visited a health centre in the course of one year. From January to July inclusive, depressive symptoms in 453 of the participants were also assessed using MADRS-S. Age and regular medication data were recorded. Results Significantly better mental health and less depressive symptoms were reported during the summer, than in winter months. Seasonality was more related to the SF-36 mental, than physical health subscales. Respondents treated with hormonal contraceptives (HCs) only and those not taking any medication scored better on several SF-36 subscales, than girls on antidepressives and other medications. Respondents taking HCs tended to report better physical health and less depressive symptoms on MADRS-S than those taking no medication. Conclusions Adolescent girls showed seasonal variations in self-reported health and depressive symptoms, with more symptoms during winter months. HC users tended to report better physical health and less depressive symptoms than those on no medication. The high prevalence of suspected depression during the winter months deserves attention.

Keywords
Adolescence, Depression, Mental health, Contraception, Quality of life
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-209461 (URN)10.3109/13625187.2013.821107 (DOI)000324618100004 ()
Available from: 2013-10-24 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved
Päären, A., von Knorring, L., Jonsson, U., Bohman, H., Olsson, G. & von Knorring, A.-L. (2012). Drug prescriptions of adults with adolescent depression in a community sample. Pharmacoepidemiology and Drug Safety, 21(2), 130-136
Open this publication in new window or tab >>Drug prescriptions of adults with adolescent depression in a community sample
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2012 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 21, no 2, p. 130-136Article in journal (Refereed) Published
Abstract [en]

Purpose

The prescription drugs have, to our knowledge, not been much studied in epidemiological samples with long-term follow-up. Accordingly, our purpose was to analyze the use of prescription drugs in adults with adolescent depression.

Methods

A population-based cohort of adolescents (n = 2465) was screened for the presence of depressive symptoms and diagnosed according to a structured interview. Totally, 362 individuals were identified as depressed and compared with 250 non-depressed controls. The prescription drugs were evaluated at the age of 29-31 years from a register kept by the National Health and Welfare Board.

Results

The formerly depressed females received significantly more prescription drugs, such as antidepressants, antiepileptics, antibacterials, antimycotics, and antihistamines for systemic use as well as other drugs, compared with controls (15.6 +/- 27.4 vs 8.2 +/- 7.4 recipes, p < 0.001). Formerly depressed males did not differ from controls regarding prescription drugs.

Conclusions

The females but not males with adolescent depression subsequently received more prescription drugs than non-depressed peers. Depressed female adolescents received more psychotropic and non-psychotropic drugs later in life compared to the non-depressed. This might be as a result of physical illnesses, different treatment-seeking behaviors, or somatizing reactions.

Keywords
adolescent depression, follow-up, prescription drugs
National Category
Medical and Health Sciences
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-169101 (URN)10.1002/pds.2120 (DOI)000299549600002 ()
Available from: 2012-02-27 Created: 2012-02-23 Last updated: 2017-12-07Bibliographically approved
Päären, A., Jonsson, U., von Knorring, A.-L., Olsson, G., Bohman, H. & von Knorring, L. (2012). Hypomania spectrum disorders from adolescence to adulthood: a 15-year follow-up of a community sample. Paper presented at 25th Congress of the European-College-of-Neuropsychopharmacology (ECNP), OCT 13-17, 2012, Vienna, AUSTRIA. European Neuropsychopharmacology, 22(S2), S277-S277
Open this publication in new window or tab >>Hypomania spectrum disorders from adolescence to adulthood: a 15-year follow-up of a community sample
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2012 (English)In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 22, no S2, p. S277-S277Article in journal, Meeting abstract (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-200869 (URN)10.1016/S0924-977X(12)70419-4 (DOI)000317948600310 ()
Conference
25th Congress of the European-College-of-Neuropsychopharmacology (ECNP), OCT 13-17, 2012, Vienna, AUSTRIA
Available from: 2013-06-04 Created: 2013-06-04 Last updated: 2017-12-06Bibliographically approved
Bohman, H., Jonsson, U., Päären, A., von Knorring, L., Olsson, G. & von Knorring, A.-L. (2012). Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers. BMC Psychiatry, 12, 90
Open this publication in new window or tab >>Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers
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2012 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 12, p. 90-Article in journal (Refereed) Published
Abstract [en]

Background

There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms.

Methods

The total population of 16–17-year-olds in Uppsala, Sweden, was screened for depression in 1991–1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later.

Results

Somatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders.

Conclusions

Somatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms.

Keywords
Adolescent depression, Long-term follow-up, Functional somatic symptoms, Anxiety and suicidal behavior
National Category
Psychiatry
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-180071 (URN)10.1186/1471-244x-12-90 (DOI)000308698500001 ()22839681 (PubMedID)
Projects
Långtidsuppföljning av deprimerade tonåringar
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2017-12-07Bibliographically approved
Bohman, H., Jonsson, U., Päären, A., von Knorring, A.-L., Olsson, G. & von Knorring, L. (2010). Long term follow up of adolescent depression: a population based study. Upsala Journal of Medical Sciences, 115(1), 21-29
Open this publication in new window or tab >>Long term follow up of adolescent depression: a population based study
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2010 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, no 1, p. 21-29Article in journal (Refereed) Published
Abstract [en]

Adolescent depression is common. Earlier studies indicate that relapses and recurrences are common. But many questions are still unanswered. The aim of the present study has been to follow subjects with adolescent depressions, identified in a population-based study, over a 15-year period. Subjects with adolescent depression (n = 362) and a comparison group (n = 250) were followed in the National Swedish registers.

The formerly depressed females had significantly more out-patient visits, and a significantly higher proportion (78.4% versus 69.6%) had at least one out-patient visit. Among the males, no significant differences were found as concerns out-patient visits. The formerly depressed females had significantly more in-patient stays (3.6 versus 2.4) and a significantly higher total number of in-patient days (27.4 versus 10.1). A significantly higher proportion had in-patient days due to mental disorders (9.5% versus 4.6%), in particular anxiety disorders (4.9% versus 1.0%). As concerns the males, a significantly higher proportion had in-patient days due to mental disorders (16.5% versus 1.8%), in particular alcohol and drug abuse (7.6% versus 0%).

Among the formerly depressed females there were no significant differences against the comparison group as concerns the proportion of being a mother, number of children per woman, or age at first child. However, a significantly higher proportion of the formerly depressed females had had different, usually mild, disorders related to pregnancy (8.6% versus 0.6%). The children of the women with adolescent depressions were not affected.

Keywords
adolescent depression, child-birth, health care, long-term follow-up, population-based sample, pregnancy
National Category
Basic Medicine Clinical Medicine
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-171046 (URN)10.3109/03009730903572057 (DOI)000275061700004 ()20095923 (PubMedID)
Available from: 2012-03-15 Created: 2012-03-15 Last updated: 2018-01-12Bibliographically approved
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