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Alaie, Iman
Publications (10 of 18) Show all publications
Ssegonja, R., Alaie, I., Philipson, A., Hagberg, L., Sampaio, F., Möller, M., . . . Feldman, I. (2019). Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood: A longitudinal cost-of-illness study. Journal of Affective Disorders, 258, 33-41
Open this publication in new window or tab >>Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood: A longitudinal cost-of-illness study
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2019 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 258, p. 33-41Article in journal (Refereed) Published
Abstract [en]

Background: Depression in adolescence is associated with increased healthcare consumption in adulthood, but prior research has not recognized the heterogeneity of depressive disorders. This paper investigated the additional healthcare usage and related costs in mid-adulthood for individuals with adolescent depression, and examined the mediating role of subsequent depression in early adulthood.

Methods: This study was based on the Uppsala Longitudinal Adolescent Depression Study, initiated in Sweden in the early 1990s. Depressive disorders were assessed in adolescence (age 16-17) and early adulthood (age 19-30). Healthcare usage and related costs in mid-adulthood (age 31-40) were estimated using nationwide population-based registries. Participants with specific subtypes of adolescent depression (n = 306) were compared with matched non-depressed peers (n = 213).

Results: Women with persistent depressive disorder (PDD) in adolescence utilized significantly more healthcare resources in mid-adulthood. The association was not limited to psychiatric care, and remained after adjustment for individual and parental characteristics. The total additional annual cost for a single age group of females with a history of PDD at a population level was estimated at 3.10 million USD. Depression recurrence in early adulthood mediated the added costs for psychiatric care, but not for somatic care.

Limitations: Primary health care data were not available, presumably resulting in an underestimation of the true healthcare consumption. Estimates for males had limited precision due to a relatively small male proportion.

Conclusions: On a population level, the additional healthcare costs incurred in mid-adulthood in females with a history of adolescent PDD are considerable. Early treatment and prevention should be prioritized.

Place, publisher, year, edition, pages
ELSEVIER, 2019
Keywords
Adolescence, Depression, Direct costs, Adulthood, Psychiatric healthcare, Non-psychiatric healthcare
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-393715 (URN)10.1016/j.jad.2019.07.077 (DOI)000482176400004 ()31382102 (PubMedID)
Funder
Swedish Research Council, 2014-10092Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council FormasVinnova
Available from: 2019-09-30 Created: 2019-09-30 Last updated: 2019-09-30Bibliographically approved
Alaie, I., Låftman, S. B., Jonsson, U. & Bohman, H. (2019). Parent-youth conflict as a predictor of depression in adulthood: a 15-year follow-up of a community-based cohort.. European Child and Adolescent Psychiatry
Open this publication in new window or tab >>Parent-youth conflict as a predictor of depression in adulthood: a 15-year follow-up of a community-based cohort.
2019 (English)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Experiencing conflictual relations with one's parents while growing up has been linked to onset, recurrence, and worse treatment outcome of adolescent depression. While this suggests that significant problems in the parent-youth relationship make depressive disorders more relentless, it is not clear whether this effect lasts into adulthood. Our aim was to examine if major and minor conflict with parents while growing up predicts depression in adulthood in youth with and without a history of depression. We utilized data from the Uppsala Longitudinal Adolescent Depression Study. This community-based cohort was assessed with structured diagnostic interviews both at age 16-17 and at follow-up 15 years later. The analyses included 382 individuals (227 with a history of child or adolescent depression; 155 peers without such a history). Binary logistic regression was used, adjusting for sex, disruptive behavior disorders, and additional family-related adversities. Among individuals with adolescent depression, major conflict with parents was strongly associated with adult depression (adjusted OR 2.28, 95% CI 1.07-4.87). While major conflict with parents was rare among non-depressed controls, a non-significant association of similar magnitude was still observed. Minor conflict, on the other hand, was not significantly associated with adult depression. Overall, conflict with parents did not predict adult anxiety disorders, substance use, suicidal behavior, somatoform disorders, or psychotic disorders. In conclusion, major parent-youth conflict during upbringing seems to be linked with an increased risk of depression in adulthood. These findings underscore the need to consider contextual/familial factors in the prevention and clinical management of early-life depression.

Keywords
Adolescent depression, Adulthood, Cohort study, Epidemiology, Family conflict, Longitudinal design
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-396745 (URN)10.1007/s00787-019-01368-8 (DOI)31302772 (PubMedID)
Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-08
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
Jonsson, U., Alaie, I., Löfgren Wilteus, A., Zander, E., Marschik, P. B., Coghill, D. & Bölte, S. (2017). Annual Research Review: Quality of life and childhood mental and behavioural disorders - a critical review of the research.. Journal of Child Psychology and Psychiatry and Allied Disciplines, 58(4), 439-469
Open this publication in new window or tab >>Annual Research Review: Quality of life and childhood mental and behavioural disorders - a critical review of the research.
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2017 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 58, no 4, p. 439-469Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: An individual's subjective perception of well-being is increasingly recognized as an essential complement to clinical symptomatology and functional impairment in children's mental health. Measurement of quality of life (QoL) has the potential to give due weight to the child's perspective.

SCOPE AND METHODOLOGY: Our aim was to critically review the current evidence on how childhood mental disorders affect QoL. First, the major challenges in this research field are outlined. Then we present a systematic review of QoL in children and adolescents aged 0-18 years formally diagnosed with a mental and behavioural disorder, as compared to healthy or typically developing children or children with other health conditions. Finally, we discuss limitations of the current evidence base and future directions based on the results of the systematic review and other relevant literature.

FINDINGS AND CONCLUSIONS: The systematic review identified 41 eligible studies. All were published after the year 2000 and 21 originated in Europe. The majority examined QoL in neurodevelopmental disorders, including attention-deficit hyperactivity disorder (k = 17), autism spectrum disorder (k = 6), motor disorders (k = 5) and intellectual disability (k = 4). Despite substantial heterogeneity, studies demonstrate that self-reported global QoL is significantly reduced compared to typical/healthy controls across several disorders and QoL dimensions. Parents' ratings were on average substantially lower, casting doubt on the validity of proxy-report. Studies for large diagnostic groups such as depressive disorders, anxiety disorders, (early onset) schizophrenia and eating disorders are largely lacking. We conclude that representative, well-characterized normative and clinical samples as well as longitudinal and qualitative designs are needed to further clarify the construct of QoL, to derive measures of high ecological validity, and to examine how QoL fluctuates over time and is attributable to specific conditions or contextual factors.

Keywords
Quality of life, adolescence, mental health, psychopathology
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-319598 (URN)10.1111/jcpp.12645 (DOI)000398122800010 ()27709604 (PubMedID)
Funder
Swedish Research Council
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2017-05-11Bibliographically approved
Faria, V., Gingnell, M., M. Hoppe, J., Hjorth, O., Alaie, I., Frick, A., . . . Furmark, T. (2017). Do You Believe It? Verbal Suggestions Influence the Clinical and Neural Effects of Escitalopram in Social Anxiety Disorder: A Randomized Trial. EBioMedicine (24), 179-188, Article ID S2352-3964(17)30385-7.
Open this publication in new window or tab >>Do You Believe It? Verbal Suggestions Influence the Clinical and Neural Effects of Escitalopram in Social Anxiety Disorder: A Randomized Trial
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2017 (English)In: EBioMedicine, ISSN 0360-0637, E-ISSN 2352-3964, no 24, p. 179-188, article id S2352-3964(17)30385-7Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety, but their efficacy relative to placebo has been questioned. We aimed to test how manipulation of verbally induced expectancies, central for placebo, influences SSRI treatment outcome and brain activity in patients with social anxiety disorder (SAD).

METHODS: We did a randomized clinical trial, within an academic medical center (Uppsala, Sweden), of individuals fulfilling the DSM-IV criteria for SAD, recruited through media advertising. Participants were 18years or older and randomized in blocks, through a computer-generated sequence by an independent party, to nine weeks of overt or covert treatment with escitalopram (20mg daily). The overt group received correct treatment information whereas the covert group was treated deceptively with the SSRI described, by the psychiatrist, as active placebo. The treating psychiatrist was necessarily unmasked while the research staff was masked from intervention assignment. Treatment efficacy was assessed primarily with the self-rated Liebowitz Social Anxiety Scale (LSAS-SR), administered at week 0, 1, 3, 6 and 9, also yielding a dichotomous estimate of responder status (clinically significant improvement). Before and at the last week of treatment, brain activity during an emotional face-matching task was assessed with functional magnetic resonance imaging (fMRI) and during fMRI sessions, anticipatory speech anxiety was also assessed with the Spielberger State-Trait Anxiety Inventory - State version (STAI-S). Analyses included all randomized patients with outcome data at posttreatment. This study is registered at ISRCTN, number 98890605.

FINDINGS: Between March 17th 2014 and May 22nd 2015, 47 patients were recruited. One patient in the covert group dropped out after a few days of treatment and did not provide fMRI data, leaving 46 patients with complete outcome data. After nine weeks of treatment, overt (n=24) as compared to covert (n=22) SSRI administration yielded significantly better outcome on the LSAS-SR (adjusted difference 21.17, 95% CI 10.69-31.65, p<0.0001) with more than three times higher response rate (50% vs. 14%; χ(2)(1)=6.91, p=0.009) and twice the effect size (d=2.24 vs. d=1.13) from pre-to posttreatment. There was no significant between-group difference on anticipatory speech anxiety (STAI-S), both groups improving with treatment. No serious adverse reactions were recorded. On fMRI outcomes, there was suggestive evidence for a differential neural response to treatment between groups in the posterior cingulate, superior temporal and inferior frontal gyri (all z thresholds exceeding 3.68, p≤0.001). Reduced social anxiety with treatment correlated significantly with enhanced posterior cingulate (z threshold 3.24, p=0.0006) and attenuated amygdala (z threshold 2.70, p=0.003) activity.

INTERPRETATION: The clinical and neural effects of escitalopram were markedly influenced by verbal suggestions. This points to a pronounced placebo component in SSRI-treatment of SAD and favors a biopsychosocial over a biomedical explanatory model for SSRI efficacy.

FUNDING RESOURCES: The Swedish Research Council for Working Life and Social Research (grant 2011-1368), the Swedish Research Council (grant 421-2013-1366), Riksbankens Jubileumsfond - the Swedish Foundation for Humanities and Social Sciences (grant P13-1270:1).

Keywords
Expectancies, Neuroimaging, Placebo effect, SSRI, Social anxiety disorder, fMRI
National Category
Psychology General Practice
Identifiers
urn:nbn:se:uu:diva-331755 (URN)10.1016/j.ebiom.2017.09.031 (DOI)000414392900030 ()29033138 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-1368Swedish Research Council, 421-2013-1366Riksbankens Jubileumsfond, P13-1270:1
Note

Vanda Faria and Malin Gingnell contributed equally

Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2018-02-12Bibliographically approved
Engman, J., Frick, A., Alaie, I., Björkstrand, J., Ågren, T., Faria, V., . . . Furmark, T. (2014). Amygdala and Default Mode Network Resting-State Functional Connectivity in Social Anxiety Disorder. In: : . Paper presented at 20th Annual Meeting of the Organization for Human Brain Mapping, Hamburg, Germany, 8-12 juni 2014.
Open this publication in new window or tab >>Amygdala and Default Mode Network Resting-State Functional Connectivity in Social Anxiety Disorder
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2014 (English)Conference paper, Oral presentation only (Refereed)
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-247730 (URN)
Conference
20th Annual Meeting of the Organization for Human Brain Mapping, Hamburg, Germany, 8-12 juni 2014
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2015-03-23
Frick, A., Engman, J., Alaie, I., Björkstrand, J., Faria, V., Gingnell, M., . . . Furmark, T. (2014). Enlargement of visual processing regions in social anxiety disorder is related to symptom severity. Neuroscience Letters, 583, 114-119
Open this publication in new window or tab >>Enlargement of visual processing regions in social anxiety disorder is related to symptom severity
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2014 (English)In: Neuroscience Letters, ISSN 0304-3940, E-ISSN 1872-7972, Vol. 583, p. 114-119Article in journal (Refereed) Published
Abstract [en]

Social anxiety disorder (SAD) is associated with altered brain function and structure, but most structural studies include small samples and findings are mixed. This study compared regional gray matter volume between 48 SAD patients and 29 healthy controls (HC) as well as the relationship between volume and symptom severity. Structural magnetic resonance images from SAD patients and HC were evaluated using standard voxel-based morphometry (VBM) processing in the SPM8 software package. Social anxiety symptom severity was rated in SAD patients by a clinician using the Liebowitz Social Anxiety Scale (LSAS). SAD patients had greater regional gray matter volume in the lingual gyrus and lateral occipital cortex than the controls, and within the SAD group a positive correlation was found between symptom severity and regional gray matter volume in the lingual gyrus and the retrosplenial cortex. These findings replicate and extend earlier reports of enlarged visual processing areas in SAD. Increased gray matter volume in regions involved in visual processing and self-consciousness could underlie, or be the result of, abnormal emotional information processing and self-focused attention previously demonstrated in patients with SAD.

National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-236363 (URN)10.1016/j.neulet.2014.09.033 (DOI)000345604300022 ()25258347 (PubMedID)
Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2018-01-11Bibliographically approved
Frick, A., Engman, J., Alaie, I., Björkstrand, J., Jonasson, M., Lubberink, M., . . . Furmark, T. (2014). Increased serotonin synthesis and transporter availability in social anxiety disorder revealed by [11C]5-HTP and [11C]DASB PET imaging. In: : . Paper presented at International Symposium on Functional Neuroreceptor Mapping of the Living Brain, Egmond aan Zee, The Netherlands.
Open this publication in new window or tab >>Increased serotonin synthesis and transporter availability in social anxiety disorder revealed by [11C]5-HTP and [11C]DASB PET imaging
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2014 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-247808 (URN)
Conference
International Symposium on Functional Neuroreceptor Mapping of the Living Brain, Egmond aan Zee, The Netherlands
Available from: 2015-03-24 Created: 2015-03-24 Last updated: 2015-03-24
Frick, A., Engman, J., Alaie, I., Björkstrand, J., Jonasson, M., Lubberink, M., . . . Furmark, T. (2014). Increased serotonin transporter availability in social anxiety disorder revealed by [11C]DASB positron emission tomography. In: : . Paper presented at International Symposium on Functional Neuroreceptor Mapping of the Living Brain, Egmond aan Zee, The Netherlands, 21-24 maj 2014.
Open this publication in new window or tab >>Increased serotonin transporter availability in social anxiety disorder revealed by [11C]DASB positron emission tomography
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2014 (English)Conference paper, Oral presentation only (Refereed)
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-247673 (URN)
Conference
International Symposium on Functional Neuroreceptor Mapping of the Living Brain, Egmond aan Zee, The Netherlands, 21-24 maj 2014
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2015-03-23
Frick, A., Engman, J., Alaie, I., Björkstrand, J., Gingnell, M., Morell, A., . . . Furmark, T. (2014). Predicting Outcome of Combined CBT and SSRI Treatment for Social Anxiety Disorder Using a Machine Learning Approach. In: : . Paper presented at 69th Society of Biological Psychiatry Annual Meeting, New York, New York, USA, 8-10 maj 2014.
Open this publication in new window or tab >>Predicting Outcome of Combined CBT and SSRI Treatment for Social Anxiety Disorder Using a Machine Learning Approach
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2014 (English)Conference paper, Oral presentation only (Refereed)
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-247676 (URN)
Conference
69th Society of Biological Psychiatry Annual Meeting, New York, New York, USA, 8-10 maj 2014
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2015-03-23
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