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  • 1.
    Alenius, Malin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Hammarlund-Udenaes, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Hartvig, Per
    Lindström, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Knowledge and insight in relation to functional remission in patients with long-term psychotic disorders2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 5, p. 523-529Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with psychotic symptoms often respond poorly to treatment. Outcomes can be affected by biological, physiological and psychological factors according to the vulnerability-stress model. The patient's coping strategies and beliefs have been correlated with outcomes. OBJECTIVES: To investigate the knowledge and insight in relation to treatment response. METHODS: A naturalistic study was performed using patient interviews and information gathered from patient drug charts. Apart from the rating scales used for classification of treatment response (CANSEPT method), the SPKS knowledge of illness and drugs rating scale was utilized. RESULTS: In the group of patients in functional remission (FR; n = 38), 37% had insight into their illness as compared to 10% among those not in functional remission (non-FR; n = 78; P < 0.01). As much as 23% of the non-FR group had no strategy for responding to warning signs versus 8% in the FR group (P < 0.05). CONCLUSIONS: Better treatment outcomes appear to be associated with better insight into illness, higher knowledge of warning signs and better coping strategies.

  • 2.
    Bodén, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine.
    Lindström, Eva
    Wieselgren, Ing-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Lindström, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Five-year outcome of first-episode psychosis before and after the implementation of a modified assertive community treatment programme2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 6, p. 665-674Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Assertive community treatment programmes are increasingly common worldwide but without much knowledge of their long-term effect. We investigated whether the implementation of such a programme would improve symptomatic and functional outcome 5 years later. METHODS: Naturalistic cohort study between 1995 and 2000 of all first-episode psychosis patients (n = 144) in Uppsala County, Sweden. We compared a 3-year period before (non-mACT) and after the introduction of a modified assertive community treatment (mACT) programme in 1998. Five-year outcome was assessed for symptoms and functioning and the two co-primary outcome measures were positive and negative symptoms. Regression models were adjusted for a propensity score based on multiple baseline variables and use of antipsychotics at 5-year follow-up. RESULTS: Contrary to our hypothesis, patients in the mACT group, compared to those in the non-mACT group, had a borderline significant increased risk of having a poor 5-year outcome regarding positive psychotic symptoms [adjusted odds ratio (OR) 3.21, 95% confidence interval (CI) 0.97-10.63]. There was no difference at the 5-year follow-up between the mACT and non-mACT group regarding negative symptoms (adjusted OR 1.65, 95% CI 0.48-5.66), or any of the secondary outcome measures: global assessment of functioning, hazardous alcohol use, use of illicit drugs, working or being in education, independent living, subjective satisfaction with life or suicide. Results were similar in subgroup analyses. CONCLUSIONS: The implementation of a modified assertive community treatment was not followed by subsequent improvements of 5-year outcome on a group level for patients with first-episode psychosis.

  • 3.
    Bradby, Hannah
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Weich, Scott
    University of Warwick, UK.
    Griffith, Laura
    University of Warwick.
    Commander, Martin
    University of Warwick.
    Experiences of Acute Mental Health Care in an Ethnically Diverse Inner City: Qualitative Interview Study2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 47, no 1, p. 119-128Article in journal (Refereed)
  • 4. Catalano, Ralph
    et al.
    Hartig, Terry
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Institute for Housing and Urban Research.
    Economic predictors of admissions to inpatient psychiatric treatment in Sweden2004In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 39, p. 305-310Article in journal (Refereed)
  • 5.
    Falk Dahl, Christian A
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Dahl, Alv A
    Lifestyle and social network in individuals with high level of social phobia/anxiety symptoms: a community-based study2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 3, p. 309-317Article in journal (Refereed)
    Abstract [en]

    To study the lifestyle issues and social network in a community-based sample of individuals with a high level of social phobia/anxiety symptoms (SPAS) compared to controls, and to explore the factors that were most strongly associated with unhealthy lifestyle and a small social network. The MINI-SPIN test was administered in The Oslo Health Study (HUBRO), and the scores used to identify persons with a high level of SPAS. The SPAS group consisted of 446 individuals aged 30, 40 or 45 years defined by MINI-SPIN score a parts per thousand yen8. We randomly selected five controls for each case among those with a MINI-SPIN score of 0-7 (N = 2,230). Information was collected with questionnaires, physical measurements and blood samples. The SPAS group showed significantly higher prevalence of unhealthy lifestyle than controls, which did not hold up in multivariate analyses. The SPAS group showed significantly more alcohol problems and higher future risk of coronary heart disease among females, but not in males. Low level of physical activity in general, and in spare time, was significantly associated with the SPAS group. Small social network was significantly more common in the SPAS group and that result held up in multivariate analysis. In that analysis not being in paired relationship and mental comorbidity were also significantly associated with a small social network. Unhealthy lifestyle and a small social network places younger adults with SPAS under considerable risk for the development of future morbidity. This risk calls for counseling by general practitioners in such individuals.

  • 6. Gren-Landell, Malin
    et al.
    Tillfors, Maria
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Bohlin, Gunilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Andersson, Gerhard
    Svedin, Carl Göran
    Social phobia in Swedish adolescents: Prevalence and gender differences2009In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 44, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background The aim of this study was to investigate the prevalence of self-reported social phobia in a community sample of Swedish adolescents in junior high school, at the risk-period for developing social phobia. Of particular interest was to investigate gender differences in prevalence across ages. Prevalence of sub-threshold social phobia was also studied. Methods Students in grades 6-8 (aged 12-14) from seventeen schools in five Swedish municipalities were screened by means of a self-report questionnaire, the social phobia screening questionnaire-for children (SPSQ-C). Results Data from a sample of 2,128 students were analysed and showed a point-prevalence rate of 4.4% (95% CI 3.5-5.2) and a significant gender difference (6.6% girls vs. 1.8% boys, P < 0.001). No significant differences in prevalence of probable cases emerged across the ages. At sub-threshold level, marked social fear of at least one social situation was reported by 13.8% of the total group. "Speaking in front of class'' and "calling someone unfamiliar on the phone'' were the most feared social situations. In the social phobia group, 91.4% reported impairment in the school-domain due to their social fear. Conclusion Social phobia is a common psychiatric condition in Swedish adolescents, especially in girls. As impairment in the school-domain is reported to a high degree, professionals and teachers need to recognize social phobia in adolescents so that help in overcoming the difficulties can be offered.

  • 7.
    Gupta Löfving, Sandra
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Lindblad, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Stickley, Andrew
    Schwab-Stone, Mary
    Ruchkin, Vladislav
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Community violence exposure and severe posttraumatic stress in suburban American youth: risk and protective factors2015In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 50, no 4, p. 539-547Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The psychological effects of community violence exposure among inner-city youth are severe, yet little is known about its prevalence and moderators among suburban middle-class youth. This study aimed to assess the prevalence of community violence exposure among suburban American youth, to examine associated posttraumatic stress and to evaluate factors related to severe vs. less severe posttraumatic stress, such as co-existing internalizing and externalizing problems, as well as the effects of teacher support, parental warmth and support, perceived neighborhood safety and conventional involvement in this context.

    METHOD: Data were collected from 780 suburban, predominantly Caucasian middle-class high-school adolescents in the Northeastern US during the Social and Health Assessment (SAHA) study.

    RESULTS: A substantial number of suburban youth were exposed to community violence and 24 % of those victimized by community violence developed severe posttraumatic stress. Depressive symptoms were strongly associated with higher levels and perceived teacher support with lower levels of posttraumatic stress.

    CONCLUSION: Similar to urban youth, youth living in suburban areas in North American settings may be affected by community violence. A substantial proportion of these youth reports severe posttraumatic stress and high levels of comorbid depressive symptoms. Teacher support may have a protective effect against severe posttraumatic stress and thus needs to be further assessed as a potential factor that can be used to mitigate the detrimental effects of violence exposure.

  • 8.
    Gustafsson, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Occurrence of mental health problems in Swedish samples of adults with intellectual disabilities.2004In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 39, no 6, p. 448-456Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE

    The aim of this study was to investigate the occurrence of mental health problems in adults with intellectual disabilities (ID) and the number of adults with ID receiving care at general mental health clinics.

    METHOD

    The Reiss Screen for Maladaptive Behaviour and the Psychopathology Inventory for Mentally Retarded Adults were used to investigate mental health problems in samples from two Swedish counties. Adults with ID receiving psychiatric care at general mental health clinics were investigated via the mental health services register in one county.

    RESULTS

    The overall occurrence of mental health problems in adults with ID ranged from 34% to 64%. The most common mental health problems were aggressive, self-injurious behaviours, signs of depression, anxiety or adjustment problems. The occurrence of adults with ID among patients receiving out- or in-patient psychiatric care was approximately 1%. Between 70% and 90% of these persons had a mild level of ID.

    CONCLUSION

    The overall occurrence of mental health problems was similar to reported overall figures in comparable studies conducted in the US, UK and Denmark. The number of adults with ID registered for out- or in-patient psychiatric care was low compared with the occurrence of mental health problems based on the screening results.

  • 9. Haggård-Grann, Helena
    et al.
    Hallqvist, Johan
    Dept. of Public Health Sciences Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
    Långström, Niklas
    Möller, Jette
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Preventive Medicine.
    Short-term effects of psychiatric symptoms and interpersonal stressors on criminal violence: a case cross-over study2006In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 41, no 7, p. 532-540Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The aim of the study was to analyse the triggering or acute risk effect of psychiatric symptoms and interpersonal stressors on criminal violence.

    METHOD:

    One hundred and thirty three violent offenders were recruited from a forensic psychiatric evaluation (FPE) unit and a national prison evaluation unit in Sweden during 2002-2003, and were interviewed about trigger exposures. A case-crossover design was used eliminating long-term within individual confounding.

    RESULTS:

    Suicidal ideation or parasuicide within 24 h before the violent event conferred a ninefold risk increase. In contrast, violent ideation did not trigger criminal violence. Hallucinations yielded a fourfold risk increase, whereas paranoid thoughts were associated with a small and statistically non-significant risk increase. Acute conflicts with others and being denied psychiatric care within 24 h before violence also increased the risk of acting violently.

    CONCLUSIONS:

    Some tested psychiatric symptoms and stressors triggered criminal violence, whereas others did not. The case-crossover design may be particularly useful for the study of triggers of violence.

  • 10.
    Jonsson, Ulf
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Bohman, Hannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Hjern, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Päären, Aivar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Olsson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    von Knorring, Anne-Liis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Intimate relationships and childbearing after adolescent depression: a population-based 15 year follow-up study2011In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 46, no 8, p. 711-721Article in journal (Refereed)
    Abstract [en]

    Purpose: Adolescent depression is associated with a range of interpersonal adversities. We hypothesized that depressed adolescents are at subsequent increased risk of problems related to intimate relationships and childbearing in adulthood, and used longitudinal data to examine this.

    Method: A population-based investigation of depression in 16 to 17 year olds was followed up after 15 years, at around the age of 30 years. Comparisons were made between adolescents with depression (n = 361, 78% females) and non-depressed peers (n = 248, 77% females). Data from both national registers and personal interviews were used.

    Results: At follow-up, the former depressed and non-depressed adolescents had become parents to a similar extent. The former depressed females were more likely than the non-depressed females to report abortion, miscarriage, intimate partner violence and sexually transmitted disease. They also reported a higher number of intimate relationships and were more likely to have divorced and to be registered as single mothers. Depressed females with a comorbid disruptive disorder had a particularly poor outcome. In the depressed females without a disruptive disorder, only those who subsequently had recurrent depressions in adulthood were at increased risk of poor outcome. There was no indication that the formerly depressed males were at increased risk of subsequent problems related to intimate relationships.

    Conclusion: Females with adolescent depression subsequently have problems related to intimate relationships and childbearing. Disruptive disorders and recurrence of depression appear to be instrumental in this association. Attention should be given to intimate relationship problems and sexual and reproductive health issues in young women with depression.

  • 11.
    Jonsson, Ulf
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Goodman, Anna
    von Knorring, Anne-Liis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Koupil, Ilona
    School performance and hospital admission due to unipolar depression: a three-generational study of social causation and social selection2012In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 47, no 10, p. 1695-1706Article in journal (Refereed)
    Abstract [en]

    Purpose

    Both "social causation" and "social selection" offer plausible explanations for an association between education and mental health. We aimed to explore these processes in unipolar depression, with a specific focus on school performance and family tradition of education.

    Method

    Grandchildren (N = 28,089, 49% female, aged 13-47 years in 2002) of a cohort born in Uppsala, Sweden, in 1915-1929 were studied in national registers. We obtained data on final grade point average (GPA) in compulsory school, hospitalizations for unipolar depression, grandparental/parental education and other parental social characteristics. Hospitalization in adolescence and adulthood were studied separately, as were hospitalization for depression with or without a lifetime externalizing disorder.

    Results

    Low compulsory school GPA (1-2 SD or > 2 SD below average vs. average GPA) was associated with increased rate of adolescent hospitalization for unipolar depression, both with externalizing comorbidity [hazard ratio (HR) point estimates of 66-80] and without (HR point estimates of 4-6). By contrast, low GPA was only associated with first-time hospitalization in adulthood for the subgroup with externalizing comorbidity (HR point estimates of 4-6). These associations were largely independent of family education and social characteristics. Overall, low parental/grandparental education was not related to increased rates of hospitalization.

    Conclusion

    The association between school performance and hospitalization for depression depended on adolescent hospitalization or externalizing comorbidity, suggesting that disorders with an early onset are decisive. Contrary to the social patterning of many health outcomes, low grandparental/parental education did not appear to increase the rate of hospitalization for unipolar depression in the offspring.

  • 12.
    Jukkala, Tanya
    et al.
    Baltic and East European Graduate School (BEEGS), Södertörn University, Sweden.
    Mäkinen, I H
    Acceptance of Suicide in Moscow2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 46, no 8, p. 753-765Article in journal (Refereed)
    Abstract [en]

    Purpose Attitudes concerning the acceptability of suicidehave been emphasized as being important for understandingwhy levels of suicide mortality vary in different societiesacross the world. While Russian suicide mortalitylevels are among the highest in the world, not much isknown about attitudes to suicide in Russia. This study aimsto obtain a greater understanding about the levels andcorrelates of suicide acceptance in Russia.Methods Data from a survey of 1,190 Muscovites wereanalysed using logistic regression techniques. Suicideacceptance was examined among respondents in relation tosocial, economic and demographic factors as well as inrelation to attitudes towards other moral questions.Results The majority of interviewees (80%) expressedcondemnatory attitudes towards suicide, although menwere slightly less condemning. The young, the highereducated, and the non-religious were more accepting ofsuicide (OR[2). However, the two first-mentioned effectsdisappeared when controlling for tolerance, while a positiveeffect of lower education on suicide acceptanceappeared. When controlling for other independent variables,no significant effects were found on suicide attitudesby gender, one’s current family situation, or by healthrelatedor economic problems.Conclusions The most important determinants of therespondents’ attitudes towards suicide were their toleranceregarding other moral questions and their religiosity. Moretolerant views, in general, also seemed to explain the moreaccepting views towards suicide among the young and thehigher educated. Differences in suicide attitudes betweenthe sexes seemed to be dependent on differences in otherfactors rather than on gender per se. Suicide attitudes alsoseemed to be more affected by one’s earlier experiences interms of upbringing and socialization than by events andprocesses later in life.

  • 13.
    Koposov, Roman
    et al.
    UiT, Reg Ctr Child & Youth Mental Hlth & Child Welf, Tromso, Norway.
    Stickley, Andrew
    Sodertorn Univ, Stockholm Ctr Hlth & Social Change SCOHOST, Huddinge, Sweden.
    Ruchkin, Vladislav V.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Yale Univ, Sch Med, Ctr Child Study, New Haven, CT 06510 USA;Sater Forens Psychiat Clin, Sater, Sweden.
    Inhalant use in adolescents in northern Russia2018In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 53, no 7, p. 709-716Article in journal (Refereed)
    Abstract [en]

    To determine the prevalence of inhalant use in Russian adolescents and to investigate associated psychosocial problems from a gender perspective. Data on inhalant use and comorbid psychopathology were collected by means of self-reports from 2892 (42.4% boys) sixth to tenth grade students in public schools in Arkhangelsk, Russia. Multivariate analysis of covariance was used to assess differences in the levels of internalizing and externalizing problems in boys and girls, who were non-users and users of inhalants. The prevalence of inhalant use was 6.1% among boys and 3.4% among girls. Compared with non-users, inhalant users scored significantly higher on internalizing and externalizing problems, functional impairment and lower on academic motivation, with psychopathology increasing with age. While there were no gender differences for internalizing problems, increased levels of externalizing problems in inhalant users were gender-specific (significantly higher in boys). Inhalant use is related to significantly higher levels of comorbid psychopathology in Russian adolescents. Comprehensive, evidence-based prevention and intervention policies are needed to address inhalant use and its harmful effects.

  • 14. Ruchkin, V V
    et al.
    Eisemann, M
    Hägglöf, B
    Parental rearing and problem behaviours in male delinquent adolescents versus controls in northern Russia.1998In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 33, no 10, p. 477-82Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate possible relationships between parental rearing practices and problem behaviours in a sample of male delinquent adolescents versus controls. A total of 133 subjects from a juvenile correction centre and 108 matched school-children in the Arkhangelsk region, Russia, were assessed by means of the EMBU questionnaire and Youth Self-Report. Delinquents were more severely treated by parents and had more pronounced problem scores. Furthermore, problem scores were found to be highly correlated with parental rejection and lack of emotional warmth in both delinquents and controls. Parental rearing practices may influence the development of problem behaviours. The implications of these findings with regard to preventive measures are discussed.

  • 15.
    Rydell, Ann-Margret
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Family factors and children's disruptive behaviour: An investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 2, p. 233-244Article in journal (Refereed)
    Abstract [en]

    Oppositional defiant disorder behaviours (ODD) and attention deficit/hyperactivity disorder symptoms (ADHD) are common disruptive childhood problems and co-occur to a large extent. In this study, prime questions were the specificity of relations between demographic factors and negative life events, respectively, and ADHD and ODD symptoms, and the role of negative life events in the relations between demographic factors and ODD and ADHD symptoms. Concurrent relations between maternal education, family structure, ethnicity/immigrant background and symptoms of ADHD and ODD were investigated in a Swedish population sample of 1,200 10-year-old children (52% boys). Parents completed questionnaires containing information about demographic characteristics and negative life events and rated the child's ADHD and ODD symptoms using DSM-IV criteria. Low maternal education, single/step-parenthood and non-European descent were associated with higher numbers of ODD and ADHD symptoms. Regression analyses identified ethnicity as specifically associated with ODD symptoms and single/step-parenthood as specific to ADHD symptoms, while there was no specificity with regard to negative life events. Experiences of multiple negative life events were more common in families in non-optimal circumstances. Negative life events had mainly additive effects on the level of ODD and ADHD symptoms above effects of the demographic stressors and especially conflicts between adults around the child were related to high symptom levels. The few gender effects pointed to boys as being more vulnerable than girls to non-optimal family factors expressed in relations to ODD and ADHD symptoms. Even in an affluent and egalitarian society, children's life circumstances are related to their mental health. Further, there seems to be some specificity in the demographic risk factors associated with ODD and with ADHD symptoms, while negative life events act as general stressors.

  • 16.
    Stickley, Andrew
    et al.
    Natl Ctr Neurol & Psychiat, Natl Inst Mental Hlth, Dept Prevent Intervent Psychiat Disorders, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan;Sodertorn Univ, Stockholm Ctr Hlth & Social Change SCOHOST, S-14189 Huddinge, Sweden.
    Koposov, Roman
    UiT Arctic Univ Norway, Reg Ctr Child & Youth Mental Hlth & Child Welf, Tromso, Norway.
    Koyanagi, Ai
    Univ Barcelona, Fundacio St Joan Deu, Parc Sanitari St Joan Deu,Dr Antoni Pujadas 42, Barcelona 08830, Spain;Inst Salud Carlos III, Ctr Invest Biomed Red Salud Mental, CIBERSAM, Monforte Lemos 3-5 Pabellon 11, Madrid 28029, Spain.
    Inoue, Yosuke
    Univ N Carolina, Carolina Populat Ctr, 123 West Franklin St, Chapel Hill, NC 27516 USA.
    Ruchkin, Vladislav V.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Yale Univ, Med Sch, Child Study Ctr, New Haven, CT 06520 USA.
    ADHD and depressive symptoms in adolescents: the role of community violence exposure2019In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 54, no 6, p. 683-691Article in journal (Refereed)
    Abstract [en]

    Purpose Comorbid depression is common in adolescents with attention-deficit/hyperactivity disorder (ADHD). As yet, however, little is known about the factors associated with co-occurring depression in this population. To address this research gap, the current study examined the role of community violence exposure in the association between ADHD symptoms and depression. Methods Data came from 505 Russian adolescents [mean age 14.37 (SD = 0.96)] who had teacher-reported information on ADHD symptoms that was collected in conjunction with the Social and Health Assessment (SAHA). Adolescent self-reports of witnessing and being a victim of community violence were also obtained while depressive symptoms were self-assessed with an adapted version of the Center for Epidemiologic Studies-Depression Scale (CES-D). Logistic regression analyses were performed to examine associations. Results In univariable analyses, both witnessing and being a victim of violence were associated with significantly increased odds for depressive symptoms in adolescents with ADHD symptoms compared to non-ADHD adolescents who had not experienced community violence. However, in the multivariable analysis only being a victim of violence continued to be associated with significantly increased odds for depression [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.33-16.35]. Conclusion Exposure to community violence may be associated with depression in adolescents with ADHD symptoms. Clinicians should enquire about exposure to community violence in adolescents with ADHD/ADHD symptoms. Early therapeutic interventions to address the effects of violence exposure in adolescents with ADHD may be beneficial for preventing depression in this group.

  • 17. Tillfors, Maria
    et al.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior2007In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 42, no 1, p. 79-86Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Public speaking is a common situation that university students have to endure. This situation is feared or avoided by most individuals with social phobia, which has been associated with low levels of educational attainment. However, epidemiological data on social phobia in university students are scarce. The present study examined the prevalence of social phobia and its subgroups in a university student population. Demographic characteristics and avoidant behavior in educational settings were also examined. METHODS: The Social Phobia Screening Questionnaire (SPSQ)--a validated and DSM-IV compatible instrument, was distributed as a postal survey to 753 randomly selected university students in Sweden. Interpretable questionnaires were obtained from 523 students (69.5%). To investigate subgroups, students who met the SPSQ diagnostic criteria of social phobia were analyzed by hierarchical cluster analysis. RESULTS: The point prevalence of social phobia among the Swedish university students was 16.1%, comparable with 15.6% previously reported for the general population. Two clusters were distinguished consisting of students scoring either low (discrete subgroup) or high (generalized subgroup) on all cluster variables. The discrete subgroup was more common representing 83% of the cases. Social phobia was associated with use of dysfunctional avoidant strategies in educational situations and in anticipation of public speaking. The disorder was less common among students following a pedagogic university program. CONCLUSIONS: Social phobia was highly prevalent among Swedish university students, most cases pertaining to a mild or discrete form of the disorder. The commonness and severity of social phobia in students did not deviate significantly from the general population suggesting that socially anxious individuals do apply for higher education. However, since avoidance and low educational attainment are commonly reported features, future studies should investigate whether sufferers of social phobia underachieve or abolish their studies prematurely.

  • 18. Tinghög, Petter
    et al.
    Hemmingsson, Tomas
    Lundberg, Ingvar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?2007In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 42, no 12, p. 990-996Article in journal (Refereed)
    Abstract [en]

    Background  Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can be explained by a different distribution of known risk factors for impaired mental health between groups of immigrants and persons born in Sweden. Methods  The study is based on data from the Swedish PART-study, designed to identify risk factors for, and social consequences of, mental illness. The study population consists of a random sample of 10,423 Swedish citizens, whereof 1,109 were immigrants. The data was collected in the year 2000. The immigrants were divided into three groups based on country of origin (Scandinavians born outside Sweden, Europeans born outside Scandinavia, non-Europeans). The occurrence of mental illness among immigrants and native Swedes were compared not adjusting and adjusting for indicators of socioeconomic advantage/disadvantage (education, income, labour market position, etc). Mental illness was approximated with the WHO (ten) wellbeing index scale and depressive symptoms were measured with the major depression inventory scale (MDI). Results   Immigrants’ excess risk for low subjective wellbeing was completely accounted for by adjustment for known risk factors in all the immigrant groups. However, social-economic disadvantages could not account for the non-European immigrants’ higher prevalence of depression (MDI), although the increased relative risk found in univariate analyses was substantially reduced. Conclusions  The findings in this study suggest that the association between immigrant status and mental illness appears above all to be an effect of a higher prevalence of social and economic disadvantage.

  • 19.
    Wallsten, Tuula
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Kjellin, Lars
    Lindström, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Short-term outcome of inpatient psychiatric care - impact of coercion and treatment characteristics2006In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 41, no 12, p. 975-980Article in journal (Refereed)
    Abstract [en]

    Aims: Little is known about the outcome of brief inpatient treatment interventions in routine psychiatric practice. The aim of this article was to study if subjective and assessed outcome of brief psychiatric inpatient care are related to patient characteristics, coercion at admission and during care, and other treatment characteristics. Method: A total of 233 involuntarily and voluntarily admitted patients were interviewed within 5 days from admission and at discharge or after 3 weeks of care. Outcome was measured as reported by patients and by change in GAF (Global Assessment Scale) scores. Results: Predictors fora positive subjective outcome were if the patients reported that they had been well treated by the staff and had contact persons at the ward. Predictors for a GAF improvement were a low GAF score at admission and a mood disorder diagnosis. Conclusions: Subjectively reported outcome and outcome measured by assessing change in level of functioning differed. Coercion was not related to outcome. The way the patient perceived they had been treated by the staff was strongly related to subjective outcome.

  • 20.
    Wennström, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Berglund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Lindbäck, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    The Met Needs Index: a new metric for outcome assessment in mental health care2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 3, p. 425-432Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: No apt method has been available to assess and monitor the responsiveness of services in meeting ongoing needs of patients with long-term mental illness. The present study examines the utility of a new metric for such a purpose, the Met Needs Index (MNI), applied to the Camberwell Assessment of Need (CAN). METHODS: The MNI was estimated as an aggregated measure of met need or beneficial outcome, based on annual staff rated CAN-assessments of 321 outpatients (76% psychotic disorders) in psychiatric care during 7 years. Corresponding confidence intervals were estimated with the bootstrap percentile method. RESULTS: The overall MNI was estimated at 0.71 (95% CI 0.69-0.74), indicating that identified needs in general were met during 71% of the intervals between the annual assessments. However, the MNI for specific need domains of the CAN ranged from 0.89 (95% CI 0.84-0.93) for 'food' to 0.11 (95% CI 0.07-0.16) for 'sexual expression', indicating a significant variation in responsiveness of services to different types of need in this patient population. CONCLUSIONS: The MNI seems to be a useful and powerful metric for outcome assessment and monitoring of psychiatric services from a needs assessment approach.

  • 21.
    Wennström, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Berglund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Lindbäck, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Wiesel, Frits-Axel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Deconstructing the 'black box' of the Camberwell assessment of need score in mental health services evaluation2008In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 43, no 9, p. 714-719Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to examine an alternative way of scoring the Camberwell Assessment of Need (CAN) for the purpose of service evaluation, using the by us defined Social Services (SI) and Psychiatric Services (PI) subindices. Methods: CAN assessments in 1997 and 1999 of 262 outpatients (mean age 45 years, 77.1% psychotic disorders) were reanalysed to fit the SI and the PI, which were compared to the full CAN. Results: The mean total needs on the full CAN decreased from 6.65 to 6.22 (P = 0.007), as did the mean unmet needs (1.55-1.81, P = 0.049). The mean total needs on the PI decreased from 2.42 to 2.22 (P = 0.006), as did the mean unmet needs (1.66-0.57, P < 0.001). No changes in mean needs occurred on the SI. Conclusions: All significant changes occurred on the PI, indicating a more beneficial outcome of the psychiatric care than the social care in terms of meeting needs, a result impossible to discern from the total scores of the CAN. Thus, output scores on subindices of the CAN might be useful as outcome measures in service evaluation.

  • 22.
    Wennström, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wiesel, Frits-Axel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    The Camberwell Assessment of Need as an outcome measure in routine mental health care2006In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 41, no 9, p. 728-733Article in journal (Refereed)
    Abstract [en]

    Background. Subsidiary findings in several studies indicate that the standard summary scores (total number of needs, met needs and unmet needs) of the Camberwell Assessment of Need (CAN) may conceal important differences among patient populations at the item level of the measure. The aim of this study was to investigate whether changes in need and need status at the item level are adequately reflected by changes in the summary scores. Methods. In a longitudinal design assessments of need in 1997 and 2003 of 192 outpatients (mean age 45.4 years, 78.1% psychotic disorders) in routine mental health care were compared. Results. None of the summary scores changed between 1997 and 2003. This result, however, was contradicted by significant changes in needs at the item level. Conclusions. The summary scores conceal changes in need on the underlying items and thus is recommended not to be used as dependent measures when comparisons among populations or between points in time are of interest.

  • 23.
    Wright, A. Michelle
    et al.
    Wayne State Univ, Dept Psychol, 71 W Warren Ave, Detroit, MI 48202 USA.;Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA..
    Aldhalimi, Abir
    Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Univ Detroit Mercy, Dept Psychol, Detroit, MI 48221 USA..
    Lumley, Mark A.
    Wayne State Univ, Dept Psychol, 71 W Warren Ave, Detroit, MI 48202 USA..
    Jamil, Hikmet
    Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Wayne State Univ, Inst Environm Hlth Sci, Detroit, MI USA..
    Pole, Nnamdi
    Smith Coll, Dept Psychol, Northampton, MA 01063 USA..
    Arnetz, Judith E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Wayne State Univ, Inst Environm Hlth Sci, Detroit, MI USA..
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Wayne State Univ, Cardiovasc Res Inst, Detroit, MI USA.;Michigan State Univ, Coll Human Med, E Lansing, MI 48824 USA..
    Determinants of resource needs and utilization among refugees over time2016In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 51, no 4, p. 539-549Article in journal (Refereed)
    Abstract [en]

    This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.

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