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  • 251.
    Gingnell, Malin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Frick, Andreas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Marquand, Andre F.
    Howner, Katarina
    Fischer, Hakan
    Kristiansson, Marianne
    Williams, Steven C. R.
    Fredrikson, Mats
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Classifying Social Anxiety Disorder Using Multivoxel Pattern Analyses of Brain Function and Structure2014In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 75, no 9, p. 358S-358SArticle in journal (Other academic)
  • 252. Gold, Rinat
    et al.
    Butler, Pamela
    Revheim, Nadine
    Leitman, David I.
    Hansen, John A.
    Gur, Ruben C.
    Kantrowitz, Joshua T.
    Laukka, Petri
    Justin, Patrik N.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Silipo, Gail S.
    Javitt, Daniel C.
    Auditory Emotion Recognition Impairments in Schizophrenia: Relationship to Acoustic Features and Cognition2012In: American Journal of Psychiatry, ISSN 0002-953X, E-ISSN 1535-7228, Vol. 169, no 4, p. 424-432Article in journal (Refereed)
    Abstract [en]

    Objective: Schizophrenia is associated with deficits in the ability to perceive emotion based on tone of voice. The basis for this deficit remains unclear, however, and relevant assessment batteries remain limited. The authors evaluated performance in schizophrenia on a novel voice emotion recognition battery with well-characterized physical features, relative to impairments in more general emotional and cognitive functioning.

    Method: The authors studied a primary sample of 92 patients and 73 comparison subjects. Stimuli were characterized according to both intended emotion and acoustic features (e.g., pitch, intensity) that contributed to the emotional percept. Parallel measures of visual emotion-recognition, pitch perception, general cognition, and overall outcome were obtained. More limited measures were obtained in an independent replication sample of 36 patients, 31 age-matched comparison subjects, and 188 general comparison subjects.

    Results: Patients showed statistically significant large-effect-size deficits in voice emotion recognition (d=1.1) and were preferentially impaired in recognition of emotion based on pitch features but not intensity features. Emotion recognition deficits were significantly correlated with pitch perception impairments both across (r=0.56) and within (r=0.47) groups. Path analysis showed both sensory-specific and general cognitive contributions to auditory emotion recognition deficits in schizophrenia. Similar patterns of results were observed in the replication sample.

    Conclusions: The results demonstrate that patients with schizophrenia show a significant deficit in the ability to recognize emotion based on tone of voice and that this deficit is related to impairment in detecting the underlying acoustic features, such as change in pitch, required for auditory emotion recognition. This study provides tools for, and highlights the need for, greater attention to physical features of stimuli used in studying social cognition in neuropsychiatric disorders.

  • 253.
    Goldin, Stephen
    et al.
    Division of Child and Adolescent Psychiatry, Department of Clinical Sciences, Umeå University, Sweden.
    Hägglöf, Bruno
    Division of Child and Adolescent Psychiatry, Department of Clinical Sciences, Umeå University, Sweden.
    Levin, Lilian
    Division of Child and Adolescent Psychiatry, Department of Clinical Sciences, Umeå University, Sweden.
    Persson, Lars Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Mental health of Bosnian refugee children: A comparison of clinician appraisal with parent, child and teacher reports2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 3, p. 204-216Article in journal (Refereed)
    Abstract [en]

    This study compares clinician appraisal of Bosnian refugee children with independent parent, child and teacher reports. From whom and by what means can children “at risk” be reasonably identified? Forty-eight Bosnian refugee children (aged 7-20), resettled in Sweden 1994-95, were assessed clinically by means of a semi-structured interview. Thereafter, standardized mental health questionnaires were administered to parents (Achenbach's Child Behavior Checklist), children (Achenbach's Youth Self-Report and Macksoud's Posttraumatic Stress Reaction Checklist) and teachers (clinician designed School Competence Scale and Achenbach's Teacher's Report Form). On clinician interview, nearly half of the children (48%) were identified with one or more mental health problem “demanding further attention”. Depressiveness was the single most prevalent symptom (31%); followed by post-traumatic stress (23%), and anxiety-regressiveness (15%). At the same time, 75% of the children were rated by teachers as “quite competent” in school. Parent, child and clinician appraisals of primary school children showed broad similarities. Teachers reported a similar prevalence of child distress, but identified different symptoms and different children demanding attention. Evaluation of teenage youths showed greater disparity: teenagers labeled their own symptoms more often as post-traumatic stress reactions and teachers identified few youths in need of attention. Inter-relatedness among parent, child and clinician appraisals supports the robustness of our semi-structured interview. At the same time, apartness of teacher report underscores the need to incorporate an outside-world vantage point in the process of risk assessment. Also, a more concrete presentation of post-traumatic stress reactions and a higher “further attention” threshold for inward emotional problems seem called for.

  • 254.
    Goodwin, G. M.
    et al.
    Warneford Hosp, Univ Dept Psychiat, Oxford OX3 7JX, England.
    Haddad, P. M.
    Greater Manchester West Mental Hlth NHS Fdn Trust, Manchester, Lancs, England.
    Ferrier, I. N.
    Newcastle Univ, Inst Neurosci, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England;Northumberland Tyne & Wear NHS Fdn Trust, Newcastle, NSW, Australia.
    Aronson, J. K.
    Radcliffe Observ Quarter, Nuffield Dept Primary Care Hlth Sci, Ctr Evidence Based Med, Oxford, England.
    Barnes, T. R. H.
    Univ London Imperial Coll Sci Technol & Med, Ctr Mental Hlth, Du Cane Rd, London, England.
    Cipriani, A.
    Warneford Hosp, Univ Dept Psychiat, Oxford OX3 7JX, England.
    Coghill, D. R.
    Univ Dundee, Ninewells Hosp & Med Sch, MACHS 2, Dundee DD1 9SY, Scotland;Univ Melbourne, Fac Med Dent & Hlth Sci, Dept Paediat, Melbourne, Vic, Australia;Univ Melbourne, Fac Med Dent & Hlth Sci, Dept Psychiat, Melbourne, Vic, Australia.
    Fazel, S.
    Warneford Hosp, Univ Dept Psychiat, Oxford OX3 7JX, England.
    Geddes, J. R.
    Warneford Hosp, Univ Dept Psychiat, Oxford OX3 7JX, England.
    Grunze, H.
    Univ Klin Paracelsus Med Privatuniv PMU, Christian Doppler Klin, Univ Klin Psychiat & Psychotherapie, Salzburg, Austria;Christian Doppler Klin Salzburg, Salzburg, Austria.
    Holmes, Emily A.
    MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Howes, O.
    Inst Psychiat, Box 67, London, England.
    Hudson, S.
    Bipolar UK, London, England.
    Hunt, N.
    Fulbourn Hosp, Cambridge, England.
    Jones, I.
    MRC, Ctr Neuropsychiat Genet & Genom, Cardiff, S Glam, Wales.
    Macmillan, I. C.
    Queen Elizabeth Hosp, Northumberland Tyne & Wear NHS Fdn Trust, Gateshead, Tyne & Wear, England.
    McAllister-Williams, H.
    Newcastle Univ, Inst Neurosci, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England;Northumberland Tyne & Wear NHS Fdn Trust, Newcastle, NSW, Australia.
    Miklowitz, D. R.
    Univ Calif Los Angeles, David Geffen Sch Med, Div Child & Adolescent Psychiat, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90095 USA.
    Morriss, R.
    Univ Nottingham, Inst Mental Hlth, Div Psychiat & Appl Psychol, Innovat Pk, Nottingham NG7 2RD, England.
    Munafo, M.
    Univ Bristol, Sch Expt Psychol, UK Ctr Tobacco & Alcohol Studies, MRC Integrat Epidemiol Unit, Bristol, Avon, England.
    Paton, C.
    Oxleas NHS Fdn Trust, Dartford, England.
    Saharkian, B. J.
    Univ Cambridge, Sch Clin Med, Addenbrookes Hosp, Dept Psychiat, Box 189, Cambridge, England.
    Saunders, K. E. A.
    Warneford Hosp, Univ Dept Psychiat, Oxford OX3 7JX, England.
    Sinclair, J. M. A.
    Univ Dept Psychiat, Southampton, Hants, England.
    Taylor, D.
    South London & Maudsley NHS Fdn Trust, Maudsley Hosp, Dept Pharm, London, England.
    Vieta, E.
    Univ Barcelona, Hosp Clin, IDIBAPS, CIBERSAM, Barcelona, Spain.
    Young, A. H.
    Kings Coll London, Ctr Affect Disorders, London, England.
    Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology2016In: Journal of Psychopharmacology, ISSN 0269-8811, E-ISSN 1461-7285, Vol. 30, no 6, p. 495-553Article, review/survey (Refereed)
    Abstract [en]

    The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.

  • 255.
    Goodwin, Guy M.
    et al.
    Univ Dept Psychiat, Oxford, England.
    Holmes, Emily A.
    Univ Dept Psychiat, Oxford, England.
    Bipolar anxiety2009In: REVISTA DE PSIQUIATRIA Y SALUD MENTAL, ISSN 1888-9891, Vol. 2, no 2, p. 95-98Article in journal (Other academic)
  • 256.
    Gotby, Vide Ohlsson
    et al.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Box 281, SE-17177 Stockholm, Sweden.
    Lichtenstein, Paul
    Karolinska Inst, Dept Med Epidemiol & Biostat, Box 281, SE-17177 Stockholm, Sweden.
    Långström, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Karolinska Inst, Dept Med Epidemiol & Biostat, Box 281, SE-17177 Stockholm, Sweden.
    Pettersson, Erik
    Karolinska Inst, Dept Med Epidemiol & Biostat, Box 281, SE-17177 Stockholm, Sweden.
    Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence: a population-based prospective twin study2018In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 59, no 9, p. 957-965Article in journal (Refereed)
    Abstract [en]

    Background: Autism spectrum disorder (ASD), Attention-deficit/Hyperactivity disorder (ADHD), and other related neurodevelopmental disorders (NDDs) have, in some previous studies, been shown to increase the risk of being sexually victimized. However, no studies have examined whether the association is driven by a general NDD phenotype versus specific diagnoses, nor the etiology of the association. Method: Using a genetically informative, prospective design, we examined the association between ASD and ADHD in childhood and coercive sexual victimization up to age 18. A total of 4,500 children participating in the Child and Adolescent Twin Study in Sweden (CATSS) were rated by their parents on NDDs at age 9 or 12 years, and self-reported at age 18 on lifetime experiences of coercive sexual touching and/or coercive sex. First, we regressed sexual victimization on the NDDs. Second, we regressed sexual victimization on general and specific NDD symptoms identified via a bifactor model. Third, we decomposed the observed associations into genetic and environmental parts. Results: In females, ASD was associated with an almost threefolded increased risk of coercive sexual victimization, and ADHD with a doubled risk. In males, the risk associated with ASD and ADHD was of the same magnitude but not significant. When controlling for overall NDD symptom load ASD or ADHD, no longer uniquely predicted coercive sexual victimization. The association between the NDD general factor and coercive sexual victimization was due to shared genetics. Conclusions: General NDD symptom load, rather than specific ASD or ADHD symptoms, seems to be a moderate vulnerability factor for coercive sexual victimization. We speculate that an evocative gene-environment correlation might account for this observation, such that sexual perpetrators actively target NDD individuals.

  • 257.
    Grafton, Ben
    et al.
    Univ Western Australia, Sch Psychol, Ctr Advancement Res Emot, M304,35 Stirling Highway, Crawley, WA 6009, Australia.
    MacLeod, Colin
    Babes Bolyai Univ, Sch Psychol, Univ Western Australia, Ctr Advancement Res Emot,Sch Psychol, Cluj Napoca, Romania.
    Rudaizky, Daniel
    Univ Western Australia, Sch Psychol, Ctr Advancement Res Emot, M304,35 Stirling Highway, Crawley, WA 6009, Australia.
    Holmes, Emily A.
    MRC, Cognit & Brain Sci Unit, Cambridge, England;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Salemink, Elske
    Univ Amsterdam, Dev Psychol, Amsterdam, Netherlands.
    Fox, Elaine
    Univ Oxford, Oxford Ctr Emot & Affect Neurosci, Oxford, England;Univ Oxford, Dept Expt Psychol, Oxford, England.
    Notebaert, Lies
    Univ Western Australia, Sch Psychol, Ctr Advancement Res Emot, M304,35 Stirling Highway, Crawley, WA 6009, Australia.
    Confusing procedures with process when appraising the impact of cognitive bias modification on emotional vulnerability2017In: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 211, no 5, p. 266-271Article in journal (Refereed)
    Abstract [en]

    If meta-analysis is to provide valuable answers, then it is critical to ensure clarify about the questions being asked. Here, we distinguish two important questions concerning cognitive bias modification research that are not differentiated in the meta-analysis recently published by Cristea et al (2015) in this journal: (1) do the varying procedures that investigators have employed with the intention of modifying cognitive bias, on average, significantly impact emotional vulnerability?; and (2) does the process of successfully modifying cognitive bias, on average, significantly impact emotional vulnerability? We reanalyse the data from Cristea et al to address this latter question. Our new analyses demonstrate that successfully modifying cognitive bias does significantly alter emotional vulnerability. We revisit Cristea et al's conclusions in light of these findings.

  • 258.
    Gravensteen, Ida Kathrine
    et al.
    Oslo Univ Hosp, Dept Forens Sci, Box 4950 Nydalen, N-0424 Oslo, Norway.
    Ekeberg, Öivind
    Univ Oslo, Inst Basic Med Sci, Dept Behav Sci Med, Fac Med, Box 1111 Blindern, N-0317 Oslo, Norway;Oslo Univ Hosp Ullevaal, Div Mental Hlth & Addict, Box 4956 Nydalen, Oslo, Norway.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Helweg-Larsen, Karin
    Univ Copenhagen, Dept Social Med, Copenhagen, Denmark.
    Hem, Erlend
    Univ Oslo, Inst Basic Med Sci, Dept Behav Sci Med, Fac Med, Box 1111 Blindern, N-0317 Oslo, Norway;Oslo Univ Hosp Ullevaal, Div Mental Hlth & Addict, Box 4956 Nydalen, Oslo, Norway.
    Rogde, Sidsel
    Oslo Univ Hosp, Dept Forens Sci, Box 4950 Nydalen, N-0424 Oslo, Norway;Univ Oslo, Inst Clin Med, Box 1072 Blindern, N-0316 Oslo, Norway.
    Töllefsen, Ingvild Maria
    Oslo Univ Hosp Ullevaal, Div Med, Dept Acute Med, Box 4950 Nydalen, N-0424 Oslo, Norway.
    Psychoactive substances in natural and unnatural deaths in Norway and Sweden: a study on victims of suicide and accidents compared with natural deaths in psychiatric patients2019In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 19, article id 33Article in journal (Refereed)
    Abstract [en]

    Background: The extent of post-mortem detection of specific psychoactive drugs may differ between countries, and may greatly influence the national death register's classification of manner and cause of death. The main objective of the present study was to analyse the magnitude and pattern of post-mortem detection of various psychoactive substances by the manner of death (suicide, accidental, undetermined and natural death with a psychiatric diagnosis) in Norway and Sweden.

    Methods: The Cause of Death Registers in Norway and Sweden provided data on 600 deaths in 2008 from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of death and 200 as natural deaths in individuals with a diagnosis of mental disorder as the underlying cause of death. We examined death certificates and forensic reports including toxicological analyses.

    Results: The detection of psychoactive substances was commonly reported in suicides (66 and 74% in Norway and Sweden respectively), accidents (85 and 66%), undetermined manner of deaths (80% in the Swedish dataset) and in natural deaths with a psychiatric diagnosis (50 and 53%). Ethanol was the most commonly reported substance in the three manners of death, except from opioids being more common in accidental deaths in the Norwegian dataset. In cases of suicide by poisoning, benzodiazepines and z-drugs were the most common substances in both countries. Heroin or morphine was the most commonly reported substance in cases of accidental death by poisoning in the Norwegian dataset, while other opioids dominated the Swedish dataset. Anti-depressants were found in 22% of the suicide cases in the Norwegian dataset and in 29% of suicide cases in the Swedish dataset.

    Conclusions: Psychoactive substances were detected in 66 and 74% of suicides and in 85 and 66% of accidental deaths in the Norwegian and Swedish datasets, respectively. Apart from a higher detection rate of heroin in deaths by accident in Norway than in Sweden, the pattern of detected psychoactive substances was similar in the two countries. Assessment of a suicidal motive may be hampered by the common use of psychoactive substances in suicide victims.

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  • 259.
    Gredebäck, Gustaf
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Kochukhova, Olga
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Goal anticipation during action observation is influenced by synonymous action capabilities, a puzzling developmental study2010In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 202, no 2, p. 493-497Article in journal (Refereed)
    Abstract [en]

    Eighteen- and 25-month-old human toddlers' ability to manually solve a puzzle and their ability to anticipate the goal during observation of similar actions were investigated. Results demonstrate that goal anticipation during action observation is dependent on manual ability, both on a group level (only 25-month-olds solved the manual task and anticipated the goal during observation) and individually within the older age group (r (xy) = 0.53). These findings suggests a connection between manual ability and the ability to anticipate the goal of others' actions in toddlers, in accordance with the direct matching hypothesis.

  • 260.
    Grey, Nick
    et al.
    Traumat Stress Clin, London, England.
    Holmes, Emily A.
    Traumat Stress Clin, London, England;UCL, London WC1E 6BT, England.
    Brewin, Chris R.
    UCL, London WC1E 6BT, England.
    PERITRAUMATIC EMOTIONAL "HOT SPOTS'' IN MEMORY2001In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 29, no 3, p. 367-372Article in journal (Refereed)
    Abstract [en]

    Individuals with posttraumatic stress disorder (PTSD) frequently report periods of intense emotional distress ("hot spots'') when asked to describe their traumatic experience in detail. "Primary'' emotions felt during the trauma (i.e., peri-traumatically) are believed to consist mainly of fear, helplessness and horror. We report a preliminary investigation into the emotions associated with these hot spots. Patients with PTSD described a wide variety of emotions such as anger, humiliation and guilt present at the time of the trauma. The peri-traumatic cognitions associated with these emotions are also detailed.

  • 261.
    Grey, Nick
    et al.
    Inst Psychiat, Ctr Anxiety Disorders & Trauma, London SE5 8AF, England.
    Young, Kerry
    Traumat Stress Clin, London, England.
    Holmes, Emily A.
    Traumat Stress Clin, London, England;UCL, London, England.
    COGNITIVE RESTRUCTURING WITHIN RELIVING: A TREATMENT FOR PERITRAUMATIC EMOTIONAL "HOTSPOTS'' IN POSTTRAUMATIC STRESS DISORDER2002In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 30, no 1, p. 37-56Article in journal (Refereed)
    Abstract [en]

    This paper describes a distinct clinical approach to the treatment of Posttraumatic Stress Disorder (PTSD). It is theoretically guided by recent cognitive models of PTSD and explicitly combines cognitive therapy techniques within exposure/reliving procedures. A clinically pertinent distinction is made between the cognitions and emotions experienced at the time of the trauma and, subsequently, in flashback experiences, and secondary negative appraisals. The term peritraumatic emotional "hotspot" is used to describe moments of peak distress during trauma. It is argued that a focus on cognitively restructuring these peritraumatic emotional hotspots within reliving can significantly improve the effectiveness of the treatment of PTSD and help explain some treatment failures with traditional prolonged exposure. An approach to the identification and treatment of these hotspots is detailed for a range of cognitions and emotions not limited to fear.

  • 262.
    Groenewold, Nynke
    et al.
    Univ Cape Town, Rondebosch, South Africa.
    Bas-Hoogendam, Janna Marie
    Leiden Univ, Med Ctr, Leiden, Netherlands.
    Amod, Alyssa R.
    Univ Cape Town, Rondebosch, South Africa.
    van Velzen, Laura
    Vrije Univ Amsterdam, Amsterdam, Netherlands.
    Aghajani, Moji
    Vrije Univ Amsterdam, Amsterdam, Netherlands; Leiden Inst Brain & Cognit, Leiden, Netherlands.
    Filippi, Courtney
    NIMH, NIH, Bethesda, MD 20892 USA.
    Gold, Andrea
    NIMH, NIH, Bethesda, MD 20892 USA.
    Ching, Christopher R. K.
    Univ Southern Calif, Keck Sch Med, Los Angeles, CA USA.
    Roelofs, Karin
    Radboud Univ Nijmegen, Behav Sci Inst, Nijmegen, Netherlands; Radboud Univ Nijmegen, Donders Inst Brain Cognit & Behav, Nijmegen, Netherlands.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Månsson, Kristoffer
    Stockholm Univ, Stockholm, Sweden; Karolinska Inst, Stockholm, Sweden.
    Straube, Thomas
    University of Münster, Münster, Germany.
    Peterburs, Jutta
    University of Münster, Münster, Germany.
    Klumpp, Heide
    Univ Illinois, Chicago, IL USA.
    Phan, K. Luan
    Univ Illinois, Chicago, IL USA.
    Lochner, Christine
    University of Münster, Münster, Germany.
    Doruyter, Alexander
    Stellenbosch Univ, Stellenbosch, South Africa.
    Pujol, Jesus
    Hosp Mar, CIBER SAM, Barcelona, Spain.
    Cardoner, Narcis
    Univ Autonoma Barcelona, Parc Tauli Hosp Univ, CIBERSAM, Barcelona, Spain.
    Blanco-Hinojo, Laura
    Hosp Mar, CIBER SAM, Barcelona, Spain.
    Beesdo-Baum, Katja
    Tech Univ Dresden, Dresden, Germany.
    Hilbert, Kevin
    Tech Univ Dresden, Dresden, Germany.
    Kreifelts, Benjamin
    Univ Tubingen, Tubingen, Germany.
    Erb, Michael
    Univ Tubingen, Tubingen, Germany.
    Gong, Qiyong
    Sichuan Univ, West China Hosp, HMRRC, Chengdu, Sichuan, Peoples R China.
    Lui, Su
    Sichuan Univ, West China Hosp, HMRRC, Chengdu, Sichuan, Peoples R China.
    Soares, Jair
    Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, Houston, TX 77030 USA.
    Wu, Mon-Ju
    Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, Houston, TX 77030 USA.
    Westenberg, P. Michiel
    Leiden Univ, Inst Psychol, Leiden, Netherlands.
    Grotegerd, Dominik
    Univ Münster, Münster, Germany.
    Leehr, Elisabeth J.
    Univ Münster, Münster, Germany.
    Dannlowski, Udo
    Univ Münster, Münster, Germany.
    Zwanzger, Peter
    Leiden Inst Brain & Cognit, Leiden, Netherlands.
    Veltman, Dick J.
    Vrije Univ Amsterdam, Amsterdam, Netherlands.
    Pine, Daniel S.
    NIMH, NIH, Bethesda, MD 20892 USA.
    Jahanshad, Neda
    Univ Southern Calif, Keck Sch Med, Los Angeles, CA USA.
    Thompson, Paul M.
    Univ Southern Calif, Keck Sch Med, Los Angeles, CA USA.
    Stein, Dan J.
    Univ Cape Town, Rondebosch, South Africa; Univ Munich, KBO Inn Salzach Hosp, Munich, Germany.
    van der Wee, Nic. J. A.
    Leiden Univ, Med Ctr, Leiden, Netherlands; Leiden Inst Brain & Cognit, Leiden, Netherlands; Leiden Univ, Leiden, Netherlands.
    Subcortical Volumes in Social Anxiety Disorder: Preliminary Results From Enigma-Anxiety2018In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 83, no 9, p. S247-S248Article in journal (Other academic)
  • 263.
    Grönbladh, Leif
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience.
    A National Swedish Methadone Program 1966-19892004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Methadone Maintenance treatment of compulsive opioid addiction was started by the study of Dole and Nyswander (1965) and has subsequently been replicated in programs throughout the world. Methadone treatment has become the most effective modality for the treatment of chronic heroin addiction.

    In 1966 a Swedish National methadone maintenance program was opened at the Psychiatric Research Center, Ulleråker hospital at Uppsala.

    The aim of this thesis was to study the outcome of methadone treatment along various lines:

    • An open randomised controlled study comparing the efficacy of methadone treatment and drug free treatment in 34 heroin addicts, 20-24 years of age.

    • Before/after comparisons of rehabilitation among 345 heroin addicts admitted during the 23 years when this was a centralised National program.

    • Retention in treatment.

    Study subjects, methods and treatment goals: Subjects underwent an admission procedure when background data was collected through hospital records, and personal interviews. Therapeutic efforts focused on vocational rehabilitation, i.e. a return to full-time work or studies, hoping to make patients abandon their drug addict’s life-style and make them socially accepted and self-supporting.

    Results: Thirty-four heroin addicts with a history of 4-8 years of heroin use were randomly assigned either to methadone treatment (17) or an untreated control group (17). The controls could not apply for methadone treatment until two years later. Outcome after six years observation showed that 81% became free of drug abuse, while the corresponding figure for the controls was only 1/17 (6%). The mean yearly death rate for the controls was 7.2%. Likewise, among the total material of 345 heroin addicts, 70-80% of the patients became engaged in work or studies, a significant increase compared with the situation before treatment (1.7%). The program was an effective reducer of illicit heroin use and criminality among its patients and prevented the occurrence of HIV infection among patients in long-term methadone treatment. The average one-year retention during 1967-1989 was 90% and cumulative retention showed that 29% were still in treatment 10 years after admission.

    Conclusion: The present results emphasise the importance of vocational rehabilitation and support in a treatment strategy based on long-term maintenance therapy.

    List of papers
    1. The Swedish methadone maintenance program: A controlled study
    Open this publication in new window or tab >>The Swedish methadone maintenance program: A controlled study
    1981 In: Drug and Alcohol Dependence, p. 249-256Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-91373 (URN)
    Available from: 2004-02-10 Created: 2004-02-10Bibliographically approved
    2. Methadone-assisted rehabilitation of Swedish heroin addicts
    Open this publication in new window or tab >>Methadone-assisted rehabilitation of Swedish heroin addicts
    1989 In: Drug and Alcohol Dependance, Vol. 24, p. 31-37Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-91374 (URN)
    Available from: 2004-02-10 Created: 2004-02-10Bibliographically approved
    3. Mortality in heroin addiction: impacat of methadone treatment
    Open this publication in new window or tab >>Mortality in heroin addiction: impacat of methadone treatment
    1990 In: Acta Psychiatr Scand, Vol. 82, p. 233-237Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-91375 (URN)
    Available from: 2004-02-10 Created: 2004-02-10Bibliographically approved
    4. The impacat of methadone maintenance treatment on the spread of HIV among iv heroin addicts in Sweden
    Open this publication in new window or tab >>The impacat of methadone maintenance treatment on the spread of HIV among iv heroin addicts in Sweden
    1991 In: Loimer, N, Schmid, A (eds) Drug Addiction and Aids, 1991, p. 200-205Chapter in book (Other academic) Published
    Identifiers
    urn:nbn:se:uu:diva-91376 (URN)
    Available from: 2004-02-10 Created: 2004-02-10Bibliographically approved
    5. The street life and treatment respons of 105 heroin addicted women
    Open this publication in new window or tab >>The street life and treatment respons of 105 heroin addicted women
    1995 In: Tagliamonte, A, Maremanni I (eds) Drug addiction and related clinical problems, 1995, p. 91-107Chapter in book (Other academic) Published
    Identifiers
    urn:nbn:se:uu:diva-91377 (URN)
    Available from: 2004-02-10 Created: 2004-02-10Bibliographically approved
    6. Treatment characteristics and retention in methadone maintenance
    Open this publication in new window or tab >>Treatment characteristics and retention in methadone maintenance
    2002 In: Heroin Addiction and related Clinical Problems, Vol. 4, p. 37-45Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-91378 (URN)
    Available from: 2004-02-10 Created: 2004-02-10Bibliographically approved
    Download full text (pdf)
    FULLTEXT01
  • 264.
    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.

  • 265.
    Gustafsson, Carina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Intellectual Disability and Mental Health Problems: Evaluation of Two Clinical Assessment Instruments, Occurrence of Mental Health Problems and Psychiatric Care Utilisation2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    It has been suggested that persons with intellectual disabilities (ID) manifest the full range of mental health problems. The main purpose of this thesis is to adapt and evaluate two clinical assessment instruments and to investigate the occurrence of mental health problems as well as psychiatric care utilisation in persons with ID.

    The psychometric properties of a Swedish version of the two instruments [Reiss Screen for Maladaptive Behaviour (RSMB) and the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)] were investigated in a random, institutional and clinical sample of administratively defined (ADDEF) adults with ID (n = 199). The analyses suggest that the RSMB could be used as intended by staff as a primary screening device for the identification of mental health problems in persons with ID, and that the PIMRA had a potential to identify individuals with a specific mental disorder. The psychometric evaluation reveals that the Swedish versions of the RSMB and PIMRA measure a construct related to the diagnostic categories in the DSM-III-R and DSM-IV. This construct could be conceptualised as mental health problems.

    The RSMB and PIMRA results show that the overall occurrence of mental health problems in ADDEF samples of persons with ID (175 men and 148 women) ranged from 34 to 64%.

    The preliminary level of ID was mild (23%), moderate (39%) and severe (38%). The most common mental health problems were aggressive and self-injurious behaviours, depression, anxiety and adjustment disorders. In registered patients receiving out- or in-patient psychiatric care the occurrence of adults with an ICD-10 diagnosis of ID was approximately 1% (70 to 90% had a mild level of ID).

    In contrast to the high frequency of mental health problems reported, psychiatric care was used infrequently. This tendency is particularly evident in persons with moderate and severe ID.

    List of papers
    1. The prevalence of people with intellectual disability admitted to general hospital psychiatric units: level of handicap, psychiatric diagnoses and care utilization
    Open this publication in new window or tab >>The prevalence of people with intellectual disability admitted to general hospital psychiatric units: level of handicap, psychiatric diagnoses and care utilization
    1997 In: Journal of Intellectual Disability Research, Vol. 41, no 6, p. 519-526Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-90693 (URN)
    Available from: 2003-09-08 Created: 2003-09-08Bibliographically approved
    2. Psychometric evaluation of a Swedish version of the Reiss Screen for Maladaptive Behavior
    Open this publication in new window or tab >>Psychometric evaluation of a Swedish version of the Reiss Screen for Maladaptive Behavior
    2002 (English)In: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 46, no 3, p. 218-229Article in journal (Refereed) Published
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-90694 (URN)10.1046/j.1365-2788.2002.00398.x (DOI)000175116300004 ()11896807 (PubMedID)
    Available from: 2003-09-08 Created: 2003-09-08 Last updated: 2017-12-14Bibliographically approved
    3. A psychometric evaluation of the Swedish version of the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)
    Open this publication in new window or tab >>A psychometric evaluation of the Swedish version of the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)
    Article in journal (Refereed) Submitted
    Identifiers
    urn:nbn:se:uu:diva-90695 (URN)
    Available from: 2003-09-08 Created: 2003-09-08Bibliographically approved
    4. Occurrence of mental health problems in Swedish samples of adults with intellectual disabilities
    Open this publication in new window or tab >>Occurrence of mental health problems in Swedish samples of adults with intellectual disabilities
    Article in journal (Refereed) Submitted
    Identifiers
    urn:nbn:se:uu:diva-90696 (URN)
    Available from: 2003-09-08 Created: 2003-09-08Bibliographically approved
    Download full text (pdf)
    FULLTEXT01
  • 266.
    Hackmann, A
    et al.
    Univ Oxford, Oxford OX1 2JD, England;Inst Psychiat, London, England;MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Holmes, Emily A.
    Univ Oxford, Oxford OX1 2JD, England;Inst Psychiat, London, England;MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Reflecting on imagery: A clinical perspective and overview of the special issue of Memory on mental imagery and memory in psychopathology2004In: Memory, ISSN 0965-8211, E-ISSN 1464-0686, Vol. 12, no 4, p. 389-402Article in journal (Refereed)
    Abstract [en]

    The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post-traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.

  • 267.
    Hagenaars, Muriel A.
    et al.
    Leiden Univ, Dept Clin Hlth & Neuropsychol, NL-2300 RB Leiden, Netherlands.
    Brewin, Chris R.
    UCL, London WC1E 6BT, England.
    van Minnen, Agnes
    Overwaal Ctr Anxiety Disorders, Nijmegen, Netherlands;Radboud Univ Nijmegen, Nijmegen, Netherlands.
    Holmes, Emily A.
    Univ Oxford, Oxford OX1 2JD, England.
    Hoogduin, Kees A. L.
    Radboud Univ Nijmegen, Nijmegen, Netherlands.
    Intrusive images and intrusive thoughts as different phenomena: Two experimental studies2010In: Memory, ISSN 0965-8211, E-ISSN 1464-0686, Vol. 18, no 1, p. 76-84, article id PII 918662140Article in journal (Refereed)
    Abstract [en]

    According to the dual representation theory of PTSD, intrusive trauma images and intrusive verbal thoughts are produced by separate memory systems. In a previous article it was shown that after watching an aversive film, participants in non-movement conditions reported more intrusive images than participants in a free-to-move control condition (Hagenaars, Van Minnen, Holmes, Brewin, Hoogduin, 2008). The present study investigates whether the experimental conditions of the Hagenaars et al. study had a different effect on intrusive thoughts than on intrusive images. Experiment 2 further investigated the image-thoughts distinction by manipulating stimulus valence (trauma film versus neutral film) and assessing the subsequent development of intrusive images and thoughts. In addition, both experiments studied the impact of peri-traumatic emotions on subsequent intrusive images and thoughts frequency across conditions. Results showed that experimental manipulations (non-movement and trauma film) caused higher levels of intrusive images relative to control conditions (free movement and neutral film) but they did not affect intrusive thoughts. Peri-traumatic anxiety and horror were associated with subsequent higher levels of intrusive images, but not intrusive thoughts. Correlations were inconclusive for anger and sadness. The results suggest intrusive images and thoughts can be manipulated independently and as such can be considered different phenomena.

  • 268.
    Hagenaars, Muriel A
    et al.
    Behavioural Science Institute, The Netherlands.
    Holmes, Emily A.
    Department of Psychiatry, Oxford University, UK.
    Mental Imagery in Psychopathology: Another Step: Editorial for the special issue of Journal of Experimental Psychopathology2012In: Journal of Experimental Psychopathology, ISSN 2043-8087, E-ISSN 2043-8087, Vol. 3, no 2, p. 121-126Article in journal (Refereed)
  • 269.
    Hagenaars, Muriel A.
    et al.
    Radboud Univ Nijmegen, NL-6525 ED Nijmegen, Netherlands.
    van Minnen, Agnes
    GGZ Nijmegen, Nijmegen, Netherlands.
    Holmes, Emily A.
    Univ Oxford, Oxford, England.
    Brewin, Chris R.
    UCL, London, England.
    Hoogduin, Kees A. L.
    Radboud Univ Nijmegen, NL-6525 ED Nijmegen, Netherlands.
    The effect of hypnotically induced somatoform dissociation on the development of intrusions after an aversive film2008In: Cognition & Emotion, ISSN 0269-9931, E-ISSN 1464-0600, Vol. 22, no 5, p. 944-963Article in journal (Refereed)
    Abstract [en]

    Peritraumatic dissociation is thought to effect trauma information encoding, leading to PTSD symptoms like intrusive memories. Most studies have focused on peritraumatic psychological dissociation. The present experiment studied the impact of hypnotically induced somatoform dissociation (dissociative non-movement) versus deliberate non-movement during an aversive film on intrusion development. Seventy-nine participants were randomised into three conditions: dissociative non-movement (catalepsy), deliberate non-movement, and non-restricted control. Participants recorded their intrusions of the film in a diary for one week. In the dissociative non-movement condition, catalepsy effectively provoked somatoform dissociation. Spontaneous somatoform dissociation across conditions was positively related to implicit bias to film-related words and negatively related to explicit recall, but was not related to intrusion frequency. Dissociative non-movement and deliberate non-movement conditions combined had more intrusions than controls. However, the dissociative non-movement group did not have more intrusions than deliberate non-movement and control groups combined. The implications of these findings are discussed.

  • 270.
    Haglund, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Forced medication in psychiatric care: patient experiences and nurse perceptions2003In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 10, no 1, p. 65-72Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to describe: patient experiences of and nurse perceptions of patient experiences of forced medication before, during and after forced medication; patient and nurse perceptions of alternatives to forced medication; and whether patients, according to patients and nurses, retrospectively approved of forced medication. Eleven patients and nurses were interviewed about a certain situation of forced medication. Data were analysed by content analysis. The findings demonstrate that forced medication evokes a number of patient experiences according to patients and nurses. These are related to the disease, the situation of being forcibly medicated and the drug. Patients mentioned several alternatives to the forced medication, whereas nurses mentioned no alternatives. A minority of the patients, and not as many patients as the nurses’ thought, retrospectively approved of the use of forced medication. It can be concluded that patients and nurses do not share the same perceptions about what patients experience when forcibly medicated.

  • 271.
    Haglund, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Psychiatric wards with locked doors: advantages and disadvantages according to nurses and mental health nurse assistants2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 4, p. 387-394Article in journal (Refereed)
    Abstract [en]

    Aims and objective. To describe nurses’ and mental health nurse assistants’ perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door.

    Background. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent.

    Design. The study was explorative and descriptive.

    Method. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis.

    Results. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against ‘the outside’. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients’ needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants.

    Conclusion. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients’ experiences.

    Relevance to clinical practice. It is important for staff working within psychiatric care to reflect upon the fact that a locked entrance door is connected with a range of negative as well as positive perceptions and to minimize patient and own concerns connected to the locked door.

  • 272.
    Hagström, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Ander, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Cernvall, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Ljótsson, Brjánn
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Wiman, Henrik W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Woodford, Joanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Heeding the psychological concerns of young cancer survivors: A single-arm feasibility trial of CBT and a cognitive behavioral conceptualization of distress2020In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 8, article id e8714Article in journal (Refereed)
    Abstract [en]

    Background

    A subgroup of adolescent and young adult (AYA) survivors of cancer during adolescence report high levels of psychological distress. To date, evidence-based psychological interventions tailored to the cancer-related concerns experienced by this population are lacking. The present study aimed to (1) examine the feasibility and preliminary efficacy of an individualized cognitive behavioral therapy (CBT) intervention for AYA survivors of cancer during adolescence; and (2) identify and conceptualize cancer-related concerns as well as maintaining factors using cognitive-behavioral theory.

    Methods

    A single-arm trial, whereby AYA survivors of cancer during adolescence (aged 17–25 years) were provided individualized face-to-face CBT at a maximum of 15 sessions. Clinical outcomes were assessed at baseline, post-intervention, and three-month follow-up. Intervention uptake, retention, intervention delivery, and reliable change index scores were examined. An embedded qualitative study consisted of two unstructured interviews with each participant pre-intervention. Along with individual behavioral case formulations developed to guide the intervention, interview data was analyzed to identify and conceptualize cancer-related concerns and potential maintaining factors.

    Results

    Ten out of 213 potential participants invited into the study were included, resulting in an overall participation rate of 4.7%. Nine participants completed the intervention, with respectively seven and eight participants completing the post-intervention and three month follow-up assessment. The majority of reported cancer-related concerns and maintaining factors were conceptualized into four themes: social avoidance, fear of emotions and bodily symptoms, imbalance in activity, and worry and rumination.

    Conclusions

    Given significant recruitment difficulties, further research is required to examine barriers to help-seeking in the AYA cancer survivor population. However, the conceptualization of cancer-related concerns and maintaining factors experienced by the population may represent an important first step in the development of psychological support tailored toward AYA cancer survivors’ unique needs.

    Download full text (pdf)
    Peerj.8714
  • 273.
    Hales, Susie A.
    et al.
    Univ Oxford, Dept Psychiat, Oxford OX3 7JX, England.
    Deeprose, Catherine
    Univ Oxford, Dept Psychiat, Oxford OX3 7JX, England.
    Goodwin, Guy M.
    Univ Oxford, Dept Psychiat, Oxford OX3 7JX, England.
    Holmes, Emily A.
    Univ Oxford, Dept Psychiat, Oxford OX3 7JX, England.
    Cognitions in bipolar affective disorder and unipolar depression: imagining suicide2011In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 13, no 7-8, p. 651-661Article in journal (Refereed)
    Abstract [en]

    Objective: Bipolar disorder has the highest rate of suicide of all the psychiatric disorders. In unipolar depression, individuals report vivid, affect-laden images of suicide or the aftermath of death (flashforwards to suicide) during suicidal ideation but this phenomenon has not been explored in bipolar disorder. Therefore the authors investigated and compared imagery and verbal thoughts related to past suicidality in individuals with bipolar disorder (n = 20) and unipolar depression (n = 20). Methods: The study used a quasi-experimental comparative design. The Structured Clinical Interview for DSM-IV was used to confirm diagnoses. Quantitative and qualitative data were gathered through questionnaire measures (e. g., mood and trait imagery use). Individual interviews assessed suicidal cognitions in the form of (i) mental images and (ii) verbal thoughts. Results: All participants reported imagining flashforwards to suicide. Both groups reported greater preoccupation with these suicide-related images than with verbal thoughts about suicide. However, compared to the unipolar group, the bipolar group were significantly more preoccupied with flashforward imagery, rated this imagery as more compelling, and were more than twice as likely to report that the images made them want to take action to complete suicide. In addition, the bipolar group reported a greater trait propensity to use mental imagery in general. Conclusions: Suicidal ideation needs to be better characterized, and mental imagery of suicide has been a neglected but potentially critical feature of suicidal ideation, particularly in bipolar disorder. Our findings suggest that flashforward imagery warrants further investigation for formal universal clinical assessment procedures.

  • 274.
    Hales, Susie A.
    et al.
    Oxford Inst Clin Psychol Training, Oxford, England.
    Di Simplicio, Martina
    Imperial Coll London, Brain Sci Div, Ctr Psychiat, London, England;MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Iyadurai, Lalitha
    Univ Oxford, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Oxford, England.
    Blackwell, Simon E.
    Ruhr Univ Bochum, Bochum, Germany.
    Young, Kerry
    Cent & North West London NHS Fdn Trust, London, England.
    Fairburn, Christopher G.
    Univ Oxford, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Oxford, England.
    Geddes, John R.
    Univ Oxford, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Oxford, England;NIHR Oxford Hlth Biomed Res Ctr, Oxford, England.
    Goodwin, Guy M.
    Univ Oxford, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Oxford, England.
    Holmes, Emily A.
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden.
    Imagery-Focused Cognitive Therapy (ImCT) for Mood Instability and Anxiety in a Small Sample of Patients with Bipolar Disorder: a Pilot Clinical Audit2018In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 46, no 6, p. 706-725Article in journal (Refereed)
    Abstract [en]

    Background: Despite the global impact of bipolar disorder (BD), treatment success is limited. Challenges include syndromal and subsyndromal mood instability, comorbid anxiety, and uncertainty around mechanisms to target. The Oxford Mood Action Psychology Programme (OxMAPP) offered a novel approach within a cognitive behavioural framework, via mental imagery-focused cognitive therapy (ImCT). Aims: This clinical audit evaluated referral rates, clinical outcomes and patient satisfaction with the OxMAPP service. Method: Eleven outpatients with BD received ImCT in addition to standard psychiatric care. Mood data were collected weekly from 6 months pre-treatment to 6 months post-treatment via routine mood monitoring. Anxiety was measured weekly from start of treatment until 1 month post-treatment. Patient feedback was provided via questionnaire. Results: Referral and treatment uptake rates indicated acceptability to referrers and patients. From pre- to post-treatment, there was (i) a significant reduction in the duration of depressive episode relapses, and (ii) a non-significant trend towards a reduction in the number of episodes, with small to medium effect size. There was a large effect size for the reduction in weekly anxiety symptoms from assessment to 1 month follow-up. Patient feedback indicated high levels of satisfaction with ImCT, and underscored the importance of the mental imagery focus. Conclusions: This clinical audit provides preliminary evidence that ImCT can help improve depressive and anxiety symptoms in BD as part of integrated clinical care, with high patient satisfaction and acceptability. Formal assessment designs are needed to further test the feasibility and efficacy of the new ImCT treatment on anxiety and mood instability.

  • 275.
    Halonen, Jaana
    et al.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Merikukka, Marko
    Natl Inst Hlth & Welf THL, Dept Welf, Oulu, Finland; Univ Oulu, PEDEGO Res Uni, Oulu, Finland.
    Gissler, Mika
    Natl Inst Hlth & Welf THL, Informat Serv Dept, Helsinki, Finland; Univ Turku, Res Ctr Child Psychiat, Turku, Finland; Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Stockholm, Sweden.
    Kerkelä, Martta
    Natl Inst Hlth & Welf THL, Dept Welf, Oulu, Finland.
    Virtanen, Marianna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Ristikari, Tiina
    Natl Inst Hlth & Welf THL, Dept Welf, Oulu, Finland.
    Hiilamo, Heikki
    Univ Helsinki, Social & Publ Policy, Dept Social Res, Helsinki, Finland.
    Lallukka, Tea
    Finnish Inst Occupat Hlth, Helsinki, Finland; Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood—The 1987 Finnish Birth Cohort2019In: Depression and anxiety (Print), ISSN 1091-4269, E-ISSN 1520-6394, Vol. 36, no 4, p. 305-312Article in journal (Refereed)
    Abstract [en]

    Background: Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence.

    Methods: Study population consisted of the 1987 Finnish Birth Cohort. Data on parents’ psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants’ health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring's health and social disadvantage.

    Results: The pathway model indicated that the association from parental mental disorders to offspring's work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring's psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46–2.34) in the model including offspring's mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47–2.35) and 28% for social disadvantage in adolescence.

    Conclusions: These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.

  • 276.
    Hammarberg, Anders
    et al.
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Riddargatan 1, S-11435 Stockholm, Sweden.; Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Öster, Caisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nehlin, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Drinking motives of adult patients seeking treatment for problematic alcohol use2017In: Journal of Addictive Diseases, ISSN 1055-0887, E-ISSN 1545-0848, Vol. 36, no 2, p. 127-135Article in journal (Refereed)
    Abstract [en]

    The Drinking Motives Questionnaire measures motives for alcohol consumption on four subscales. Coping with negative affect and enhancement of positive affect have been shown to be associated with high levels of alcohol consumption and alcohol-related problems. Few studies exist concerning drinking motives among treatment-seeking patients. The aims of the study were to investigate the factor structure of the shortened-form of the revised Drinking Motives Questionnaire, map main drinking motives, explore group differences in motives due to sex, age, level of drinking problems, and symptoms of depression/anxiety and to investigate whether different drinking motives predict alcohol-related problems in this group. There were 274 treatment-seeking patients recruited from four addiction treatment clinics in Sweden. The shortened-form of the revised Drinking Motives Questionnaire was administered in conjunction with a regular visit to the clinics together with measures of degree of alcohol-related problems, psychiatric symptoms, and demographic factors. Main drinking motives were identified. A confirmatory factor analysis was run to confirm the factor structure of the shortened-form of the revised Drinking Motives Questionnaire. A logistic regression using the Enter method was performed to investigate associations between predictors and Alcohol Use Disorder Identification Test scores. The results confirmed the four-factor structure reported in studies on non-treatment-seeking individuals. Coping was the most commonly expressed motive. Not previously found in a clinical sample, the results showed that coping motives, together with being male and having elevated anxiety scores, were associated to Alcohol Use Disorder Identification Test scores indicative of alcohol dependence. The shortened-form of the revised Drinking Motives Questionnaire is a brief and valid instrument that holds potential for clinical use in mapping drinking motives among treatment seekers.

  • 277.
    Han, Laura K. M.
    et al.
    Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Res Inst, Dept Psychiat, Oldenaller 1, Netherlands;Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Neurosci, Dept Psychiat, Boelelaan 1117, Amsterdam, Netherlands.
    Verhoeven, Josine E.
    Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Res Inst, Dept Psychiat, Oldenaller 1, Netherlands.
    Tyrka, Audrey R.
    Brown Univ, Butler Hosp, Providence, RI 02912 USA;Brown Univ, Warren Alpert Med Sch, Dept Psychiat & Human Behav, Providence, RI 02912 USA.
    Penninx, Brenda W. J. H.
    Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Res Inst, Dept Psychiat, Oldenaller 1, Netherlands;Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Neurosci, Dept Psychiat, Boelelaan 1117, Amsterdam, Netherlands.
    Wolkowitz, Owen M.
    Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA USA;Univ Calif San Francisco, Sch Med, Weill Inst Neurosci, San Francisco, CA USA.
    Månsson, Kristoffer N.T.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Stockholm Univ, Dept Psychol, Stockholm, Sweden;.
    Lindqvist, Daniel
    Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA USA;Lund Univ, Dept Clin Sci, Fac Med, Psychiat, Lund, Sweden;Psychiat Clin, Div Psychiat, Lund, Sweden.
    Boks, Marco P.
    Univ Med Ctr Utrecht, Dept Psychiat, Brain Ctr Rudolf Magnus, Utrecht, Netherlands.
    Revesz, Dora
    Tilburg Univ, Dept Med & Clin Psychol, Ctr Res Psychol Somat Dis CoRPS, Tilburg, Netherlands.
    Mellon, Synthia H.
    Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA USA;Univ Calif San Francisco, Sch Med, Weill Inst Neurosci, San Francisco, CA USA.
    Picard, Martin
    Columbia Univ, Med Ctr, Div Behav Med, Dept Psychiat, New York, NY 10027 USA;Columbia Univ, Med Ctr, Columbia Translat Neurosci Initiat, Dept Neurol,H Houston Merritt Ctr, New York, NY USA;Columbia Univ, Columbia Aging Ctr, New York, NY USA.
    Accelerating research on biological aging and mental health: Current challenges and future directions2019In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 106, p. 293-311Article in journal (Refereed)
    Abstract [en]

    Aging is associated with complex biological changes that can be accelerated, slowed, or even temporarily reversed by biological and non-biological factors. This article focuses on the link between biological aging, psychological stressors, and mental illness. Rather than comprehensively reviewing this rapidly expanding field, we highlight challenges in this area of research and propose potential strategies to accelerate progress in this field. This effort requires the interaction of scientists across disciplines - including biology, psychiatry, psychology, and epidemiology; and across levels of analysis that emphasize different outcome measures - functional capacity, physiological, cellular, and molecular. Dialogues across disciplines and levels of analysis naturally lead to new opportunities for discovery but also to stimulating challenges. Some important challenges consist of 1) establishing the best objective and predictive biological age indicators or combinations of indicators, 2) identifying the basis for inter-individual differences in the rate of biological aging, and 3) examining to what extent interventions can delay, halt or temporarily reverse aging trajectories. Discovering how psychological states influence biological aging, and vice versa, has the potential to create novel and exciting opportunities for healthcare and possibly yield insights into the fundamental mechanisms that drive human aging.

  • 278.
    Hartzell, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    The First Meeting at Child and Adolescent Psychiatry2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Children and parents who visited child and adolescent psychiatry (CAP) for the first time were interviewed in the presence of their therapists about the first meeting. The interview was intended to make the attendants describe in their own words what the meeting was like for them. The interview was repeated after six months to get complementary information. Research assistants, reflectors, helped the interviewer to prevent from bias and to hold on to the theme.

    The grounded theory approach was utilised in papers I, II, and III, and qualitative content analysis was used in paper IV.

    Children appreciated the therapist being in an active as well as in a more passive but alert position, moving between asking adjusted questions and including the parents. The therapists’ skill of listening was also important to them.

    For the parents, it was important what happened between their child and the therapists. They questioned their own role and presence. Also, they focused on the plan for the meeting and for the coming process. Certain things that happened in the dialogue were useful after the meeting. The results indicate that what was helpful was connected to family therapy matters rather than psychiatric ones.

    The therapists balanced between a psychiatric and a family therapeutic position, and it was a dilemma for them how to best fulfil their assignment in the organisation as they perceived it.

    Two competing discourses were found in the first meeting; Structuring, which stood for structure, planning and expertise, while Collaboration represented negotiations of how to work together, empowerment and emotional aspects. The Structuring discourse tended to dominate. Both discourses consisted of valuable elements that needed to be included to ensure that the atmosphere would not be too strict or too flexible.

    The findings are tentative because of the lack of studies to compare to, and because of the few interviews made.

     

     

     

    List of papers
    1. Structuring and Collaboration: Balancing Discourses in the First Meeting at Child and Adolescent Psychiatry
    Open this publication in new window or tab >>Structuring and Collaboration: Balancing Discourses in the First Meeting at Child and Adolescent Psychiatry
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    The aim was to join together children's, parents' and therapists' views and detect discourses and their influence in the first meeting. Data were collected in joint interviews and qualitative content analysis was used. Two competing discourses were found; Structuring, which was instrumental and Collaboration, concerning relational aspects. The latter dominated. All three parties conveyed that both discourses needed to be acknowledged to avoid that the meeting would be too strict or too flexible.

    Keywords
    Discourse, child psychiatry, family therapy, first meeting, Diskurs, barnpsykiatri, familjeterapi, första mötet
    National Category
    Psychiatry
    Research subject
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-129921 (URN)
    Projects
    The first meeting at Child and Adolescent Psychiatry
    Available from: 2010-08-26 Created: 2010-08-26 Last updated: 2010-08-27Bibliographically approved
    2. What children feel about their first encounter with child and adolescent psychiatry
    Open this publication in new window or tab >>What children feel about their first encounter with child and adolescent psychiatry
    2009 (English)In: Contemporary family therapy, ISSN 0892-2764, E-ISSN 1573-3335, Vol. 31, no 3, p. 177-192Article in journal (Refereed) Published
    Abstract [en]

    The first meeting in psychotherapeutic and psychosocial work, has a big impacton the continuation. It is a less explored research field. Children’s ‘‘voices’’ tend to come inthe back-ground in family therapy and other settings. In a project at CAP (Child andAdolescent Psychiatry) the children’s views were collected in interviews with parents andtherapists present. The grounded theory analysis process was used. The children addressedthe importance of the therapist’s actions and positions in helping them to be able tocommunicate and to be in a dialogue. To be accepted and allowed to express feelings wasimportant, and so was how the therapist managed to adjust to each person in the room andgive space for various perspectives.

    Keywords
    Family therapy, Child psychiatry, First interview, Children’s views
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-125136 (URN)10.1007/s10591-009-9090-x (DOI)
    Available from: 2010-05-07 Created: 2010-05-07 Last updated: 2017-12-12Bibliographically approved
    3. Parents' perception of their first encounter with child and adolescent psychiatry
    Open this publication in new window or tab >>Parents' perception of their first encounter with child and adolescent psychiatry
    2010 (English)In: Contemporary family therapy, ISSN 0892-2764, E-ISSN 1573-3335, ISSN 0892-2764, Vol. 32, no 3, p. 273-289Article in journal (Refereed) Published
    Abstract [en]

    Parents who came with their child to Child and Adolescent Psychiatry (CAP) for the first time were interviewed 1–2 weeks afterwards in the presence of the child and the therapists. In a grounded theory analysis they revealed uncertainty about their role in the first meeting as well as of future planning. What had been important to them were aspects like communication, sharing perspectives, and the reformulation of problems.

     

    Place, publisher, year, edition, pages
    Springer, 2010
    Keywords
    Family therapy, parents' views, child psychiatry, first interview, Familjeterapi, föräldrars synpunkter, barnpsykiatri, första mötet
    National Category
    Psychiatry
    Research subject
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-129914 (URN)10.1007/s10591-010-9119-1 (DOI)
    Projects
    The first meeting in child and adolescent psychiatry
    Available from: 2010-08-25 Created: 2010-08-25 Last updated: 2017-12-12Bibliographically approved
    4. Therapists' Views of the First Meeting at Child and Adolescent Psychiatry
    Open this publication in new window or tab >>Therapists' Views of the First Meeting at Child and Adolescent Psychiatry
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Therapists’ influence on the therapeutic relationship is not much studied. In the first session in child and adolescent psychiatry (CAP) therapists are supposed to conduct assignments connected to the medical model. In psychotherapy the first meeting is regarded as having great impact on the continuation. Despite this, there are few studies on the issue. The aim was to learn more about the therapists’ perception of first meetings in CAP.

    Therapists were interviewed together with the families they had met. Reflectors helped the interviewer to hold on to the theme. The interviews were video-recorded. The data analysis was inspired by grounded theory.

    Two aspects appeared in the therapists’ descriptions, psychiatric and family psychotherapeutic ones. Psychiatric aspects included the demands from the organisation like making assessments and making families want to come back. In the meeting it converged with wishes from the family members: wanting to be in a dialogue with their therapists and negotiating the planning process. The therapists addressed that parents and children contributed to success in the meeting. Balancing between the psychiatric and the family psychotherapeutic aspects without questioning one’s own professional skills as CAP personnel seemed to be a challenge for the therapists.

    Keywords
    Therapists' views, family therapy, child psychiatry, first interview, Behandlares synpunkter, familjeterapi, barnpsykiatri, första mötet
    National Category
    Psychiatry
    Research subject
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-129922 (URN)
    Projects
    The First Meeting at Child and Adolescent Psychiatry
    Available from: 2010-08-26 Created: 2010-08-26 Last updated: 2010-08-26Bibliographically approved
    Download full text (pdf)
    FULLTEXT01
  • 279.
    Hartzell, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Seikkula, Jaakko
    Jyväskylä universitet.
    Structuring and Collaboration: Balancing Discourses in the First Meeting at Child and Adolescent PsychiatryManuscript (preprint) (Other academic)
    Abstract [en]

    The aim was to join together children's, parents' and therapists' views and detect discourses and their influence in the first meeting. Data were collected in joint interviews and qualitative content analysis was used. Two competing discourses were found; Structuring, which was instrumental and Collaboration, concerning relational aspects. The latter dominated. All three parties conveyed that both discourses needed to be acknowledged to avoid that the meeting would be too strict or too flexible.

  • 280.
    Hartzell, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Seikkula, Jaakko
    Jyväskylä universitet.
    von Knorring, Anne-Liis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Parents' perception of their first encounter with child and adolescent psychiatry2010In: Contemporary family therapy, ISSN 0892-2764, E-ISSN 1573-3335, ISSN 0892-2764, Vol. 32, no 3, p. 273-289Article in journal (Refereed)
    Abstract [en]

    Parents who came with their child to Child and Adolescent Psychiatry (CAP) for the first time were interviewed 1–2 weeks afterwards in the presence of the child and the therapists. In a grounded theory analysis they revealed uncertainty about their role in the first meeting as well as of future planning. What had been important to them were aspects like communication, sharing perspectives, and the reformulation of problems.

     

  • 281.
    Hartzell, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Seikkula, Jaakko
    Jyväskylä universitet.
    von Knorring, Anne-Liis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Therapists' Views of the First Meeting at Child and Adolescent PsychiatryManuscript (preprint) (Other academic)
    Abstract [en]

    Therapists’ influence on the therapeutic relationship is not much studied. In the first session in child and adolescent psychiatry (CAP) therapists are supposed to conduct assignments connected to the medical model. In psychotherapy the first meeting is regarded as having great impact on the continuation. Despite this, there are few studies on the issue. The aim was to learn more about the therapists’ perception of first meetings in CAP.

    Therapists were interviewed together with the families they had met. Reflectors helped the interviewer to hold on to the theme. The interviews were video-recorded. The data analysis was inspired by grounded theory.

    Two aspects appeared in the therapists’ descriptions, psychiatric and family psychotherapeutic ones. Psychiatric aspects included the demands from the organisation like making assessments and making families want to come back. In the meeting it converged with wishes from the family members: wanting to be in a dialogue with their therapists and negotiating the planning process. The therapists addressed that parents and children contributed to success in the meeting. Balancing between the psychiatric and the family psychotherapeutic aspects without questioning one’s own professional skills as CAP personnel seemed to be a challenge for the therapists.

  • 282. Hasan, Alkomiet
    et al.
    Falkai, Peter
    Wobrock, Thomas
    Lieberman, Jeffrey
    Glenthoj, Birte
    Gattaz, Wagner F
    Thibaut, Florence
    Möller, Hans-Jürgen
    World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects2013In: World Journal of Biological Psychiatry, ISSN 1562-2975, E-ISSN 1814-1412, Vol. 14, no 1, p. 2-44Article in journal (Refereed)
    Abstract [en]

    These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful. They are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A-F) and five levels of recommendation (1-5) ( Bandelow et al. 2008a ,b, World J Biol Psychiatry 9:242, see Table 1 ). This second part of the updated guidelines covers long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication and other pharmacological treatment options) of adults suffering from schizophrenia.

  • 283.
    Haug, Sigrid Helene Kjorven
    et al.
    MF Norwegian Sch Theol, Innlandet Hosp Trust, Ctr Psychol Relig, Ottestad, Norway..
    DeMarinis, Valerie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions.
    Danbolt, Lars Johan
    MF Norwegian Sch Theol, Innlandet Hosp Trust, Ctr Psychol Relig, Ottestad, Norway..
    Kvigne, Kari
    Hemark Univ Coll, Inst Nursing & Mental Hlth, Dept Publ Hlth, Elverum, Norway.;Nesna Univ Coll, Dept Nursing, Elverum, Norway..
    The illness reframing process in an ethnic-majority population of older people with incurable cancer: variations of cultural- and existential meaning-making adjustments2016In: Mental Health, Religion & Culture, ISSN 1367-4676, E-ISSN 1469-9737, Vol. 19, no 2, p. 150-163Article in journal (Refereed)
    Abstract [en]

    Increasing numbers of older people in Western countries are living with incurable cancer as a chronic disease, receiving palliative care from specialised healthcare contexts. The study's aim was to understand variations of cultural- and existential meaning-making adjustments in a Norwegian majority population of older people with incurable cancer. Semi-structured interviews from 21 participants, aged 70-88, were analysed according to three identified types of belief frames: atheistic/humanistic, religious, and spiritual. Kleinman's medical anthropology cultural framework was adapted and applied deductively together with a reframing metaphor concept in a four-part analytic process. Independent of the differences among the types of belief frames and heterogeneous illness reframing processes, changes in the existential cultural dimension seemed to facilitate psychosocial adjustments in relation to illness, daily living, relationships, and surroundings. The results point to the need for collecting and assessing the function of this type of patient information for better understanding the patient's framework of interpretation, and for identifying treatment-planning resources.

  • 284.
    Hedborg, Kerstin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Anderberg, Ulla Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Muhr, Carin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Stress in migraine: personality-dependent vulnerability, life events, and gender are of significance2011In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 116, no 3, p. 187-199Article in journal (Refereed)
    Abstract [en]

    Background and aim. The individual's experiences of stress as well as constitutional factors, including high neuroticism and female gender, are known determinants for migraine. The present aim was to further elucidate factors of personality and stress, including life events, in relation to gender in migraine. Methods. A cross-sectional study was performed on 150 persons, 106 women and 44 men, suffering from at least two migraine attacks a month. All obtained a doctor-defined migraine diagnosis based on a structured face-to-face interview concerning their health situation and current and prior stress. All of them also answered validated questionnaires regarding personality traits (SSP), life events, and perceived ongoing stress. Results. The personality trait inventory showed high mean scores for stress susceptibility and low mean scores for aggressiveness and adventure seeking, both for women and for men, as well as high mean scores for psychic and somatic anxiety in women. Stress susceptibility, the overall most deviant trait, correlated strikingly with current level of stress in both sexes. In women, stress susceptibility also correlated strongly with experiences of negative life events. Tension-type headache, anxiety, and depression were approximately twice as prevalent in women compared to men. Conclusions. The present study confirms previous research, showing that stress is an important factor in migraine. Stress susceptibility, life events, and concomitant psychosomatic illnesses should be considered important when evaluating individuals with migraine, and gender aspects need to be taken into account.

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    fulltext
  • 285.
    Heinsoo, Julia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Arnberg, Filip K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Assessing Prolonged Grief Disorder: Psychometric properties of the Swedish PG-132017Conference paper (Refereed)
  • 286. Heir, Trond
    et al.
    Rosendal, Susanne
    Bergh-Johannesson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Michel, Per-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Mortensen, Erik L.
    Weisaeth, Lars
    Andersen, Henrik S.
    Hultman, Christina M.
    Tsunami-affected Scandinavian tourists: Disaster exposure and post-traumatic stress symptoms2011In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 65, no 1, p. 9-15Article in journal (Refereed)
    Abstract [en]

    Background: Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies. Aims: To examine the association between exposure to the 2004 Southeast Asian tsunami and symptoms of post-traumatic stress in three Scandinavian tourist populations. Methods: Postal survey of Norwegian, Danish and Swedish Southeast Asia tourists registered by the police when arriving at national airports. Follow-up time was 6 (Norway), 10 (Denmark) and 14 months (Sweden) post-disaster; 6772 individuals were included and categorized according to disaster exposure: danger exposed (caught or chased by the waves), non-danger exposed (other disaster-related stressors) and non-exposed. Outcome measures were the Impact of Event Scale-Revised (IES-R) and Post Traumatic Stress Disorder Check List (PCL). Results: Danger exposed reported more post-traumatic stress than non-danger exposed, and the latter reported more symptoms than non-exposed (each P<0.001). Comparison of the Norwegian and Swedish data suggested that symptoms were attenuated at 14 months follow-up (P<0.001). Female gender and low education, but not age, predicted higher levels of symptoms. Conclusions: Disaster-exposed tourists repatriated to unaffected home environments show long-term post-traumatic stress disorder symptoms related to the severity of exposure.

  • 287.
    Helles, Adam
    et al.
    Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Gillberg Neuropsychiat Ctr, Gothenburg, Sweden;Uppsala Univ, Ctr Res & Dev, Uppsala, Sweden;Cty Council Gavleborg, Gavle, Sweden.
    Wallinius, Marta
    Lund Univ, Dept Clin Sci, Lund, Sweden.
    Gillberg, I. Carina
    Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Gillberg Neuropsychiat Ctr, Gothenburg, Sweden.
    Gillberg, Christopher
    Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Gillberg Neuropsychiat Ctr, Gothenburg, Sweden.
    Billstedt, Eva
    Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Gillberg Neuropsychiat Ctr, Gothenburg, Sweden.
    Asperger syndrome in childhood - personality dimensions in adult life: temperament, character and outcome trajectories2016In: BJPsych Open, E-ISSN 2056-4724, Vol. 2, no 3, p. 210-216Article in journal (Refereed)
    Abstract [en]

    Background Temperament and character have been shown to be important factors in understanding psychiatric and neurodevelopmental disorder. Adults with autism spectrum disorder (ASD) have repeatedly been shown to have a distinct temperament and character, but this has not been evaluated in relation to psychiatric comorbidity and ASD diagnostic stability. Aims To examine temperament and character in males that were diagnosed with ASD in childhood and followed prospectively over almost two decades. Method Temperament and character were assessed in 40 adult males with a childhood diagnosis of ASD. Results were analysed by the stability of ASD diagnosis over time and current psychiatric comorbidity. Results Three distinct temperament and character profiles emerged from the data. Those no longer meeting criteria for ASD had high reward dependence while those with a stable ASD diagnosis and psychiatric comorbidity showed elevated harm avoidance and low self-directedness and cooperativeness. Finally, those with a stable ASD and no comorbidity showed low novelty seeking and somewhat elevated harm avoidance. Conclusions Temperament and character are important factors correlated with long-term diagnostic stability and psychiatric comorbidity in males diagnosed with ASD in childhood.

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    FULLTEXT01
  • 288.
    Henje-Blom, Eva
    et al.
    Department of Clinical Neuroscience, Karolinska Institute.
    Olsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care.
    Serlachius, Eva
    Department of Woman and Child Health, Karolinska Institute.
    Respiratory Patterns in Adolescent Girls with Anxiety and Depression As Compared to Healthy Controls2012Conference paper (Refereed)
  • 289.
    Henriksson, Hanna E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Malavaki, Christina
    Metabolic Engineering & Systems Biology Laboratory, Institute of Chemical Engineering Sciences, Foundation for Research and Technology-Hellas (FORTH/ICE-HT), Patras, Greece.
    Bränn, Emma
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Drainas, Vasilis
    Metabolic Engineering & Systems Biology Laboratory, Institute of Chemical Engineering Sciences, Foundation for Research and Technology-Hellas (FORTH/ICE-HT), Patras, Greece; Department of Chemical Engineering, University of Patras, Patras, Greece .
    Lager, Susanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Iliadis, Stavros I
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Papadopoulos, Fotios
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Chrousos, George P.
    First Department of Pediatrics, Athens University Medical School, Athens, Greece.
    Klapa, Maria I.
    Metabolic Engineering & Systems Biology Laboratory, Institute of Chemical Engineering Sciences, Foundation for Research and Technology-Hellas (FORTH/ICE-HT), Patras, Greece.
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Blood plasma metabolic profiling of pregnant women with antenatal depressive symptoms2019In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 9, article id 204Article in journal (Refereed)
    Abstract [en]

    Antenatal depression affects similar to 9-19% of pregnant women and can exert persistent adverse effects on both mother and child. There is a need for a deeper understanding of antenatal depression mechanisms and the development of tools for reliable diagnosis and early identification of women at high risk. As the use of untargeted blood metabolomics in the investigation of psychiatric and neurological diseases has increased substantially, the main objective of this study was to investigate whether untargeted gas chromatography-mass spectrometry (GC-MS) plasma metabolomics in 45 women in late pregnancy, residing in Uppsala, Sweden, could indicate metabolic differences between women with and without depressive symptoms. Furthermore, seasonal differences in the metabolic profiles were explored. When comparing the profiles of cases with controls, independently of season, no differences were observed. However, seasonal differences were observed in the metabolic profiles of control samples, suggesting a favorable cardiometabolic profile in the summer vs. winter, as indicated by lower glucose and sugar acid concentrations and lactate to pyruvate ratio, and higher abundance of arginine and phosphate. Similar differences were identified between cases and controls among summer pregnancies, indicating an association between a stressed metabolism and depressive symptoms. No depression-specific differences were apparent among depressed and non-depressed women, in the winter pregnancies; this could be attributed to an already stressed metabolism due to the winter living conditions. Our results provide new insights into the pathophysiology of antenatal depression, and warrant further investigation of the use of metabolomics in antenatal depression in larger cohorts.

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  • 290.
    Henriksson, Hanna E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetric research.
    Sylvén, Sara M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetric research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kallak, Theodora Kunovac
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Papadopoulos, Fotios
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetric research.
    Seasonal patterns in self-reported peripartum depressive symptoms2017In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 43, p. 99-108Article in journal (Refereed)
    Abstract [en]

    Background: In the peripartum period, the literature on seasonality in depression is still scarce and studies present varying findings. The aims of this study were to investigate whether seasonal patterns in postpartum depressive symptoms previously identified in a Swedish study could be replicated in a larger study, as well as to assess seasonal patterns in depressive symptoms during pregnancy.

    Methods: This was a nested case-control study comprised of 4129 women who participated in the BASIC project and gave birth at Uppsala University Hospital, Uppsala, Sweden, between February 2010 and December 2015.

    Results: Women who gave birth in October-December 2011 had an increased odds of depressive symptoms at 6 weeks postpartum, when compared with women giving birth in April-June 2011 (aOR = 2.42; 95% CI: 1.12-5.26). The same pattern was found among women with a history of depression. No other seasonal patterns for depressive symptoms during pregnancy or at 6 weeks postpartum were identified.

    Conclusions: In general, no consistent seasonal patterns were found in peripartum depressive symptoms. Whether the seasonal patterns found in some studies during certain years may be due to other factors relating to specific years and seasons, such as extreme climatic conditions or other particular events, warrants further investigation.

  • 291.
    Hensler, Ida
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Cernvall, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Arnberg, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    PTSD Coach Sweden: A Self-Management App for Trauma-Related Symptoms: A RCT study protocol evaluating a self-help app for posttraumatic stress in a Swedish community sample2019In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 10, no S1, article id 4–010Article in journal (Other academic)
    Abstract [en]

    Background: Resources to administer evidence-based care for PTSD and trauma-related complications are scarce, especially in particular geographical areas, during mass casualty situations and for individuals with subclinical symptoms as clinics prioritize more severe cases. Effective interventions for PTSD through technical platforms could disseminate information and self-management strategies to decrease individual suffering and societal costs. Assessment at multiple time points can elucidate which aspects of an intervention that are effective, in addition to the evolution of intervention use and well-being over time. 

    Objective: Evaluate an app-administered self-help intervention (PTSD Coach Sweden) aiming to reduce and manage PTSD symptoms and other related complications. 

    Method: In this trial, 200 participants from Sweden who have experienced a traumatic event in the past two years and who report posttraumatic stress symptoms will be randomized to three months use of the app or waitlist. The primary endpoint is self-rated PTSD symptom severity at three months, with follow-up at six and nine months. Secondary outcomes include depressive symptoms, physical symptoms, functional impairment and health care use. Ecological momentary assessment of health status and use of strategies corresponding to app content is used for 21 days during the first three months.

    Results: Lessons learned and recommendations from the preparations of app-based intervention trials are presented. Available data from the primary endpoint are presented. 

    Conclusions: App-based interventions hold promise to increase outreach, but further trials are needed. Several challenges introduced when preparing an app-based intervention are discussed.

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  • 292.
    Heyes, S. Burnett
    et al.
    Univ Oxford, Dept Expt Psychol, Oxford OX1 3UD, England.
    Lau, J. Y. F.
    Univ Oxford, Dept Expt Psychol, Oxford OX1 3UD, England.
    Holmes, Emily A.
    MRC Cognit & Brain Sci, Cambridge, England.
    Mental imagery, emotion and psychopathology across child and adolescent development2013In: Developmental Cognitive Neuroscience, ISSN 1878-9293, E-ISSN 1878-9307, Vol. 5, p. 119-133Article, review/survey (Refereed)
    Abstract [en]

    Mental imagery-based interventions are receiving increasing interest for the treatment of psychological disorders in adults. This is based on evidence that mental imagery potently influences the experience of emotion in non-clinical samples, and that a number of psychological disorders are marked by syndrome-specific, distressing abnormalities in mental imagery. During childhood and adolescence, neurocognitive development impacting mental imagery processes may moderate its relationship with clinically-relevant emotional symptoms at a number of potential loci. Crucially, these changes could impact vulnerability to distressing mental imagery and the efficacy of mental imagery-based clinical interventions. This review synthesises evidence pertaining to developmental changes in the role and content of mental imagery, and in the cognitive sub-processes required to generate and sustain mental images. Subsequently, we discuss implications for understanding the developmental relationship between mental imagery, emotion and psychopathology. Translational cognitive neuroscience research investigating the content, emotional impact and neurocognitive substrates of mental imagery across development may reveal insights into trajectories of vulnerability to symptoms of a number of psychological disorders. If proper consideration is given to developmental factors, techniques based on mental imagery may be valuable as part of a treatment armoury for child and adolescent clinical populations and those at risk of emotional disorders. (C) 2013 Elsevier Ltd. All rights reserved.

  • 293.
    Hildingsson, Ingegerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Sense of coherence in pregnant and new mothers - A longitudinal study of a national cohort of Swedish speaking women2017In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 11, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Background: Previous research shows inconsistent results about the stability of SOC during the childbearing period, and few studies have focused on longitudinal measures. There are contradictory results regarding the association between SOC and birth outcome. The link between levels of SOC and parental stress needs to be further explored. Aim: The aim of this study was to investigate changes in SOC from early pregnancy to one year after birth and associations with background characteristics, birth outcome and parental stress. Methods: A longitudinal survey of a national cohort of Swedish speaking women during 3 weeks in 1999-2000. Data were collected by questionnaires in early pregnancy, 2 months and 1 year after birth. Results: SOC increased from pregnancy to 2 months after birth but decreased 1 year after birth. SOC was associated with women's background characteristics, emotional wellbeing and attitudes, but not with labour outcome. Women with low SOC reported higher parental stress after one year. Conclusion: Sense of coherence is not stable during the childbearing period and is associated with women's sociodemographic background, emotional health and attitudes, but not with reproductive history or birth outcome. Parental stress is negatively correlated with SOC, and some important characteristics are similar in women having low SOC and high parental stress. Identifying women with low SOC in early pregnancy could be a means to prevent later parental stress.

  • 294.
    Hjorth, Olof
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Imaging serotonin and dopamine transporters in social anxiety disorder: Characterization, treatment and expectancy effects2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The monoamines serotonin and dopamine are likely to be involved in the pathophysiology of social anxiety and other affective disorders, but their respective contributions and putative interactions in the causes and cures of these disorders are still not well understood. It is also largely unknown if and how expectations of treatment success affect brain neurochemistry and neural activations, and if expectations interact with antidepressants like selective serotonin reuptake inhibitors (SSRIs). In this thesis some of these issues were addressed by use of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Using the highly selective radiotracers [11C]DASB and [11C]PE2I to characterize the availability of serotonin (SERT) and dopamine (DAT) transporter proteins, study I compared non-displaceable binding potentials (BPND), probing the transporters, between patients with social anxiety disorder and healthy controls. Increased SERT binding was observed in the reward related region nucleus accumbens (NAcc), in the social anxiety group. Moreover, increased DAT binding was associated with severity of the disorder and social anxiety was also associated with higher SERT-DAT co-expression in fear- and reward-related areas, including the amygdala and NAcc. Study II showed that verbal instructions regarding expected treatment efficacy strongly affected the clinical outcome of SSRI-treatment. Overt treatment, when patients with social anxiety disorder were correctly informed, was vastly superior to covert SSRI treatment, when patients expected an ineffective placebo. Groups were also differentiated on objective brain activity measures. Study III further demonstrated different SERT and DAT binding changes in limbic and striatal areas with overt as compared to covert SSRI-treatment. Decreased DAT BPND in the striatum, as assessed with PET, correlated with improvement in the overt group, suggesting increased dopaminergic signalling. Study IV compared treatment-induced changes in SERT and DAT binding after cognitive-behavior therapy (CBT) combined with an SSRI or placebo in patients with social anxiety disorder. Both groups showed initial co-expression similar to study I. The SSRI+CBT and placebo+CBT combinations yielded dissimilar transporter change patterns. Higher SERT occupancy in the NAcc correlated with reduced symptoms and this relationship was moderated by the change in DAT BPND. The results of this thesis support that functional interactions between serotonin and dopamine modulate social anxiety symptomatology and are important brain targets for successful treatment. Further it demonstrates that the treatment success of SSRIs in social anxiety disorder depends on how the treatment is presented. These results can be informative for the practice of clinicians, but also highlights an ethical dilemma because a large portion of the total treatment effects is elicited by processes within the patient itself.

    List of papers
    1. Expression and co-expression of serotonin and dopamine transporters in social anxiety disorder: a multitracer positron emission tomography study.
    Open this publication in new window or tab >>Expression and co-expression of serotonin and dopamine transporters in social anxiety disorder: a multitracer positron emission tomography study.
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    2019 (English)In: Molecular Psychiatry, ISSN 1359-4184, E-ISSN 1476-5578Article in journal (Refereed) Epub ahead of print
    Abstract [en]

    Serotonin and dopamine are putatively involved in the etiology and treatment of anxiety disorders, but positron emission tomography (PET) studies probing the two neurotransmitters in the same individuals are lacking. The aim of this multitracer PET study was to evaluate the regional expression and co-expression of the transporter proteins for serotonin (SERT) and dopamine (DAT) in patients with social anxiety disorder (SAD). Voxel-wise binding potentials (BPND) for SERT and DAT were determined in 27 patients with SAD and 43 age- and sex-matched healthy controls, using the radioligands [11C]DASB (3-amino-4-(2-dimethylaminomethylphenylsulfanyl)-benzonitrile) and [11C]PE2I (N-(3-iodopro-2E-enyl)-2beta-carbomethoxy-3beta-(4'-methylphenyl)nortropane). Results showed that, within transmitter systems, SAD patients exhibited higher SERT binding in the nucleus accumbens while DAT availability in the amygdala, hippocampus, and putamen correlated positively with symptom severity. At a more lenient statistical threshold, SERT and DAT BPND were also higher in other striatal and limbic regions in patients, and correlated with symptom severity, whereas no brain region showed higher binding in healthy controls. Moreover, SERT/DAT co-expression was significantly higher in SAD patients in the amygdala, nucleus accumbens, caudate, putamen, and posterior ventral thalamus, while lower co-expression was noted in the dorsomedial thalamus. Follow-up logistic regression analysis confirmed that SAD diagnosis was significantly predicted by the statistical interaction between SERT and DAT availability, in the amygdala, putamen, and dorsomedial thalamus. Thus, SAD was associated with mainly increased expression and co-expression of the transporters for serotonin and dopamine in fear and reward-related brain regions. Resultant monoamine dysregulation may underlie SAD symptomatology and constitute a target for treatment.

    National Category
    Psychology
    Identifiers
    urn:nbn:se:uu:diva-400349 (URN)10.1038/s41380-019-0618-7 (DOI)31822819 (PubMedID)
    Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2020-03-06Bibliographically approved
    2. Do You Believe It? Verbal Suggestions Influence the Clinical and Neural Effects of Escitalopram in Social Anxiety Disorder: A Randomized Trial
    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: 2020-03-06Bibliographically approved
    3. Response expectancies shape the effect of SSRI treatment on serotonin and dopamine transporters in patients with social anxiety disorder
    Open this publication in new window or tab >>Response expectancies shape the effect of SSRI treatment on serotonin and dopamine transporters in patients with social anxiety disorder
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-406310 (URN)
    Available from: 2020-03-06 Created: 2020-03-06 Last updated: 2020-03-06
    4. Changes in serotonin and dopamine transporter availability after combined treatment with escitalopram and cognitive-behavioral therapy in patients with social anxiety disorder
    Open this publication in new window or tab >>Changes in serotonin and dopamine transporter availability after combined treatment with escitalopram and cognitive-behavioral therapy in patients with social anxiety disorder
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-406311 (URN)
    Available from: 2020-03-06 Created: 2020-03-06 Last updated: 2020-03-06
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  • 295.
    Hjorth, Olof
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Frick, Andreas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Gingnell, Malin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Engman, Jonas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Björkstrand, Johannes
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Faria, Vanda
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Alaie, Iman
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Carlbring, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Andersson, Gerhard
    Jonasson, My
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Lubberink, Mark
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Antoni, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preclinical PET-MRI Platform. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preparative Medicinal Chemistry.
    Larsson, Elna-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Reis, Margareta
    Wahlstedt, Kurt
    Fredrikson, Mats
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Changes in serotonin and dopamine transporter availability after combined treatment with escitalopram and cognitive-behavioral therapy in patients with social anxiety disorderManuscript (preprint) (Other academic)
  • 296.
    Hjorth, Olof
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Frick, Andreas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Gingnell, Malin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Motilla Hoppe, Johanna
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Faria, Vanda
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Hultberg, Sara
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Alaie, Iman
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Månsson, Kristoffer N.T.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Rosén, Jörgen
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Reis, Margareta
    Wahlstedt, Kurt
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Jonasson, My
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Lubberink, Mark
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Antoni, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preclinical PET-MRI Platform. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preparative Medicinal Chemistry.
    Fredrikson, Mats
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Response expectancies shape the effect of SSRI treatment on serotonin and dopamine transporters in patients with social anxiety disorderManuscript (preprint) (Other academic)
  • 297. Hodgins, Sheilagh
    et al.
    Lövenhag, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Rehn, Mattias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    A 5-year follow-up study of adolescents who sought treatment for substance misuse in Sweden2014In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 23, no 5, p. 347-360Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown that substance misuse in adolescence is associated with increased risks of hospitalizations for mental and physical disorders, convictions for crimes, poverty, and premature death from age 21 to 50. The present study examined 180 adolescent boys and girls who sought treatment for substance misuse in Sweden. The adolescents and their parents were assessed independently when the adolescents first contacted the clinic to diagnose mental disorders and collect information on maltreatment and antisocial behavior. Official criminal files were obtained. Five years later, 147 of the ex-clients again completed similar assessments. The objectives were (1) to document the prevalence of alcohol use disorders (AUD) and drug use disorders (DUD) in early adulthood; and (2) to identify family and individual factors measured in adolescence that predicted these disorders, after taking account of AUD and DUD in adolescence and treatment. Results showed that AUD, DUD, and AUD + DUD present in mid-adolescence were in most cases also present in early adulthood. Prediction models detected no positive effect of treatment in limiting persistence of these disorders. Thus, treatment-as-usual provided by the only psychiatric service for adolescents with substance misuse in a large urban center in Sweden failed to prevent the persistence of substance misuse. Despite extensive clinical assessments of the ex-clients and their parents, few factors assessed in mid-adolescence were associated with substance misuse disorders 5 years later. It may be that family and individual factors in early life promote the mental disorders that precede adolescent substance misuse.

  • 298.
    Hogstedt, Carl
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden.
    Forsell, Yvonne
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.
    Hemmingsson, Tomas
    Karolinska Inst, Occupat & Environm Med, Stockholm, Sweden;Stockholm Univ, Ctr Social Res Alcohol & Drug, Stockholm, Sweden.
    Lundberg, Ingvar
    Karolinska Inst, Occupat & Environm Med, Stockholm, Sweden.
    Lundin, Andreas
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.
    Psychological Symptoms in Late Adolescence and Long-Term Risk of Suicide and Suicide Attempt2018In: Journal of Suicide and Life-threatening Behaviour, ISSN 0363-0234, E-ISSN 1943-278X, Vol. 48, no 3, p. 315-327Article in journal (Refereed)
    Abstract [en]

    Mental disorders in the general population are associated with increased risk of suicidality, but less is known about the independent predictive ability of self-reported psychological symptoms. We followed 49,321 screened and interviewed Swedish conscripts through 36-year follow-up to test whether psychological symptoms predicted suicide and hospitalization for suicide attempts. There were 619 suicides and 1,230 suicide attempts during the follow-up period. After excluding subjects with any psychiatric diagnoses (n=5,691, 12%) and controlling for other psychological symptoms, severe symptoms of anger, trouble falling asleep, and feeling down predicted suicide. Similarly anger, headaches, feeling down, and nervousness predicted suicide attempt. Self-reported psychological symptoms may have a predictive value beyond psychiatric diagnosis.

  • 299. Holm, H.
    et al.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Bjorkenstam, E.
    Bjorkenstam, C.
    Increased mortality in young women with personality disorder2013In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 28, no S1, p. 1841-Article in journal (Other academic)
  • 300.
    Holm, Jonas
    et al.
    Orebro Univ, Sch Med Sci, Orebro, Sweden..
    Brus, Ole
    Orebro Univ, Sch Med Sci, Clin Epidemiol & Biostat, Orebro, Sweden..
    Båve, Ullvi
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Landen, Mikael
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.;Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Gothenburg, Sweden..
    Lundberg, Johan
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden..
    Nordanskog, Pia
    Linkoping Univ, Dept Clin & Expt Med, Ctr Social & Affect Neurosci, Fac Hlth Sci, Linkoping, Sweden.;Reg Ostergotland, Dept Psychiat, Linkoping, Sweden..
    von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nordenskjöld, Axel
    Orebro Univ, Sch Med Sci, Orebro, Sweden..
    Improvement of cycloid psychosis following electroconvulsive therapy2017In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 71, no 6, p. 405-410Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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