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  • 751.
    Voogt, L. Amar
    et al.
    GGD Zaanstreek Waterland, Vurehout 2, NL-1507 EC Zaandam, Netherlands.;Mental Hlth Care Hosp GGZ Noord Holland Noord, Heerhugowaard, Netherlands.;Radboud Univ Nijmegen, Med Ctr, NL-6525 ED Nijmegen, Netherlands..
    Nugter, Annet
    Mental Hlth Care Hosp GGZ Noord Holland Noord, Heerhugowaard, Netherlands..
    van Achterberg, Theo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Radboud Univ Nijmegen, Med Ctr, NL-6525 ED Nijmegen, Netherlands.;Katholieke Univ Leuven, Leuven, Belgium..
    Goossens, Peter J. J.
    Radboud Univ Nijmegen, Med Ctr, NL-6525 ED Nijmegen, Netherlands.;Dimence Mental Hlth Care, Deventer, Netherlands.;GGZ VS Inst Educ Clin Nurse Specialist Mental Hlt, Utrecht, Netherlands.;Univ Ghent, B-9000 Ghent, Belgium..
    Development of the Psychiatric Nursing Intervention Providing Structure: An International Delphi Study2016In: Journal of the American Psychiatric Nurses Association, ISSN 1078-3903, E-ISSN 1532-5725, Vol. 22, no 2, p. 100-111Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychiatric nurses commonly refer to providing structure (PS) as a key intervention. But no consensus exists about what PS entails. PS can be understood as a complex intervention. In four previous studies, a definition, activities, and context variables were described that were presented to experts in a Delphi study. OBJECTIVE: To reach consensus about the definition of PS, its activities, and context variables. DESIGN: In a qualitative study, a Delphi study is used to gather the opinions of experts. The Delphi study consisted of three rounds with statements to score in each round. RESULTS: Experts reached consensus about a definition of PS, its activities, and context variables. Eleven statements related to the definition were accepted. Fourteen statements of a total of 17 statements related to the specific activities reached sufficient agreement, and 4 statements related to context variables were accepted. CONCLUSIONS: A definition could be given of PS with 4 general PS activities, 15 specific activities, and 3 context variables. Psychiatric nurses can use the information about PS to reflect on the use of PS activities within their own working environment, and these insights can help nurses develop their professional growth.

  • 752.
    Vrettou, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Comasco: Neuropsychopharmacology.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Tuvblad, Catherine
    Orebro Univ, Sch Law Psychol & Social Work, Orebro, Sweden; Univ Southern Calif, Dept Psychol, Los Angeles, CA USA.
    Rehn, Mattias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Åslund, Cecilia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Andershed, Anna-Karin
    Orebro Univ, Sch Law Psychol & Social Work, Orebro, Sweden.
    Wallén-Mackenzie, Åsa
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Organismal Biology, Comparative Physiology.
    Andershed, Henrik
    Orebro Univ, Sch Law Psychol & Social Work, Orebro, Sweden.
    Hodgins, Sheilagh
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden; Univ Montreal, Inst Univ Sante Mentale Montreal, Montreal, PQ, Canada.
    Nylander, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Comasco, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Comasco: Neuropsychopharmacology.
    VGLUT2 rs2290045 genotype moderates environmental sensitivity to alcohol-related problems in three samples of youths2019In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 28, no 10, p. 1329-1340Article in journal (Refereed)
    Abstract [en]

    The importance of Vesicular Glutamate Transporter 2 (VGLUT2)-mediated neurotransmission has been highlighted in studies on addiction-related phenotypes. The single nucleotide polymorphism rs2290045 in VGLUT2 has been associated with alcohol dependence, but it is unknown whether or how this association is affected by environmental factors. The present study determined whether the association of alcohol-related problems with the rs2290045 in the VGLUT2 gene was modified by negative and positive environmental factors. Three samples were included: a clinical sample of 131 adolescents followed from age 17 to 22; a general population sample of 1794 young adults; and a general population sample of 1687 adolescents followed from age 14 to 17. DNA was extracted from saliva and the rs2290045 (T/C) was genotyped. Alcohol-related problems were assessed using the Alcohol Use Disorders Identification Test. Stressful life events (SLE) and parenting were assessed by questionnaires. Gene-environment interactions were investigated using a dual statistical approach. In all samples (effect sizes 0.6-6.2%), and consistent with the differential susceptibility framework, T carriers exposed to SLE reported more alcohol-related problems if they had experienced poor parenting, and lower alcohol-related problems if they had received supportive parenting. T carriers not exposed to SLE reported higher alcohol-related problems if they had received supportive parenting and lower alcohol-related problems if they had received poor parenting. Among CC carriers, alcohol-related problems did not vary as a function of negative and positive environmental factors. In conclusion, in three samples of youths, alcohol-related problems were associated with an interaction of VGLUT2 rs2290045, SLE, and parenting.

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  • 753.
    Wallen, E. Flygare
    et al.
    Stockholm Cty Council, Acad Primary Hlth Care Ctr, Solnavagen 1e, S-11365 Stockholm, Sweden.;Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ljunggren, G.
    Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Stockholm Cty Council, Publ Hlth Care Serv Comm Adm, Stockholm, Sweden..
    Carlsson, Axel C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Pettersson, D.
    Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Wändell, P.
    Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    High prevalence of diabetes mellitus, hypertension and obesity among persons with a recorded diagnosis of intellectual disability or autism spectrum disorder2018In: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 62, no 4, p. 269-280Article in journal (Refereed)
    Abstract [en]

    Background: Obesity and lack of physical activity are frequently reported in persons with intellectual disability (ID) or autism spectrum disorder (ASD). We hypothesised a higher prevalence of diabetes and hypertension in this population.

    Method: We used administrative data for all primary and specialist outpatient and inpatient healthcare consultations for people with at least one recorded diagnosis of diabetes mellitus, hypertension or obesity from 1998 to 2015. Data were drawn from the central administrative database for Stockholm County, Sweden. It was not possible to separate data for type 1 and type 2 diabetes. We stratified 26988 individuals with IDs or ASD into three groups, with Down syndrome treated separately, and compared these groups with 1996140 people from the general population.

    Results: Compared with the general population, men and women with ID/ASD had 1.6-3.4-fold higher age-adjusted odds of having a registered diagnosis of obesity or diabetes mellitus, with the exception of diabetes among men with Down syndrome. A registered diagnosis of hypertension was only more common among men with ID/ASD than in the general population.

    Conclusions: Diabetes and blood pressure health screening, along with efforts to prevent development of obesity already in childhood, are necessary for individuals with IDs and ASD. We believe that there is a need for adapted community-based health promotion programmes to ensure more equitable health for these populations.

  • 754. Wallin, Ulf
    et al.
    Swenne, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tidig viktuppgång vid anorexia nervosa ger god prognos: Intensiv familjebaserad behandling ger bäst resultat2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, article id DWWXArticle in journal (Refereed)
    Abstract [sv]

    Vid anorexia nervosa orsakar svälten de allvarligaste symtomen, och risken för ett långdraget förlopp ökar ju längre patienten är i svält.

     Avgörande för behandlingsresultatet är att häva svälten snabbt. Viktuppgång tidigt i behandlingen ger bättre prognos.

    Familjebaserad behandling har bäst stöd i forskningen för att åstadkomma tidig viktuppgång för ungdomar med anorexia nervosa.

    Många patienter erhåller i dag inte familjebaserad behandling som är evidensbaserad och fokuserar på ätstörningen.

    Barnpsykiatrin måste organisera sig så att patienterna direkt får god och intensiv vård utan dröjsmål.

    Den initiala vården bör skötas på specialenheter för ätstörningar

  • 755.
    Wallsten, Tuula
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Östman, Margareta
    Sjöberg, Rickard L.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Kjellin, Lars
    Patients and next of kins’ attitudes towards compulsory psychiatric care2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 6, p. 444-449Article in journal (Refereed)
    Abstract [en]

    The introduction of a new Civil Commitment Act in Sweden in 1992 involved a shift of emphasis from medical to judicial authority. Little is known about general patient attitudes to compulsory care. The aim of the study was to study possible differences in attitudes, before and after the mental health law reform, among involuntarily and voluntarily admitted patients and their next-of-kins towards involuntary psychiatric admission. Samples of 84 committed and 84 voluntarily admitted patients in 1991 and 118 committed and 117 voluntarily admitted patients in 1997-99 were interviewed within 5 days from admission and at discharge, or after 3 weeks of care. Samples of 64 next-of-kins to the committed patients and 69 next-of-kins to the voluntarily admitted patients in 1991, and 73 and 89 next-of-kins, respectively, in 1997-99 were interviewed approximately 1 month after the admission. Few changes in attitudes were found between the two study occasions. A majority of all patients stated that it should be possible to compulsorily admit patients, and a great majority of the patients and the next-of kins stated that decisions regarding compulsory admission should be taken by doctors. Most patients and next-of-kins regarded decisions about involuntary psychiatric care mainly as a medical matter. Strong support for coercion in order to protect the patient and others was found among next-of-kins. The law reform was not reflected in attitudinal differences.

  • 756. Wandell, Per
    et al.
    Ljunggren, Gunnar
    Wahlstrom, Lars
    Carlsson, Axel C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Diabetes and psychiatric illness in the total population of Stockholm2014In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 77, no 3, p. 169-173Article in journal (Refereed)
    Abstract [en]

    Objective: Concomitant psychiatric disorders in people with diabetes affect morbidity and mortality. We aimed to study psychiatric morbidity in people with diabetes and the general population using administrative health care data in Stockholm County. Methods: The study population included all living persons who resided in Stockholm County, Sweden, on January 1, 2011 (N = 2,058,408). Subjects with a diagnosis of diabetes were identified with data from all consultations in primary health care, specialist outpatient care and inpatient care during the time span 2009-2013. As outcome, information was obtained on all consultations due to any psychiatric diagnosis as well as, specifically, schizophrenia, bipolar disorders, depression, and anxiety disorders, in 2011-2013. Analyses were performed by age group and gender. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% Cl) for women and men with diabetes, using individuals without diabetes as referents, were calculated. Results: Age-adjusted OR for all psychiatric diagnoses among people with diabetes was 1.296 (95% Cl 1.267-1.326) for women and 1.399 (95% Cl 1.368-1.432) for men. The greatest excess risk was found for schizophrenia, with OR 3.439 (95% Cl 3.057-3.868) in women and 2.787 (95% Cl 2.514-3.089) in men, with ORs between 1276 (95% Cl 1227-1327) and 1.714 (95% Cl 1.540-1.905) for the remaining diagnoses. Conclusion: The prevalence of psychiatric disorders is elevated in people with diabetes, which calls for preventive action to be taken to minimize suffering and costs to society.

  • 757.
    Weber, Megan
    et al.
    Ersta Sköndal Bräcke University College, Department of Caring Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Caring Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden; Capio Palliative Care, Dalen Hospital, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College, Department of Caring Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden; Dept of Women and Child’s Health,Karolinska Institute, Stockholm, Sweden.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry. Ersta Sköndal Bräcke University College, Department of Caring Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Adaptation of a Grief and Communication Family Support Intervention for Parentally Bereaved Families in Sweden2019In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683Article in journal (Refereed)
    Abstract [en]

    This article aims to describe the adaptation of the evidence-based Family Bereavement Program to a Swedish context. Empirical support indicating that family communication is a protective factor for parentally bereaved children was used to motivate the focus of the intervention. Modules from the Family Bereavement Program manual were translated, culturally adapted, and modified to fit a family format. The manual for the Grief and Communication Family Support Intervention was pilot-tested with two families, which resulted in minor modifications being made to the manual. Therapists reported that they could follow the manual and adapt it to children's varying ages.

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  • 758. Welch, Elisabeth
    et al.
    Ghaderi, Ata
    Swenne, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    A comparison of clinical characteristics between adolescent males and females with eating disorders2015In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 15, article id 45Article in journal (Refereed)
    Abstract [en]

    Background: Eating disorders (ED) are serious disorders that have a negative impact on both the psychological and the physiological well-being of the afflicted. Despite the fact that ED affect both genders, males are often underrepresented in research and when included the sample sizes are often too small for separate analyses. Consequently we have an unclear and sometimes contradictory picture of the clinical characteristics of males with ED. The aim of the present study was to improve our understanding of the clinical features of adolescent males with eating disorders. Methods: We compared age at presentation, weight at presentation, history of significantly different premorbid weight and psychiatric (Attention Deficit Hyperactivity Disorder (ADHD)) and somatic comorbidity (celiac disease and diabetes) of 58 males to 606 females seeking medical care for eating disorders at the Children's Hospital in Uppsala, Sweden during the years 1999-2012. As all boys were diagnosed with either AN or Other Specified Feeding or Eating Disorder (OSFED) atypical AN, the age and weight comparisons were limited to those girls fulfilling the diagnostic criteria for AN or OSFED atypical AN. Results: There was no significant difference in age at presentation. Differences in weight at presentation and premorbid weight history were mixed. A significantly higher percentage of males had a history of a BMI greater than two standard deviations above the mean for their corresponding age group. As well, there was a higher prevalence of ADHD among the males whereas celiac disease and diabetes only was found among the females. Conclusions: A better understanding of the clinical characteristics of males with ED at presentation should improve our ability to identify males with ED and thereby aid in tailoring the best treatment alternatives.

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  • 759.
    Wennström, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Berglund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Lindbäck, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    The Met Needs Index: a new metric for outcome assessment in mental health care2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 3, p. 425-432Article in journal (Refereed)
    Abstract [en]

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

  • 760.
    Wennström, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wiesel, Frits-Axel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    The Camberwell Assessment of Need as an outcome measure in routine mental health care2006In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 41, no 9, p. 728-733Article in journal (Refereed)
    Abstract [en]

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

  • 761.
    Wesström, Jan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Manconi, Mauro
    Sleep & Epilepsy Center Bellinzona, TI, Switzerland .
    Fulda, Stephany
    Sleep & Epilepsy Center Bellinzona, TI, Switzerland .
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Pre-pregnancy Restless Legs Syndrome (Willis-Ekbom Disease) Is Associated with Perinatal Depression2014In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 10, no 5, p. 527-533Article in journal (Refereed)
    Abstract [en]

    Objectives: Both restless legs syndrome ([RLS], also known as Willis-Ekbom Disease [WED]) and depression are common during pregnancy. However, no prior studies have assessed if pregnant women with RLS have an elevated risk of depression during and/or after pregnancy.

    Methods: 1,428 women who were pregnant in gestational week 16-17 were asked to participate in a longitudinal survey. They were followed by web-based questionnaires in gestational week 17 and 32, and 6 weeks after delivery. Data were also retrieved from prenatal and birth records. Two different sets of criteria were used to examine the prevalence of RLS in the cohort (International Restless Legs Syndrome Society Group standard criteria and the later developed CH-RLSQ11 questionnaire). The latter questionnaire attempts to exclude those with common "mimics" of RLS.

    Results: Adjusted odds ratio for depression in gestational week 17, 32, and postpartum week 6 in relation to pre-pregnancy RLS onset and moderate to severe symptom severity were 4.74 (2.30 - 9.76), 3.67 (1.85 - 7.28), and 2.58 (1.28 - 5.21), respectively. No significant associations were seen in pregnant women with de novo RLS during pregnancy. When using the standard diagnostic RLS criteria and frequency of symptoms more than 2-3 days per week, the prevalence of RLS was 12.3%. With the CH-RLSQ11 questionnaire and the same threshold for frequency of symptoms the prevalence was 6.5%.

    Conclusion: Women with RLS onset before pregnancy with moderate or severe symptoms had an increased risk of both antenatal and postnatal depression. The self-reported prevalence of RLS during pregnancy is lower when a questionnaire dealing with "mimics" is used.

  • 762.
    Wesström, Jan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna.
    Ulfberg, Jan
    Sleep Disorder Department, Capio, Örebro, Sweden.
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Periodic Limb Movements are Associated with Vasomotor Symptoms2014In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 10, no 1, p. 15-20Article in journal (Refereed)
    Abstract [en]

    Study objectives:

    Periodic limb movements (PLMs) are characterized by involuntary movements of the lower extremity during sleep. The etiology of PLM has been suggested to involve the dopaminergic system which, in turn, can be modulated by estrogen. It is currently unknown whether PLMs are associated with the menopausal transition and/or concomitant vasomotor symptoms. The aim of the present study was to examine if objectively-diagnosed PLMs (with and without arousals) are more common in postmenopausal women or in women with vasomotor symptoms. Another aim was to analyze the influence of PLMs on self-reported HRQoL.

    Methods:

    A community-based sample of 348 women underwent full-night polysomnography. PLMs (index > 15) and associated arousals (PLM arousal index > 5) were evaluated according to AASM scoring rules. Health related quality of life was measured using the SF-36 questionnaire. The occurrence of peri- and postmenopausal symptoms were evaluated by a questionnaire and plasma levels of follicle stimulating hormone (FSH) were measured.

    Results:

    After adjusting for confounding factors, vasomotor symptoms remained a significant explanatory factor for the occurrence of PLMs (adj. OR 1.86, 95% CI 1.03 - 3.37). In women with PLM arousals, adjusted OR for vasomotor symptoms was 1.61, 95% CI 0.76 – 3.42. PLMs did not seem to affect HRQoL.

    Conclusion:

    We found that clinically-significant PLMs, but not PLM with arousals, were more common among women with vasomotor symptoms, even after controlling for confounding factors. Menopausal status per se, as evidenced by FSH in the postmenopausal range, was not associated with PLMs.

     

  • 763.
    Wester Oxelgren, Ulrika
    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), Neuropediatrics/Paediatric oncology.
    Åberg, Marie
    Kungsgardet Ctr, Dept Hlth & Habilitat, Uppsala, Sweden.
    Myrelid, Åsa
    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), Paediatric Inflammation, Metabolism and Child Health Research.
    Annerén, Göran
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    Westerlund, Joakim
    Stockholm Univ, Dept Psychol, Stockholm, Sweden; Gothenburg Univ, Gillberg Neuropsychiat Ctr, Dept Neurosci & Physiol, Gothenburg, Sweden.
    Gustafsson, Jan
    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), Paediatric Inflammation, Metabolism and Child Health Research.
    Fernell, Elisabeth
    Gothenburg Univ, Gillberg Neuropsychiat Ctr, Dept Neurosci & Physiol, Gothenburg, Sweden.
    Autism needs to be considered in children with Down syndrome2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 11, p. 2019-2026Article in journal (Refereed)
    Abstract [en]

    Aim: To compare levels and profiles of autistic symptoms in children with Down syndrome (DS) with diagnosed autism spectrum disorder (ASD), with those with DS without ASD and with children with idiopathic autism.

    Methods From a population-based cohort of 60 children with DS (age 5-17 years) with 41 participating, those with ASD were compared to those without ASD using the scores obtained with the Autism Diagnostic Observation Schedule (ADOS) Module-1 algorithm.

    Results: Children with both DS and ASD had significantly higher ADOS scores in all domains compared to those without ASD. When the groups with DS, with and without ASD, were restricted to those with severe intellectual disability (ID), the difference remained. When the children with DS and ASD were compared with a group with idiopathic autism, the ADOS profile was broadly similar.

    Conclusion: A considerable proportion of children with DS, exhibit autism in addition to severe ID. In addition, there is also a group of children with DS and severe ID, but without autism. There is a need to increase awareness of the high prevalence of autism in children with DS. Recognizing the prevalence of autism is important for the appropriate diagnosis and care of children with DS.

  • 764. Westergren, Albert
    et al.
    Broman, Jan-Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Hellstrom, Amanda
    Fagerstrom, Cecilia
    Willman, Ania
    Hagell, Peter
    Measurement properties of the Minimal Insomnia Symptom Scale as an insomnia screening tool for adults and the elderly2015In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 16, no 3, p. 379-384Article in journal (Refereed)
    Abstract [en]

    Background: The psychometric properties of the three-item Minimal Insomnia Symptom Scale (MISS) were evaluated using the classical test theory. Different cut-offs for identifying insomnia were suggested in two age groups (>= 6 and >= 7 among adult and elderly people, respectively). The aim of the present study was to test the measurement properties of the MISS using the Rasch measurement model, with special emphasis on differential item functioning by gender and age. Methods: Cross-sectional MISS data from adult (age 20-64 years, n = 1075) and elderly (age 65+, n = 548) populations were analysed using the Rasch measurement model. Results: Data generally met Rasch model requirements and the scale could separate between two distinct groups of people. Differential item functioning was found by age but not gender. The difference between the adult and elderly samples was lower for the originally recommended >= 6 points cut-off (0.09 logits) than for the >= 7 points cut-off (0.23 logits), but greater at the lower and higher ends of the scale. Conclusions: This study provides general support for the measurement properties of the MISS. Caution should be exercised in comparing raw MISS scores between age groups, but applying a = 6 cut-off appears to allow for valid comparisons between adults and the elderly regarding the presence of insomnia. Nevertheless, additional studies are needed to determine the clinically optimal cut-score for identification of insomnia. (C) 2014 Elsevier B.V. All rights reserved.

  • 765. Westling, Sofie
    et al.
    Ramklint, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Självskadebeteende vanligt även utan personlighetssyndrom - Felaktig koppling trolig orsak till överdiagnostik av borderline-personlighetssyndrom2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, article id DZTLArticle in journal (Refereed)
    Abstract [sv]

    Self-harm is prevalent in non-psychiatric populations as well as in psychiatric settings, and is common in patients with most psychiatric diagnoses. Persons with self-harm behaviour can be incorrectly diagnosed with borderline personality disorder. There is support for self-harm having an emotion regulating function. Most treatments for self-harm are lengthy and comprehensive and have been developed primarily for persons with borderline personality disorder. Emotion Regulation Group Therapy is an exception, and is given in the form of 14 sessions of group therapy. Persons who self-harm and do not fulfil formal criteria for having a borderline personality disorder are at risk for not receiving effective treatment for self-harm.

  • 766.
    Wetterborg, Dan
    et al.
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden.
    Dehlbom, Peter
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden;Karolinska Inst, Dept Publ Hlth Sci, Epidemiol Mental Hlth Div, 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, Stockholm, Sweden.
    Andersson, Gerhard
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.
    Fruzzetti, Alan E.
    Harvard Med Sch, McLean Hosp, Boston, MA 02115 USA;Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA.
    Enebrink, Pia
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden.
    Dialectical Behavior Therapy for Men With Borderline Personality Disorder and Antisocial Behavior: A Clinical Trial2020In: Journal of Personality Disorders, ISSN 0885-579X, E-ISSN 1943-2763, Vol. 34, no 1, p. 22-39Article in journal (Refereed)
    Abstract [en]

    In addition to suicidal behaviors, men with borderline personality disorder (BPD) often display antisocial behavior that could impair contacts with mental health services. While research has established effective treatments for women with BPD, this is not yet the case for men. The authors evaluated 12 months of dialectical behavior therapy (DBT) for 30 men with BPD and antisocial behavior, using a within-group design with repeated measurements. The authors found moderate to strong, statistically significant pre-to posttreatment reductions of several dysfunctional behaviors, including self-harm, verbal and physical aggression, and criminal offending (rate ratios 0.17-0.39). Symptoms of BPD and depression were also substantially decreased. The dropout rate was 30%, and completing participants reported high satisfaction with treatment and maintained their improvements at 1-year follow-up. The authors conclude that DBT could be an effective treatment alternative for men with BPD and antisocial behavior, and it merits future studies with more rigorous design.

  • 767. Wettermark, B
    et al.
    Brandt, L
    Kieler, H
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Centre for pharmacoepidemiology, Karolinska Institutet.
    Pregabalin is increasingly prescribed for neuropathic pain, generalised anxiety disorder and epilepsy but many patients discontinue treatment2014In: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 68, no 1, p. 104-110Article in journal (Refereed)
    Abstract [en]

    AIM: To assess prescribing patterns, sociodemographic characteristics and previous disease history in patients receiving pregabalin.

    METHODS: An observational study using register data on dispensed drugs and recorded diagnoses for all patients in Stockholm, Sweden, who filled at least one prescription of pregabalin between July 2005 and December 2009. Analyses focused on prevalence, incidence, diagnosis patterns, prior dispensing of other analgesics/psychotropics and persistence to treatment over time.

    RESULT: A total of 18,626 patients (mean age 55 years, 63% women) were initiated on treatment between July 2006 and December 2009. Approved indications were recorded in hospital and/or primary care within 1 year prior to the first dispensing for 40% of the patients (epilepsy 1.3%, neuropathic pain 35.5% and generalised anxiety disorder (GAD) 3.6%). Antidepressants were used by 55%, opioids by 49% and sedatives by 48% prior to initiation of pregabalin. One-third (34%) only purchased one prescription and the proportion purchasing pregabalin 1 year after initiation was 42.1% for epilepsy, 36.3% for GAD, 21.5% for neuropathic pain and 25.6% for those without any of the included diagnoses.

    CONCLUSION: Pregabalin was mainly used as a second-line drug for the treatment of GAD or neuropathic pain and to a lesser extent as add-on therapy in epilepsy. However, a large proportion of all patients only purchased one prescription and the persistence declined rapidly over time. The issue of potential off-label prescribing or poor registration of diagnoses should also be noted as a high proportion had been prescribed the drug without a record of any of the approved indications.

  • 768. White, Richard A.
    et al.
    Azrael, Deborah
    Papadopoulos, Fotios C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Lambert, Gavin W.
    Miller, Matthew
    Does suicide have a stronger association with seasonality than sunlight?2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 6, article id e007403Article in journal (Refereed)
    Abstract [en]

    Objectives: Suicide rates have widely been reported to peak in spring and summer. A frequent hypothesis is that increased sunlight exposure alters biological mechanisms. However, few attempts have been made to systematically untangle the putative suicidogenic risk of sunlight exposure from that of seasonality. We examined whether average hours of daily sunlight in a month confer additional risk over month of year when predicting monthly suicide rates. Design: Historical population-based ecological longitudinal study. Setting and participants: We used 3 longitudinal studies (n=31 060 suicides) with monthly suicide and meteorological data from Greece (1992-2001), Victoria, Australia (1990-1998) and Norway (1969-2009). Intervention: We used a negative binomial regression to observe (1) the association of month of year with suicides, adjusting for different sunlight exposures, and (2) the association of sunlight exposure with suicides, adjusting for month of year. We then investigated claims that suicides were associated with daily sunlight exposures, defined by us as 2550 sunlight exposure combinations corresponding to a 1-50 days exposure window with lags of 0-50 days. Results: Using monthly data, the association between month of year and suicides remained after adjusting for mean daily hours of sunlight and change in the mean daily hours of sunlight. Adjusted for month of year, the associations between sunlight exposure and suicides became non-significant and attenuated towards the null (the coefficient estimate for mean daily hours of sunlight decreased in absolute magnitude by 72%). The findings were consistent across all 3 cohorts, both when analysed separately and combined. When investigating daily sunlight exposures, we found no significant results after correcting for multiple testing. Conclusions: Using monthly data, the robustness of our month of year effects, combined with the transient and modest nature of our sunlight effects, suggested that the association between sunlight exposure and suicide was a proxy for the association between seasonality and suicide.

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  • 769. Wiklund, Gunnar
    et al.
    Ruchkin, Vladislav V.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Koposov, Roman A.
    af Klinteberg, Britt
    Pro-bullying attitudes among incarcerated juvenile delinquents: Antisocial behavior, psychopathic tendencies and violent crime2014In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 37, no 3, p. 281-288Article in journal (Refereed)
    Abstract [en]

    The objective was to evaluate a new scale aimed at assessing antisocial attitudes, the Pro-bullying Attitude Scale (PAS), on a group of 259 voluntarily-recruited male juvenile delinquents from a juvenile correctional institution in Arkhangelsk, North-western Russia. Exploratory factor analysis gave a two-factor solution: Factor 1 denoted Callous/Dominance and Factor 2 denoted Manipulativeness/Impulsiveness. Subjects with complete data on PAS and Childhood Psychopathy Scale (CPS) (n = 171) were divided into extreme groups (first and fourth quartiles) according to their total scores on PAS and the two factor scores, respectively. The extreme groups of total PAS and PAS Factor 1 differed in CPS ratings and in violent behavior as assessed by the Antisocial Behavior Checklist (ABC). They also differed in the personality dimension Harm Avoidance as measured by use of the Temperament and Character Inventory (TCI), and in delinquent and aggressive behavior as assessed by the Youth Self Report (YSR). The extreme groups of PAS Factor 2, in turn, differed in aggressive behavior as assessed by the YSR, and in the TCI scale Self-Directedness. When PAS was used as a continuous variable, total PAS and PAS Factor 1 (Callous/Dominance) were significantly positively related to registered violent crime. The possible usefulness of PAS in identifying high-risk individuals for bullying tendencies among incarcerated delinquents is discussed.

  • 770.
    Wikman, Anna
    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), Reproductive Health.
    Axfors, Cathrine
    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. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    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.
    Cox, John
    Keele University, Keele, United Kingdom.
    Fransson, 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.
    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.
    Characteristics of women with different perinatal depression trajectories2019In: Journal of Neuroscience Research, ISSN 0360-4012, E-ISSN 1097-4547Article in journal (Refereed)
    Abstract [en]

    Maternal perinatal depression (PND), a common mental disorder with a prevalence of over 10%, is associated with long-term health risks for both mothers and offspring. This study aimed at describing characteristics related to background and lifestyle, pregnancy, delivery, and postpartum of different PND trajectories defined according to the onset of depressive symptoms. Participants were drawn from a large population-based cohort study in Uppsala, Sweden (n = 2,466). Five trajectory groups of depressive symptom onset were created using the Edinburgh Postnatal Depression Scale ≥13 (pregnancy) or ≥12 points (postpartum): (a) healthy (60.6%), (b) pregnancy depression (8.5%), (c) early postpartum onset (10.9%), (d) late postpartum onset (5.4%), and (e) chronic depression (14.6%). In multinomial logistic regressions, the associations between trajectories and the included characteristics were tested using the healthy trajectory as reference. Background characteristics (younger age, lower education, unemployment) were primarily associated with pregnancy depression and chronic depression. Characteristics associated with all PND trajectories were smoking prior to pregnancy, migraine, premenstrual mood symptoms, intimate partner violence, interpersonal trauma, negative delivery expectations, pregnancy nausea, and symphysiolysis. Nulliparity, instrumental delivery, or a negative delivery experience was associated with early postpartum onset. Postpartum factors (e.g., infantile colic, lack of sleep, low partner support, and bonding difficulties) were associated with early and late postpartum onset together with chronic depression. The findings suggest that different PND trajectories have divergent characteristics, which could be used to create individualized treatment options. To find the most predictive characteristics for different PND trajectories, studies with even larger and more diverse samples are warranted.

  • 771.
    Willebrand, Mimmie
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience.
    Coping, Personality and Cognitive Processes in Burn Injured Patients2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Being severely burned is a traumatic life event that affects the victim both physically and psychologically. Recovery can be a long process that is dependent in part upon psychological factors, but research in this area is still quite limited. The main aim of the thesis was to explore coping, personality and cognitive processes in long-term and short-term adaptation. The participants were recruited from three separate samples of former and consecutive adult burn patients.

    A questionnaire, the Coping with Burns Questionnaire (CBQ), was developed to retrospectively assess coping. It consisted of six coping factors related in different ways to self-reported health status. Regarding personality, the former patients displayed slightly more Neuroticism than people in general, suggesting an overrepresentation of premorbid neurotic personality traits. Avoidant coping was related to poorer perceived health status, more maladaptive personality traits, and was a strong predictor of psychological symptoms at three months post-burn. Regarding cognitive processes, a moderate attentional bias towards burn-related information was found in the former patients when using the emotional Stroop task. This indicates that the burn may still be an important issue years after the event. Finally, former patients’ reactions to participating in a trauma-related postal survey were investigated. A majority felt that participation was positive or even beneficial, while a small subgroup felt that participation was cumbersome or negative.

    To summarise, although many burn patients adapt well in the long run, the burn may still be a significant theme and the subgroup of Avoidant copers are especially vulnerable. The CBQ seems to be an adequate tool for discerning individuals at risk for poor adjustment. Trauma-related postal questionnaires are well accepted by a majority of former burn patients. Although long-term prospective follow-ups are needed to further validate the results, it is suggested that early screening of psychological factors could be of value in burn care.

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  • 772.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Burn Specific Health up to 24 Months After the Burn: A Prospective Validation of the Simplified Model of the Burn Specific Health Scale-Brief2011In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, no 1, p. 78-84Article in journal (Refereed)
    Abstract [en]

    Background: Outcome after burn injury is a multidimensional concept, but few multidimensional, injury-specific outcome measures have been psychometrically evaluated. A recent cross-sectional study using the Burn Specific Health Scale-Brief (BSHS-B) found three psychometrically sound health domains: function, skin involvement, and affect and relations. The aim of this study was to reexamine the psychometric properties of the BSHS-B using a prospective study design. Methods: Ninety-four consecutive adult patients with burns were included and asked to fill in questionnaires, the BSHS-B, the Hospital Anxiety and Depression Scale, and the short-form 36 (SF-36), at 6 months, 12 months, and 24 months postburn. Results: The factor structure was replicated and the three domains, function, skin involvement, and affect and relations, had excellent internal consistency. Over time the scores of function and skin involvement increased, indicating health improvement, whereas the domain affect and relations did not change over time. At 6 months and 12 months postburn, all domains were associated with burn severity. The function domain was highly associated with the SF-36 subscales physical functioning and role-physical, the affect and relations domain was highly associated with the Hospital Anxiety and Depression Scale and the SF-36 subscales denoting psychological health, and the domain skin involvement was highly associated with subscales indicating role-concerns, social functioning, vitality, and mental health. Conclusion: The psychometric properties of the BSHS-B domains were excellent and they had intelligible concurrent associations with other measures. Thus, the simplified model of the BSHS-B is a reliable, valid, and useful tool in describing postburn health over time.

  • 773.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Injury-related fear-avoidance and symptoms of posttraumatic stress in parents of children with burns2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 2, p. 414-420Article in journal (Refereed)
    Abstract [en]

    Parents of children with burns experience a range of psychological reactions and symptoms, and parents’ health is known to impact children's health. So far, there is little research into potential mechanisms that maintain parents’ symptoms. The aim was to investigate parental injury-related fear-avoidance, and its associations with injury severity and health measures. Parents (n = 107) of children aged 0.4–18 years that sustained burns 0.1–9.0 years previously completed questionnaires on fear-avoidance, posttraumatic stress, and health of the child. Analyses showed that the average level of fear-avoidance was low and positively associated with measures of injury severity and parents’ symptoms of posttraumatic stress, and negatively associated with parents’ ratings of their child's health. In two separate multiple regressions with parents’ symptoms of PTSD and the child's health as dependent variables, fear-avoidance made the largest contribution in both models while injury severity was non-significant. Results were not related to comorbid conditions of the child, scarring, or parent-related socio-demographic variables. In summary, injury-related fear-avoidance is more likely among parents whose children sustain more severe burns. In turn, fear-avoidance contributes significantly to parents’ symptoms of PTSD and to poorer health ratings regarding the child, irrespective of injury severity or child comorbidity.

  • 774.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Perceived support in parents of children with burns2016In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 38, no 1, p. 105-108Article in journal (Refereed)
    Abstract [en]

    Objective

    Children sustaining burns that require treatment in a burn center have a need for multiprofessional aftercare services over a prolonged time. So far, there is little research into satisfaction with care and support after pediatric burns. The aim was to investigate parents’ perception of support after pediatric burn and associations with parent, child and injury characteristics.

    Method

    Parents (n= 101) of children aged 0.4–17.8 years completed questionnaires on support, parent’s psychological symptoms and health of the child. Time since injury was 0.1–9.0 years.

    Results

    Perceived lack of psychosocial, medical, societal or family support was reported by 21% of the parents. Lack of support was not associated with injury or sociodemographic characteristics, but it was significantly associated with parents’ symptoms of general anxiety, depression and injury-related fear avoidance, as well as parents’ ratings of their child’s general health and heat sensitivity.

    Conclusion

    Perceived support did not differ on account of burn severity or sociodemographic status. However, care providers should be more attentive to and supportive of parents signaling poorer general health in their child and cognitive beliefs that the child is at risk for harm when active and parents who themselves show signs of psychological symptoms.

  • 775.
    Williams, Alishia D.
    et al.
    Univ New S Wales, Sch Psychiat, UNSW Med, Sydney, NSW, Australia;St Vincents Hosp, Clin Res Unit Anxiety & Depress CRUfAD, Sydney, NSW 2010, Australia.
    Blackwell, Simon E.
    MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Holmes, Emily A.
    MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Andrews, Gavin
    Univ New S Wales, Sch Psychiat, UNSW Med, Sydney, NSW, Australia;St Vincents Hosp, Clin Res Unit Anxiety & Depress CRUfAD, Sydney, NSW 2010, Australia.
    Positive imagery cognitive bias modification (CBM) and internet-based cognitive behavioural therapy (iCBT) versus control CBM and iCBT for depression: study protocol for a parallel-group randomised controlled trial2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 10, article id e004049Article in journal (Refereed)
    Abstract [en]

    Introduction The current randomised controlled trial will evaluate the efficacy of an internet-delivered positive imagery cognitive bias modification (CBM) intervention for depression when compared with an active control condition and help establish the additive benefit of positive imagery CBM when delivered in combination with internet cognitive behavioural therapy for depression. Methods and analysis Patients meeting diagnostic criteria for a current major depressive episode will be recruited through the research arm of a not-for-profit clinical and research unit in Australia. The minimum sample size for each group ( set at 0.05, power at 0.80) was identified as 29, but at least 10% more will be recruited to hedge against expected attrition. We will measure the impact of CBM on primary measures of depressive symptoms (Beck Depression Inventorysecond edition (BDI-II), Patient Health Questionnaire (PHQ9)) and interpretive bias (ambiguous scenarios test-depression), and on a secondary measure of psychological distress (Kessler-10 (K10)) following the 1-week CBM intervention. Secondary outcome measures of psychological distress (K10), as well as disability (WHO disability assessment schedule-II), repetitive negative thinking (repetitive thinking questionnaire), and anxiety (state trait anxiety inventory-trait version) will be evaluated following completion of the 11-week combined intervention, in addition to the BDI-II and PHQ9. Intent-to-treat marginal and mixed effect models using restricted maximum likelihood estimation will be used to evaluate the primary hypotheses. Clinically significant change will be defined as high-end state functioning (a BDI-II score <14) combined with a total score reduction greater than the reliable change index score. Maintenance of gains will be assessed at 3-month follow-up. Ethics and dissemination The current trial protocol has been approved by the Human Research Ethics Committee of St Vincent's Hospital and the University of New South Wales, Sydney. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12613000139774 and Clinicaltrials.gov: NCT01787513. This trial protocol is written in compliance with the Standard Protocol Items: recommendations for Interventional Trials (SPIRIT) guidelines.

  • 776.
    Williams, Alishia D.
    et al.
    Univ New S Wales, Sch Psychiat, UNSW Med, Sydney, NSW, Australia;St Vincents Hosp, Clin Res Unit Anxiety & Depress CRUfAD, Sydney, NSW 2010, Australia.
    Blackwell, Simon E.
    MRC Cognit & Brain Sci Unit, Cambridge, England.
    Mackenzie, Anna
    St Vincents Hosp, CRUfAD, Sydney, NSW 2010, Australia.
    Holmes, Emily A.
    MRC Cognit & Brain Sci Unit, Cambridge, England.
    Andrews, Gavin
    Univ New S Wales, Sch Psychiat, UNSW Med, Sydney, NSW, Australia;St Vincents Hosp, CRUfAD, Sydney, NSW 2010, Australia.
    Combining Imagination and Reason in the Treatment of Depression: A Randomized Controlled Trial of Internet-Based Cognitive-Bias Modification and Internet-CBT for Depression2013In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 81, no 5, p. 793-799Article in journal (Refereed)
    Abstract [en]

    Objective: Computerized cognitive-bias modification (CBM) protocols are rapidly evolving in experimental medicine yet might best be combined with Internet-based cognitive behavioral therapy (iCBT). No research to date has evaluated the combined approach in depression. The current randomized controlled trial aimed to evaluate both the independent effects of a CBM protocol targeting imagery and interpretation bias (CBM-I) and the combined effects of CBM-I followed by iCBT. Method: Patients diagnosed with a major depressive episode were randomized to an 11-week intervention (1 week/CBM-I + 10 weeks/iCBT; n = 38) that was delivered via the Internet with no face-to-face patient contact or to a wait-list control (WLC; n = 31). Results: Intent-to-treat marginal models using restricted maximum likelihood estimation demonstrated significant reductions in primary measures of depressive symptoms and distress corresponding to medium-large effect sizes (Cohen's d = 0.62-2.40) following CBM-I and the combined (CBM-I + iCBT) intervention. Analyses demonstrated that the change in interpretation bias at least partially mediated the reduction in depression symptoms following CBM-I. Treatment superiority over the WLC was also evident on all outcome measures at both time points (Hedges gs = .59-.98). Significant reductions were also observed following the combined intervention on secondary measures associated with depression: disability, anxiety, and repetitive negative thinking (Cohen's d = 1.51-2.23). Twenty-seven percent of patients evidenced clinically significant change following CBM-I, and this proportion increased to 65% following the combined intervention. Conclusions: The current study provides encouraging results of the integration of Internet-based technologies into an efficacious and acceptable form of treatment delivery.

  • 777.
    Williams, Alishia D.
    et al.
    Univ New S Wales, UNSW Med, Sch Psychiat, Sydney, NSW, Australia;St Vincents Hosp, CRUfAD, Darlinghurst, NSW 2010, Australia.
    O'Moore, Kathleen
    St Vincents Hosp, CRUfAD, Darlinghurst, NSW 2010, Australia.
    Blackwell, Simon E.
    MRC Cognit & Brain Sci Unit, Cambridge, England.
    Smith, Jessica
    St Vincents Hosp, CRUfAD, Darlinghurst, NSW 2010, Australia.
    Holmes, Emily A.
    MRC Cognit & Brain Sci Unit, Cambridge, England;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Andrews, Gavin
    Univ New S Wales, UNSW Med, Sch Psychiat, Sydney, NSW, Australia;St Vincents Hosp, CRUfAD, Darlinghurst, NSW 2010, Australia.
    Positive imagery cognitive bias modification (CBM) and internet-based cognitive behavioral therapy (iCBT): A randomized controlled trial2015In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 178, p. 131-141Article in journal (Refereed)
    Abstract [en]

    Background: Accruing evidence suggests that positive imagery-based cognitive bias modification (CBM) could have potential as a standalone targeted intervention for depressive symptoms or as an adjunct to existing treatments. We sought to establish the benefit of this form of CBM when delivered prior to Internet cognitive behavioral therapy (iCBT) for depression Methods: A randomized controlled trial (RCT) of a 1-week Internet-delivered positive CBM vs. an active control condition for participants (N-75, 69% female, mean age-42) meeting diagnostic criteria for major depression; followed by a 10-week iCBT program for both groups. Results: Modified intent-to-treat marginal and mixed effect models demonstrated no significant difference between conditions following the CBM intervention or the iCBT program. In both conditions there were significant reductions (Cohen's d .57-1.58, 95% CI=-.12-2.07) in primary measures of depression and interpretation bias (PHQ9, BDI-II, AST-D). Large effect size reductions (Cohen's d .81-1.32, 95% CI=.31-1.79) were observed for secondary measures of distress, disability, anxiety and repetitive negative thinking (K10, WHODAS, STAI, RTQ). Per protocol analyses conducted in the sample of participants who completed all seven sessions of CBM indicated between-group superiority of the positive over control group on depression symptoms (PHQ9, BDI-II) and psychological distress (K10) following CBM (Hedges g.55-.88, 95% CI=-.03-146) and following iCBT (PHQ9, 1(10). The majority (> 70%) no longer met diagnostic criteria for depression at 3-month follow-up. Limitations: The control condition contained many active components and therefore may have represented a smaller 'dose' of the positive condition. Conclusions: Results provide preliminary support for the successful integration of imagery-based CBM into an existing Internet-based treatment for depression. (C) 2015 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http:creativecommons.org/licenses/by/4.0/).

  • 778. Wiltfang, J.
    et al.
    Lewczuk, P.
    Riederer, P.
    Gruenblatt, E.
    Hock, C.
    Scheltens, P.
    Hampel, H.
    Vanderstichele, H.
    Iqbal, K.
    Galasko, D.
    Lannfelt, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Otto, M.
    Esselman, H.
    Henkel, A. W.
    Kornhuber, J.
    Blennow, K.
    Consensus Paper of the WFSBP Task Force on Biological Markers of Dementia: The role of CSF and blood analysis in the early and differential diagnosis of dementia2009In: Revista de Psiquiatria Clinica, ISSN 0101-6083, Vol. 36, p. 1-16Article, review/survey (Refereed)
    Abstract [en]

    Aging of population, and increasing life expectancy result in an increasing number of patients with dementia. This symptom can be a part of a completely curable disease of the central nervous system (e.g, neuroinflammation), or a disease currently considered irreversible (e.g, Alzheimer's disease, AD). In the latter case, several potentially successful treatment approaches are being tested now, demanding reasonable standards of pre-mortem diagnosis. Cerebrospinal fluid and serum analysis (CSF/serum analysis), whereas routinely performed in neuroinflammatory diseases, still requires standardization to be used as an aid to the clinically based diagnosis of AD. Several AD-related CSF parameters (total tau, phosphorylated forms of tau, A beta peptides, ApoE genotype, p97, etc.) tested separately or in a combination provide sensitivity and specificity in the range of 85%, the figure commonly expected from a good diagnostic tool. In this review, recently published reports regarding progress in neurochemical pre-mortem diagnosis of dementias are discussed with a focus on an early and differential diagnosis of AD. Novel perspectives offered by recently introduced technologies, e.g, fluorescence correlation spectroscopy (FCS) and surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) are briefly discussed.

  • 779.
    Wingard, Louise
    et al.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Taipale, Heidi
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland;Univ Eastern Finland, Sch Pharm, Kuopio, Finland.
    Reutfors, Johan
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Westerlund, Anna
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Tiihonen, Jari
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.
    Tanskanen, Antti
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.
    Andersen, Morten
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden;Univ Copenhagen, Dept Drug Design & Pharmacol, Fac Hlth & Med Sci, Copenhagen, Denmark;Univ Southern Denmark, Res Unit Gen Practice, Odense, Denmark.
    Initiation and long-term use of benzodiazepines and Z-drugs in bipolar disorder2018In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 20, no 7, p. 634-646Article in journal (Refereed)
    Abstract [en]

    Objectives

    Increasing evidence points to the harmful effects of long‐term benzodiazepine treatment. Our objective was to study the incidence of, and predictors for, long‐term use of benzodiazepines and Z‐drugs in bipolar disorder.

    Methods

    We conducted a population‐based cohort study, using data from Swedish national registers. Swedish residents aged 18‐75 years with a recorded diagnosis of bipolar disorder or mania between July 2006 and December 2012, and no history of benzodiazepine/Z‐drug use in the past year, were included. Patients were followed for 1 year with regard to prescription fills of benzodiazepines/Z‐drugs. Initiators were followed for another year during which continuous use for >6 months was defined as “long‐term”. Patient and prescription characteristics were investigated as potential predictors for long‐term use in multivariate logistic regression models.

    Results

    Out of the 21 883 patients included, 29% started benzodiazepine/Z‐drug treatment, of whom one in five became long‐term users. Patients who were prescribed clonazepam or alprazolam had high odds for subsequent long‐term use (adjusted odds ratios [aORs] 3.78 [95% confidence interval (CI) 2.24‐6.38] and 2.03 [95% CI 1.30‐3.18], respectively), compared to those prescribed diazepam. Polytherapy with benzodiazepines/Z‐drugs also predicted long‐term use (aOR 2.46, 95% CI 1.79‐3.38), as did age ≥60 years (aOR 1.93, 95% CI 1.46‐2.53, compared to age <30 years), and concomitant treatment with psychostimulants (aOR 1.78, 95% CI 1.33‐2.39).

    Conclusions

    The incidence of subsequent long‐term use among bipolar benzodiazepine initiators is high. Patients on clonazepam, alprazolam or benzodiazepine/Z‐drug polytherapy have the highest risk of becoming long‐term users, suggesting that these treatments should be used restrictively.

  • 780.
    Wingård, L.
    et al.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Brandt, L.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kieler, H.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Andersen, M.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Reutfors, J.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Comparative risks of treatment failure in bipolar 1 disorder: a population based study of lithium, valproate, olanzapine, quetiapine and aripiprazole in post mania relapse prevention2017In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 19, no S1, p. 100-101Article in journal (Other academic)
  • 781.
    Wingård, Louise
    et al.
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Karolinska Univ Hosp, Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Brandt, Lena
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Tiihonen, Jari
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.; Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.
    Tanskanen, Antti
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.; Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.
    Kieler, Helle
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Andersen, Morten
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Reutfors, Johan
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Reducing the rehospitalization risk after a manic episode: A population based cohort study of lithium, valproate, olanzapine, quetiapine and aripiprazole in monotherapy and combinations2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 217, p. 16-23Article in journal (Refereed)
    Abstract [en]

    Background: Data on real-world rehospitalization risks in patients using different drugs and combination therapies for relapse prevention after a manic episode is limited.

    Methods: We conducted a nationwide population based cohort study using data from Swedish national registers. Swedish residents aged 18-75 years who were hospitalized for a manic episode between July 1, 2006 and December 2, 2014 were included. Prescription fills of lithium, valproate, olanzapine, quetiapine and aripiprazole were recorded throughout the first four weeks after hospital discharge, after which the patients were followed for up to one year. General and treatment specific rehospitalization risks were determined and results were adjusted for clinical and sociodemographic factors.

    Results: The study included follow-up data from 6 502 hospitalizations for mania. Pharmacologic relapse prevention was used after 78% of these hospitalizations. Monotherapies and combination therapies were equally common. The average one-year rehospitalization risk for patients who did versus did not initiate prophylactic treatment was 39% and 46%, respectively. The lowest rehospitalization risks were seen in patients on combination therapy with olanzapine and valproate or olanzapine and lithium, experiencing one year rehospitalization risks of 32% and 34% (adjusted hazard ratios 0.76 (95% confidence interval [CI] 0.62-0.93) and 0.83 (95% CI 0.70-0.98), compared to lithium monotherapy).

    Limitations: Register data does not provide information on all clinical parameters affecting treatment choices.

    Conclusions: One-year rehospitalization rates after a manic episode are considerable also for patients who initiate prophylactic treatment. Combination therapies including olanzapine and a classic mood-stabilizer may be beneficial for reducing rehospitalization risks after a manic episode.

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  • 782.
    Wingård, Louise
    et al.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol, T2, SE-17176 Stockholm, Sweden.
    Brandt, Lena
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol, T2, SE-17176 Stockholm, Sweden.
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry. Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol, T2, SE-17176 Stockholm, Sweden.
    Kieler, Helle
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol, T2, SE-17176 Stockholm, Sweden.
    Andersen, Morten
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol, T2, SE-17176 Stockholm, Sweden;Univ Copenhagen, Fac Hlth & Med Sci, Dept Drug Design & Pharmacol, Copenhagen, Denmark.
    Reutfors, Johan
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol, T2, SE-17176 Stockholm, Sweden.
    Monotherapy vs. combination therapy for post mania maintenance treatment: A population based cohort study2019In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 29, no 6, p. 691-700Article in journal (Refereed)
    Abstract [en]

    In recent years, the use of atypical antipsychotics and combination therapy for relapse prevention in bipolar disorder has increased substantially. However, real-world data on the comparative effectiveness of these treatment options are largely non-existent. We conducted a population-based cohort study, using data from Swedish national registers. All patients aged 18-75 years who were hospitalized for mania 2006-2014 and filled at least one prescription of lithium, valproate, olanzapine, quetiapine, aripiprazole or any combination of these drugs were included, and followed for up to one year after hospital discharge, generating follow-up data from 5 713 hospitalizations. We used Cox proportional hazard regression models to study time to treatment failure for each individual drug and combination therapy, using lithium as comparator. Treatment failure was defined as treatment discontinuation, switch, or rehospitalization, and the results were adjusted for clinical and sociodemographic factors. We found that treatment failure occurred in 85% of cases and that the majority of combination therapies were associated with lower risks of treatment failure compared to monotherapies. Patients combining lithium + valproate + quetiapine had the lowest risk of treatment failure (adjusted HR [AHR] 0.40, 95% CI 0.30-0.54), followed by patients on lithium + valproate + olanzapine (AHR 0.55, 95% CI 0.45-0.68). In contrast, monotherapies with antipsychotics were associated with significantly higher risks of treatment failure compared to single use of lithium. In conclusion, our results support experimental findings, suggesting that combination therapy is more effective than monotherapy after a manic episode.

  • 783.
    Witteveen, Anke B.
    et al.
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
    Bisson, Jonathan I.
    School of Medicine, Cardiff University, Cardiff, United Kingdom.
    Ajdukovic, Dean
    Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
    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.
    Bergh Johannesson, Kerstin
    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.
    Bolding, Hendrieke B.
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
    Elklit, Ask
    National Center of Psychotraumatology, Institute of Psychology, University of Southern Denmark, Odense, Denmark.
    Jehel, Louis
    Fort de France University Hospital Center, Antilles-Guyane University, Fort de France, Martinique.
    Johansen, Venke A.
    Resource Center on Violence, Traumatic Stress and Suicide prevention, Western Norway (RVTS West), Haukeland University Hospital, Norway.
    Lis-Turlejska, Maja
    Warsaw School of Social Sciences and Humanities, Warsaw, Poland.
    Nordanger, Dag O.
    Centre for Child and Adolescent Mental Health, Bergen, Norway.
    Orengo-Garcia, Francisco
    Sociedad Española de Psicotraumatología y Estrés Traumatico (SEPET), Madrid, Spain.
    Polak, A. Rosaura
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
    Punamaki, Raija-Leena
    School of Social Sciences and Humanities/ Psychology, University of Tampere, Finland.
    Schnyder, Ulrich
    Department of Psychiatry, University Hospital Zurich, Switzerland.
    Wittmann, Lutz
    Department of Psychiatry, University Hospital Zurich, Switzerland.
    Olff, Miranda
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
    Post-disaster psychosocial services across Europe: the TENTS project2012In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 75, no 9, p. 1708-1714Article in journal (Refereed)
    Abstract [en]

    At present post-disaster activities and plans seem to vary widely. An adequate estimation of the availability of post-disaster psychosocial services across Europe is needed in order to compare them with recently developed evidence-informed psychosocial care guidelines. Here we report on the results of a cross-sectional web-based survey completed in 2008 by two hundred and eighty-six representatives of organizations involved in psychosocial responses to trauma and disaster from thirty-three different countries across Europe. The survey addressed planning and delivery of psychosocial care after disaster, methods of screening and diagnosis, types of interventions used, and other aspects of psychosocial care after trauma. The findings showed that planning and delivery of psychosocial care was inconsistent across Europe. Countries in East Europe seemed to have less central coordination of the post-disaster psychosocial response and fewer post-disaster guidelines that were integrated into specific disaster or contingency plans. Several forms of psychological debriefing, for which there is no evidence of efficacy to date, were still used in several areas particularly in North Europe. East European countries delivered evidence-based interventions for PTSD less frequently, whilst in South- and South-Eastern European countries anxiety suppressing medication such as benzodiazepines were prescribed more frequently to disaster victims than in other areas. Countries across Europe are currently providing sub-optimal psychosocial care for disaster victims. This short report shows that there is an urgent need for some countries to abandon non-effective interventions and others to develop more evidence based and effective services to facilitate the care of those involved in future disasters.

  • 784.
    Wolf, Martina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Ebner-Priemer, Ulrich
    Schramm, Elisabeth
    Domsalla, Melanie
    Hautzinger, Martin
    Bohus, Martin
    Maximizing Skills Acquisition in Dialectical Behavioral Therapy with a CD-ROM-Based Self-Help Program: Results from a Pilot Study2011In: Psychopathology, ISSN 0254-4962, E-ISSN 1423-033X, Vol. 44, no 2, p. 133-135Article in journal (Refereed)
  • 785. Woolfenden, Susan
    et al.
    Eapen, Valsamma
    Axelsson, Emma L
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Hendry, Alexandra
    Jalaludin, Bin
    Dissanayake, Cheryl
    Overs, Bronwyn
    Descallar, Joseph
    Eastwood, John
    Einfeld, Stewart
    Silove, Natalie
    Short, Kate
    Beasley, Deborah
    Crnčec, Rudi
    Murphy, Elisabeth
    Williams, Katrina
    Who is our cohort:: recruitment, representativeness, baseline risk and retention in the 'Watch Me Grow' study?2016In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 16Article in journal (Refereed)
    Abstract [en]

    BACKGROUND The "Watch Me Grow" (WMG) study examines the current developmental surveillance system in South West Sydney. This paper describes the establishment of the study birth cohort, including the recruitment processes, representativeness, follow-up and participants’ baseline risk for future developmental risk. METHODS Newborn infants and their parents were recruited from two public hospital postnatal wards and through child health nurses during the years 2011-2013. Data was obtained through a detailed participant questionnaire and linked with the participant’s electronic medical record (EMR). Representativeness was determined by Chi-square analyses of the available clinical, psychosocial and sociodemographic EMR data, comparing the WMG participants to eligible non-participants. Reasons for non-participation were also elicited. Participant characteristics were examined in six, 12, and 18-month follow-ups. RESULTS The number of infants recruited totalled 2,025, with 50 % of those approached agreeing to participate. Reasons for parents not participating included: lack of interest, being too busy, having plans to relocate, language barriers, participation in other research projects, and privacy concerns. The WMG cohort was broadly representative of the culturally diverse and socially disadvantaged local population from which it was sampled. Of the original 2025 participants enrolled at birth, participants with PEDS outcome data available at follow-up were: 792 (39 %) at six months, 649 (32 %) at 12 months, and 565 (28 %) at 18 months. Participants with greater psychosocial risk were less likely to have follow-up outcome data. Almost 40 % of infants in the baseline cohort were exposed to at least two risk factors known to be associated with developmental risk. CONCLUSIONS The WMG study birth cohort is a valuable resource for health services due to the inclusion of participants from vulnerable populations, despite there being challenges in being able to actively follow-up this population.

  • 786.
    Woud, Marcella L.
    et al.
    Ruhr Univ Bochum, Mental Hlth Res & Treatment Ctr, Dept Psychol, Bochum, Germany.
    Blackwell, Simon E.
    Ruhr Univ Bochum, Mental Hlth Res & Treatment Ctr, Dept Psychol, Bochum, Germany.
    Cwik, Jan C.
    Ruhr Univ Bochum, Mental Hlth Res & Treatment Ctr, Dept Psychol, Bochum, Germany.
    Margraf, Juergen
    Ruhr Univ Bochum, Mental Hlth Res & Treatment Ctr, Dept Psychol, Bochum, Germany.
    Holmes, Emily A.
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Steudte-Schmiedgen, Susann
    Tech Univ Dresden, Dept Psychol, Dresden, Germany;Tech Univ Dresden, Dept Psychotherapy & Psychosomat Med, Dresden, Germany.
    Herpertz, Stephan
    Ruhr Univ Bochum, LWL Univ Hosp, Dept Psychosomat Med & Psychotherapy, Bochum, Germany.
    Kessler, Henrik
    Ruhr Univ Bochum, LWL Univ Hosp, Dept Psychosomat Med & Psychotherapy, Bochum, Germany.
    Augmenting inpatient treatment for post-traumatic stress disorder with a computerised cognitive bias modification procedure targeting appraisals (CBM-App): protocol for a randomised controlled trial2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 6, article id e019964Article in journal (Refereed)
    Abstract [en]

    Introduction Influential theories of post-traumatic stress disorder (PTSD) suggest that dysfunctional appraisals of trauma play a key role in the maintenance of symptoms, and this suggestion is increasingly supported by research. Experimental studies have indicated that a simple computerised cognitive training procedure, here termed cognitive bias modification-appraisals (CBM-App), can modify trauma-relevant appraisals and reduce analogue trauma symptoms among healthy volunteers. This suggests the possibility that CBM-App could improve outcomes in PTSD via targeting the key process of dysfunctional appraisals, for example, if applied as an adjunct to treatment. Methods and analysis The study is a randomised controlled trial with two parallel arms. It is planned to randomise 80 patients admitted for treatment for PTSD to an inpatient treatment clinic to complete either sessions of CBM-App or a sham-training control condition, the peripheral vision task. Both interventions comprise eight sessions scheduled over a 2-week period and are completed in addition to the standard treatment programme in the clinic. Outcome assessment occurs pretraining, after 1 week of training, post-training, at discharge from the inpatient clinic and 6 weeks and 3 months postdischarge. The primary outcome is dysfunctional trauma-relevant appraisals at post-training, measured using a scenario completion task. Secondary outcomes include symptom measures and hair cortisol. Outcome analyses will be primarily via mixed linear models and conducted with both intention to treat and per protocol samples. Ethics and dissemination The trial has been approved by the Ethics Committee for the Faculty of Psychology, Ruhr-Universitat Bochum (approval no 204) and the Ethics Committee for the Faculty of Medicine, Ruhr-Universitat Bochum (approval no 15-5477). Results will be published in peer-reviewed journals and will inform future clinical and experimental studies into targeting maladaptive appraisals for the reduction of PTSD symptoms.

  • 787.
    Woud, Marcella L.
    et al.
    Radboud Univ Nijmegen, Inst Behav Sci, NL-6525 ED Nijmegen, Netherlands.
    Holmes, Emily A.
    Univ Oxford, Dept Psychiat, Oxford OX3 7JX, England.
    Postma, Peggy
    Cambridgeshire & Peterborough NHS Trust, Peterborough, Cambs, England.
    Dalgleish, Tim
    MRC, Cognit & Brain Sci Unit, Emot Res Grp, Cambridge, England.
    Mackintosh, Bundy
    Univ E Anglia, Sch Med Hlth Policy & Practice, Norwich NR4 7TJ, Norfolk, England.
    Ameliorating Intrusive Memories of Distressing Experiences Using Computerized Reappraisal Training2012In: Emotion, ISSN 1528-3542, E-ISSN 1931-1516, Vol. 12, no 4, p. 778-784Article in journal (Refereed)
    Abstract [en]

    The types of appraisals that follow traumatic experiences have been linked to the emergence of posttraumatic stress disorder (PTSD). Could changing reappraisals following a stressful event reduce the emergence of PTSD symptoms? The present proof-of-principle study examined whether a nonexplicit, systematic computerized training in reappraisal style following a stressful event (a highly distressing film) could reduce intrusive memories of the film, and symptoms associated with posttraumatic distress over the subsequent week. Participants were trained to adopt a generally positive or negative poststressor appraisal style using a series of scripted vignettes after having been exposed to highly distressing film clips. The training targeted self-efficacy beliefs and reappraisals of secondary emotions (emotions in response to the emotional reactions elicited by the film). Successful appraisal induction was verified using novel vignettes and via change scores on the Post Traumatic Cognitions Inventory. Compared with those trained negatively, those trained positively reported in a diary fewer intrusive memories of the film during the subsequent week, and lower scores on the Impact of Event Scale (a widely used measure of posttraumatic stress symptoms). Results support the use of computerized, nonexplicit, reappraisal training after a stressful event has occurred and provide a platform for future translational studies with clinical populations that have experienced significant real-world stress or trauma.

  • 788.
    Woud, Marcella L.
    et al.
    Radboud Univ Nijmegen, Inst Behav Sci, NL-6525 HR Nijmegen, Netherlands.
    Postma, Peggy
    Hertfordshire Partnership NHS Fdn Trust, St Albans, Hertford, England.
    Holmes, Emily A.
    MRC Cognit & Brain Sci Unit, Cambridge, England.
    Mackintosh, Bundy
    Univ Essex, Dept Psychol, Colchester CO4 3SQ, Essex, England.
    Reducing analogue trauma symptoms by computerized reappraisal training - Considering a Cognitive prophylaxis?2013In: Journal of Behavior Therapy and Experimental Psychiatry, ISSN 0005-7916, E-ISSN 1873-7943, Vol. 44, no 3, p. 312-315Article in journal (Refereed)
    Abstract [en]

    Background and objectives: Distressing intrusions are a hallmark of posttraumatic stress disorder (PTSD). Dysfunctional appraisal of these symptoms may exacerbate the disorder, and conversely may lead to further intrusive memories. This raises the intriguing possibility that learning to 'reappraise' potential symptoms more functionally may protect against such symptoms. Woud, Holmes, Postma, Dalgleish, and Mackintosh (2012) found that 'reappraisal training' when delivered after an analogue stressful event reduced later intrusive memories and other posttraumatic symptoms. The present study aimed to investigate whether reappraisal training administered before a stressful event is also beneficial. Methods: Participants first received positive or negative reappraisal training (CBM-App training) using a series of scripted vignettes. Subsequently, participants were exposed to a film with traumatic content. Effects of the CBM-App training procedure were assessed via three distinct outcome measures, namely: (a) post-training appraisals of novel ambiguous vignettes, (b) change scores on the Post Traumatic Cognitions Inventory (PTCI), and (c) intrusive symptom diary. Results: CBM-App training successfully induced training-congruent appraisal styles. Moreover, those trained positively reported less distress arising from their intrusive memories of the trauma film during the subsequent week than those trained negatively. However, the induced appraisal bias only partly affected PTCI scores. Limitations: Participants used their own negative event as a reference for the PTCI assessments. The events may have differed regarding their emotional impact. There was no control group. Conclusions: CBM-App training has also some beneficial effects when applied before a stressful event and may serve as a cognitive prophylaxis against trauma-related symptomatology. (C) 2013 Elsevier Ltd. All rights reserved.

  • 789.
    Wright, A. Michelle
    et al.
    Wayne State Univ, Dept Psychol, 71 W Warren Ave, Detroit, MI 48202 USA.;Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA..
    Aldhalimi, Abir
    Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Univ Detroit Mercy, Dept Psychol, Detroit, MI 48221 USA..
    Lumley, Mark A.
    Wayne State Univ, Dept Psychol, 71 W Warren Ave, Detroit, MI 48202 USA..
    Jamil, Hikmet
    Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Wayne State Univ, Inst Environm Hlth Sci, Detroit, MI USA..
    Pole, Nnamdi
    Smith Coll, Dept Psychol, Northampton, MA 01063 USA..
    Arnetz, Judith E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Wayne State Univ, Inst Environm Hlth Sci, Detroit, MI USA..
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Wayne State Univ, Dept Family Med & Publ Hlth Sci, Detroit, MI USA.;Wayne State Univ, Cardiovasc Res Inst, Detroit, MI USA.;Michigan State Univ, Coll Human Med, E Lansing, MI 48824 USA..
    Determinants of resource needs and utilization among refugees over time2016In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 51, no 4, p. 539-549Article in journal (Refereed)
    Abstract [en]

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

  • 790.
    Wåhlstedt, Cecilia
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Bohlin, Gunilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    DSM-IV-Defined Inattention and Sluggish Cognitive Tempo: Independent and Interactive Relations to Neuropsychological Factors and Comorbidity2010In: Child Neuropsychology, ISSN 0929-7049, E-ISSN 1744-4136, Vol. 16, no 4, p. 350-365Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the independent relations of DSM-IV-defined inattention and behaviors characteristic of sluggish cognitive tempo (SCT) to neuropsychological factors and problem behaviors often comorbid with attention deficit/hyperactivity disorder (ADHD). By controlling for symptoms of DSM-IV-defined inattention, unique relations to SCT could be ascertained. Additionally, interactive relations of DSM-IV-defined inattention and SCT were of interest. A community-based sample of school children (N = 209; the higher end of the ADHD-symptom range was oversampled) completed neuropsychological tasks designed to measure executive function (EF), sustained attention, and state regulation. Behavioral symptoms were measured using parental and teacher ratings of the DSM-IV criteria for ADHD and Oppositional Defiant Disorder (ODD). The results showed that these two domains of inattention, DSM-IV-defined inattention and SCT, have neuropsychological processes and comorbid behavioral problems in common. However, when controlling for the overlap, DSM-IV-defined inattention was uniquely related to EF and state regulation, while SCT was uniquely related to sustained attention. In addition, the results showed an interactive relation of DSM-IV-defined inattention and SCT to ODD. Findings from the present study support the notion that DSM-IV-defined inattention constitutes a somewhat heterogeneous condition. Such results can further our theoretical understanding of the neuropsychological impairments and comorbid behavioral problems associated with ADHD symptoms.

  • 791.
    Yao, Shuyang
    et al.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, Stockholm, Sweden.
    Kuja-Halkola, Ralf
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, Stockholm, Sweden.
    Thornton, Laura M.
    Univ North Carolina Chapel Hill, Dept Psychiat, Chapel Hill, NC USA.
    Norring, Claes
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Stockholm Hlth Care Serv, Stockholm Ctr Eating Disorders, Stockholm, Sweden.
    Almqvist, Catarina
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, Stockholm, Sweden;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden.
    D'Onofrio, Brian M.
    Indiana Univ, Dept Psychol & Brain Sci, Bloomington, IN USA.
    Lichtenstein, Paul
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, 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, Nobels Vag 12A, Stockholm, Sweden.
    Bulik, Cynthia M.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, Stockholm, Sweden;Univ North Carolina Chapel Hill, Dept Nutr, Chapel Hill, NC USA;Univ North Carolina Chapel Hill, Dept Psychiat, Chapel Hill, NC USA.
    Larsson, Henrik
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, Stockholm, Sweden;Orebro Univ, Sch Med Sci, Orebro, Sweden.
    Risk of being convicted of theft and other crimes in anorexia nervosa and bulimia nervosa: A prospective cohort study in a Swedish female population2017In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 50, no 9, p. 1095-1103Article in journal (Refereed)
    Abstract [en]

    ObjectiveWe examined epidemiological associations between anorexia nervosa (AN) and bulimia nervosa (BN) and risks of committing theft and other crimes in a nationwide female population. MethodFemales born in Sweden during 1979-1998 (N=957,106) were followed from age 15 for up to 20 years using information on clinically diagnosed AN and BN (exposures), convictions of theft and other crimes (outcomes), psychiatric comorbidities, and familial relatedness from Swedish national registers. We estimated hazard ratios (HRs) of criminality in exposed versus unexposed females using Cox proportional hazards regressions and explored how comorbidities and unmeasured familial factors explained the associations. ResultsThe cumulative incidence of convictions of theft (primarily petty theft) and other crimes was higher in exposed females (AN: 11.60% theft, 7.39% other convictions; BN: 17.97% theft, 13.17% other convictions) than in unexposed females (approximate to 5% theft, approximate to 6% other convictions). The significantly increased risk of being convicted of theft in exposed females (AN: HR=2.51, 95% confidence interval=[2.29, 2.74], BN: 4.31 [3.68, 5.05]) was partially explained by comorbidities; unmeasured familial factors partially explained the association with convictions of theft in BN but not in AN. Females with BN had a doubled risk of convictions of other crimes, which was partially explained by comorbidities. DiscussionIndividuals with eating disorders had increased risk for convictions of theft and potentially other crimes. Results underscore the importance of regular forensic screening and encourage research on mechanisms underlying the relation between crime and eating disorder psychopathology and efforts to determine how best to address such relation in treatment.

  • 792.
    Yasar, Evin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Användning av psykofarmaka hos nyförlösta kvinnor i Stockholm2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Postpartum depression (PPD) förekommer efter 8-15 % av alla förlossningar och kännetecknas av nedstämdhet, skuldkänslor, hopplöshet, självmordstankar samt tankar om att skada det nyfödda barnet. Orsaken till sjukdomen är ett samspel mellan psykosociala, genetiska och biologiska faktorer. Syfte: Analysera nyinsättning och utköp av antidepressiva hos nyförlösta kvinnor i Stockholm för att bedöma förekomst av postpartum depression. Material och metod: En deskriptiv tvärsnittsstudie med data över förlossningar, demografi och uthämtade läkemedel i Stockholms läns landstings (SLL) vårdproduktionsdatabas (VAL) mellan januari-juni 2014. Resultat: Totalt födde 14901 kvinnor hos sex vårdgivare i SLL. Antidepressiva läkemedel nyinsattes till 123 kvinnor (0,83 %) inom 2-289 dagar efter sin förlossning, medan 286 kvinnor (1,9 %) fick en möjlig PPD relaterad diagnos efter förlossning. Selektiv serotoninåterupptagshämmare (SSRI) var det vanligaste expedierade läkemedlet och vårdgivare som förskrev antidepressiva till högst andel förlösta kvinnor var Södertälje sjukhus, Karolinska Solna och BB Sophia. En signifikant skillnad avseende utköp av antidepressiva kunde påvisas mellan kvinnor som fött med olika förlossningssätt medan paritet och mosaikgrupper inte skilde signifikant. Konklusion: PPD förekom i lägre utsträckning än i litteraturen både vad gäller utköpta antidepressiva läkemedel och diagnosförekomst. PPD diagnos förekom dubbelt så ofta som utköp av antidepressiva hos kvinnor som fött barn i Stockholm under studieperioden. 

  • 793.
    Yi-Ting, Lin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Family Med, Kaohsiung, Taiwan.
    Chou, Mei-Chuan
    Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Neurol, Kaohsiung, Taiwan;Kaohsiung Med Univ, Kaohsiung Municipal Ta Tung Hosp, Dept Neurol, Kaohsiung, Taiwan.
    Wu, Shyh-Jong
    Kaohsiung Med Univ, Dept Med Lab Sci & Biotechnol, Kaohsiung, Taiwan.
    Yang, Yuan-Han
    Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Neurol, Kaohsiung, Taiwan;Kaohsiung Med Univ, Kaohsiung Municipal Ta Tung Hosp, Dept Neurol, Kaohsiung, Taiwan;Kaohsiung Med Univ, Fac Med, Dept Neurol, Kaohsiung, Taiwan;Kaohsiung Med Univ, Fac Med, Masters Program Neurol, Kaohsiung, Taiwan;Kaohsiung Med Univ, Neurosci Res Ctr, Kaohsiung, Taiwan.
    Galantamine plasma concentration and cognitive response in Alzheimer's disease2019In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 7, article id e6887Article in journal (Refereed)
    Abstract [en]

    Background

    Galantamine has been approved for the treatment of Alzheimer's disease (AD). However, there are few studies which have reported the association between cognitive responses and galantamine plasma concentration. The aim of this study was to determine the correlation between galantamine plasma concentration and the subsequent cognitive response following treatment in AD patients.

    Methods

    ADsufferers who continuously took 8 mg/d galantamine for at least 6 months without previous exposure to other kinds of AChEI such as donepezil, rivastigmine, or memantine were included in this cohort study. The assessments included the Mini Mental Status Examination (MMSE), Clinical Dementia Rating Scale (CDR) and the Cognitive Assessment Screening Instrument (CASI). Each subdomain of the CASI assessment was conducted at baseline and after 6 months of galantamine. The plasma concentrations of galantamine were measured by capillary electrophoresis after 6 months of the treatment. Logistic regression was performed to adjust for age, gender, apolipoprotein E epsilon 4 genotype status, and baseline score to investigate the association between galantamine plasma concentrations and the cognitive response.

    Results

    The total sample consisted of 33 clinically diagnosed AD patients taking galantamine 8 mg/d for 6 months. There was no linear correlation between galantamine concentration and cognitive response in patients. However, 22 patients were responsive to the treatment in the long-term memory domain. In CASI subset domain, concentration improved during the 6 months follow up.

    Conclusions

    In the limited samples study, galantamine mostly benefitted the cognitive domain of long-term memory. The benefits were not related to the galantamine plasma concentration. Objective intra-individual evaluation of therapeutic response should be encouraged.

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  • 794.
    Yücel, Mehmet Onur
    et al.
    Antakya Devlet Hastanesi, Psikiyatri Bl, Antakya, Turkey..
    Devrimci Özgüven, Halise
    Ankara Univ, Tip Fak, Psikiyatri AD, TR-06100 Ankara, Turkey..
    Sakarya, Ayşegül
    Kastamonu Devlet Hastanesi, Psikiyatri Bl, Kastamonu, Turkey..
    Baskak, Bora
    Ankara Univ, Tip Fak, Psikiyatri AD, TR-06100 Ankara, Turkey..
    Özel Kızıl, Erguvan Tuğba
    Ankara Univ, Tip Fak, Psikiyatri AD, TR-06100 Ankara, Turkey..
    Sakarya, Direnç
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Haran, Seda
    Serbest Calisan, Ankara, Turkey..
    The Relationship of Verbal Working Memory and Theory of Mind in First Degree Relatives of Patients With Schizophrenia and Bipolar Disorder2016In: Turk Psikiyatri Dergisi, ISSN 1300-2163, Vol. 27, no 1, p. 8-14Article in journal (Refereed)
    Abstract [tr]

    OBJECTIVE: We aimed to compare Theory of Mind (ToM) functions and investigate the relationship between ToM functions and verbal working memory (VWM) in first degree relatives of bipolar disorder and schizophrenia patients.

    METHOD: The sample consisted of first degree relatives of patients with bipolar disorder (n=22), schizophrenia (n=28), and age, gender, education and total IQ matched healthy volunteers (n=27) without a family history of schizophrenia or bipolar disorder. We administered Auditory Consonants Test (ACT) to evaluate VWM, first and second order false belief tests (ToM-1, ToM-2), Faux Pas Test (FPT), Hinting Test (HT) to evaluate different domains of ToM functions.

    RESULTS: Both relative groups performed significantly lower in all components of ToM and VWM tests compared to the control group. When VWM scores were employed as covariate in the analyses, the FPT difference between the groups remained significant, HT difference regressed to a marginal level, and the difference between ToM-1 and ToM-2 disappeared.

    CONCLUSION: To our knowledge, this is the first study indicating the presence of ToM impairment among first degree relatives of bipolar disorder patients similar to relatives of schizophrenia patients. VWM performance seems to affect first and second order ToM functions in relatives of patients with schizophrenia and bipolar disorder. On the other hand, FPT and HT domains seem to be independent of VWM performances in these groups. FPT and HT impairments may be familial vulnerability markers that are independent from neurocognitive impairment.

  • 795.
    Zachrison, Linnea
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Ruchkin, Vladislav
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Yale Univ, Sch Med, Ctr Child Study, New Haven, CT 06510 USA.;Sater Forens Psychiat Clin, Sater, Sweden..
    Stickley, Andrew
    Sodertorn Univ, Stockholm Ctr Hlth & Social Change, Huddinge, Sweden..
    Koposov, Roman
    Arctic Univ Norway UiT, Reg Ctr Child & Youth Mental Hlth & Child Welf, Tromso, Norway..
    Inhalant Use and Mental Health Problems in Russian Juvenile Delinquents2017In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 52, no 12, p. 1616-1623Article in journal (Refereed)
    Abstract [en]

    Background: Inhalant use by children and adolescents has been linked to an increased risk of multiple drug use, mental health problems and antisocial behavior. Objectives: The purpose of this study was to examine the association between the frequency of inhalant use and psychiatric diagnoses amongincarcerated delinquent youths in Russia. Methods: Atotal of 370 incarcerated delinquents from a juvenile correction center in Northern Russia were assessed by means of a semi-structured psychiatric interview and by self-reports. Results: Compared to non-users (N = 266), inhalant users ( N = 104) reported higher rates of PTSD, early onset conduct disorder, ADHD, alcohol abuse and dependence, as well as higher levels of antisocial behavior, impulsiveness and more psychopathic traits. Frequent inhalant users also reported the highest rates of co-occurring psychopathology. Conclusions: Our findings suggest that inhalant use in delinquents is frequent and may require additional clinical measures to address the issue of psychiatric comorbidity.

  • 796.
    Zanchi, Davide
    et al.
    Univ Basel, Dept Psychiat UPK, Basel, Switzerland..
    Brody, Arthur
    Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA.;VA Greater Los Angeles Healthcare Syst, Dept Res, Los Angeles, CA USA..
    Borgwardt, Stefan
    Univ Basel, Dept Psychiat UPK, Basel, Switzerland..
    Haller, Sven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Affidea Ctr Diagnost Radiol Carouge CDRC, Geneva, Switzerland.;Univ Geneva, Fac Med, Geneva, Switzerland.;Univ Hosp Freiburg, Dept Neuroradiol, Freiburg, Germany..
    Sex Effects on Smoking Cue Perception in Non-Smokers, Smokers, and Ex-Smokers: A Pilot Study2016In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 7, article id 187Article in journal (Refereed)
    Abstract [en]

    Introduction: Recent neuroimaging research suggests sex-related brain differences in smoking addiction, In the present pilot study, we assessed gender-related differences in brain activation in response to cigarette-related video cues, investigating non-smokers, smokers, and ex-smokers. Methods: First, we compared 29 females (28.6 +/- 5.3) vs. 23 males (31.5 +/- 6.4), regardless of current smoking status to assess global gender-related effects. Second, we performed a post hoc analysis of non-smokers (9 females and 7 males). Participants performed a block-design functional magnetic resonance imaging paradigm contrasting smoking with control cue video exposures. Data analyses included task-related general linear model, voxel-based morphometry of gray matter (GM), and tract-based spatial statistics of white matter (WM). Results: First, the global effect regardless of current smoking status revealed higher activation in the bilateral superior frontal gyrus and anterior cingulate cortex (ACC) for females compared to males. Second, the analysis according to current smoking status demonstrated higher activation in female vs. male smokers vs. non-smokers in the superior frontal gyrus, anterior and posterior cingulate cortex, and precuneus, and higher activationi in female vs. male ex-smokers vs. non-smokers in the right precentral gyrus, in the right insula and ACC. No structural differences were found in GM or WM. Conclusion: The current study identifies gender-related brain functional differences in smokers and ex-smokers compared to non-smokers. The current work can be considered as a starting point for future investigations into gender differences in brain responses to cigarette-related cues

  • 797.
    Zandian, A.
    et al.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Wingard, L.
    Karolinska Inst, Ctr Mol Med, Karolinska Univ Hosp Solna, Dept Clin Neurosci, L8 01, Stockholm, Sweden.;Karolinska Univ Hosp Solna, SLSO, Psykiatri Nordvast, Stockholm, Sweden.;Karolinska Inst, Karolinska Univ Hosp Solna, Ctr Pharmacoepidemiol, Dept Med, Stockholm, Sweden..
    Nilsson, H.
    Karolinska Inst, Ctr Mol Med, Karolinska Univ Hosp Solna, Dept Clin Neurosci, L8 01, Stockholm, Sweden..
    Sjöstedt, Evelina
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical and experimental pathology.
    Johansson, D. X.
    Karolinska Inst, Ctr Mol Med, Karolinska Univ Hosp Solna, Dept Clin Neurosci, L8 01, Stockholm, Sweden..
    Just, D.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Hellstrom, C.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Uhlen, M.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Schwenk, J. M.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Haemark-Manberg, A.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Norbeck, O.
    Karolinska Inst, Karolinska Univ Hosp Solna, Ctr Mol Med, Dept Med, L8 01, Stockholm, Sweden.;Karolinska Inst, Sect Psychiat, Karolinska Univ Hosp Huddinge, Dept Clin Neurosci,Ctr Psychiat Res, Stockholm, Sweden..
    Owe-Larsson, B.
    Karolinska Inst, Sect Psychiat, Karolinska Univ Hosp Huddinge, Dept Clin Neurosci,Ctr Psychiat Res, Stockholm, Sweden..
    Nilsson, P.
    KTH Royal Inst Technol, Sch Biotechnol, Affin Prote, SciLifeLab, Tomtebodavagen 23A, S-17165 Stockholm, Sweden..
    Persson, M. A. A.
    Karolinska Inst, Ctr Mol Med, Karolinska Univ Hosp Solna, Dept Clin Neurosci, L8 01, Stockholm, Sweden.;Karolinska Univ Hosp Solna, SLSO, Psykiatri Nordvast, Stockholm, Sweden..
    Untargeted screening for novel autoantibodies with prognostic value in first-episode psychosis2017In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 7, article id e1177Article in journal (Refereed)
    Abstract [en]

    Immunological and inflammatory reactions have been suggested to have a role in the development of schizophrenia, a hypothesis that has recently been supported by genetic data. The aim of our study was to perform an unbiased search for autoantibodies in patients with a first psychotic episode, and to explore the association between any seroreactivity and the development of a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder characterized by chronic or relapsing psychotic symptoms. We collected plasma samples from 53 patients when they were treated for their first-episode psychosis, and 41 non-psychotic controls, after which the patients were followed for a mean duration of 7 years. Thirty patients were diagnosed with schizophrenia, delusional disorder, schizoaffective disorder, bipolar disorder or a long-term unspecified nonorganic psychosis during follow-up, whereas 23 patients achieved complete remission. At the end of follow-up, plasma samples were analyzed for IgG reactivity to 2304 fragments of human proteins using a multiplexed affinity proteomic technique. Eight patient samples showed autoreactivity to the N-terminal fragment of the PAGE (P antigen) protein family (PAGE2B/PAGE2/PAGE5), whereas no such autoreactivity was seen among the controls. PAGE autoreactivity was associated with a significantly increased risk of being diagnosed with schizophrenia during follow-up (odds ratio 6.7, relative risk 4.6). An immunohistochemistry analysis using antisera raised against the N-terminal fragment stained an unknown extracellular target in human cortical brain tissue. Our findings suggest that autoreactivity to the N-terminal portion of the PAGE protein family is associated with schizophrenia in a subset of patients with first-episode psychosis.

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  • 798. Zheng, Ming
    et al.
    Appel, Lieuwe
    Luo, Feng
    Lane, Roger
    Risinger, Robert
    Antoni, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preclinical PET Platform.
    Cahir, Matthews
    Sanjay, Keswani
    Hayes, Wendy
    Burt, David
    Zubin, Bhagwaragar
    Safety, Pharmacokinetic, and Positron Emission Tomography Evaluation of Serotonin and Dopamine Transporter Occupancy Following Multiple-Dose Administration of the Triple Monoamine Reuptake Inhibitor BMS-8208362015In: Psychopharmacology, ISSN 0033-3158, E-ISSN 1432-2072, Vol. 232, no 3, p. 529-540Article in journal (Refereed)
    Abstract [en]

    Rationale

    BMS-820836 is a novel antidepressant that selectively inhibits the reuptake of serotonin, norepinephrine, and dopamine.

    Objective

    This Phase I study assessed safety, tolerability, and pharmacokinetics of multiple daily doses of BMS-820836 in healthy subjects. Central serotonin transporter (SERT) and dopamine transporter (DAT) occupancy were assessed using positron emission tomography and [11C]MADAM or [11C]PE2I, respectively.

    Methods

    Fifty-seven healthy volunteers were enrolled in this double-blind, placebo-controlled, ascending multiple-dose study (ClincalTrials.gov identifier: NCT00892840). Eight participants in seven dose cohorts received oral doses of BMS-820836 (0.1–4 mg) or placebo for 14 days to assess safety, tolerability, and pharmacokinetics. Additionally, SERT and DAT occupancies were evaluated in 4–8 subjects per cohort at 8 h post-dose on Day 10 and 24 h post-dose on Day 15 at anticipated steady-state conditions.

    Results

    Most adverse events were mild to moderate; there were no serious safety concerns. Median maximum concentrations of BMS-820836 were observed at 4.0–5.5 h post-dose; estimated elimination half-life was 44–74 h. About 80 % striatal SERT occupancy was achieved after multiple doses of 0.5 mg BMS-820836 at both 8 and 24 h post-dose. Striatal DAT occupancy ranged between 14 % and 35 % at 8 h post-dose with a slight decline at 24 h post-dose.

    Conclusions

    Multiple daily doses of up to 4 mg BMS-820836 appeared to be generally safe and well tolerated in a healthy population. SERT and DAT occupancies were in a range associated with therapeutic efficacy of antidepressants. Together with the pharmacokinetic profile of BMS-820836, the occupancy data support once-daily administration.

  • 799.
    Åhs, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Michelgård Palmquist, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Pissiota, Anna
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Appel, Lieuwe
    Frans, Örjan
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Liberzon, Israel
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Fredrikson, Mats
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Arousal modulation of memory and amygdala-parahippocampal connectivity: A PET-psychophysiology study in specific phobia2011In: Psychophysiology, ISSN 0048-5772, E-ISSN 1469-8986, Vol. 48, no 11, p. 1463-1469Article in journal (Refereed)
    Abstract [en]

    Phobic fear is accompanied by intense bodily responses modulated by the amygdala. An amygdala moderated psychophysiological measure related to arousal is electrodermal activity. We evaluated the contributions of electrodermal activity to amygdala-parahippocampal regional cerebral blood flow (rCBF) during phobic memory encoding in subjects with spider or snake phobia. Recognition memory was increased for phobia-related slides and covaried with rCBF in the amygdala and the parahippocampal gyrus. The covariation between parahippocampal rCBF and recognition was related to electrodermal activity suggesting that parahippocampal memory processes were associated with sympathetic activity. Electrodermal activity further mediated the amygdala effect on parahippocampal activity. Memory encoding during phobic fear therefore seems contingent on amygdala's influence on arousal and parahippocampal activity.

  • 800.
    Åslund, Cecilia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Depression and Antisocial Behaviour in Adolescents: Influence of Social Status, Shaming, and Gene-Environment Interaction2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis investigated (1) social status and shaming experiences in relation to aggressive behaviour and depression, and (2) gene-environment interactions between two genetic polymorphisms related to the serotonergic system – MAOA-VNTR and 5HTTLPR – and experiences of maltreatment in relation to delinquent behaviour and depression among adolescents.

    The four included studies are based on questionnaire data from the Survey of Adolescent Life in Vestmanland 2006 (SALVe-2006). A total of 5396 students in 9th (15-16 years old) grade of elementary school and 2nd (17-18 years old) grade of high school comprised the target population. The students in 2nd grade of high school also provided a saliva sample for gene extraction.

    There were strong associations between shaming experiences and both aggressive behaviour and depression. In addition, individuals who reported many shaming experiences and had either low or high social status had increased risks of physical aggression or depression, whereas medium social status seemed to have a protective effect.

    Gene-environment interactions were found between experiences of maltreatment and the MAOA-VNTR in relation to delinquent behaviour. Moreover, the direction of the gene-environment interaction differed depending on sex: boys with the short (S) variant of the MAOA-VNTR, in contrast to girls with the long (LL) variant, had the highest risk of delinquency in combination with maltreatment.

    Gene-environment interactions were also found between experiences of maltreatment and the 5HTTLPR in relation to depression among girls. The girls that were homozygous for the S allele (SS) had the highest risk of depression in combination with maltreatment. Among boys however, no gene-environment interaction was found between the 5HTTLPR and maltreatment in relation to depression.

    In conclusion, it is important to consider both genetic effects, and psychosocial factors such as social status, shaming experiences, and experiences of maltreatment when investigating different aspects of health and behaviour among adolescents.

    List of papers
    1. Social status and shaming experiences related to adolescent overt aggression at school
    Open this publication in new window or tab >>Social status and shaming experiences related to adolescent overt aggression at school
    2009 (English)In: Aggressive Behavior, ISSN 0096-140X, E-ISSN 1098-2337, Vol. 35, no 1, p. 1-13Article in journal (Refereed) Published
    Abstract [en]

    Feelings of rejection and humiliation in interpersonal interaction are strongly related to aggressive behavior. The aim of the present study was to investigate the association between social status, shaming experiences, gender and adolescent aggressive behavior by using a status-shaming model. A population-based sample of 5396 adolescents aged from 15 to 18 completed a questionnaire which asked questions regarding psychosocial background, shaming experiences, social status of family, peer group and school, and involvement in physical or verbal aggression at school.

    Shaming experiences, i.e. being ridiculed or humiliated by others, were strongly related to aggressive behavior. Social status and shaming were related in the prediction of aggressive behavior, suggesting that a person’s social status may influence the risk for taking aggressive action when subjected to shaming experiences. Medium social status seemed to have a protective function in the association between shaming experiences and aggression. The study confirms the importance of further evaluation of the role of perceived social status and shaming experiences in the understanding of aggressive behavior. Moreover, the results indicate the need for different kinds of status measures when investigating associations between status and behavior in adolescent populations. The results may have important implications for the prevention of bullying at school as well as other deviant aggressive behavior among adolescents.

    Keywords
    physical and verbal aggression, social status, shame, adolescence, gender differences
    National Category
    Medical and Health Sciences
    Research subject
    Child and Youth Psychiatry; Sociology; Psychology
    Identifiers
    urn:nbn:se:uu:diva-109846 (URN)10.1002/ab.20286 (DOI)000261934600001 ()18925634 (PubMedID)
    Available from: 2009-10-27 Created: 2009-10-27 Last updated: 2017-12-12Bibliographically approved
    2. Subjective social status and shaming experiences in relation to adolescent depression
    Open this publication in new window or tab >>Subjective social status and shaming experiences in relation to adolescent depression
    2009 (English)In: Archives of Pediatrics & Adolescent Medicine, ISSN 1072-4710, E-ISSN 1538-3628, Vol. 163, no 1, p. 55-60Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate associations between social status, shaming experiences and adolescent depression by the use of a status-shaming model.

    Design: Population-based self-report cohort study.

    Setting: Västmanland, Sweden.

    Participants: A cohort of 5396 students in grade nine (15-16 years old) and second year of high school (17-18 years old).

    Intervention: Participants completed the anonymous questionnaire Survey of Adolescent Life in Vestmanland - 2006 (SALVe 2006) during class hours.

    Outcome Measures: We investigated prevalence of depression according to DSRS (DSM IV, A-criterion), in relation to subjective social status, shaming experiences, and social background factors. Social status was measured in two ways - attributed status of a family’s socioeconomic and social standing, and acquired status of peer group and school. Binary logistic regressions were used for the analyses.

    Results: Shaming experiences and low social status interacted in relation to depression. If shaming experiences were present, participants with both high and low attributed status showed an elevated risk for depression (OR 5.4-6.9), whereas medium status seemed to have a protective function. For acquired status, the highest elevated risk was found among participants with low status (OR 6.7-8.6).

    Conclusions: It is possible that a person’s social status may influence the risk for depression when subjected to shaming experiences. The study contributes to the mapping of the influence of social status on health, and may have essential implications in the understanding, prevention and treatment of adolescent depression.

    Keywords
    social status, shame, adolescence, depression
    National Category
    Medical and Health Sciences
    Research subject
    Child and Youth Psychiatry; Sociology
    Identifiers
    urn:nbn:se:uu:diva-109847 (URN)10.1001/archpedi.163.1.55 (DOI)000262179000009 ()19124704 (PubMedID)
    Available from: 2009-10-27 Created: 2009-10-27 Last updated: 2017-12-12Bibliographically approved
    3. Maltreatment, MAOA, and delinquency: Sex differences in gene-environment interaction in a large population-based cohort of adolescents
    Open this publication in new window or tab >>Maltreatment, MAOA, and delinquency: Sex differences in gene-environment interaction in a large population-based cohort of adolescents
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    2011 (English)In: Behavior Genetics, ISSN 0001-8244, E-ISSN 1573-3297, Vol. 41, no 2, p. 262-272Article in journal (Refereed) Published
    Abstract [en]

    The present study investigated a possible interaction between a functional polymorphism in the MAOA gene promoter (MAOA-VNTR) and childhood maltreatment in the prediction of adolescent male and female delinquency. A cohort of 1 825 high school students, 17-18 years old, completed an anonymous questionnaire during class hours which included questions on childhood maltreatment, sexual abuse, and delinquency. Saliva samples were collected for DNA isolation, and analyzed for the MAOA-VNTR polymorphism.

    Self-reported maltreatment was a strong risk factor for adolescent delinquent behavior. The MAOA genotype also showed a significant main effect when controlled for maltreatment. Boys with a short variant and girls with one or two long variants of the polymorphism showed a higher risk for delinquency when exposed to maltreatment. Our results confirm previous findings of an interaction between the MAOA-VNTR polymorphism and self-reported maltreatment. Results for boys and girls differ according to MAOA-VNTR genotype and direction of phenotypic expression.

    Keywords
    Monoamine oxidase, child maltreatment, juvenile delinquency, sex characteristics, MAOA, gene-environment interaction
    National Category
    Psychiatry
    Research subject
    Child and Youth Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-109848 (URN)10.1007/s10519-010-9356-y (DOI)000287749700010 ()20734127 (PubMedID)
    Available from: 2009-10-27 Created: 2009-10-27 Last updated: 2017-12-12Bibliographically approved
    4. Impact of the interaction between the 5HTTLPR polymorphism and maltreatment on adolescent depression.: A population-based study
    Open this publication in new window or tab >>Impact of the interaction between the 5HTTLPR polymorphism and maltreatment on adolescent depression.: A population-based study
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    2009 (English)In: Behavior Genetics, ISSN 0001-8244, E-ISSN 1573-3297, Vol. 39, no 5, p. 524-531Article in journal (Refereed) Published
    Abstract [en]

    Serotonin plays a central role in mood regulation and the development of depressive disorders. The present study investigated whether a functional polymorphism (5HTTLPR) of the serotonin transporter gene interacts with maltreatment in the prediction of depression. A cohort of 17-18 year old students (n=1482) anonymously completed the Survey of Adolescent Life and Health in Vestmanland 2006 and gave a saliva sample for DNA extraction. An association between maltreatment and adolescent depression was found independent of sex. When the whole population was analyzed, no main effect of 5HTTLPR in association with depression was found. When separated by sex, a significant main effect and a GxE interaction effect of the SS allele was found among girls. No gene main effect or GxE interaction effect was found among boys. The present study confirms previous findings of sex differences in interaction effects between the 5HTTLPR polymorphism and maltreatment in the prediction of adolescent depression.

    Keywords
    depression, serotonin transporter, child maltreatment, sex characteristics, 5HTTLPR, gene-environment interaction
    National Category
    Medical and Health Sciences
    Research subject
    Child and Youth Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-109849 (URN)10.1007/s10519-009-9285-9 (DOI)000268995200007 ()19582567 (PubMedID)
    Available from: 2009-10-27 Created: 2009-10-27 Last updated: 2017-12-12Bibliographically approved
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