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  • 1.
    Kerstis, Birgitta
    et al.
    Malardalen Univ, Sch Hlth Care & Social Welf, S-72218 Vasteras, Sweden.
    Åslund, Cecilia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    More secure attachment to the father and the mother is associated with fewer depressive symptoms in adolescents2018In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 1, p. 62-67Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate whether more secure attachment to the father and the mother is associated with less depressive symptoms among adolescents, and to explore possible sex differences.

    Method: A population-based sample of adolescents completed a school-based survey assessing demographic data, attachment to father and mother, as well as depressive symptoms. Participation rate was 80% of the eligible population, and 3,988 adolescents (1,937 boys and 2,051 girls) had complete data for the analyses.

    Results: Paired samples t tests showed that participants rated their attachment to mothers as slightly more secure than their attachment to fathers (t = 15.94, P < 0.001; boys: t = 5.23, P < 0.001; girls: t = 16.16, P < 0.001). In linear regression analyses there was an association between the outcome, number of depressive symptoms, and more secure attachment to the mother for boys (B=-0.532; 95% confidence interval [CI] -0.656, -0.407, P < 0.001) and for girls (B = -0.623; 95% CI -0.730, -0.516, P < 0.001). Analogous results were found for more secure attachment to the father for boys (B = -0.499; 95% CI -0.608, -0.391, P < 0.001) and for girls (B = -0.494; 95% CI -0.586, -0.401, P < 0.001).

    Conclusions: Understanding the relationship between attachment to both father and mother and depressive symptoms in adolescent boys and girls is essential for further development of strategies for prevention and treatment of depression.

  • 2.
    Nilsson, Kent W.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Nordquist, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Comasco, Erica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neuro-psycho-pharmacology.
    Leppert, Jerzy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Oreland, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neuro-psycho-pharmacology.
    Sjöberg, Richard L
    Transcription Factor Activating Protein-2β (TFAP-2β) genotype and symptoms of attention deficit hyperactivity disorder in relation to symptoms of depression in two independent samples2014In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 23, no 4, p. 207-217Article in journal (Refereed)
    Abstract [en]

    The Transcription Factor Activating Protein-2β (TFAP-2β) gene has been shown to influence monoaminergic neurotransmission, and several genes important for monoaminergic function have binding sites for TFAP-2β. Familial studies of attention deficit hyperactivity disorder (ADHD) suggest a hereditary-determined subtype of ADHD with comorbid depression. We examined a functional variation of the TFAP-2β gene in the context of co-occurring symptoms of ADHD and depression in two independent population-based samples of adolescents (Group A, n = 175 and Group B, n = 1,506) from Sweden. Results indicated 6.1 to 7.8 % of adolescents screened positively for ADHD and depression symptoms. Symptoms of depression were more common among girls who screened positively for ADHD and did not carry the nine-repeat allele of the TFAP-2β intron 1 Variable Number Tandem Repeat (VNTR) polymorphism. The presence of the nine-repeat variant of the TFAP-2β intron 1 VNTR appears to protect girls with ADHD symptoms from the co-expression of symptoms of depression.

  • 3.
    Olofsdotter, Susanne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Vadlin, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Nilsson, Kent W
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Assessing Adolescent Anxiety in General Psychiatric Care: Diagnostic Accuracy of the Swedish Self-Report and Parent Versions of the Spence Children's Anxiety Scale2016In: Assessment (Odessa, Fla.), ISSN 1073-1911, E-ISSN 1552-3489, Vol. 23, no 6, p. 744-757Article in journal (Refereed)
    Abstract [en]

    This study examined the psychometric properties and diagnostic accuracy of the Swedish translations of the Spence Children's Anxiety Scale, self- and parent report versions, in a sample of 104 adolescents presenting at two general psychiatric outpatient units. Results showed high informant agreement and good internal reliability and concurrent and discriminant validity for both versions and demonstrated that this scale can distinguish between adolescents with and without an anxiety disorder in a non-anxiety-specific clinical setting. The relative clinical utility of different cutoff scores was compared by looking at the extent to which dichotomized questionnaire results altered the pretest probability of the presence of a diagnosis as defined by the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Optimized for screening and diagnostic purposes in Sweden, cutoff scores obtained in the current study outperformed a previously identified cutoff score derived from an Australian community sample. The Spence Children's Anxiety Scale is a useful clinical instrument for the assessment of anxiety in adolescents.

  • 4.
    Olofsdotter, Susanne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Vadlin, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Anxiety disorders among adolescents referred to general psychiatry for multiple causes: clinical presentation, prevalence, and comorbidity2016In: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, E-ISSN 2245-8875, Vol. 4, no 2, p. 55-64Article in journal (Refereed)
    Abstract [en]

    Reports of anxiety disorder characteristics among youth in clinical settings typically include descriptions of patients who have been specifically referred for anxiety treatment. At odds with a large body of evidence which demonstrates these disorders to be most common among young people, prevalence studies in samples referred to general psychiatry for multiple causes are scarce and report highly discrepant estimates.

    For this study and regardless of their presenting symptoms, 125 adolescents (57.6% girls) between the ages of 12 and 18 years who were consecutively referred to two child and adolescent general psychiatry clinics in Sweden were assessed for anxiety disorders and comorbidity using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Self-ratings of anxiety symptoms and difficulties with family, school, friends, sleep, and body aches were also obtained.

    At least one anxiety disorder was found in 46% of participants. Among anxious adolescents, homotypic comorbidity (concurrent anxiety) was observed in 43%, and heterotypic comorbidity (concurrent non-anxiety psychiatric disorders) was observed in 91%. No comorbidity was observed in 5%. Trauma, ache, and difficulties making friends were more common among anxious adolescents as compared with psychiatrically referred adolescents without anxiety.

    The finding that only 21% of adolescents diagnosed with anxiety disorders were referred for anxiety further supports the routine use of standardized and structured instruments—irrespective of referral cause—to improve both precision and detection rates in the clinical setting. Comprehensive assessments are of utmost importance to fully address the complexity of the symptoms in this patient group.

  • 5.
    Sjölander, Linda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Vadlin, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Olofsdotter, Susanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Validation of the parent version of the World Health Organization Adult ADHD Self-Report Scale for adolescents.2016In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 4, p. 255-261Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the validity of a parent version of the World Health Organization Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale for adolescents (ASRS-AP) and the 6-question screening version (ASRS-AP-S).

    METHODS: Adolescent psychiatric outpatients (N = 112, mean age 15 years, 40% boys) and their parents were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), and the parents reported on the ASRS-AP/ASRS-AP-S.

    RESULTS: Internal consistency (Cronbach's alpha) was 0.93 for ASRS-AP and 0.85 for ASRS-AP-S, 0.91 and 0.87 for the inattention subscale, and 0.91 and 0.72 for the hyperactivity subscale, respectively. The concurrent validity (Spearman's correlation coefficient) between the total K-SADS ADHD symptom severity score and the sum of the score on the ASRS-AP/ASRS-AP-S was 0.75 and 0.66, respectively. Diagnostic accuracy measures for the ASRS-AP and ASRS-AP-S were 78% and 80% sensitivity, 75% and 74% specificity, 73% and 71% positive predictive value (PPV), and 81% and 82% negative predictive value (NPV), respectively.

    CONCLUSIONS: The ASRS-AP and ASRS-AP-S showed high internal consistency and concurrent validity in relation to total K-SADS ADHD symptom severity score. Both scales showed favourable diagnostic accuracy measures.

  • 6.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Centrum för klinisk forskning, Västerås.
    Co-occurring Symptoms of Attention Deficit Hyperactivity Disorder and Depression: Sex, Aetiology, Help-Seeking and Assessment2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of the thesis was to contribute to the knowledge about co-occurring symptoms of ADHD and depression in adolescence, focusing on sex differences, as well as aetiology, help-seeking and assessment.

    Studies I–III used epidemiological samples of self-reports from all students in Västmanland aged 15–16 and 17–18 years. Study I investigated the prevalence of co-occurring symptoms of ADHD and depression, as well as associations between co-occurring symptoms of ADHD and depression and one environmental stress factor; experience of sexual abuse. Study II examined associations between one biological factor—a polymorphism in TFAP-2βand co-occurring symptoms of ADHD with andco-occurringsymptoms of depression. Study III investigated the association between the parent–adolescent relationship and seeking help from specialized mental health services in relation to symptoms of ADHD and/or depression. Study IV was a clinical study among adolescent psychiatric patients that compared self-reported ADHD symptoms via the Adult ADHD Self-Report Scale–Adolescent version (ASRS-A) and the Adult ADHD Self-Report Scale–Adolescent–Screening version (ASRS-A-S) with an ADHD diagnosis determined by the gold-standard method; the Kiddie Schedule of Affective Disorders and Schizophrenia diagnostic interview.

    Studies I–III showed that the phenotype of co-occurring symptoms of ADHD and depression is frequent, with a distinct preponderance among girls. Approximately 50% of both boys and girls with co-occurring symptoms of ADHD and depression had also experienced sexual abuse, indicating that this is a group with multiple risk factors for long-term impaired mental health.

    Results also support biological sex differences because girls with symptoms of ADHD and a common polymorphism of TFAP-2β (absence of a 9 repeat) reported more symptoms of depression, but boys did not.

    Further, only 5% of the adolescents with symptoms of ADHD and/or depression sought help from specialized mental health services. The co-occurrence of symptoms of ADHD and depression was a stronger predictor of help-seeking than all other psychosocial factors investigated, including secure attachment cognitions styles to parents. Among help-seeking girls, co-occurring symptoms of ADHD and depression were more common than symptoms of ADHD without co-occurring symptoms of depression.

    The ASRS-A/ASRS-A-S showed promising psychometric properties for further validation in adolescentsresults as a screening tool for use in adolescents.

    List of papers
    1. Symptoms of ADHD and depression in a large adolescent population: Co-occurring symptoms and associations to experiences of sexual abuse
    Open this publication in new window or tab >>Symptoms of ADHD and depression in a large adolescent population: Co-occurring symptoms and associations to experiences of sexual abuse
    2011 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 65, no 5, p. 315-322Article in journal (Refereed) Published
    Abstract [en]

    Background: Symptoms of either attention-deficit hyperactivity disorder (ADHD) or depression constitute the most common reasons for contact with child and adolescent psychiatry. The development of psychiatric symptoms can be explained by a combination of environmental stress events and genetic vulnerability. One common form of environmental stress with high impact on health is sexual abuse.

    Aims: To investigate the prevalence and co-occurrence of symptoms of ADHD and depression in relation to experiences of sexual abuse in a large adolescent general population.

    Method: All 15- and 18-year-old students (n = 4910) in the Swedish county of Vestmanland answered a school-based screening instrument including the six-question ADHD self-rating scale (ASRS), the Depression Self-Rating Scale (DSRS) and questions relating to experiences of sexual abuse.

    Results: The prevalence of co-occurring symptoms of ADHD and depression was 2.4% (boys 1.0%, girls 3.9%). The prevalence of experience of any sexual abuse was 20.9% (boys 13.3%, girls 28.7%). Of those with co-occurring symptoms, 48% of the boys and 47% of the girls reported a history of sexual abuse.

    Conclusions: School-based screening for co-occurring symptoms of ADHD and depression might be a method that identifies students at psychiatric and psychosocial risk.

    Keywords
    ADHD, adolescents, depression, sex differences, sexual abuse
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-153363 (URN)10.3109/08039488.2010.545894 (DOI)000295001900006 ()21189056 (PubMedID)
    Available from: 2011-05-12 Created: 2011-05-12 Last updated: 2017-12-11Bibliographically approved
    2. Transcription Factor Activating Protein-2β (TFAP-2β) genotype and symptoms of attention deficit hyperactivity disorder in relation to symptoms of depression in two independent samples
    Open this publication in new window or tab >>Transcription Factor Activating Protein-2β (TFAP-2β) genotype and symptoms of attention deficit hyperactivity disorder in relation to symptoms of depression in two independent samples
    Show others...
    2014 (Norwegian)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 23, no 4, p. 207-217Article in journal (Refereed) Published
    Abstract [en]

    The Transcription Factor Activating Protein-2β (TFAP-2β) gene has been shown to influence monoaminergic neurotransmission, and several genes important for monoaminergic function have binding sites for TFAP-2β. Familial studies of attention deficit hyperactivity disorder (ADHD) suggest a hereditary-determined subtype of ADHD with comorbid depression. We examined a functional variation of the TFAP-2β gene in the context of co-occurring symptoms of ADHD and depression in two independent population-based samples of adolescents (Group A, n = 175 and Group B, n = 1,506) from Sweden. Results indicated 6.1 to 7.8 % of adolescents screened positively for ADHD and depression symptoms. Symptoms of depression were more common among girls who screened positively for ADHD and did not carry the nine-repeat allele of the TFAP-2β intron 1 Variable Number Tandem Repeat (VNTR) polymorphism. The presence of the nine-repeat variant of the TFAP-2β intron 1 VNTR appears to protect girls with ADHD symptoms from the co-expression of symptoms of depression.

    Keywords
    attention deficit hyperactivity disorder, depression, adolescents, comorbitidy, transcription factor AP-2β, 
    National Category
    Psychiatry
    Research subject
    Child and Youth Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-219063 (URN)10.1007/s00787-013-0450-6 (DOI)000334175700004 ()23824473 (PubMedID)
    Available from: 2014-02-28 Created: 2014-02-20 Last updated: 2018-05-31Bibliographically approved
    3. Influence of the parent–adolescent relationship on mental health help-seeking
    Open this publication in new window or tab >>Influence of the parent–adolescent relationship on mental health help-seeking
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To investigate help-seeking from specialized mental health services, especially in relation to the parent–adolescent relationship, as measured by attachment, and symptoms of attention deficit hyperactivity disorder (ADHD) and/or depression and sex.

    Methods: The study was epidemiological and cross-sectional, and used the Experiences in Close Relationships-Revised-Children (ECR-RC9), the Adult ADHD Self-Report Scale Screener and the Depression Self-Rating Scale-Adolescents. Adolescents, 15 to 18 years old, from the Swedish county of Västmanland participated (N = 4,506, 74% participation rate).

    Results: Help-seeking was predicted by co-occurring symptoms of ADHD and depression (OR = 5.4), symptoms of depression (OR = 4.8) and symptoms of ADHD (OR = 2.6), as well as any experience of sexual abuse (OR = 1.7) and being female (OR = 1.6). Secure attachment to parents, assessed with the ECR-RC9, did not increase help-seeking. Furthermore, in interaction analyses secure attachment to parents in combination with experiences of sexual abuse and/or conduct problems, or to be female and have symptoms of ADHD, decreased the probability of help-seeking.

    Conclusion: Secure attachment, as a measure of the adolescent’s willingness to communicate with their parents about their problems, did not increase help-seeking. Symptoms of ADHD and/or depression predicted help-seeking more than any psychosocial factor.

    Keywords
    help-seeking, attachment, ADHD, depression, sex
    National Category
    Medical and Health Sciences
    Research subject
    Child and Youth Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-219109 (URN)
    Available from: 2014-02-21 Created: 2014-02-21 Last updated: 2014-04-29Bibliographically approved
    4. Validation of the World Health Organization Adult ADHD Self-Report Scale for adolescents
    Open this publication in new window or tab >>Validation of the World Health Organization Adult ADHD Self-Report Scale for adolescents
    Show others...
    2015 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 3, p. 216-223Article in journal (Refereed) Published
    Abstract [en]

    Background: The World Health Organization Adult ADHD Self Report Scale (ASRS) is a widely used diagnostic tool for assessment of attention-deficit hyperactivity disorder (ADHD) symptoms in clinical psychiatry in Sweden. The ASRS consists of 18 questions, the first six of which can be used as a short screening version (ASRS-S). There is a version for adolescents—ASRS-Adolescent (ASRS-A)—and the corresponding screening version (ASRS-A-S), which has not been validated to date.

    Aim: The aim was to validate the ASRS-A and the ASRS-A-S for use in adolescent clinical populations.

    Methods: Adolescent psychiatric outpatients (n = 134, mean age 15 years, 40% boys) reported on the ASRS-A, and were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), a semi-structured interview, together with a parent.

    Results: Internal consistency was 0.79 for the ASRS-A-S and 0.92 for the ASRS-A (Cronbach's alpha). Internal consistency values were 0.79 and 0.87 for the inattention subscale, and 0.68 and 0.89 for the hyperactivity subscale, respectively. Concurrent validity values, measured with Spearman's correlation coefficient, between the total K-SADS ADHD symptom severity score and the sum of ASRS-A-S and ASRS-A total scores were 0.51 and 0.60, respectively. Psychometric properties of the ASRS-A-S and the ASRS-A were: sensitivity 74% and 79%; negative predictive value 81% and 84%; specificity 59% and 60%; and positive predictive value 49% and 51%, respectively. Both versions showed better properties for girls than for boys.

    Conclusion: Both the ASRS-A-S and the ASRS-A showed promising psychometric properties for use in adolescent clinical populations.

    Keywords
    Validation Study, Attention Deficit Disorder with Hyperactivity, Adolescent
    National Category
    Psychiatry
    Research subject
    Child and Youth Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-219112 (URN)10.3109/08039488.2014.968203 (DOI)000351231500009 ()25348323 (PubMedID)
    Available from: 2014-02-21 Created: 2014-02-21 Last updated: 2017-12-05Bibliographically approved
  • 7.
    Sonnby, Karin
    et al.
    Centrum för klinisk forskning, Västerås.
    Nilsson, Kent W.
    Centrum för klinisk forskning, Västerås.
    Ramklint, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala Universitet.
    Influence of the parent–adolescent relationship on mental health help-seekingManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To investigate help-seeking from specialized mental health services, especially in relation to the parent–adolescent relationship, as measured by attachment, and symptoms of attention deficit hyperactivity disorder (ADHD) and/or depression and sex.

    Methods: The study was epidemiological and cross-sectional, and used the Experiences in Close Relationships-Revised-Children (ECR-RC9), the Adult ADHD Self-Report Scale Screener and the Depression Self-Rating Scale-Adolescents. Adolescents, 15 to 18 years old, from the Swedish county of Västmanland participated (N = 4,506, 74% participation rate).

    Results: Help-seeking was predicted by co-occurring symptoms of ADHD and depression (OR = 5.4), symptoms of depression (OR = 4.8) and symptoms of ADHD (OR = 2.6), as well as any experience of sexual abuse (OR = 1.7) and being female (OR = 1.6). Secure attachment to parents, assessed with the ECR-RC9, did not increase help-seeking. Furthermore, in interaction analyses secure attachment to parents in combination with experiences of sexual abuse and/or conduct problems, or to be female and have symptoms of ADHD, decreased the probability of help-seeking.

    Conclusion: Secure attachment, as a measure of the adolescent’s willingness to communicate with their parents about their problems, did not increase help-seeking. Symptoms of ADHD and/or depression predicted help-seeking more than any psychosocial factor.

  • 8.
    Sonnby, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Centrum för klinisk forskning, Västerås, Uppsala Universitet.
    Skordas, Konstantinos
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala Universitet.
    Olofsdotter, Susanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Centrum för klinisk forskning, Västerås, Uppsala Universitet.
    Vadlin, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Centrum för klinisk forskning, Västerås, Uppsala Universitet.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Centrum för klinisk forskning, Västerås.
    Ramklint, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala Universitet.
    Validation of the World Health Organization Adult ADHD Self-Report Scale for adolescents2015In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 3, p. 216-223Article in journal (Refereed)
    Abstract [en]

    Background: The World Health Organization Adult ADHD Self Report Scale (ASRS) is a widely used diagnostic tool for assessment of attention-deficit hyperactivity disorder (ADHD) symptoms in clinical psychiatry in Sweden. The ASRS consists of 18 questions, the first six of which can be used as a short screening version (ASRS-S). There is a version for adolescents—ASRS-Adolescent (ASRS-A)—and the corresponding screening version (ASRS-A-S), which has not been validated to date.

    Aim: The aim was to validate the ASRS-A and the ASRS-A-S for use in adolescent clinical populations.

    Methods: Adolescent psychiatric outpatients (n = 134, mean age 15 years, 40% boys) reported on the ASRS-A, and were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), a semi-structured interview, together with a parent.

    Results: Internal consistency was 0.79 for the ASRS-A-S and 0.92 for the ASRS-A (Cronbach's alpha). Internal consistency values were 0.79 and 0.87 for the inattention subscale, and 0.68 and 0.89 for the hyperactivity subscale, respectively. Concurrent validity values, measured with Spearman's correlation coefficient, between the total K-SADS ADHD symptom severity score and the sum of ASRS-A-S and ASRS-A total scores were 0.51 and 0.60, respectively. Psychometric properties of the ASRS-A-S and the ASRS-A were: sensitivity 74% and 79%; negative predictive value 81% and 84%; specificity 59% and 60%; and positive predictive value 49% and 51%, respectively. Both versions showed better properties for girls than for boys.

    Conclusion: Both the ASRS-A-S and the ASRS-A showed promising psychometric properties for use in adolescent clinical populations.

  • 9.
    Torres Soler, Catalina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Olofsdotter, Susanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Vadlin, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Ramklint, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Sonnby, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Diagnostic accuracy of the Montgomery-Åsberg Depression Rating Scale parent report among adolescent psychiatric outpatients2018In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 3, p. 184-190Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The diagnostic accuracy of the parent report of the Montgomery-Åsberg Depression Rating Scale (MADRS-P) for the screening of major depressive disorder (MDD) in adolescents has not been evaluated.

    AIM: The aim was to explore the psychometric properties and diagnostic accuracy of the MADRS-P in general child and adolescent psychiatric outpatient services in Sweden.

    METHOD: The study was a validation and a diagnostic accuracy study. Consecutive adolescent psychiatric patients (n = 101, 45 males, mean age 15 years) were assessed with a diagnostic interview, the Kiddie Schedule of Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL), as a reference test. Thereafter, their parents reported on the MADRS-P. Both categorical MDD diagnoses and dimensional MDD symptom severity scores were obtained from the K-SADS-PL.

    RESULTS: The internal consistency of the MADRS-P, measured with Cronbach's alpha, was 0.846. The concurrent validity, assessed by Spearman's rho as a correlation between the K-SADS MDD symptom severity score and the MADRS-P score, was 0.580. The area under the curve in a receiver operating characteristic analysis for all participants was 0.786 (95% confidence interval 0.694-0.877, p < .001). At a cut-off of 10, sensitivity was 0.86, specificity 0.54, positive predictive value 0.59 and negative predictive value 0.84.

    CONCLUSIONS: The parent-rated MADRS-P showed similar psychometric properties as previously shown for the self-rated MADRS-S in adults. Although the MADRS-P has acceptable diagnostic accuracy for screening for MDD in adolescents in a general psychiatric setting, it cannot be used alone for diagnosing MDD.

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