Logotyp: till Uppsala universitets webbplats

Introduction: Newly graduated nurses (NGNs) encounter difficulties in their professional development and experience high stress during the transition into practice, which may contribute to early turnover. Providing structured transition support is essential for navigating the complexities of patient care and alleviating stress.

Objective: To explore whether participation in a professional development programme (ProDeveloP) with a reflective component during the initial months of transition into practice is associated with NGNs' perceived stress and professional development in terms of role clarity, task mastery, and social acceptance.

Methods: A quantitative intervention study with a non-randomised design. The study was conducted in a region in mid-Sweden. A total of 66 NGNs participated in the study: a control group (n = 27) in 2022 and an intervention group (n = 39) in 2023. The intervention group comprised NGNs who participated in a ProDeveloP, which builds upon a previous introduction programme consisting of eight educational days. ProDeveloP introduced four additional focus areas - role clarity, task mastery, social acceptance, and recovery - and incorporated structured reflection through six facilitated dialogue group sessions. Data were collected through surveys and analysed statistically.

Results: The intervention group, comprising NGNs who participated in ProDeveloP, had significantly lower perceived stress compared with the control group (Mann-Whitney U = 241.000, z = -3.311, p < .001), with a large effect size (Hedges' g = .956, 95% CI [0.489, 1.575]). This difference remained statistically significant after adjusting for relevant covariates in a linear regression model. No significant differences were observed between the groups in relation to role clarity, task mastery, or social acceptance.

Conclusion: Transition support employing a reflective approach, such as ProDeveloP, may lower perceived stress among NGNs during the early transition and can be crucial for ensuring a positive transition experience.

Background/Objectives 

Valid and time-efficient measurement instruments for the assessment of perinatal distress beyond depressive symptoms are yet to be determined. The main objective was to analyse the psychometric measurement properties of the Depression Anxiety Stress Scales (DASS) short forms in Swedish pregnant women during the third trimester. The secondary objective was to analyse the measurement properties of DASS short forms for the postnatal period.

Methods

Data from the Scania Birth Cohort study including 78 women followed prospectively from the third pregnancy trimester to one year postpartum were used. The DASS-21, DASS-12, DASS-9 (two versions), and the 12-item Mini-DASS were analysed using confirmatory factor analysis (CFA), inter-item analysis, and Spearman's rho subscale cross-correlations. Postnatal analysis at infant ages 1, 6, and 12 months was performed using CFA and inter-item analysis.

Results

When used with third-trimester pregnant women, the DASS-9 version 1 and the Mini-DASS exhibited overall acceptable psychometric properties in terms of internal consistency (McDonald's omega >= 0.77) and structural and discriminant validity (e.g., CFI > 0.90 and SRMR < 0.08 for all DASS-9 two- and three-factor models; and CFI > 0.95 and SRMR < 0.08 for one-factor models of the Mini-DASS subscales - including a modified anxiety scale - and for the Mini-DASS depression and anxiety two-factor model). Support for these DASS short forms postpartum was also indicated.

Conclusions

Although preliminary, the current results support the DASS-9 and the Mini-DASS as parsimonious tools for the assessment of perinatal distress and its subtypes. Further validation in the perinatal context is warranted.

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonneurodevelopmental disorders in adolescence resulting in functional impairment that often persist toadulthood. Girls seem to be diagnosed with ADHD later in life than boys and more often have acomorbid major depressive disorder (MDD). It has been suggested that comorbidity with MDD caninterfere with early identification of ADHD.Aims: The aim of the study was to investigate the diagnostic delay for boys and girls with ADHD inchild and adolescent outpatient settings as well the interference of self-reported symptoms of MDD.Methods: Adolescent psychiatric outpatients were assessed with DSRS-A Screener (version of DepressionSelf-Rating Scale for Adolescents) at intake. Diagnostic delay for ADHD was estimated with Kaplan-Meiersurvival curve with separated analysis for boys/girls and for negative/positive MDD screening. Coxregression analysis was used to examine the association of sex and MDD screening.Results: Diagnostic delay for N = 252 (41% boys, mean age =15.23 years) was 3.5 years, 1.4 for boys and4.9 for girls (p = 0.004). Positive MDD screening was associated with prolonged diagnostic delay (from1.4 to 4.9 years p = 0.002), which in separated analyses was statistically significant only for girls from 1.8to 4.9 years (p = 0.018). In Cox regression male sex was associated with decreased diagnostic delay(p = 0.023) while positive MDD screening with prolonged diagnostic delay (p = 0.015).Conclusions: The diagnostic delay of ADHD was more than three times longer for girls. Co-occurringsymptoms of MDD prolonged diagnostic delay significantly only for girls.

Interest in ayahuasca and its main component, N,N-Dimethyltryptamine (DMT), has currently moved from historical and experimental use into modern clinical development. Yet, current evidence is fragmented, and systematic mapping of trial methods and design choices remains limited. We therefore systematically examined registered interventional trials of DMT, ayahuasca, and DMT combined with harmine on ClinicalTrials.gov, identifying 26 eligible trial registers for review. We extracted and harmonized trial characteristics, participant eligibility and enrollment patterns, design features, administration routes, and registered outcomes, and linked completed registrations to associated publications. The registry landscape expanded after 2020–2021 and was dominated by early-stage development, with most trials in phase I and more than half listed as completed at the time of extraction. Trials were primarily DMT-only and most often sponsored by academic or hospital institutions. Eligibility criteria were conservative, emphasizing medically and psychiatrically healthy adult cohorts and extensive cardiovascular and psychiatric exclusions. Accordingly, primary outcomes prioritized acute safety and physiological monitoring, alongside structured characterization of the subjective and altered-states profile, while disorder-specific symptom endpoints were less commonly prioritized as primary objectives. Publications linked to included trials largely reflect this early-stage focus, describing controlled administration, tolerability limits, route and formulation refinement, and initial mechanistic readouts. A smaller set of publications from depression-focused trials provides preliminary evidence of potential clinical effects, supporting further controlled replication and broader disorder-focused development. Overall, registered trials indicate an active and maturing field that has generated foundational safety and regimen knowledge, but remains constrained by a limited number of indication-specific programs beyond depression.

Background

Standardized diagnostic interviews are essential tools for accurate assessment in child and adolescent psychiatry (CAP). However, many existing interviews are restricted by licensing costs, platform dependencies, limited clinical adaptability, or legal ambiguity regarding digital implementation. To address these limitations, the Electronic Psychiatric Semi-structured Interview for Children and Adolescents (EPSI-C) was developed as an open-access, platform-independent instrument aligned with the DSM-5. The modular structure, comprising 22 modules covering the full range of common psychiatric disorders, allows for both systematic and targeted administration. This instrument development and psychometric validation study evaluated the content validity and internal consistency of the EPSI-C.

Methods

Content validity was assessed by ten independent experts who rated the relevance of the instrument for assessing DSM-5 diagnostic criteria. Additionally, experts rated six global aspects of clinical utility. Internal consistency was examined in a large naturalistic sample of 3,506 patients (mean age = 12.0 years, SD = 3.2, range 5–18 years; 54.5% girls) assessed with a digital implementation of the EPSI-C during routine outpatient CAP assessments in Sweden.

Results

The EPSI-C demonstrated excellent scale-level average content validity for both the screening sections (S-CVI/Ave = 0.95) and full modules (S-CVI/Ave = 0.94). Expert consensus was high (90–100%) regarding overall clinical utility. Internal consistency was acceptable to excellent (α range 0.71 – 0.90) for 87.5% of eligible modules. Lower consistency was observed for modules assessing psychotic disorders (α = 0.53) and anorexia nervosa (α = 0.49), reflecting limited DSM-5 criteria and sub-threshold presentations.

Conclusions

The findings support the foundational psychometric properties of the EPSI-C and indicate its clinical feasibility within a high-volume, naturalistic CAP outpatient setting. The current study establishes content validity and internal consistency, while criterion validity remains to be evaluated. As an open-access, modular instrument, EPSI-C offers a scalable solution for the digital implementation of standardized diagnostic interviews in routine clinical practice.

Adolescent mental health is a growing global concern, with depressive and anxiety symptoms on the rise over recent decades. The significance of supportive social relationships, particularly within family and peer groups, is well-established in research. However, limited evidence exists on the impact of social relationships in predicting the developmental trajectories of mental health problems over time. This study aims to fill this gap by identifying groups with distinct trajectories of depressive and anxiety symptoms among adolescents and exploring the impact of various factors, including family relationships, peer relationships, sex, and country of origin, on predicting individuals' likelihood of belonging to specific trajectories. Data come from a community sample of Swedish young people born in 1997 and 1999 (N = 1834, 50% female) and followed over 12 years (four waves conducted at three-year intervals). The Group-Based Trajectory Modeling (GBTM) was used to identify profiles of young people longitudinally. Moreover, multinomial logistic regression models were conducted to examine the predictive effects of social relationships, sex and country of origin on depressive and anxiety symptom trajectories. Four groups were identified for both depression (Stable-Low, Declining, Rising-D, Persistent High) and anxiety (Low and Declining, Stable-Moderate, Rising-A, High). Positive social relationships with family and peers emerged as robust predictors across depressive and anxiety symptom trajectories. Female participants consistently exhibited higher mean scores of depressive and anxiety symptoms than males, while participants originating from countries outside the Nordic region were at higher risk of belonging to risky depressive symptom trajectory groups. These findings highlight the critical importance of strengthening supportive family and peer environments for preventive strategies and targeted interventions in adolescent mental health.

Monetary reward processing during gambling is associated with dopaminergic functioning. Emotional reactivity to different gambling stimuli can be indexed by autonomic nervous system (ANS) responses measured by skin conductance responses (SCR) and heart rate (HR). Genetic markers regulating neural dopaminergic activity, such as the D2 dopamine receptor, might confer differential sensitivity to gambling stimuli, which may also be modulated by previous exposure to gambling. To date, no previous studies have explored the relationship between genetic markers of the D2 dopamine receptor, real-life gambling exposure and ANS responses during gambling. Hence, this study explored associations and interactions between DRD2 C957T (rs6277) and ANKK1 Taq1A (rs1800497) genotypes, real-life gambling frequency and autonomic responses during reward anticipation and outcome delivery in a slot machine task producing wins, near-misses and full-misses. Participants (n = 270) performed a computerized slot machine task with recordings of SCRs and HR responses during gambling performance and provided saliva samples for DNA extraction. Taq1A A1 carriers showed increased SCRs and HR responses during reward anticipation and to wins. Greater responsivity during anticipation, as well as to wins and full-misses, was also observed in C957T heterozygotes. Regarding real-life gambling involvement, higher gambling frequency among Taq1A A1 carriers was associated with decreased HR responses during anticipation and to wins. Results suggest that polymorphic variants of the D2 dopamine receptor may confer differential sensitivity to different gambling stimuli which may further be modulated by real-life gambling exposures. However, further studies are needed in well powered samples of gamblers and control subjects.

Introduction: The interplay between genetic and environmental factors, as explored through studies of gene-environment interactions (cGxE), has illuminated the complex dynamics influencing behavior and cognition, including decision-making processes. In this study, we investigated the differential susceptibility effects of the 5-HTTLPR and MAOA genotypes on decision-making under risk using the Iowa Gambling Task.

Methods: Data from 264 participants (138 women, 126 men) aged 18-22 years, from the 2015 wave of the Survey of Adolescent Life in V & auml;stmanland (SALVe Cohort) was analyzed. Participants provided genetic data including the MAOA and 5-HTTLPR genotypes, and completed the Iowa Gambling Task (IGT) to evaluate decision-making behavior. Parent reports, including assessments of positive parenting styles and early life stress were used for cGxE analysis.

Results: In a General Linear Model, significant interactions were found among males for the 5-HTTLPR, with SS/SL carriers showing higher net scores with positive parenting and lower scores with less positive parenting in relation to decision-making under risk in the IGT (trials 61-100), indicating differential susceptibility effects. Male LL carriers showed minimal fluctuation in IGT scores. Similar effects were observed for males with the MAOA S-allele. No significant interactions were found for females.

Discussion: In conclusion, our study indicates that the 5-HTTLPR and MAOA genes demonstrate susceptibility to environmental factors in influencing decision-making under risk among males, as assessed by the Iowa Gambling Task. We anticipate that these findings will contribute to advancing the understanding of the complex interactions between genetic and environmental factors in shaping human behavior and decision-making.

Children treated with psychotropic medication have regular medication follow-ups with registered nurses (RNs) at the child and adolescent psychiatric outpatient care (CAPOC) unit, where RNs are responsible for ensuring that children can actively participate in their care on their own terms. This study explored how RNs in Swedish CAPOC units promote children's participation in medication follow-ups. Five focus group interviews were conducted with in total 32 RNs, and the data obtained were analyzed by qualitative thematic analysis. Three themes demonstrate how RNs adapt the medication follow-ups to promote children's participation: the first concerns balancing the needs and desires of both the child and the parents; the second involves recognizing each child based on their unique circumstances and interests; and the third theme is about how RNs adjust their communication to ensure that the child is given comprehensible information and has the opportunity to express themself. Our findings highlight how RNs promote children's participation in medication follow-ups and the challenges they encounter in accordance with child-centered care. In this three-way relationship with RNs, the child, and parents, RNs need to balance between the child's perspective and the parents' needs and desires.

Objective:

Recently, an increased trend toward nondrinking among adolescents has arisen. Thus, the aim of this study was to evaluate the popular view in Sweden that adolescents have replaced alcohol with illicit drugs or other substances and to examine whether the use of illicit drugs, cigarettes, and/or snus among moderate and heavy alcohol users has changed.

Method:

Data were taken from a large population-based health survey distributed in 1995, 1997, 2001, 2004, 2006, 2008, 2010, 2012, 2014, 2017, and 2020, covering all students in 9th grade (15–16 years) and 11th grade (17–18 years) in a mid-sized Swedish county.

Results:

The proportion of nondrinkers who used other substances was very low, varying from 1.1% to 3.3% for illicit drugs, from 1.0% to 7.6% for current smoking, and from 1.2% to 6.2% for snus use. Further, no change was found in illicit drug use among moderate and heavy alcohol users from 2004 to 2017, but current smoking and snus use decreased. However, when compared with low alcohol users, moderate and heavy alcohol users had a higher probability of illicit drug use, cigarette smoking, and snus use.

Conclusions:

Adolescents have not replaced alcohol with other substances. When compared with low alcohol users, moderate and heavy alcohol users are more likely to use illicit drugs and nicotine. The low prevalence of substance use among nondrinkers may indicate that preventing alcohol use could have additional positive effects on illicit drug and nicotine use.