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  • 1.
    Adeback, Petra
    et al.
    Karolinska Institute, Sweden.
    Schulman, Abbe
    Karolinska Institute, Sweden.
    Nilsson, Doris
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Karolinska Institute, Sweden.
    Children exposed to a natural disaster: psychological consequences eight years after 2004 tsunami2018In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 1, p. 75-81Article, review/survey (Refereed)
    Abstract [en]

    Background: There is a need for studies that follow up children and adolescents for many years post disaster since earlier studies have shown that exposure during natural disasters constitutes a risk factor for poor psychological health.Aims: The main aim was to examine whether there was an association between severity of exposures during a natural disaster experienced in childhood or adolescence and posttraumatic stress symptoms, psychological distress, self-rated health, diagnosis of depression, anxiety or worry, thoughts about or attempted suicide, physical symptoms or daily functioning eight years later in young adulthood. A second aim was to compare psychological distress and self-rated health of exposed young adults with a matched population-based sample.Method: Young adults, who experienced the 2004 tsunami as children between 10 and 15 years of age, responded to a questionnaire eight years post disaster. The results were compared to a matched population sample.Results: The results showed that the likelihood for negative psychological outcomes was higher for those who had been exposed to several types of exposures during this natural disaster.Conclusions: The negative psychological impact on children and adolescents can still be present eight years post-disaster and seems to have association with the type of exposure; loss, physical presence and subjective experience. It is important for clinicians, who meet young adults seeking help, to be conscious about the impact as long as eight years post disaster and to be aware of possible clinical implications associated with severity of exposures.

  • 2.
    Afzelius, Maria
    et al.
    Malmö University, Sweden.
    Ostman, Margareta
    Malmö University, Sweden.
    Råstam, Maria
    Lund University, Sweden; University of Gothenburg, Sweden.
    Priebe, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Lund University, Sweden.
    Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry2018In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 1, p. 31-38Article in journal (Refereed)
    Abstract [en]

    Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.

  • 3.
    Ahmad, Abdulbaghi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Larsson, Bo
    Sundelin Wahlsten, Viveka
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    EMDR treatment for children with PTSD: Results of a randomized controlled trial2007In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 5, p. 349-354Article in journal (Refereed)
    Abstract [en]

    The objective of the study was to examine the efficacy of EMDR treatment for children with post-traumatic stress disorder ( PTSD) compared with untreated children in a waiting list control group (WLC) participating in a randomized controlled superiority trial (RCT). Thirty-three 6-16-year-old children with a DSM-IV diagnosis of PTSD were randomly assigned to eight weekly EMDR sessions or the WLC group. The Posttraumatic Stress Symptom Scale for Children (PTSS-C scale) was used in interviews with children to evaluate their symptoms and outcome. Post-treatment scores of the EMDR group were significantly lower than the WLC indicating improvement in total PTSS-C scores, PTSD-related symptom scale, and the subscales re-experiencing and avoidance among subjects in the EMDR group, while untreated children improved in PTSD-non-related symptom scale. The improvement in re-experiencing symptoms proved to be the most significant between-group difference over time. The results of the present exploratory study including a limited number of children with PTSD are encouraging and warrant further controlled studies of larger samples of children suffering from PTSD.

  • 4.
    Ahmad, Abdulbaghi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    von Knorring, Anne-Liis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Sundelin Wahlsten, Viveka
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Traumatic experiences and post-traumatic stress disorder in Kurdistanian children and their parents in homeland and exile: An epidemiological approach2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 6, p. 457-463Article in journal (Refereed)
    Abstract [en]

    The prevalence and correlates of post-traumatic stress disorder (PTSD) were assessed in random samples of school-aged Kurdistanian children and their parents in homeland and exile. Of the 376 eligible children at the two sites, 312 children and their parents (293 mothers and 248 fathers) completed the Harvard-Uppsala Trauma Questionnaire and Posttraumatic Stress Symptom interviews for children, and Harvard Trauma Questionnaire for parents. Unlike their children, fathers showed significantly higher PTSD frequencies in exile than in the homeland. The fathers' PTSD negatively correlated with the living standard and fathers' education, while child PTSD mostly correlated with maternal education and living in exile. Living in exile seems to have a negative impact on fathers' post-traumatic reactions, despite its positive influence on children. High drop-outs in exile limit the conclusions.

  • 5. Aluoja, Anu
    et al.
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Leinsalu, Mall
    Development and psychometric properties of the Emotional State Questionnaire: a self-report questionnaire for depression and anxiety1999In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 53, no 6, p. 443-449Article in journal (Refereed)
    Abstract [en]

    Anxiety and depression are dimensions of emotional state that can be validly assessed with self-report measures. This article introduces a new self-report questionnaire for depression and anxiety (Emotional State Questionnaire (EST-Q)) and presents data on its reliability and validity. The items of the EST-Q were derived from diagnostic criteria of DSM-IV and ICD-10. Thirty-three items were rated on a five-point frequency scale. The questionnaire was administered to 194 inpatients with depressive and anxiety disorders and to a population sample of 479 subjects. According to the results of factor analysis, five subscales were formed: Depression, Anxiety, Agoraphobia-Panic, Fatigue, and Insomnia. EST-Q and subscales showed acceptable internal consistency (alpha = 0.69-0.88). Significant differences in subscales between patients and population and across diagnostic groups confirmed the discriminant validity of the instrument. Depression, Anxiety, and Agoraphobia-Panic subscales distinguished corresponding diagnostic groups. Fatigue and Insomnia appeared to assess nonspecific psychopathology dimensions characteristic of several psychiatric disorders.

  • 6.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Carlbring, Per
    Kaldo, Viktor
    Ström, Lars
    Screening of psychiatric disorders via the Internet. A pilot study with tinnitus patients2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, no 4, p. 287-291Article in journal (Refereed)
    Abstract [en]

    Tinnitus has been associated with psychiatric disorders and more recently diagnostic tools have been used in a systematic manner. In the present study, we administered the World Health Organisation's Composite International Diagnostic Interview - Short form (CIDI-SF) in a computerized Internet-based version to a self-selected sample of tinnitus patients (n=48). Using the cut-off for 'probable case' (12-month prevalence), 69% of the tinnitus patients fulfilled the criteria for depression, 60% for generalized anxiety disorder, 83% for specific phobia, 67% for social phobia, 58% for agoraphobia, 21% panic attack, 83% obsessive - compulsive disorder, 2% alcohol dependence and 0% drug dependence. Decreased percentages were found for depression (4%), specific phobia (62%) and social phobia (27%) when applying a more conservative criteria (maximum case criteria). In conclusion, the findings suggest that the Internet version of CIDI-SF can be used as a screening tool for psychiatric disturbance in somatic patients, but that diagnostic criteria need to be adjusted for Internet use.

  • 7. Andre, Kadri
    et al.
    Kampman, Olli
    Illi, Ari
    Viikki, Merja
    Setala-Soikkeli, Eija
    Mononen, Nina
    Lehtimaki, Terho
    Haraldsson, Susann
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Koivisto, Pasi A.
    Leinonen, Esa
    SERT and NET polymorphisms, temperament and antidepressant response2015In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 7, p. 531-538Article in journal (Refereed)
    Abstract [en]

    Background: The genetic variations in norepinephrine transporter (NET) and serotonin transporter (SERT) genes have been associated with personality traits, several psychiatric disorders and the efficacy of antidepressant treatment. Aims: We investigated the separate effects and possible interactions between NET T-182C (rs2242446) and SERT 5-HTTLPR (rs4795541) polymorphisms on selective serotonin reuptake inhibitors (SSRI) treatment response and temperamental traits assessed by the Temperament and Character Inventory (TCI) in a clinical sample of subjects with major depressive disorder (MDD). Methods: Our sample of 97 patients with major depression completed the 107-item TCI temperament questionnaire (version IX) at the initial assessment of the study and after 6 weeks of follow-up. All subjects received selective SSRI medications. Temperament dimension scores at baseline (1) and endpoint (2) during antidepressant treatment were analyzed between NET and SERT genotypes. Results: SS-genotype of 5-HTTLPR was associated with higher baseline Persistence scores than SL- or LL-genotype. A corresponding but weaker association was found at endpoint. No differences were found between 5-HTTLPR genotypes and other temperament dimensions and 5-HTTLPR genotypes had no effect on treatment response. Conclusions: Our results suggest that the SS-genotype of 5-HTTLPR is associated with Persistence scores in patients with MDD. Higher Persistence could be viewed as a negative trait when recovering from stress and its association with short and "weaker" S-allele may be related to less efficient serotonin neurotransmission, possibly resulting in less effective coping strategies on a behavioral level.

  • 8. Bejerholm, Ulrika
    et al.
    Areberg, Cecilia
    Hofgren, Caisa
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Rinaldi, Miles
    Individual placement and support in Sweden: a randomized controlled trial2015In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 1, p. 57-66Article in journal (Refereed)
    Abstract [en]

    Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered with ClinicalTrials.gov: NCT00960024. Results: One hundred and twenty participants were randomized. Eighty seven per cent were assessed after 6 months, and 73% after 18 months. IPS was more effective than TVR in terms of gaining employment at 18-month follow-up (46% vs. 11%; difference 36%, 95% CI 18-54), along with the amount of working hours and weeks, longer job tenure periods and income. Cox regression analysis showed that IPS participants gained employment five times quicker than those in TVR. Ninety per cent of the IPS participants became involved in work, internships or education, i.e. activities integrated in mainstream community settings, while 24% in the TVR group achieved this. Conclusions: IPS is effective in a Swedish context in terms of gaining employment and becoming integrated within the local community. The welfare system presented obstacles for gaining competitive employment directly and it was indicated that internships delayed time to first competitive employment.

  • 9.
    Bejerot, Susanne
    et al.
    Örebro University Hospital. Dept Clin Neurosci, Karolinska Inst, Stockholm, Sweden.
    Edman, Gunnar
    Dept Psychiat, TioHundra AB, Norrtälje, Sweden.
    Anckarsäter, Henrik
    Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Berglund, Gunilla
    Dept Psychol, Stockholm Univ, Stockholm, Sweden.
    Gillberg, Christopher
    Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Hofvander, Björn
    Dept Clin Sci, Lund Univ, Malmö, Sweden.
    Humble, Mats B.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Mörtberg, Ewa
    Dept Psychol, Stockholm Univ, Stockholm, Sweden.
    Råstam, Maria
    Dept Clin Sci, Lund Univ, Malmö, Sweden.
    Ståhlberg, Ola
    Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Frisen, Louise
    Dept Clin Neurosci, Karolinska Inst, Stockholm, Sweden.
    The Brief Obsessive-Compulsive Scale (BOCS): a self-report scale for OCD and obsessive-compulsive related disorders2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 8, p. 549-559Article in journal (Refereed)
    Abstract [en]

    Background: The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive-compulsive symptoms and diagnosis of obsessive-compulsive disorder (OCD). It is widely used throughout child, adolescent and adult psychiatry settings in Sweden but has not been validated up to date.

    Aim: The aim of the current study was to examine the psychometric properties of the BOCS amongst a psychiatric outpatient population.

    Method: The BOCS consists of a 15-item Symptom Checklist including three items (hoarding, dysmorphophobia and self-harm) related to the DSM-5 category "Obsessive-compulsive related disorders", accompanied by a single six-item Severity Scale for obsessions and compulsions combined. It encompasses the revisions made in the Y-BOCS-II severity scale by including obsessive-compulsive free intervals, extent of avoidance and excluding the resistance item. 402 adult psychiatric outpatients with OCD, attention-deficit/hyperactivity disorder, autism spectrum disorder and other psychiatric disorders completed the BOCS.

    Results: Principal component factor analysis produced five subscales titled "Symmetry", "Forbidden thoughts", "Contamination", "Magical thoughts" and "Dysmorphic thoughts". The OCD group scored higher than the other diagnostic groups in all subscales (P < 0.001). Sensitivities, specificities and internal consistency for both the Symptom Checklist and the Severity Scale emerged high (Symptom Checklist: sensitivity = 85%, specificities = 62-70% Cronbach's alpha = 0.81; Severity Scale: sensitivity = 72%, specificities = 75-84%, Cronbach's alpha = 0.94).

    Conclusions: The BOCS has the ability to discriminate OCD from other non-OCD related psychiatric disorders. The current study provides strong support for the utility of the BOCS in the assessment of obsessive-compulsive symptoms in clinical psychiatry.

  • 10. Bejerot, Susanne
    et al.
    Edman, Gunnar
    Anckarsäter, Henrik
    Berglund, Gunilla
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gillberg, Christopher
    Hofvander, Björn
    Humble, Mats B.
    Mörtberg, Ewa
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Råstam, Maria
    Ståhlberg, Ola
    Frisén, Louise
    The Brief Obsessive - Compulsive Scale (BOCS): A self-report scale for OCD and obsessive–compulsive related disorders2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 8, p. 549-559Article in journal (Refereed)
    Abstract [en]

    Background: The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive–compulsive symptoms and diagnosis of obsessive–compulsive disorder (OCD). It is widely used throughout child, adolescent and adult psychiatry settings in Sweden but has not been validated up to date. Aim: The aim of the current study was to examine the psychometric properties of the BOCS amongst a psychiatric outpatient population. Method: The BOCS consists of a 15-item Symptom Checklist including three items (hoarding, dysmorphophobia and self-harm) related to the DSM-5 category “Obsessive–compulsive related disorders”, accompanied by a single six-item Severity Scale for obsessions and compulsions combined. It encompasses the revisions made in the Y-BOCS-II severity scale by including obsessive–compulsive free intervals, extent of avoidance and excluding the resistance item. 402 adult psychiatric outpatients with OCD, attention-deficit/hyperactivity disorder, autism spectrum disorder and other psychiatric disorders completed the BOCS. Results: Principal component factor analysis produced five subscales titled “Symmetry”, “Forbidden thoughts”, “Contamination”, “Magical thoughts” and “Dysmorphic thoughts”. The OCD group scored higher than the other diagnostic groups in all subscales (P < 0.001). Sensitivities, specificities and internal consistency for both the Symptom Checklist and the Severity Scale emerged high (Symptom Checklist: sensitivity = 85%, specificities = 62–70% Cronbach's α = 0.81; Severity Scale: sensitivity = 72%, specificities = 75–84%, Cronbach's α = 0.94). Conclusions: The BOCS has the ability to discriminate OCD from other non-OCD related psychiatric disorders. The current study provides strong support for the utility of the BOCS in the assessment of obsessive–compulsive symptoms in clinical psychiatry.

  • 11.
    Bejerot, Susanne
    et al.
    Department of Neuroscience, Psychiatry, University Hospital, Uppsala, Sweden.
    Nylander, L
    Lindström, E
    Autistic traits in obsessive-compulsive disorder2001In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 55, no 3, p. 169-176Article in journal (Refereed)
    Abstract [en]

    In contrast to other non-psychotic psychiatric populations, subjects with obsessive-compulsive disorder (OCD) are more prone to have personality disorder from cluster A (the odd and eccentric cluster). The present study aims at further investigating the relationship between these and other personality traits in OCD subjects and their relation to high functioning autism (HFA) and Asperger disorder. Sixty-four subjects with OCD were included. Personality traits were assessed with the Karolinska Scales of Personality (KSP), and personality disorders with DSM-adapted questionnaires. In addition, autistic traits were assessed in 29 videotaped subjects, by 3 independent raters. Twenty percent of the subjects with OCD were identified as also having autistic traits. These subjects scored higher on KSP scales measuring muscular tension, psychasthenia, and inhibition of aggression and lower on socialization as compared with OCD subjects without autistic traits. Additionally, subjects with autistic traits fulfilled criteria for anxious personality disorders and paranoid personality disorders significantly more often than subjects without autistic traits. We propose that OCD is often related to HFA and Asperger disorder. Self-report questionnaires may be useful in establishing the diagnosis. However, those with the most obvious autistic features seem to be less able to identify these traits in themselves.

  • 12.
    Bengtsson Tops, Anita
    et al.
    Växjö universitet.
    Markström, U
    Lewin, B
    The prevalence of abuse in Swedish female psychiatric users, the perpetrators and places where abuse occurred2005In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, no 6, p. 504-510Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to investigate self-reported physical, sexual, emotional and economical abuse in Swedish female users of psychiatric services, who the perpetrators were and in which places abuse occurred. An anonymous self-administrated questionnaire was answered in the waiting room of the services. The drop-out rate was 21% and n=1382 women completed the questionnaire. Fifty-three per cent of the women had been abused during childhood, 63% during adulthood and 31% during past year. Seventy-four per cent of those exposed during childhood were also exposed later in life. Women subjected to abuse reported longer contact with psychiatric care. Regardless of life period, the majority reported multiple and frequent abuse. Emotional abuse was most frequent reported in both childhood and adulthood followed by physical and sexual abuse. The reported perpetrators were mainly male persons to whom the woman had an intimate relationship. Mostly the abuse occurred in the women's own home. However, other women, strangers, acquaintances and relatives were also stated as perpetrator and abusive acts also took place in other homes, outdoors or down town. The high prevalence of abuse and its multiplicity point to the necessity for the care and support system to prioritize abuse against women with psychiatric illness.

  • 13.
    Bent-Ennakhil, Nawal
    et al.
    Lundbeck SAS, Paris, France.
    Perier, Marie Cecile
    Univ Paris 05, Sorbonne Paris Cite, Paris Cardiovasc Res Ctr, Paris, France.
    Sobocki, Patrik
    Pygargus AB, Stockholm, Sweden;Karolinska Inst, Unit Clin Epidemiol, Solna, Sweden.
    Gothefors, Dan
    Karsudden Hosp, Katrineholm, Sweden.
    Johansson, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Milea, Dominique
    Lundbeck SAS, Paris, France.
    Empana, Jean-Philippe
    Univ Paris 05, Sorbonne Paris Cite, Paris Cardiovasc Res Ctr, Paris, France.
    Incidence of cardiovascular diseases and type-2-diabetes mellitus in patients with psychiatric disorders2018In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 7, p. 455-461Article in journal (Refereed)
    Abstract [en]

    Objective: To assess the incidence of cardiovascular diseases (CVD) and type-2-diabetes in patients with psychiatric disorders.

    Methods: A population-based study was conducted using the Swedish national health registries. Patients were identified from the Electronic Medical Records (EMR) in 20 primary care centers and were categorized in four diagnosis cohorts according to their first psychiatric diagnosis: bipolar disorder, schizophrenia, major depressive disorder, or other mood disorder. A control cohort of patients with no psychiatric disorders followed in the same primary care centers was also identified. Incident CVD and type-2-diabetes were defined as the presence of a diagnosis of CVD or diabetes during the follow-up period in patients without prior event.

    Results: The age and sex standardized incidence rate of CVD was 13.5 per 1000 patient-year in the patients with any psychiatric disorder versus 6.3 per 1000 patient-year in the controls. A similar trend was observed for incident diabetes (5.7 versus 3.4 per 1000 patient-year, respectively). The bipolar disorder and the schizophrenia cohorts showed the highest standardized incidence rates.

    Conclusion: Incidence of CVD and to a lesser extent type-2-diabetes was particularly high in patients with psychiatric disorders. This carries strong clinical implications for the prevention of CVD and type-2-diabetes in these patients.

  • 14.
    Berg, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Charboti, Susanna
    Montgomery, Edith
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Parental PTSD and school performance in 16-year-olds – a Swedish national cohort study2019In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 73, no 4-5, p. 264-272Article in journal (Refereed)
    Abstract [en]

    Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children’s school performance and to compare the impact of PTSD with that of other major psychiatric disorders.

    Methods: Register study where multiple regression models were used to analyse school performance in 15–16-year-olds in a national cohort (n = 703,813). PTSD and other major psychiatric disorders (bipolar, depression and/or psychotic disorders) were identified from out- and in-patient hospital care.

    Results: Maternal and paternal PTSD were associated with lower grades, with adjusted effects of 0.30–0.37 SD in refugee and 0.46–0.50 SD in native Swedish families. Impact of PTSD was greater than that of other psychiatric disorders and comorbidity to PTSD did not increase this impact. Although the impact of PTSD on grades was greater in children in native Swedish families, consequences with regard to eligibility to secondary education were greater for children in refugee families, where 35% of these children were ineligible.

    Conclusions: Parental PTSD has major consequences for children’s school performance and contributes to the lower school performance in children in refugee families in Sweden. Identification and treatment of PTSD in refugee parents is important for offspring educational achievement. Psychiatric clinics and treatment centres need to have a strategy for support, including educational support, to the offspring of their patients with PTSD.

  • 15.
    Bergstrom, Jan
    et al.
    Karolinska Institute.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Andreas
    Mid Sweden University.
    Andreewitch, Sergej
    Karolinska Institute.
    Ruck, Christian
    Karolinska Institute.
    Carlbring , Per
    Karolinska Institute.
    An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 1, p. 44-50Article in journal (Refereed)
    Abstract [en]

    Panic disorder with or without agoraphobia (PD/A) is common and can be treated effectively with selective serotonin reuptake inhibitor (SSRI) medication or cognitive-behaviour therapy (CBT). However, the lack of access to CBT services has motivated the development of self-help approaches requiring less therapist contact. A novel treatment modality in this field, showing efficacy in several randomized trials but until now not evaluated within the context of regular psychiatric care, is Internet-based treatment. The aim of the present study was to evaluate the effectiveness of Internet-based CBT for patients in a psychiatric setting. Twenty consecutively referred patients with PD were included in the study. A structured clinical interview with a psychiatrist was conducted for inclusion, as well as at post-treatment and at the 6-month follow-up. The treatment consisted of a 10-week CBT-based self-help programme, including minimal therapist support by e-mail. At post-treatment, 94% of patients no longer met DSM-IV criteria for PD (82% at 6-month follow-up). The within-group effect sizes (for the main outcome PDSS; Panic Disorder Severity Scale) were Cohens d=2.5 (pre- to post-treatment) and 2.8 (pre-treatment to follow-up), respectively. The proportion of responders on the PDSS was 75% at post-treatment and 70% at 6-month follow-up. The results supports earlier efficacy data on Internet-based CBT for PD and indicates that it is effective also within a regular psychiatric setting. However, a larger randomized controlled trial should be conducted, directly comparing Internet-based CBT with traditionally administered CBT within such a setting.

  • 16. Bergström, J
    et al.
    Andersson, G
    Karlsson, Andreas
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Andreevitch, S
    Ruck, C
    Carlbring, P
    Lindefors, N
    An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 1, p. 44-50Article in journal (Refereed)
    Abstract [en]

    Panic Disorder with or without or without agoraphobia (PD/A) is common and can be treated effectively with SSRI medication or cognitive behavior therapy (CBT). There is however a great lack of access to CBT services, which has motivated the development of self-help approaches requiring less therapist contact. A novel treatment modality in this field, showing efficacy in several randomised trials but until now not evaluated within the context of regular psychiatric care, is Internet-based treatment. The present study evaluated the effectiveness of Internet-based CBT for 20 consecutively referred PD patients in a psychiatric setting. At post-treatment, 94% of patients no longer met DSM-IV criteria for PD (82% at 6-month follow up). The within-group effect sizes (for the main outcome PDSS; Panic Disorder Severity Scale) were Cohens d=2.5 (pre- to posttreatment) and 2.8 (pre-treatment to follow up) respectively. The proportion of responders on the PDSS was 75% at posttreatment and 70% at 6-month follow up. These results indicate that Internet-based CBT can be both an effective, feasible and potentially cost-effective alternative within regular psychiatric care for patients with PD.

  • 17.
    Bergström, Jan
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Andersson, Gerhard
    Karlsson, Andreas
    Andréewitch, Sergej
    Rück, Christian
    Carlbring, Per
    Lindefors, Nils
    An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 1, p. 44-50Article in journal (Refereed)
  • 18.
    Björk, Tabita
    et al.
    Psychiatric Research Centre, Örebro, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    de Santi, Miguel G
    Forensic Psychiatric Service, Örebro County Council, Örebro, Sweden.
    Kjellin, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre, Örebro, Sweden.
    Criminal recidivism and mortality among patients discharged from a forensic medium secure hospital2012In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 4, p. 283-9Article in journal (Refereed)
    Abstract [en]

    Background: One of the goals in forensic psychiatric care is to reduce the risk of recidivism, but current knowledge about the general outcome of forensic psychiatric treatment is limited.

    Aims: To analyse the rate of criminal recidivism and mortality after discharge in a sample of patients sentenced to forensic psychiatric treatment in a Swedish county.

    Methods: All offenders in Örebro County, Sweden, sentenced to forensic psychiatric treatment and discharged during 1992-2007 were included: 80 males and eight females. Follow-up data was retrieved from the Swedish National Council for Crime Prevention, the National Cause-of-Death register and clinical files. Mean follow-up time was 9.4 years.

    Results: The mean age at discharge was 40 years. Schizophrenia, other psychoses and personality disorders were the most prevalent diagnoses. Thirty-eight percent of those still alive and still living in the country re-offended and were sentenced to a new period of forensic psychiatric treatment or incarceration during follow-up. Four male re-offenders committed serious violent crimes. Substance-related diagnosis was significantly associated with risk of recidivism and after adjustment for diagnoses, age and history of serious violent crime, the Hazard Ratio was 4.04 (95% CI 1.51-10.86, P = 0.006). Of all included patients, 23% had died at the end of follow-up (standardized mortality rate 10.4).

    Conclusions: Since repetition of serious violent crimes was unusual, results indicate a positive development subsequent to treatment for those alive at follow-up.

    Clinical implications: The high mortality rate suggests that more attention should be paid in evaluation of the patients' somatic and psychiatric health during and after care in order to prevent premature death.

  • 19.
    Bodén, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Abrahamsson, Tore
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Holm, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Borg, Jacqueline
    Psychomotor and cognitive deficits as predictors of 5-year outcome in first-episode schizophrenia2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 4, p. 282-288Article in journal (Refereed)
    Abstract [en]

    Background: Cognitive deficits are common in schizophrenia but the predictive value of these deficits for long-term outcome in first-episode patients is unclear. Aims: We aimed to investigate associations of performance in psychomotor and cognitive tests with a 5-year functional and symptomatic outcome. Methods: After clinical stabilization, patients with a first schizophrenia spectrum diagnosis (n = 46) were assessed for global cognitive function [Synonyms, Reasoning, and Block Design (SRB)], psychomotor speed [Trail Making Test (TMT) and finger tapping] and verbal learning (Claeson-Dahl Verbal Learning Test). The subsequent 5-year outcome regarding independent living, occupational and social function, and symptomatic remission status was assessed. Results: Low psychomotor speed was associated with poor social function 5 years later, with an odds ratio (OR) of 3.37 and a 95% confidence interval (CI) of 1.08-10.51, adjusted for antipsychotic drug use. Better performance on finger tapping with the non-dominant hand was associated with an increased risk of a 5-year symptomatic non-remission (adjusted OR = 0.42, CI 0.19-0.96). Occupational function and independent living were not significantly associated with any of the investigated tests. Conclusions: Psychomotor speed is associated with a long-term outcome regarding social function and symptom remission in patients with first-episode schizophrenia.

  • 20.
    Bogren, Lennart
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Bogren, Inga-Britt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    The defence mechanism test in panic disorder and generalized anxiety2000In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 54, p. 15-15Conference paper (Other academic)
  • 21.
    Bogren, Lennart
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Bogren, Inga-Britt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Ohrt, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Sjödin, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Panic disorder and the Defence Mechanism Test2002In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 56, p. 195-199Article in journal (Refereed)
    Abstract [en]

    The aim was to study defence categories according to the modified version of the Defence Mechanism Test (DMTm) and to see if there was a relationship between DMTm and severity of illness. The material consists of 23 patients with panic disorder according to DSM-III-R who participated in a long-term follow-up of two clinical trials. The most common defence categories were repression, denial, disavowal or denial of the threat relation or of the identity of the peripheral person. The patients with denial or polymorphous identification had more severe symptoms and the latter group also were more handicapped by their symptoms. Denial and disavowal or denial of the threat relation may be defence categories, which are not so effective in preventing the individual from experiencing anxiety. Polymorphous identification, although not so common, does not seem to be an appropriate defence among patients with panic disorder.

  • 22. Brunt, David
    et al.
    Hansson, Lars
    Characteristics of the social environment of small group homes for individuals with severe mental illness2002In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 56, p. 39-46Article in journal (Refereed)
  • 23. Brunt, David
    et al.
    Hansson, Lars
    The quality of life of persons with severe mental illness across housing settings2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, p. 293-298Article in journal (Refereed)
  • 24. Bulow, P.
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology .
    Hansson, J.-H.
    Department of Social Work, Ersta Sköndal University College, Stockholm, Sweden.
    Long-term consequences of the reformation of psychiatric care: A 15-year follow-up study2002In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 56, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Although there are a great many epidemiological studies of psychiatric diseases and the outcomes of controlled rehabilitation programmes, there is a shortage of studies of routine psychiatric care. This study is a retrospective cohort study of the total number (n = 138) of patients receiving inpatient care at a psychiatric rehabilitation clinic in Jönköping during 1984. The follow-up period is 15 years, 1984-98. The group had a considerable amount of inpatient care, but this decreased dramatically during the time of investigation. Positive indications were that there were no suicides during the last 5 years of the period and that the number of registered crimes showed a marked decrease from 1992. Negative indications were low levels of work and occupation and few social contacts.

  • 25.
    Börjesson, Josefine
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Armelius, Bengt-Åke
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Östgård-Ybrandt, Helene
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    The psychometric propeerties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD)2007In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 3, p. 225-232Article in journal (Refereed)
    Abstract [en]

    The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument were evaluated in two adolescent groups. The participants in the Normal group comprised 121 adolescents aged 15-17 years and the participants in the group of adolescents with antisocial problems comprised 1168 youths aged 10-21 years detained under the Swedish Care of Young Persons Act in special youth homes. The ADAD instrument produced good interrater reliability; the subscales showed moderate internal consistency and concept validity was satisfactory and comparable with American and Swiss versions. Finally, the ADAD subscales produced meaningful correlations. The interviewer rating, the adolescent’s rating and the composite scores are compared and discussed. The Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescent problems and their need for treatment. However, the composite scores need to be reconstructed to be useful in future research.

  • 26.
    Carlborg, Andreas
    et al.
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Jokinen, Jussi
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Nordström, Anna-Lena
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Jönsson, Erik G
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Nordström, Peter
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Attempted suicide predicts suicide risk in schizophrenia spectrum psychosis2010In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 64, no 1, p. 68-72Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People with schizophrenia have an increased risk of suicide and attempted suicide is suggested to be an important risk factor.

    AIM: Our objective was to assess the cumulative survival, predictive values and odds ratios of attempted suicide for suicide in a long-term cohort of patients with schizophrenia spectrum psychosis with and without previous attempted suicide.

    METHOD: Inpatients (n=224) hospitalized with schizophrenia spectrum psychosis were followed for a mean of 25 years. All patients were followed up for causes of death. Information on suicide attempt before the end of the observation period was retrieved from medical records.

    RESULTS: Eight percent died by suicide during the follow-up. Eighteen percent of suicide attempters died by suicide. Two percent of non-attempters died by suicide. There was a strong association between previous suicide attempt and suicide in men and women. Odds ratio for attempters vs. non-attempters was 10. Suicide risk was almost three times higher in male than female suicide attempters.

    CONCLUSION: Previous attempted suicide is an important risk factor for suicide in both men and women with schizophrenia spectrum psychosis, particularly in male suicide attempters. The suicide risk remains high over a long period. Continuous assessment of risk factors and appropriate treatment are crucial for this patient group to prevent suicide.

  • 27.
    Carlborg, Andreas
    et al.
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Jokinen, Jussi
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Nordström, Anna-Lena
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Jönsson, Erik G
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Nordström, Peter
    Karolinska Inst, Dept Clin Neurosci, Karolinska Univ Hosp, Solna, Sweden.
    Early death and CSF monoamine metabolites in schizophrenia spectrum psychosis2011In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 65, no 2, p. 101-5Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Patients with schizophrenia have higher rates of mortality than the general population. Lower concentrations of the cerebrospinal fluid (CSF) monoamine metabolites homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) have been associated with suicidal, aggressive and impulsive behavior. Mortality has been suggested as a measure of impulsivity and a relationship between early death and lower concentrations of CSF monoamine metabolites has been reported but the studies are few with short periods of follow-up and small numbers.

    AIM: The objective of this study was to investigate a relationship between early death and concentrations of CSF 5-HIAA and HVA.

    METHODS: Three hundred and eighty-five inpatients with schizophrenia spectrum psychosis were lumbar punctured in a standardized manner and followed for a median of 26 years. Patients were searched to identify those who had died. Causes of death were obtained from the Causes of Death Register.

    RESULTS: During the time of follow-up, 97 patients died. Schizophrenia spectrum psychosis patients died at an earlier age from both natural and unnatural causes of death. No significant associations were found between CSF 5-HIAA and HVA concentrations and non-suicidal death. Attempted suicide was not a risk factor for non-suicidal death at younger age.

    CONCLUSION: Patients with schizophrenia spectrum psychosis die at an earlier age from both natural and unnatural causes of death. Attempted suicide is not a risk factor for non-suicidal death at younger age. Low concentrations of CSF HVA and 5-HIAA were not a risk factor for non-suicidal death at younger age in schizophrenia spectrum psychosis.

  • 28.
    Chotai, Jayanti
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Suicide aggregation in relation to socio-demographic variables and the suicide method in a general population: assortative susceptibility.2005In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, no 5, p. 325-30Article in journal (Refereed)
    Abstract [en]

    One area of research in suicidology aims at understanding the processes underlying aggregation or clustering of suicide cases within a limited period of time or space (suicide epidemics). Susceptibility to, or propagation of, suicidal behavior due to given risk factors may be operating through media other than space, and its susceptibility for the receiver may be different within different types of strata that are determined by socio-demographic, personality-related or biological-susceptibility differences. We use the term "assortative susceptibility" for this phenomenon. Aggregated cases, comprising calendar months with an unusually large number of suicides after adjusting for seasonal and yearly variations, were defined in the register of all 1093 completed suicides during 1969-93 in the county of Västerbotten in northern Sweden. Binary multiple logistic regressions were performed to compare the aggregated cases with the remaining cases. Compared with the remaining cases, the aggregated cases included significantly more of males and of those living in the rural forested regions. Also, suicide by firearms was significantly more aggregated than the other methods. Our results suggest that middle-aged or older men from the rural areas, who have access to firearms, are likely to belong to the socio-demographic stratum that is susceptible to the processes that give rise to aggregations or clusters of suicides in this county (assortative susceptibility).

  • 29.
    Chotai, Jayanti
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Smedh, Kristina
    Johansson, Carolina
    Nilsson, Lars-Göran
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    An epidemiological study on gender differences in self-reported seasonal changes in mood and behaviour in a general population of northern Sweden.2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, no 6, p. 429-37Article in journal (Refereed)
    Abstract [en]

    Gender differences have been reported regarding symptoms, prevalence and heritability of seasonal affective disorders (SAD). We focus on gender aspects in this study of self-reported seasonal changes in mood and behaviour in a general population. The Seasonal Pattern Assessment Questionnaire (SPAQ) was completed by 2620 adults (55.6% women) aged 35-85 years, enrolled in the Betula prospective random cohort study of Umeå, Sweden. October to February turned out to be suitable winter months. SAD was found in 2.2% and sub-syndromal SAD (S-SAD) in 5.7%. Women had about 1.5 times higher prevalences than men, and seasonality problems decreased with age in both genders. Preference for eating least was distributed with a peak in summer, whereas preference for eating most had a major peak in winter (winter eaters) and a minor peak in summer (summer eaters). Significantly more of winter eaters in women, and significantly more of summer eaters in men, felt worst in winter. Seasonal change in weight was considered significantly as a problem by women but not by men. Winter behaviour of sleeping most was considered significantly as a problem by men but not by women. Women reacted significantly to temperature-related changes (negatively to cold/short days and positively to hot/long days), whereas men reacted significantly to sunshine-related changes (negatively to cloudy days and positively to sunny days). Subtle gender differences may thus underlie the pathophysiology of seasonal problems. Studies of an eventual efficacy of treating SAD women with raised ambient temperature, and gender-specific comparisons with other therapies, would be of interest.

  • 30.
    Cuijpers, Pim
    et al.
    Vrije University of Amsterdam.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Donker, Tara
    Vrije University of Amsterdam.
    van Straten, Annemieke
    Vrije University of Amsterdam.
    Psychological treatment of depression: Results of a series of meta-analyses2011In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 65, no 6, p. 354-364Article in journal (Refereed)
    Abstract [en]

    Cuijpers P, Andersson G, Donker T, van Straten A. Psychological treatment of depression: Results of a series of meta-analyses. Nord J Psychiatry 2011;65:354-364. less thanbrgreater than less thanbrgreater thanBackground: In the past few decades, a considerable number of studies have examined the effects of psychotherapies for adult depression. Aim: We described the results of a series of meta-analyses examining what this large body of research has contributed to our knowledge of these treatments of depression. Results: We found that different types of psychotherapy are efficacious in the treatment of adult depression, including cognitive behavior therapy, interpersonal psychotherapy, problem-solving therapy, non-directive supportive therapy and behavioral activation therapy. Differences between types of psychotherapy are small. The efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy, and that combined treatment is more effective than psychotherapy alone and pharmacotherapy alone. Psychotherapy is not only effective in depressed adults in general, but also in older adults, women with postpartum depression, patients with general medical disorders, in inpatients, in primary care patients, patients with chronic depression and in subthreshold depression. Conclusions: We found no evidence showing that psychotherapy is less efficacious in severe depression ( with mean baseline Hamilton Depression Rating Scale scores up to 31, mean Beck Depression Inventory scores up to 35.85 and mean Beck Depression Inventory-II scores up to 36.50), but effects are smaller in chronic depression. We also found that the effects of psychotherapy are probably overestimated because of publication bias and the relatively low quality of many studies in the field.

  • 31.
    Daderman, Anna M.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Edman, Gunnar
    Meurling, Ann Wirsen
    Levander, Sten
    Kristiansson, Marianne
    Flunitrazepam intake in male offenders2012In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 2, p. 131-140Article in journal (Refereed)
    Abstract [en]

    The abuse of flunitrazepam (FZ) compounds is worldwide, and several studies have reflected on the consequences with regard to violence, aggression and criminal lifestyle of FZ users. Criminals take high doses of FZ or some other benzodiazepines to calm down before the planned crime. There is support from earlier studies that most likely, all benzodiazepines may increase aggression in vulnerable males. Chronic intake of high doses of FZ increases aggression in male rats. Because psychopathy involves aggression, we have examined whether psychopathy as well as any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle and Antisocial) are related to different substance use disorders, with the focus on FZ. We have also examined the relationship between each PCL-R item and FZ use. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Substance use, including FZ, was not more common in those who scored high in psychopathy. Use of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% CI 1.86-9.94). Only one of the PCL-R items, Criminal versatility, was significantly associated with FZ use (odds ratio = 3.7). It may be concluded that intake of FZ has a specific relationship to only one of the facets and not to psychopathy per se. The findings have also important theoretical implications because Facet 4 is not a key factor of the construct of psychopathy. Clinical implications of the article: We have used the new two-factor and four-facet theoretical model of psychopathy in the young offender population, many of them with one or more substance use disorders. The present results suggest that antisocial behavior defined by Facet 4 (poor behavioral control, early behavior problems, juvenile delinquency, revocation of conditional release and criminal versatility) in the studied subjects is more typical for FZ users than it is for non-FZ users. This may have implications for assessment and treatment. Clinicians should be aware that criminals with high scores on Facet 4 have a more than fourfold odds of being a FZ user. This conclusion has an important clinical implication because FZ abuse is very common and is not always the focus of a forensic psychiatric assessment.

  • 32. Dahl, A.
    et al.
    Kruger, Bjartveit
    Dahl, Havard
    Karlsson, Hasse
    Von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Stordal, Eystein
    SPIFA-A presentation of the Structured Psychiatric Interview for General Practice2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 6, p. 443-453Article in journal (Refereed)
    Abstract [en]

    Background: The diagnostic ability of general practitioners (GPs) concerning mental disorders is not optimal, and could be improved by structured diagnostic interviews. Various aspects of the Structured Psychiatric Interview for General Practice (SPIFA) are examined. Aims: The inter-rater reliability of the SPIFA, the time used by GPs and specialists and the GPs satisfaction are examined. The properties of the SPIFA are compared with those of the Prime-MD and the MINI schedules. Methods: Inter-rater reliability of the SPIFA was tested in 336 patients in general practice. The patients were randomized to two interview strategies. Either both GPs and psychiatrists used the SPIFA, or GPs used the SPIFA and psychiatrists a modified version of the SCID for Axis I disorders. The satisfaction was investigated by a questionnaire sent to 1000 GPs who had SPIFA training. Results: The SPIFA showed adequate inter-rater reliability for depression, anxiety disorders and increased suicidal risk for both interview strategies. In patients with more than two co-morbid disorders, the inter-rater reliability was poor. The mean duration of SPIFA was 21 min for SPIFA screening and 22 min for SPIFA manual. The 192 GPs responding to the questionnaire were mostly satisfied with the SPIFA. Conclusions: The SPIFA seems to be a reliable, valid and helpful instrument for GPs making diagnoses of mental disorders in their patients. Compared with the Prime MD and the MINI, the SPIFA seemed to have comparable psychometric properties but better feasibility in primary care.

  • 33.
    Dekeyser, Linda
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Agnaförs, Sara
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Self-reported mental health in 12-year-old second-generation immigrant children in Sweden2011In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 65, no 6, p. 389-395Article in journal (Refereed)
    Abstract [en]

     Today 29.3% of all newborns in Sweden are second-generation immigrants. Studies on mental health among these children are few, inconclusive and vary widely with regard to the informant used and the age of the immigrant. The majority of previous studies focus on study groups that cover a wide age span but since mental health varies considerably during the pre-adolescent and adolescent years, more age-specific studies are needed. Additional focus on the health and well-being of these children is necessary if a well-functioning society is to develop. Aim: To investigate whether and how second-generation immigrant children in Sweden differ from non-immigrant children in their presentation of self-reported mental health at the age of 12. Methods: Second-generation immigrant children (n = 142) from a birth cohort in southern Sweden, subjects of the SESBiC-study (the South East Sweden Birth Cohort-study) were compared with non-immigrant children (n = 1036) from the same cohort in their presentation of self-reported mental health at the age of 12 using the Strengths and Difficulties Questionnaire. Gender, family structure and parents educational level were controlled for. Results: Second-generation immigrant children did not differ from the non-immigrant children in their own presentation of mental health at the age of 12 in any of the categories of immigrant groups. Conclusion: It is a promising sign for future integration that second-generation immigrant childrens self-reported mental health at the age of 12 was quite similar to that of non-immigrant children.

  • 34.
    d'Elia, Giacomo
    Linköping University, Department of Behavioural Sciences, Cognitive Psychology. Linköping University, Faculty of Health Sciences.
    Attachment: A biological basis for the therapeutic relationship?2001In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 55, no 5, p. 329-336Article in journal (Refereed)
    Abstract [en]

    When faced with loss, illness, distress, or threat, we tend to seek out an attachment figure from which we can obtain comfort and protection. The attachment theory, an evolutionary biosocial theory of development, postulates that the propensity to make strong emotional bonds to a differentiated and preferred person, conceived as stronger and or wiser, is a basic component of the human nature, distinct from feeding and sexuality. Attachment behaviour is present in germinal form in the neonate and continues to be present ''from the cradle to the grave''. On the basis of day-to-day experience of the responsiveness and accessibility of caregivers, children build internal working models of attachment figures and of themselves. Expectations about the likely behaviour of others, initially preverbal, characterize the approach of the individual to other persons. Internal working models are successively modified on the basis of recent experience. The therapeutic relationship can be viewed as the seeking of a secure base, from which the patient and the therapist, in a joint effort, explore the patient's attachment history and the painful feelings associated with it. The therapist, responsive to the patient's verbal and non-verbal attachment signals, is viewed as a supplementary attachment figure.

  • 35.
    Dobrov, Eugen
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Thorell, Lars-Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    "Reasons For Living" - Translation, psychometric evaluation and relationships to suicidal behaviour in a Swedish random sample2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, no 4, p. 277-285Article in journal (Refereed)
    Abstract [en]

    The protective role of positive beliefs and expectations against suicide has been studied using the Reasons For Living inventory (RFL). The RFL has shown to be useful in research and suggested for use in clinical practice. A Swedish translation of the RFL was examined for psychometric properties, reliability, latent structure and convergent validity in a Swedish general population. The RFL was distributed with the Suicide Behaviors Questionnaire (SBQ) to 1366 randomly selected subjects aged 20-65 years in the county of Östergötland. The results were based on 506 complete replies. The Cronbach a of the total RFL was 0.92, ranging from 0.72 to 0.93 in the six scales of RFL. The intercorrelations between the scales were weak and the scale to total RFL score moderate to high. The factor structure and item loadings of the inventory showed great similarities with the American one with exception for the scales Responsibility to Family and Child-related Concerns, which formed one common factor. The convergent validity was supported by significant relationships to the items of the SBQ. It is concluded that the Swedish translation of the RFL inventory in a Swedish general sample possesses great similarities to the American original RFL. Thus, it is suggested as an instrument for research and clinical usage in Sweden. © 2004 Taylor & Francis.

  • 36.
    Dyster-Aas, Johan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Arnberg, Filip K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Lindam, Anna
    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.
    Lundin, Tom
    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.
    Michel, Per-Olof
    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.
    Impact of physical injury on mental health after the 2004 Southeast Asia tsunami2012In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 3, p. 203-208Article in journal (Refereed)
    Abstract [en]

    Background : The risk of developing enduring post-traumatic stress reactions and mental health problems in the aftermath of disasters is substantial. However, there are inconsistencies regarding the contribution of physical injury as an independent risk factor for developing psychiatric morbidity after disasters.

    Aims : The aim was to assess whether physical injury was associated with post-traumatic stress reactions and general mental health after adjusting for perceived life-threat in the aftermath of the 2004 tsunami.

    Methods : A sample of 1501 highly exposed survivors from the 2004 Southeast Asia tsunami was selected from a cohort of Swedish survivors surveyed 14 and 36 months after the event. The impact of physical injury on post-traumatic stress and general mental health was assessed by regression models accounting for subjective life-threat.

    Results : Physical injury was associated with higher levels of post-traumatic stress reactions and poorer general mental health. These associations were observed at both 14 and 36 months after the disaster.

    Conclusions : Physical injury has a specific contribution to the association between traumatic experience and both post-traumatic stress reactions and general mental health in victims of the 2004 tsunami. The effect is stable over several years.

  • 37.
    Dåderman, Anna
    et al.
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies.
    Lindgren, May
    Lund University.
    Lidberg, Lars
    Karolinska Institutet.
    The prevalence of dyslexia and AD/HD in a sample of forensic psychiatric rapists2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, no 5, p. 371-381Article in journal (Refereed)
    Abstract [en]

    The prevalence of dyslexia and attention deficit/hyperactivity disorder (AD/HD) (DSM-IV) is markedly increased among those who are sentenced for criminal offences. The aim of the study was to identify developmental disabilities, dyslexia and AD/HD among severely disturbed men in forensic psychiatric care, and to study the co-occurrence of such disabilities, with the objective to discuss the importance of the diagnoses in forensic psychiatry. The participants were 10 males who had committed rape on adult women, and included two murder-rapists, one of which had murdered more than one victim (i.e. a serial murderer). All had been assigned to special long term forensic psychiatric care, based predominantly on a psychodynamic ground. In order to be identified as having dyslexia, a participant’s performance on at least three out of four tests of academic skills had to be markedly below the expected level (more than two stanine steps), given the participant’s non-verbal intellectual capacity and considering the length of his education. AD/HD was investigated by studying the participants’ forensic psychiatric files and by a clinical interview. Seven of the 10 participants met the DSM-IV criteria for dyslexia, and six of them met the DSM-IV criteria for AD/HD. Four participants had AD/HD and dyslexia, three had AD/HD but no dyslexia, and two had dyslexia but no AD/HD. Only one participant had neither dyslexia nor AD/HD. The participants with dyslexia performed well in tests assessing non-verbal reasoning, visuo-spatial capacity and visual memory. Although the generalization of the results from 10 rapists is severely limited, the results indicate the importance of assessing dyslexia as well as AD/HD in people who are admitted for forensic psychiatric assessment. The lack of correct diagnoses may negatively influence the choice of appropriate forensic psychiatric care. Early assessment of those disorders might have a positive influence on the psychological development and socialization process in people with dyslexia and/or AD/HD.

  • 38.
    Dåderman, Anna Maria
    et al.
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies.
    Edman, Gunnar
    Karolinska Institutet,Department of Clinical Neuroscience.
    Wirsén Meurling, Ann
    Lund University, Department of Psychology, .
    Levander, Sten
    Malmö University, Department of Health & Society.
    Kristiansson, Marianne
    Karolinska Institutet, Department of Clinical Neuroscience, Division of Social and Forensic Psychiatry.
    Flunitrazepam intake in male offenders2012In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 2, p. 131-140Article in journal (Refereed)
    Abstract [en]

    The abuse of flunitrazepam (FZ) compounds is world-wide, and several studies have reflected on the consequences with regard to violence and criminal life-style of FZ users. Criminals take FZ or some other benzodiazepines to “calm down” before the planned crime. There is support from earlier studies that most likely, all benzodiazepines may increase aggression in vulnerable males. We have examined whether psychopathy as well as any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle, and Antisocial) are related to different substance use disorders, with the focus on FZ. We have also examined the relationship between each PCL-R item and FZ use. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Substance use, including FZ, was not more common in those who scored high in psychopaty. Use of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% C.I. 1.86 - 9.94). Only one of the PCL-R items, “Criminal versatility”, was significantly associated with FZ use (odds ratio = 3.7). It may be concluded that intake of FZ has a specific relationship to only one of the facets and not to psychopathy per se. The findings have also important theoretical implications because Facet 4 is not a key factor of the construct of psychopathy.

    A short description of the clinical implications of the article: We have used the new 2-factor and 4-facet theoretical model of psychopathy in the young offender population, many of them with one or more substance use disorders. The present results suggest that antisocial behavior defined by Facet 4 (poor behavioral control, early behavior problems, juvenile delinquency, revocation of conditional release and criminal versatility) in the studied subjects, is more typical for FZ users than it is for non-FZ users. This may have implications for assessment and treatment. Clinicians should be aware that criminals with high scores on Facet 4 have a more than four-fold odds of being a FZ user. This conclusion has an important clinical implication because FZ abuse is very common and is not always the focus of a forensic psychiatric assessment.

  • 39.
    Dåderman, Anna Maria
    et al.
    The Swedish National Police Academy.
    Jonson, Carin
    Karolinska Institutet.
    Lack of psychopathic character (Rorschach) in forensic psychiatric rapists2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 3, p. 176-185Article in journal (Refereed)
    Abstract [en]

    Previous research using Rorschach is sparse in rapists. The aim of this study of 10 violent male forensic psychiatric rapists was to describe them on a set of Rorschach variables, which are assumed to reflect psychopathic character, in order to increase our understanding of rapists. The participants were involved in a long-term psychodynamic sexual offender treatment program. They were previously assessed on dyslexia and ADHD, and the results showed an overrepresentation of these disorders in this sample. Compared with normative samples, the participants scored significantly lower on three of the Rorschach variables; Lambda, WSum6 and Afr. The participants did not meet criteria for psychopathic character. Although the generalization of the results from 10 rapists is severely limited, our results suggest helplessness in managing emotionally laden situations and hint at the problems experienced by this sample of forensic psychiatric rapists. Clinicians should be aware of the lack of psychopathic character in some rapists and that effective treatment programs should focus on training this type of rapists to be able to react appropriately to emotional stimuli.

  • 40.
    Eid, Jarle
    et al.
    Swedish National Defence College, Department of Leadership and Management (ILM).
    Larsson, Gerry
    Swedish National Defence College, Department of Leadership and Management (ILM).
    Johnsen, Bjorn Helge
    Laberg, Jon Christian
    Bartone, Paul T.
    Carlstedt, Berit
    Swedish National Defence College, Department of Leadership and Management (ILM).
    Psychometric properties of the Norwegian Impact of Event Scale-Revised in a non-clinical sample2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 5, p. 426-432Article in journal (Refereed)
    Abstract [en]

    Background: Despite the widespread use of the Impact of Event Scale to measure post-traumatic stress symptoms, psychometric evaluations of the scale have revealed mixed findings. Aim: The aim of the present study is to provide new empirical evidence and examine the factor structure, reliability, and predictive validity of the Norwegian version of the IES-R. Methods: Posttraumatic stress symptoms were recorded in a student sample (n=312) 3 weeks after the Southeast Asian tsunami disaster in December 2004. Confirmatory factor analyses of the IES-R behavior items using structural equation modeling (SEM) were performed on four models from existing research. Results: The original three-factor model of intrusion, avoidance and hyperarousal symptoms exhibited the best goodness-of-fit indices when defined as oblique. The IES-R also revealed satisfactory reliability. Symptom levels of intrusion and avoidance were moderate, while hyperarousal scores were low, with a significant gender difference. Conclusion: Taken together, the IES-R revealed good psychometric properties in this nonclinical student sample and could be a useful instrument to assess and follow-up on PTSD symptoms after a certain identified trauma.

  • 41.
    Eid, Jarle
    et al.
    Department of Psychosocial Science, University of Bergen, Norway.
    Larsson, Gerry
    Swedish National Defence College, Department of Leadership and Management (ILM).
    Johnsen, Bjørn-Helge
    Department of Psychosocial Science, University of Bergen, Norway.
    Laberg, Jon-Christian
    Department of Psychosocial Science, University of Bergen, Norway.
    Bartone, Paul T
    Center for Technology & national Security Policy, National Defense University, Washington, DC, USA.
    Carlstedt, Berit
    Swedish National Defence College, Department of Leadership and Management (ILM).
    Psychometric properties of the Norwegian version of the Impact of Event Scale-Revised2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 5, p. 426-432Article in journal (Refereed)
  • 42.
    Ekholm, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Ekholm, Andreas
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Vares, Maria
    Osby, Urban
    Sedvall, Göran C
    Jönsson, Erik G
    Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses.2005In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, no 6, p. 457-464Article in journal (Refereed)
    Abstract [en]

    We aimed to estimate the value of structured interviews, medical records and Swedish register diagnoses for assessing lifetime diagnosis of patients with schizophrenia. Psychiatric records and diagnostic interviews of 143 Swedish patients diagnosed by their treating physician with schizophrenia and related disorders were scrutinized. Based on record analysis only, or a combined record and interview analysis, DSM-IV diagnoses were obtained by the OPCRIT algorithm. Independent of the OPCRIT algorithm, a standard research DSM-IV diagnosis, based on both record and interview analysis, was given by the research psychiatrist. Concordance rates for the different psychosis diagnoses were calculated. DSM-IV diagnoses based on records only, showed a good to excellent agreement with diagnoses based on records and interviews. Swedish register diagnoses displayed generally poor agreement with the research diagnoses. Nevertheless, 94% of subjects sometimes registered with a diagnosis of schizophrenic psychoses (i.e. schizophrenia, schizoaffective psychosis or schizophreniform disorder) displayed a standard research DSM-IV diagnosis of these disorders. For patients in long-term treatment for schizophrenia in Sweden, psychiatric record reviews should be optimal, cost effective and sufficient for assessment of lifetime research diagnoses of schizophrenia. For these patients a research interview adds little new information. The results further indicate that a Swedish register diagnosis of schizophrenic psychoses has a high positive predictive power to a standard research DSM-IV diagnosis of the disorders. It is concluded that for future Swedish large-scale genetic studies focusing on a broad definition of schizophrenia, it would be sufficient to rely on the Swedish register diagnoses of schizophrenic psychosis.

  • 43. Eklund, Mona
    et al.
    Bengtsson Tops, Anita
    Växjö universitet.
    Lindstedt, Helena
    Construct and discriminant validity and dimensionality of the Interview Schedule for Social Interaction (ISSI) in three psychiatric samples2007In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 3, p. 182-188Article in journal (Refereed)
    Abstract [en]

    This study was aimed at investigating the psychometric properties of the Interview Schedule for Social Interaction (ISSI), in terms of construct and discriminant validity and unidimensionality, in three psychiatric samples with varying prerequisites for social interaction: 1) an outpatient sample of working age with mixed diagnoses, 2) an outpatient sample with schizophrenia, and 3) an inpatient sample composed of mentally ill, male offenders. The target constructs were psychosocial functioning and satisfaction in different life domains. It was hypothesized that the ISSI would mainly be related to psychosocial functioning and life domains characterized by social interaction, such as friends and family. A second hypothesis was that the ISSI ratings would discriminate between the three samples. The first hypothesis was confirmed, but the pattern of relationships was somewhat different between the groups. Whereas family contacts were of great importance for social integration in Samples 1 and 2, friends seemed more important for the mentally ill offenders. The second hypothesis was partly confirmed: three ISSI sub-scales out of four discriminated between the samples. Moreover, the ISSI proved to be a unidimensional construct. The support for the four proposed sub-scales was not unanimous, however, and the sub-scales targeting attachment constituted less stable factors. This study demonstrated the construct and discriminant validity of the ISSI when applied to samples with various mental disorders. The fact that similar results were obtained in all three samples, despite varying prerequisites for social interaction, strongly supports the validity of the ISSI. Providing the sub-scales are used with caution, the ISSI seems to be a reliable tool for use with patients with severe mental disorders.

  • 44. Eklund, Mona
    et al.
    Bengtsson-Tops, Anita
    Lindstedt, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Construct and discriminant validity and dimensionality of the Interview Schedule for Social Interaction (ISSI) in three psychiatric samples2007In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 3, p. 182-188Article in journal (Refereed)
    Abstract [en]

    This study was aimed at investigating the psychometric properties of the Interview Schedule for Social Interaction (ISSI), in terms of construct and discriminant validity and unidimensionality, in three psychiatric samples with varying prerequisites for social interaction: 1) an outpatient sample of working age with mixed diagnoses, 2) an outpatient sample with schizophrenia, and 3) an inpatient sample composed of mentally ill, male offenders. The target constructs were psychosocial functioning and satisfaction in different life domains. It was hypothesized that the ISSI would mainly be related to psychosocial functioning and life domains characterized by social interaction, such as friends and family. A second hypothesis was that the ISSI ratings would discriminate between the three samples. The first hypothesis was confirmed, but the pattern of relationships was somewhat different between the groups. Whereas family contacts were of great importance for social integration in Samples 1 and 2, friends seemed more important for the mentally ill offenders. The second hypothesis was partly confirmed: three ISSI sub-scales out of four discriminated between the samples. Moreover, the ISSI proved to be a unidimensional construct. The support for the four proposed sub-scales was not unanimous, however, and the sub-scales targeting attachment constituted less stable factors. This study demonstrated the construct and discriminant validity of the ISSI when applied to samples with various mental disorders. The fact that similar results were obtained in all three samples, despite varying prerequisites for social interaction, strongly supports the validity of the ISSI. Providing the sub-scales are used with caution, the ISSI seems to be a reliable tool for use with patients with severe mental disorders.

  • 45.
    Eklund, Mona
    et al.
    Lund university.
    Bäckström, Martin
    Lund university.
    Tuvesson, Hanna
    Blekinge Institute of Technology.
    Psychometric properties and factor structure of the Swedish version of the Perceived Stress Scale.2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 7, p. 494-499Article in journal (Refereed)
    Abstract [en]

    The Perceived Stress Scale (PSS) measures general stress and the Swedish version, although used in several studies, has not been extensively evaluated for psychometric properties. Aims: This study aimed to investigate psychometric properties and the factor solution of the Swedish 14-item version when used with two samples, namely a mixed Internet sample of women and men (n = 171) and another of women with stress-related disorders (n = 84). Classical test theory, including confirmatory factor analysis, was employed. Results: The factor structure supported a two-factor model for the PSS and confirmed other language versions of the PSS, although one items showed a low item-total correlation. The PSS showed to be feasible with the investigated samples and the results indicated no ceiling or floor effects and good internal consistency of the PSS. Several aspects of construct validity were shown. An association of − 0.66 between the PSS and a measure of coping indicated good concurrent validity. Criterion validity was demonstrated through a statistically significant difference (P < 0.001) between the women with stress-related disorders and the Internet sample. Predictive validity of the PSS could be demonstrated in a short-term perspective. Based on the sample with stress-related disorders, sensitivity to change was shown through a statistically significant stress reduction (P < 0.001) from entering work rehabilitation to discharge. Conclusions: The Swedish version of the PSS showed satisfactory psychometric properties and may be recommended for use with people with and without known stress-related disorders.

  • 46. Eklund, Mona
    et al.
    Bäckström, Martin
    Tuvesson, Hanna
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Psychometric properties and factor structure of the Swedish version of the Perceived Stress Scale.2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 7, p. 494-9Article in journal (Refereed)
    Abstract [en]

    The Perceived Stress Scale (PSS) measures general stress and the Swedish version, although used in several studies, has not been extensively evaluated for psychometric properties. Aims: This study aimed to investigate psychometric properties and the factor solution of the Swedish 14-item version when used with two samples, namely a mixed Internet sample of women and men (n = 171) and another of women with stress-related disorders (n = 84). Classical test theory, including confirmatory factor analysis, was employed. Results: The factor structure supported a two-factor model for the PSS and confirmed other language versions of the PSS, although one items showed a low item-total correlation. The PSS showed to be feasible with the investigated samples and the results indicated no ceiling or floor effects and good internal consistency of the PSS. Several aspects of construct validity were shown. An association of − 0.66 between the PSS and a measure of coping indicated good concurrent validity. Criterion validity was demonstrated through a statistically significant difference (P < 0.001) between the women with stress-related disorders and the Internet sample. Predictive validity of the PSS could be demonstrated in a short-term perspective. Based on the sample with stress-related disorders, sensitivity to change was shown through a statistically significant stress reduction (P < 0.001) from entering work rehabilitation to discharge. Conclusions: The Swedish version of the PSS showed satisfactory psychometric properties and may be recommended for use with people with and without known stress-related disorders.

  • 47.
    Eklund, Mona
    et al.
    Department of Health Sciences, Lund University.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Psychometric properties of a Swedish version of the Pearlin Mastery Scale in people with mental illness and healthy people2012In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 6, p. 380-388Article in journal (Refereed)
    Abstract [en]

    Background: Mastery refers to the degree to which people perceive that they can control factors that influence their life situation, and has been found important for people's quality of life and well-being. It is thus essential to be able to measure mastery in a valid and reliable way. Aim: This study aimed at using the Rasch measurement model to investigate the psychometric properties of a Swedish version of the Pearlin Mastery Scale (Mastery-S). Methods: A sample of 300 healthy individuals and 278 persons with mental illness responded to the Mastery-S. Item responses were Rasch analysed regarding model fit, response category functioning, differential item functioning (DIF) and targeting, using the partial credit model. Results: The Mastery-S items represented a logical continuum of the measured construct but one item displayed misfit. Reliability (Person Separation Index) was 0.7. The response categories did not work as expected in three items, which could be corrected for by collapsing categories. Three items displayed DIF between the two subsamples, which caused a bias when comparing mastery levels between subsamples, suggesting the Mastery-S is not truly generic. Conclusions: The Mastery-S may be used to obtain valid and reliable data, but some precautions should be made. If used to compare groups, new analyses of DIF should first be made. Users of the scale should also consider exempting item 6 from the scale and analyse it as a separate item. Finally, rewording of response categories should be considered in order to make them more distinct and thereby improve score reliability.

  • 48.
    Eklund, Mona
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University, Lund, Sweden & Vårdal Institute, Swedish institute for Health Sciences, Lund, Sweden.
    Hagell, Peter
    Department of Health Sciences, Lund University, Lund, Sweden & School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Psychometric properties of a Swedish version of the Pearlin Mastery Scale in people with mental illness and healthy people2012In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 6, p. 380-388Article in journal (Refereed)
    Abstract [en]

    Background: Mastery refers to the degree to which people perceive that they can control factors that influence their life situation, and has been found important for people's quality of life and well-being. It is thus essential to be able to measure mastery in a valid and reliable way. Aim: This study aimed at using the Rasch measurement model to investigate the psychometric properties of a Swedish version of the Pearlin Mastery Scale (Mastery-S). Methods: A sample of 300 healthy individuals and 278 persons with mental illness responded to the Mastery-S. Item responses were Rasch analysed regarding model fit, response category functioning, differential item functioning (DIF) and targeting, using the partial credit model. Results: The Mastery-S items represented a logical continuum of the measured construct but one item displayed misfit. Reliability (Person Separation Index) was 0.7. The response categories did not work as expected in three items, which could be corrected for by collapsing categories. Three items displayed DIF between the two subsamples, which caused a bias when comparing mastery levels between subsamples, suggesting the Mastery-S is not truly generic. Conclusions: The Mastery-S may be used to obtain valid and reliable data, but some precautions should be made. If used to compare groups, new analyses of DIF should first be made. Users of the scale should also consider exempting item 6 from the scale and analyse it as a separate item. Finally, rewording of response categories should be considered in order to make them more distinct and thereby improve score reliability.

  • 49.
    Elwin, Marie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre.
    Ek, Lena
    Habilitation and Rehabilitation For Adults, Växjö, Sweden.
    Kjellin, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre.
    Development and pilot validation of a sensory reactivity scale for adults with high functioning autism spectrum conditions: Sensory Reactivity in Autism Spectrum (SR-AS)2016In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 2, p. 103-110Article in journal (Refereed)
    Abstract [en]

    Background: Unusual reactions to sensory stimuli are experienced by 90-95% of people with an autism spectrum condition (ASC). Self-reported sensory reactivity in ASC has mainly been measured with generic questionnaires developed and validated on data from the general population. Interest in sensory reactivity in ASC increased after the inclusion of hyper- and hypo-reactivity together with unusual sensory interest as diagnostic markers of ASC in the DSM-5.

    Aims: To develop and pilot validate a self-report questionnaire designed from first-hand descriptions of the target group of adults diagnosed with high functioning ASC. Psychometric properties of the questionnaire were evaluated on a sample of participants with ASC diagnoses (N = 71) and a random sample from the general population (N = 162).

    Results: The Sensory Reactivity in Autism Spectrum (SR-AS is intended to be used as a screening tool in diagnostic processes with adults and for support in adapting compensating strategies and environmental adjustments. The internal consistency was high for both the SR-AS and its subscales. The total scale Cronbach's alpha was 0.96 and the subscales alphas were 0.80. Confirmatory factor analysis (CFA) showed best fit for a four-factor model of inter-correlated factors: hyper and hypo-reactivity, strong sensory interest and a sensory/motor factor. The questionnaire discriminated well between ASC-diagnosed participants and participants from the general population.

    Conclusions: The SR-AS displayed good internal consistency and discriminatory power and promising factorial validity.

  • 50.
    Emilsson, Maria
    et al.
    University West, Sweden.
    Berndtsson, Ina
    University West, Sweden.
    Gustafsson, Per A.
    UCL, UK.
    Horne, Robert
    Linköping University, Sweden.
    Marteinsdottir, Ina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Reliability and validation of Swedish translation of Beliefs about Medication Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with attention-deficit hyperactivity disorder2019In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study was to assess the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Methods: Forward and backward translations of the BMQ-Specific and B-IPQ scales to Swedish were conducted and reviewed by adolescents with ADHD and professionals. The validity and reliability of both questionnaires were investigated in a cross-sectional study of 101 adolescents (13?17?years) on a long-term prescription of ADHD medication recruited from two child and adolescent psychiatric outpatient clinics in Sweden. Results: Regarding the BMQ-Specific, principal component analysis (PCA) loadings confirmed the previously defined components of Specific-Necessity and Specific-Concern. The PCA for B-IPQ revealed two components, the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the capability to manage the ADHD disorder (items 3, 4 and 7). The Cronbach alpha coefficients for BMQ-Specific-Necessity scale was ??=?0.80, for BMQ-Specific-Concern scale ??=?0.75, B-IPQ Consequences ??=?0.74 and for B-IPQ-Control ??=?0.44. Conclusions: The present results prove the Swedish translation of BMQ-Specific and B-IPQ to be valid and reliable for utilization in adolescents with ADHD. The PCA confirmed the original components for BMQ-Specific and the recent findings of two main B-IPQ components describing emotional and cognitive implications versus the capability for self-care maintenance of ADHD.

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Output format
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  • text
  • asciidoc
  • rtf