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  • 301. Backman, Anna
    et al.
    Zander, Eric
    Roll-Pettersson, Lise
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    Vigerland, Sarah
    Hirvikoski, Tatja
    Functioning and quality of life in transition-aged youth on the autism spectrum – associations with autism symptom severity and mental health problems2023In: Research in Autism Spectrum Disorders, ISSN 1750-9467, E-ISSN 1878-0237, Vol. 104, article id 102168Article in journal (Refereed)
    Abstract [en]

    Previous research notes difficulties in functioning and low quality of life (QoL) among transition-age youth on the autism spectrum, and poor mental health may contribute to these difficulties. This study examined the role of autism symptom severity and mental health problems on self-reported functioning and QoL in treatment-seeking transition-age autistic youth. The study included 140 autistic youth (16–25 years, M = 20.44 (SD = 2.95); n = 91 females [65%], n = 42 males [30%], n = 7 non-binary [5%]). We assessed functioning using a structured interview and QoL through a self-report questionnaire. Factors potentially associated with functioning and QoL were assessed using standardized self-report questionnaires of autism symptom severity, symptoms of anxiety and depression, and information from medical records. Participants reported functioning on the 90th percentile compared to general population norms, indicating significant disability, and also rated low overall QoL. Regression analysis showed that autism symptom severity and anxiety symptoms, and to some extent gender and having an ADHD diagnosis, explained 46% of the variance in overall functioning. Symptoms of anxiety and depression, and to a lesser extent, active friendship, explained 43% of the variance in QoL. Sampling limitations of the study include the overrepresentation of women and newly diagnosed participants. We highlight that functioning and QoL are multifactorial, necessitating a comprehensive assessment of transition-aged autistic youth, including mental health problems, to plan tangible interventions.

  • 302.
    Bador, Kourosh
    et al.
    AGERA KBT AB, Gothenburg, Sweden.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Evaluation of an Integrated Intensive Cognitive Behavioral Therapy Treatment Within Addiction Care2020In: Journal of Behavioral Health Services & Research, ISSN 1094-3412, E-ISSN 1556-3308, Vol. 47, no 1, p. 102-112Article in journal (Refereed)
    Abstract [en]

    The study aimed to evaluate an integrated intensive cognitive behavioral therapy (CBT) group treatment for people with substance-related syndrome in outpatient care and to identify eventual gender differences. The study population consisted of 35 outpatients (18 male, 17 female) at a clinic in Western Sweden. The patients completed a four-month period of intensive group therapy and participated in the data collection at admission and discharge. The data were collected using the following inventories: Beck Depression and Anxiety Inventories, Rosenberg Self-Esteem Scale,Hopelessness Scale, and Trait Hope Scale. Results showed decreases in anxiety, depression and experience of hopelessness, and increases in self-esteem and hope. In females, the most dramatic improvement was measured for the anxiety and depression attributes, while in males the strongest effect was measured for hope and self-esteem. This study provides clinical evidence of the positive effects of integrated intensive CBT in outpatient care of people with substance-related syndrome.

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  • 303.
    Baghdassarian, Eva Juselius
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Lewander, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nilsson, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Brainstem Audiometry Evoked Response (BAER) Profiling. New Potential Biomarkers in Schizoaffective Disorder and Early Psychosis2016In: Early Intervention in Psychiatry, ISSN 1751-7885, E-ISSN 1751-7893, Vol. 10, p. 160-160Article in journal (Other academic)
  • 304.
    Baghdassarian, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Lewander, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Auditory brainstem response (ABR) profiling in schizoaffective disorder2020In: Acta Neuropsychiatrica, ISSN 0924-2708, E-ISSN 1601-5215, Vol. 32, no 4, p. 214-217Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to assess whether the auditory brainstem response (ABR) profiling test for schizophrenia (SZ) would recognise schizoaffective disorder (SZA) patients as SZ or not.

    Method: Male and female SZA patients (n = 16) from the psychosis unit at Uppsala University Hospital were investigated. Coded sets of randomised ABR recordings intermingled with patients with SZ, adult attention-deficit hyperactivity disorder (ADHD) and healthy controls were analysed by an independent party blinded to clinical diagnoses.

    Results: The ABR profiling test for SZ was positive in 5/16 patients (31%) and negative in 11/16 patients (69%) with SZA. A surprising finding was that 4/16 (25%) SZA patients were positive for the ABR profiling test for ADHD.

    Conclusion: With the ABR profiling test, a minority of patients with SZA tested positive for SZ. In contrast, a majority (85%) of patients with SZ in a previous study tested positive. These preliminary results leave us ignorant whether SZA should be regarded as a SZ-like disorder or a psychotic mood disorder and add to the questions regarding the validity of this diagnostic entity. However, the ABR profiling method is still in its infancy and its exploration in a range of psychiatric disorders is warranted.

  • 305.
    Baghdassarian, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nilsson, Maria Markhed
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Lindström, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nilsson, Björn M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Lewander, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Auditory brainstem response (ABR) profiling tests as diagnostic support for schizophrenia and adult attention-deficit hyperactivity disorder (ADHD)2018In: Acta Neuropsychiatrica, ISSN 0924-2708, E-ISSN 1601-5215, Vol. 30, no 3, p. 137-147Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the performances of two auditory brainstem response (ABR) profiling tests as potential biomarkers and diagnostic support for schizophrenia and adult attention-deficit hyperactivity disorder (ADHD), respectively, in an investigator-initiated blinded study design.

    Method: Male and female patients with schizophrenia (n=26) and adult ADHD (n=24) meeting Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) diagnostic criteria and healthy controls (n=58) comprised the analysis set (n=108) of the total number of study participants (n=119). Coded sets of randomized ABR recordings were analysed by an independent party blinded to clinical diagnoses before a joint code-breaking session.

    Results: The ABR profiling test for schizophrenia identified schizophrenia patients versus controls with a sensitivity of 84.6% and a specificity of 93.1%. The ADHD test identified patients with adult ADHD versus controls with a sensitivity of 87.5% and a specificity of 91.4%.

    Conclusion: The ABR profiling tests discriminated schizophrenia and ADHD versus healthy controls with high sensitivity and specificity. The methods deserve to be further explored in larger clinical studies including a broad range of psychiatric disorders to determine their utility as potential diagnostic biomarkers.

  • 306. Bajbouj, Malek
    et al.
    Merkl, Angela
    Schlaepfer, Thomas E.
    Frick, Caroline
    Zobel, Astrid
    Maier, Wolfgang
    O'Keane, Veronica
    Corcoran, Ciaran
    Adolfsson, Rolf
    University Hospital Umeå, Umeå, Sweden.
    Trimble, Michael
    Rau, Harald
    Hoff, Hans-Joachim
    Padberg, Frank
    Müller-Siecheneder, Florian
    Audenaert, Kurt
    van den Abbeele, Dirk
    Matthews, Keith
    Christmas, David
    Eljamel, Sam
    Heuser, Isabella
    Two-year outcome of vagus nerve stimulation in treatment-resistant depression2010In: Journal of Clinical Psychopharmacology, ISSN 0271-0749, E-ISSN 1533-712X, Vol. 30, no 3, p. 273-281Article in journal (Refereed)
    Abstract [en]

    One of the major goals of antidepressant treatment is a sustained response and remission of depressive symptoms. Some of the previous studies of vagus nerve stimulation (VNS) have suggested antidepressant effects. Our naturalistic study assessed the efficacy and the safety of VNS in 74 European patients with therapy-resistant major depressive disorder. Psychometric measures were obtained after 3, 12, and 24 months of VNS. Mixed-model repeated-measures analysis of variance revealed a significant reduction (P < or = 0.05) at all the 3 time points in the 28-item Hamilton Rating Scale for Depression (HRSD28) score, the primary outcome measure. After 2 years, 53.1% (26/49) of the patients fulfilled the response criteria (> or =50% reduction in the HRSD28 scores from baseline) and 38.9% (19/49) fulfilled the remission criteria (HRSD28 scores < or = 10). The proportion of patients who fulfilled the remission criteria remained constant as the duration of VNS treatment increased. Voice alteration, cough, and pain were the most frequently reported adverse effects. Two patients committed suicide during the study; no other deaths were reported. No statistically significant differences were seen in the number of concomitant antidepressant medications. The results of this 2-year open-label trial suggest a clinical response and a comparatively benign adverse effect profile among patients with treatment-resistant depression.

  • 307.
    Bakalkin, Georgy
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Bazov, Igor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Hussain, Muhammad Zubair
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Sarkisyan, Daniil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Watanabe, Hiroyuki
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Kononenko, Olga
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Karpyak, V.
    Yakovleva, Tatiana
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Dysregulation of the endogenous opioid system in the brain of human alcoholics2013In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 28, no S1, p. 2297-Article in journal (Other academic)
  • 308.
    Baker, J. H.
    et al.
    Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia of Virginia Commonwealth University, Richmond, USA; Department of Psychology, Virginia Commonwealth University, Richmond, USA.
    Maes, H. H.
    Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia of Virginia Commonwealth University, Richmond, USA; Department of Human Genetics, Virginia Commonwealth University, Richmond, USA; Massey Cancer Center, Virginia Commonwealth University, Richmond, USA.
    Larsson, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, P.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Kendler, K. S.
    Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia of Virginia Commonwealth University, Richmond, USA; Department of Human Genetics, Virginia Commonwealth University, Richmond, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, USA.
    Sex differences and developmental stability in genetic and environmental influences on psychoactive substance consumption from early adolescence to young adulthood2011In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 41, no 9, p. 1907-1916Article in journal (Refereed)
    Abstract [en]

    Background: Genetic and environmental factors are important in the etiology of substance use. However, little is known about the stability of these factors across development. We aimed to answer three crucial questions about this etiology that have never been addressed in a single study: (1) Is there a general vulnerability to substance consumption from early adolescence to young adulthood? (2) If so, do the genetic and environmental influences on this vulnerability change across development? (3) Do these developmental processes differ in males and females?

    Method: Subjects included 1480 twin pairs from the Swedish Twin Study of Child and Adolescent Development who have been followed since 1994. Prospective, self-reported regular smoking, alcohol intoxication and illicit drug use were assessed at ages 13-14, 16-17 and 19-20 years. Structural modeling was performed with the program Mx.

    Results: An underlying common factor accounted for the association between smoking, alcohol and illicit drug consumption for the three age groups. Common genetic and shared environmental effects showed substantial continuity. In general, as participants aged, the influence of the shared environment decreased, and genetic effects became more substance specific in their effect.

    Conclusions: The current report answers three important questions in the etiology of substance use. The genetic and environmental risk for substance consumption is partly mediated through a common factor and is partly substance specific. Developmentally, evidence was strongest for stability of common genetic effects, with less evidence for genetic innovation. These processes seem to be the same in males and females.

  • 309.
    Baker, Jessica H.
    et al.
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
    Brosof, Leigh C.
    Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA.
    Munn-Chernoff, Melissa A.
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Maes, Hermine H.
    Department of Genetics, Virginia Commonwealth University, Richmond, Virginia, USA.
    Kendler, Kenneth S.
    Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA.
    Associations Between Alcohol Involvement and Drive for Thinness and Body Dissatisfaction in Adolescent Twins: A Bivariate Twin Study2018In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 42, no 11, p. 2214-2223Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Alcohol involvement has familial associations with bulimic symptoms (i.e., binge eating, inappropriate compensatory behaviors), with several studies indicating a genetic overlap between the two. It is unclear whether overlapping familial risk with alcohol involvement extends to other eating disorder symptoms. Understanding the genetic overlap between alcohol involvement and other eating disorder symptoms may aid in more targeted interventions for comorbid alcohol use-eating disorder symptoms. Thus, we investigated associations between alcohol involvement and 2 core eating disorder symptoms: drive for thinness and body dissatisfaction in adolescent female and male twins.

    METHODS: We assessed 3 levels of alcohol involvement: alcohol use in the last month, having ever been intoxicated, and alcohol intoxication frequency via self-report. The Eating Disorder Inventory-II assessed drive for thinness and body dissatisfaction. Sex-specific biometrical twin modeling examined the genetic overlap between alcohol involvement and eating disorder symptoms.

    RESULTS: Phenotypic associations between alcohol involvement, drive for thinness, and body dissatisfaction were significantly greater in girls compared with boys. A majority of the associations between alcohol involvement, drive for thinness, and body dissatisfaction in girls, but not boys, met our threshold for twin modeling (phenotypic r > 0.20). Moderate genetic correlations were observed between the 3 aspects of alcohol involvement and drive for thinness. Moderate genetic correlations were observed between alcohol use and intoxication frequency and body dissatisfaction.

    CONCLUSIONS: Together with the literature on alcohol involvement and bulimic symptoms, these findings suggest a generalized association between alcohol involvement and eating disorder symptoms in girls, whereas this association may be symptom specific in boys. Genetic correlations indicate that the amount and direction of this genetic overlap differs across specific symptoms. When intervening on comorbid alcohol involvement and eating disorder symptoms, it may be important to target-specific eating disorder symptoms.

  • 310.
    Baker, Jessica H.
    et al.
    Department of Psychiatry, University of North Carolina, Chapel Hill, United States.
    Munn-Chernoff, Melissa A.
    Department of Psychiatry, University of North Carolina, Chapel Hill, United States.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Maes, Hermine
    Department of Genetics, VA Commonwealth University, Richmond, United States.
    Kendler, Kenneth S.
    Department of Psychiatry, VA Commonwealth University, Richmond, United States.
    Shared Familial Risk Between Bulimic Symptoms and Alcohol Involvement During Adolescence2017In: Journal of Abnormal Psychology, ISSN 0021-843X, E-ISSN 1939-1846, Vol. 126, no 5, p. 506-518Article in journal (Refereed)
    Abstract [en]

    Twin studies show the established relation between bulimic symptoms and problematic alcohol involvement in adult females is partly due to shared familial factors, specifically shared genetic effects. However, it is unclear if similar shared etiological factors exist during adolescence or in males. We examined the familial overlap (i.e., genetic and common environmental correlations) between bulimic symptoms and various levels of alcohol involvement in 16- to 17-year-old female and male same-sex twin pairs using sex-specific biometrical twin modeling. Bulimic symptoms were assessed with the Eating Disorder Inventory-2. Alcohol involvement included alcohol use in the last month, having ever been intoxicated, and alcohol intoxication frequency. Results revealed 3 distinct patterns. First, in general, phenotypic correlations indicated statistically similar associations between bulimic symptoms and alcohol involvement in girls and boys. Second, common environmental overlap was significant for the bivariate associations including having ever been intoxicated. Third, moderate genetic correlations were observed between all bulimic symptoms and alcohol involvement in girls and moderate common environmental correlations were observed in boys for the more risky/deviant levels of involvement. Similar to adults, there is familial overlap between bulimic symptoms and alcohol involvement in adolescent girls and boys. These results could inform symptom-and sex-specific, developmentally targeted prevention and intervention programs for the comorbidity between bulimic symptoms and alcohol involvement.

  • 311.
    Baldwin, Jessie R.
    et al.
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK.
    Sallis, Hannah M.
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
    Schoeler, Tabea
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK.
    Taylor, Mark J.
    Medical SchoolDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Kwong, Alex S. F.
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK; stitutet, Nobels va ̈Division of Psychiatry, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
    Howe, Laura D.
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK.
    Danese, Andrea
    Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom; National and Specialist CAMHS Trauma, Anxiety, and Depression Clinic, South London and Maudsley NHS Foundation Trust, London, UK.
    McCrory, Eamon
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, London, UK .
    Rijsdijk, Fruhling
    Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK.
    Tielbeek, Jorim J.
    CNCR, Amsterdam Neuroscience Campus, VU University, Amsterdam, The Netherlands.
    Barkhuizen, Wikus
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Bristol Medical School, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Lundström, Sebastian
    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Robert
    Bristol Medical School, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, Paul
    Bristol Medical School, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Munafo, Marcus
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.
    Pingault, Jean-Baptiste
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK.
    Adverse Childhood Experiences and Mental Health: A Genetically Informed Study2021In: Behavior Genetics, ISSN 0001-8244, E-ISSN 1573-3297, Vol. 51, no 6, p. 691-692Article in journal (Other academic)
    Abstract [en]

    Children exposed to adverse childhood experiences (ACEs) have an elevated risk of mental health problems, but it is unclear whether these associations reflect genetic confounding. We tested (1) whether children with genetic liability to psychopathology are more likely to experience ACEs, and (2) the extent to which the associations between ACEs and mental health are genetically confounded. Par-ticipants were 6411 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). ACEs (including maltreatment, domestic violence, and parental psychopathology, substance abuse, criminality, and separation) were prospectively measured through parent reports at multiple assessments between birth and age 9. Internalizing and externalizing problems at age 9 were assessed through parent reports on the Development and Wellbeing Assessment. We derived polygenic scores for a range of psychiatric disorders. Children with greater genetic liability to psychopathology had a small elevation in risk of ACEs (pooled odds ratio = 1.05, 95% CI 1.01–1.09). Measured polygenic scores accounted for a very small proportion of the associations between ACEs with internalizing problems (pooled average across ACEs = 3.6%) and externalizing problems (pooled average = 4.8%). However, latent polygenic scores capturing SNP heritability in mental health outcomes explained a larger proportion of the associations between ACEs with internalizing problems (pooled average = 63%) and externalizing problems (pooled average = 17%). Risk of mental health problems in children exposed to ACEs is partly, but not completely driven by pre-existing genetic liability to psychopathology. Assuming the absence of nongenetic confounding, these findings are consistent with a partly causal effect of ACEs on mental health.

  • 312.
    Baldwin, Jessie R.
    et al.
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
    Sallis, Hannah M.
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
    Schoeler, Tabea
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK.
    Taylor, Mark J.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Kwong, Alex S. F.
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK; Division of Psychiatry, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
    Tielbeek, Jorim J.
    CNCR, Amsterdam Neuroscience Campus, VU University, Amsterdam, the Netherlands.
    Barkhuizen, Wikus
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK.
    Warrier, Varun
    Department of Psychiatry, University of Cambridge, Cambridge, UK.
    Howe, Laura D.
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK.
    Danese, Andrea
    Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National and Specialist CAMHS Trauma, Anxiety, and Depression Clinic, South London and Maudsley NHS Foundation Trust, London, UK.
    McCrory, Eamon
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, London, UK.
    Rijsdijk, Fruhling
    Psychology Department, Faculty of Social Sciences, Anton de Kom University, Paramaribo, Suriname.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Lundström, Sebastian
    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Robert
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Munafò, Marcus
    MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.
    Pingault, Jean-Baptiste
    Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
    A genetically informed Registered Report on adverse childhood experiences and mental health2023In: Nature Human Behaviour, E-ISSN 2397-3374, Vol. 7, no 2, p. 269-290Article in journal (Refereed)
    Abstract [en]

    Children who experience adversities have an elevated risk of mental health problems. However, the extent to which adverse childhood experiences (ACEs) cause mental health problems remains unclear, as previous associations may partly reflect genetic confounding. In this Registered Report, we used DNA from 11,407 children from the United Kingdom and the United States to investigate gene-environment correlations and genetic confounding of the associations between ACEs and mental health. Regarding gene-environment correlations, children with higher polygenic scores for mental health problems had a small increase in odds of ACEs. Regarding genetic confounding, elevated risk of mental health problems in children exposed to ACEs was at least partially due to pre-existing genetic risk. However, some ACEs (such as childhood maltreatment and parental mental illness) remained associated with mental health problems independent of genetic confounding. These findings suggest that interventions addressing heritable psychiatric vulnerabilities in children exposed to ACEs may help reduce their risk of mental health problems.

  • 313.
    Balter, Leonie J. T.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Matheson, Granville J.
    Sundelin, Tina
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Sterzer, Philipp
    Petrovic, Predrag
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Experimental Sleep Deprivation Results in Diminished Perceptual Stability Independently of Psychosis Proneness2022In: Brain Sciences, ISSN 2076-3425, E-ISSN 2076-3425, Vol. 12, no 10, article id 1338Article in journal (Refereed)
    Abstract [en]

    Psychotic disorders as well as psychosis proneness in the general population have been associated with perceptual instability, suggesting weakened predictive processing. Sleep disturbances play a prominent role in psychosis and schizophrenia, but it is unclear whether perceptual stability diminishes with sleep deprivation, and whether the effects of sleep deprivation differ as a function of psychosis proneness. In the current study, we aimed to clarify this matter. In this preregistered study, 146 participants successfully completed an intermittent version of the random dot kinematogram (RDK) task and the 21-item Peters Delusion Inventory (PDI-21) to assess perceptual stability and psychosis proneness, respectively. Participants were randomized to sleep either as normal (8 to 9 h in bed) (n = 72; Mage = 24.7, SD = 6.2, 41 women) or to stay awake through the night (n = 74; Mage = 24.8, SD = 5.1, 44 women). Sleep deprivation resulted in diminished perceptual stability, as well as in decreases in perceptual stability over the course of the task. However, we did not observe any association between perceptual stability and PDI-21 scores, nor a tendency for individuals with higher PDI-21 scores to be more vulnerable to sleep-deprivation-induced decreases in perceptual stability. The present study suggests a compromised predictive processing system in the brain after sleep deprivation, but variation in psychosis trait is not related to greater vulnerability to sleep deprivation in our dataset. Further studies in risk groups and patients with psychosis are needed to evaluate whether sleep loss plays a role in the occurrence of objectively measured perceptual-related clinical symptoms.

  • 314.
    Balter, Leonie J. T.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Wiwe Lipsker, Camilla
    Wicksell, Rikard K.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Neuropsychiatric Symptoms in Pediatric Chronic Pain and Outcome of Acceptance and Commitment Therapy2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, article id 576943Article in journal (Refereed)
    Abstract [en]

    Considerable heterogeneity among pediatric chronic pain patients may at least partially explain the variability seen in the response to behavioral therapies. The current study tested whether autistic traits and attention-deficit/hyperactivity disorder (ADHD) symptoms in a clinical sample of children and adolescents with chronic pain are associated with socioemotional and functional impairments and response to acceptance and commitment therapy (ACT) treatment, which has increased psychological flexibility as its core target for coping with pain and pain-related distress. Children and adolescents aged 8-18 years (N = 47) were recruited. Patients and their parents completed questionnaires pre- and post-ACT of 17 sessions. Correlational analyses and mixed-effects models were used to assess the role of autistic traits and ADHD symptoms in pretreatment functioning and ACT-treatment response. Outcome variables were degree to which pain interfered with daily activities (i.e., pain interference, sleep, and physical and school functioning), socioemotional functioning (i.e., depressive symptoms, emotional, and social functioning), psychological inflexibility, and pain intensity. Autistic traits and ADHD symptoms, pain frequency, and pain duration were measured at pretreatment only. Higher autistic traits were associated with greater pain interference, higher depression, and greater psychological inflexibility. Higher ADHD symptomatology was associated with greater pretreatment pain interference, lower emotional functioning, greater depression, and longer duration of pain. Across patients, all outcome variables, except for sleep disturbances and school functioning, significantly improved from pre- to post-ACT. Higher autistic traits were associated with greater pre- to post-ACT improvements in emotional functioning and sleep disturbance and non-significant improvements in pain interference. ADHD symptomatology was not associated with treatment outcome. The current results showed that neuropsychiatric symptoms in pediatric chronic pain patients are associated with lower functioning, particularly pain interfering with daily life and lower socioemotional functioning. The results suggest that not only pediatric chronic pain patients low in neuropsychiatric symptoms may benefit from ACT, but also those high in autism traits and ADHD symptoms. With the present results in mind, pediatric chronic pain patients higher in autistic traits may actually derive extra benefit from ACT. Future research could assess whether increased psychological flexibility, the core focus of ACT, enabled those higher in autism traits to cope relatively better with pain-related distress and thus to gain more from the treatment, as compared to those lower in autism traits. Moreover, to address specific effects of ACT, inclusion of an appropriate control group is key.

  • 315.
    Balton, Sadna
    et al.
    Univ Pretoria, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Arvidsson, Patrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Research and Development, Gävleborg. Jönköping Univ, Sch Hlth & Welf, Swedish Inst Disabil Res, CHILD, Jönköping, Sweden..
    Granlund, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Research and Development, Gävleborg.
    Huus, Karina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Research and Development, Gävleborg.
    Dada, Shakila
    Univ Pretoria, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Test-retest reliability of Picture My Participation in children with intellectual disability in South Africa2022In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 29, no 4, p. 315-324Article in journal (Refereed)
    Abstract [en]

    Background Picture My Participation (PmP) is a promising instrument for measuring the participation in everyday situations of children with intellectual disability (ID), particularly in low- and middle-income countries. Aim To explore test-retest reliability of PmP by comparing two repeated measurements of children with ID in an urban context in South Africa. Methods A picture-supported interview with 31 children with ID, aged 7-17 years, was conducted twice, two weeks apart. The children rated their participation, operationalised as attendance and involvement, in 20 everyday activities. Analyses were completed for total scores, for the four subcomponents and at item level. Results Test-retest agreement at an item level for both attendance and involvement showed slight/fair agreement for most activities (Kappa = 0.01-0.40), and moderate agreement for some activities (Kappa = 0.41-0.60). Moderate agreement was shown for the total scale and at component level (ICC = 0.5-0.75), except for (firstly) attendance of and involvement in 'Family Activities' (ICC = 0.26 for attendance, 0.33 for involvement), and (secondly) involvement in 'Personal Activities' (ICC = 0.33). Conclusion The result indicates that PmP can reliably be used at component level and as a screening tool for intervention planning to identify participation and participation restrictions in children with ID.

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  • 316.
    Bamvita, Jean-Marie
    et al.
    Univ Montreal, GRIP, CP 6128,Succ Ctr Ville,Pavillon 3050, Montreal, PQ H3C 3J7, Canada.;Karolinska Inst, Dept Clin Neurosci, Tomtebodavagen 18A,Plan 5, S-17177 Stockholm, Sweden..
    Larm, Peter
    Malardalens Univ, Sch Hlth Care & Social Welf, Box 883, S-72123 Vasteras, Sweden..
    Checknita, Dave
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Vitaro, Frank
    Univ Montreal, GRIP, CP 6128,Succ Ctr Ville,Pavillon 3050, Montreal, PQ H3C 3J7, Canada.;Univ Montreal, Res Grp Child Psychosocial Maladjustment, Montreal, PQ, Canada.;Sch Psychoeduc, Montreal, PQ, Canada..
    Tremblay, Richard E.
    Univ Montreal, Dept Pediat, Dublin, Ireland.;Univ Coll Dublin, Sch Publ Hlth, Dublin, Ireland.;Univ Montreal, Dept Psychiat, Dublin, Ireland..
    Cote, Gilles
    Univ Quebec Trois Rivieres, Psychol Dept, Inst Philippe Pinel Montreal, 10905 Henri Bourassa East, Montreal, PQ H1C 1H1, Canada..
    Hodgins, Sheilagh
    Univ Montreal, Dept Psychiat, Inst Univ Sante Mentale Montreal, GRIP Univ Montreal, CP 6128,Succ Ctr Ville,Pavillon 3050, Montreal, PQ H3C 3J7, Canada..
    Childhood predictors of adult psychopathy scores among males followed from age 6 to 332017In: Journal of criminal justice, ISSN 0047-2352, E-ISSN 1873-6203, Vol. 53, p. 55-65Article in journal (Refereed)
    Abstract [en]

    Purpose: Psychopathic traits are associated with multiple negative outcomes. The present prospective, longitudinal study identified associations of childhood factors with adult psychopathy scores.

    Methods: 311 men, aged, on average, 33 years, were assessed using the Psychopathy Checklist-Revised (PCL-R). Predictors included neighbourhood deprivation, parents' characteristics, teacher ratings of behaviour at ages 6, 10 and 12, and academic performance at age 12. Hierarchical linear regression models were computed to identify predictors at different ages of PCL-R total and facet scores.

    Results: Age 33 PCL-R total and facet scores were significantly, and independently, associated with father's and mother's criminality and mother's age at participant's birth when teacher ratings of childhood behaviours and mathematics marks were included in the models. Anxiety was negatively associated with facet 1 scores at age 6. At age 12, 22% of the variance in facet 2 scores was predicted by father's violent convictions, mother's age and criminal charges, and reactive aggression. Facet 3 scores were associated with mother's age (marginally), inattention, and reactive aggression. Facet 4 scores were associated with father's violent criminality, mother's age, conduct probleins, inattention, and reactive aggression.

    Conclusion: Etiological research and prevention programs should focus on antecedents of psychopathic traits present in early childhood.

  • 317.
    Bamvita, Jean-Marie
    et al.
    Univ Montreal, Montreal, PQ, Canada.;Univ Montreal, GRIP, CP 6128 Succ Ctr Ville Pavillon 3050, Montreal, PQ H3C 3J7, Canada..
    Larm, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Karolinska Univ Sjukhuset, Stockholm, Sweden..
    Vitaro, Frank
    Univ Montreal, GRIP, CP 6128 Succ Ctr Ville Pavillon 3050, Montreal, PQ H3C 3J7, Canada.;Res Grp Child Psychosocial Maladjustment, Montreal, PQ, Canada.;Univ Montreal, Sch Psychoeduc, Montreal, PQ, Canada..
    Tremblay, Richard
    Univ Montreal, Dept Pediat, Montreal, PQ, Canada.;Univ Montreal, Dept Psychiat, Montreal, PQ, Canada.;Univ Coll Dublin, Sch Publ Hlth, Dublin, Ireland..
    Cote, Gilles
    Univ Quebec A Trois Rivieres, Psychol Dept, Trois Rivieres, PQ, Canada.;Inst Philippe Pinel, Montreal, PQ, Canada..
    Hodgins, Sheilagh
    Univ Montreal, GRIP, CP 6128 Succ Ctr Ville Pavillon 3050, Montreal, PQ H3C 3J7, Canada.;Univ Montreal, Inst Univ Sante Mentale Montreal, Dept Psychiat, Montreal, PQ, Canada..
    How do childhood conduct problems, callousness and anxiety relate to later offending and adult mental disorder?2021In: CBMH. Criminal behaviour and mental health, ISSN 0957-9664, E-ISSN 1471-2857, Vol. 31, no 1, p. 60-76Article in journal (Refereed)
    Abstract [en]

    Background Various combinations of childhood conduct problems, callous traits and anxiety may confer increased risk of offending, psychopathic traits and mental disorders. Knowledge of these outcomes in adulthood is limited. Aims To compare adult criminal convictions, psychopathy checklist scores and mental disorders between five groups of men, variously defined in childhood by: (1) callous traits, (2) conduct problems, (3) conduct problems and callous traits, (4) conduct problems and callous traits and anxiety or (5) developing typically.

    Method Teachers rated conduct problems, callous traits and anxiety at ages 6, 10 and 12 years. Criminal convictions from age 12 to 24 were extracted from official records. The Psychopathy Checklist-Revised (PCL-R) and diagnostic interviews were completed at age 33.

    Results Relative to the typically developing group, the groups with conduct problems, with and without callous traits and anxiety, showed 5-fold elevations in risks of violent convictions and 3 to 4-fold elevations in risk for antisocial personality disorder, while the groups with conduct problems only and with conduct problems plus callous traits plus anxiety were at increased risk for borderline personality disorder. All risk groups obtained higher PCL-R total scores than the typically developing childhood group.

    Conclusions and implications It is widely accepted that childhood conduct problems in boys are associated with increased risks of criminal convictions and poorer mental health, but our findings suggest that teachers can identify different subgroups and these have different trajectories. As some subgroups were small, replication is recommended, but our findings offer preliminary support for trialling specific interventions for at risk boys.

  • 318.
    Bandelow, Borwin
    et al.
    Univ Med Ctr, Dept Psychiat & Psychotherapy, Gottingen, Germany..
    Allgulander, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Psychiatry.
    Baldwin, David S.
    Univ Southampton, Fac Med, Clin & Expt Sci, Southampton, Hants, England..
    da Conceicao Costa, Daniel Lucas
    Univ Sao Paulo, Hosp Clin, Dept & Inst Psychiat, Sch Med, Sao Paulo, Brazil..
    Denys, Damiaan
    Universitair Med Centra, Afdeling Psychiat, Amsterdam, Netherlands..
    Dilbaz, Nesrin
    Uskudar Univ, Tip Fak Psikiyatri ABD, Istanbul, Turkey..
    Domschke, Katharina
    Univ Freiburg, Med Ctr Univ Freiburg, Fac Med, Dept Psychiat & Psychotherapy, Freiburg, Germany..
    Eriksson, Elias
    Univ Gothenburg, Dept Pharmacol, Gothenburg, Sweden..
    Fineberg, Naomi A.
    Univ Hertfordshire, Sch Life & Med Sci, Hatfield, Herts, England..
    Hättenschwiler, Josef
    Treatment Ctr Anxiety & Depress, Zurich, Switzerland..
    Hollander, Eric
    Albert Einstein Coll Med, New York, NY USA..
    Kaiya, Hisanobu
    Kyoto Prefactual Med Coll, Dept Psychiat, Kyoto, Japan..
    Karavaeva, Tatiana
    St Petersburg State Pediat Med Univ, Fed State Budgetary Inst Higher Educ, Minist Hlth, VM Bekhterev Natl Med Res Ctr Psychiat & Neurol, St Petersburg, Russia..
    Kasper, Siegfried
    Med Univ Vienna, Clin Div Gen Psychiat, Vienna, Austria..
    Katzman, Martin
    START Clin, Toronto, ON, Canada.;Adler Grad Profess Sch, Toronto, ON, Canada.;Northern Ontario Sch Med, Dept Psychiat, Thunder Bay, ON, Canada.;Lakehead Univ, Dept Psychol, Thunder Bay, ON, Canada..
    Kim, Yong-Ku
    Korea Univ, Coll Med, Dept Psychiat, Seoul, South Korea..
    Inoue, Takeshi
    Tokyo Med Univ, Dept Psychiat, Tokyo, Japan..
    Lim, Leslie
    Singapore Gen Hosp, Dept Psychiat, Singapore, Singapore..
    Masdrakis, Vasilios
    Natl & Kapodistrian Univ Athens, Eginit Hosp, Dept Psychiat 1, Med Sch, Athens, Greece..
    Menchon, Jose M.
    Univ Barcelona, Bellvitge Univ Hosp, Dept Psychiat, IDIBELL,Cibersam, Barcelona, Spain..
    Miguel, Euripedes C.
    Univ Sao Paulo, Fac Med, Dept Psychiat, Sao Paulo, Brazil..
    Moller, Hans-Jürgen
    Univ Munich, Dept Psychiat & Psychotherapy, Munich, Germany..
    Nardi, Antonio E.
    Univ Fed Rio de Janeiro, Inst Psychiat, Rio De Janeiro, Brazil..
    Pallanti, Stefano
    Univ Florence, Ist Die Neurosci, Florence, Italy..
    Perna, Giampaolo
    Humanitas Univ Pieve Emanuele, Dept Biol Sci, Milan, Italy..
    Rujescu, Dan
    Med Univ Vienna, Clin Div Gen Psychiat, Vienna, Austria..
    Starcevic, Vladan
    Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Nepean Clin Sch, Sydney, NSW, Australia..
    Stein, Dan J.
    Univ Cape Town, Dept Psychiat, SA MRC Unit Risk & Resilience Mental Disorders, Cape Town, South Africa.;Univ Cape Town, Neurosci Inst, Cape Town, South Africa..
    Tsai, Shih-Jen
    Taipei Vet Gen Hosp, Dept Psychiat, Taipei, Taiwan..
    Van Ameringen, Michael
    McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON, Canada..
    Vasileva, Anna
    II Mechnikov North Western State Med Univ, VM Bekhterev Natl Med Res Ctr Psychiat & Neurol, Minist Hlth, St Petersburg, Russia..
    Wang, Zhen
    Shanghai Jiao Tong Univ, Shanghai Mental Hlth Ctr, Sch Med, Shanghai, Peoples R China..
    Zohar, Joseph
    Chaim Sheba Med Ctr, Tel Aviv, Israel..
    World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders: Version 3. Part I: Anxiety disorders2023In: World Journal of Biological Psychiatry, ISSN 1562-2975, E-ISSN 1814-1412, Vol. 24, no 2, p. 79-117Article in journal (Refereed)
    Abstract [en]

    Aim This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders (published in 2002, revised in 2008). Method A consensus panel of 33 international experts representing 22 countries developed recommendations based on efficacy and acceptability of available treatments. In total, 1007 RCTs for the treatment of these disorders in adults, adolescents, and children with medications, psychotherapy and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medications. Result This paper, Part I, contains recommendations for the treatment of panic disorder/agoraphobia (PDA), generalised anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, mixed anxiety disorders in children and adolescents, separation anxiety and selective mutism. Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line medications. Cognitive behavioural therapy (CBT) is the first-line psychotherapy for anxiety disorders. The expert panel also made recommendations for patients not responding to standard treatments and recommendations against interventions with insufficient evidence. Conclusion It is the goal of this initiative to provide treatment guidance for these disorders that has validity throughout the world.

  • 319.
    Bandelow, Borwin
    et al.
    Univ Gottingen, Dept Psychiat & Psychotherapy, Gottingen, Germany..
    Allgulander, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Psychiatry.
    Baldwin, David S.
    Univ Southampton, Fac Med, Southampton, Hants, England..
    da Conceicao Costa, Daniel Lucas
    Univ Sao Paulo, Hosp Clin, Sch Med, Dept & Inst Psychiat, Sao Paulo, Brazil..
    Denys, Damiaan
    Univ Med Ctr, Afdeling Psychiat, Amsterdam, Netherlands..
    Dilbaz, Nesrin
    Uskudar Univ, Tip Fak Psikiyatri ABD Istanbul, Istanbul, Turkey..
    Domschke, Katharina
    Univ Freiburg, Med Ctr, Fac Med, Dept Psychiat & Psychotherapy, Freiburg, Germany..
    Hollander, Eric
    Albert Einstein Coll Med, New York, NY USA..
    Kasper, Siegfried
    Univ Vienna, Clin Div Gen Psychiat Med, Vienna, Austria..
    Moeller, Hans-Juergen
    Univ Munich, Dept Psychiat & Psychotherapy, Munich, Germany..
    Eriksson, Elias
    Univ Gothenburg, Dept Pharmacol, Gothenburg, Sweden..
    Fineberg, Naomi A.
    Univ Hertfordshire, Sch Life & Med Sci, Hatfield, Herts, England..
    Haettenschwiler, Josef
    Treatment Ctr Anxiety & Depress, Zurich, Switzerland..
    Kaiya, Hisanobu
    Kyoto Prefactual Med Coll, Dept Psychiat, Kyoto, Japan..
    Karavaeva, Tatiana
    St Petersburg State Univ, Fed State Budgetary Inst Higher Educ, Minist Hlth, VM Bekhterev Natl Med Res Ctr Psychiat & Neurol, St Petersburg, Russia.;St Petersburg State Univ, Fed State Budgetary Inst Higher Educ, St Petersburg, Russia..
    Katzman, Martin A.
    START Clin, Toronto, ON, Canada.;Adler Grad Profess Sch Toronto, Toronto, ON, Canada.;Northern Ontario Sch Med Thunder Bay, Dept Psychiat, Thunder Bay, ON, Canada.;Lakehead Univ, Dept Psychol, Thunder Bay, ON, Canada..
    Kim, Yong-Ku
    Korea Univ, Coll Med, Dept Psychiat, Seoul, South Korea..
    Inoue, Takeshi
    Tokyo Med Univ, Dept Psychiat, Tokyo, Japan..
    Lim, Leslie
    Singapore Gen Hosp, Dept Psychiat, Singapore, Singapore..
    Masdrakis, Vasilios
    Natl & Kapodistrian Univ Athens, Eginit Hosp, Med Sch, Dept Psychiat 1, Athens, Greece..
    Menchon, Jose M.
    Univ Barcelona, Bellvitge Univ Hosp IDIBELL, Cibersam, Dept Psychiat, Barcelona, Spain..
    Miguel, Euripedes C.
    Univ Sao Paulo, Fac Med, Dept Psychiat, Sao Paulo, SP, Brazil..
    Nardi, Antonio E.
    Univ Fed Rio de Janeiro, Inst Psychiat, Rio De Janeiro, Brazil..
    Pallanti, Stefano
    Univ Florence, Florence, Italy..
    Perna, Giampaolo
    Humanitas Univ Pieve Emanuele, Dept Biol Sci, Milan, Italy..
    Rujescu, Dan
    Univ Vienna, Clin Div Gen Psychiat Med, Vienna, Austria..
    Starcevic, Vladan
    Univ Sydney, Sydney Med Sch, Nepean Clin Sch, Fac Med & Hlth, Sydney, NSW, Australia..
    Stein, Dan J.
    Univ Cape Town, Dept Psychiat, SA MRC Unit Risk & Resilience Mental Disorders, Cape Town, South Africa.;Univ Cape Town, Neurosci Inst, Cape Town, South Africa..
    Tsai, Shih-Jen
    Taipei Vet Gen Hosp, Dept Psychiat, Taipei, Taiwan..
    Van Ameringen, Michael
    McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON, Canada..
    Vasileva, Anna
    II Mechnikov North Western State Med Univ, Minist Hlth, VM Bekhterev Natl Med Res Ctr Psychiat & Neurol, St Petersburg, Russia..
    Wang, Zhen
    Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Shanghai, Peoples R China..
    Zohar, Joseph
    Chaim Sheba Med Ctr, Tel Aviv, Israel..
    World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part II: OCD and PTSD2023In: World Journal of Biological Psychiatry, ISSN 1562-2975, E-ISSN 1814-1412, Vol. 24, no 2, p. 118-134Article in journal (Refereed)
    Abstract [en]

    Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008.

    Method: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments.

    Result: The present paper (Part II) contains recommendations based on published randomised controlled trials (RCTs) for the treatment of OCD (n = 291) and PTSD (n = 234) in children, adolescents, and adults. The accompanying paper (Part I) contains the recommendations for the treatment of anxiety disorders. For OCD, first-line treatments are selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT). Internet-CBT was also superior to active controls. Several second-line medications are available, including clomipramine. For treatment-resistant cases, several options are available, including augmentation of SSRI treatment with antipsychotics and other drugs. Other non-pharmacological treatments, including repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and others were also evaluated. For PTSD, SSRIs and the SNRI venlafaxine are first-line treatments. CBT is the psychotherapy modality with the best body of evidence. For treatment-unresponsive patients, augmentation of SSRI treatment with antipsychotics may be an option.

    Conclusion: OCD and PTSD can be effectively treated with CBT and medications.

  • 320.
    Bang Madsen, Kathrine
    et al.
    School of Business and Social Sciences, NCRR - National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, Building R, 8210, Aarhus V, Denmark; CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark.
    Bliddal, Mette
    Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
    Skoglund, Charlotte Borg
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. SDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Munk-Olsen, Trine
    School of Business and Social Sciences, NCRR - National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, Building R, 8210, Aarhus V, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
    Madsen, Malene Galle
    School of Business and Social Sciences, NCRR - National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, Building R, 8210, Aarhus V, Denmark.
    Hove Thomsen, Per
    Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Research Center at the Department for Child and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Denmark.
    Bergink, Veerle
    Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.
    Srinivas, Chaitra
    Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway; Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway.
    Cohen, Jacqueline M.
    Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
    Brikell, Isabell
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
    Liu, Xiaoqin
    School of Business and Social Sciences, NCRR - National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, Building R, 8210, Aarhus V, Denmark; CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark.
    Attention-Deficit Hyperactivity Disorder (ADHD) Medication Use Trajectories Among Women in the Perinatal Period2024In: CNS Drugs, ISSN 1172-7047, E-ISSN 1179-1934, Vol. 38, p. 301-314Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An increasing number of women of reproductive age are treated with attention-deficit hyperactivity disorder (ADHD) medication; however, patterns of ADHD medication use for women in the perinatal period have not been well described.

    OBJECTIVE: This study aimed to describe ADHD medication use patterns from 1 year before pregnancy to 1 year after delivery, and to describe sociodemographic characteristics and clinical features by medication trajectories.

    METHODS: The population-based cohort study included pregnancies in Denmark between 1997 and 2020, from the Medical Birth Register, by women who filled at least one prescription for ADHD medication from 12 months before pregnancy until 12 months after delivery. We applied group-based trajectory modeling to classify women into subgroups based on the identification of heterogeneous ADHD medication treatment patterns, and described the characteristics associated with these groups.

    RESULTS: Overall, we included 4717 pregnancies leading to liveborn singletons by 4052 mothers with a mean (standard deviation) age of 27.5 (5.6) years. We identified four treatment trajectories across pregnancy and the postpartum period: continuers (23.3%), discontinuers (41.8%), interrupters who ceased filling prescriptions during pregnancy but resumed postpartum (17.2%), and postpartum initiators (17.7%). Continuers were older at the time of conception, gave birth in more recent years, were more likely to smoke during pregnancy, and used other psychotropic medications during pregnancy. A large proportion of continuers used methylphenidate (89.1%) compared with the other groups (75.9-84.1%) and had switched ADHD medication type during the whole period (16.4% vs. 7.4-14.8%).

    CONCLUSION: We found that approximately 60% of women discontinued or interrupted their ADHD medication around pregnancy, and those who continued differed in sociodemographic and clinical factors that may reflect more severe ADHD.

  • 321.
    Bang Madsen, Kathrine
    et al.
    National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Fuglesangs Allé 26, Building R, Aarhus 8210, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
    Lund Mægbæk, Merete
    National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Fuglesangs Allé 26, Building R, Aarhus 8210, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
    Stubkjær Thomsen, Nete
    National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Fuglesangs Allé 26, Building R, Aarhus 8210, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
    Liu, Xiaoqin
    National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Fuglesangs Allé 26, Building R, Aarhus 8210, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
    Eberhard-Gran, Malin
    Norwegian Research Centre for Women's Health, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway .
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Reproductive Health Research.
    Bergink, Veerle
    Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, NY, USA; Department of Psychiatry, Rotterdam, Erasmus MC, the Netherlands .
    Munk-Olsen, Trine
    Pregnancy and postpartum psychiatric episodes in fathers: A population-based study on treatment incidence and prevalence2022In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 296, p. 130-135Article in journal (Refereed)
    Abstract [en]

    Background

    For women, the perinatal period confers an increased risk of severe psychiatric disorders, but similar evidence for fathers is lacking. We examined rates of first-time and recurrent psychiatric disorders in men before and after becoming fathers.

    Methods

    A descriptive prospective study design was applied using information from the Danish National registers. Perinatal psychiatric episodes were assessed as incidence of first-time and prevalence (including recurrence) of recorded in- or outpatient admissions for any mental disorder and redeemed prescriptions for psychotropic medication in fathers to children born from January 1, 1998 until December 31, 2015.

    Results

    We identified 929,415 births and 543,555 unique fathers. Incidence and prevalence proportions for paternal psychiatric in- and outpatient episodes showed an increasing trend over the perinatal period and were marginally higher postpartum compared to pregnancy; e.g., median incidence proportion for inpatient treatment during pregnancy was 0.07 (95% CI: 0.04; 0.07) and 0.10 (95% CI: 0.08; 0.11) postpartum per 1000 births. No difference between the periods was found for incidence of prescriptions for psychotropic medication. Psychiatric disorders in expecting and new fathers were mainly treated in primary care with cumulative incidence of prescriptions for psychotropic medication of 14.56 per 1000 births during the first year of fatherhood.

    Limitations

    We only capture fathers who actively sought and received treatment, and we consequently underestimate milder psychiatric episodes in expecting and new fathers.

    Conclusion

    Becoming a father did not appear to trigger a substantially increased risk of severe psychiatric disorders, as it has been observed for new mothers.

  • 322.
    Bang Madsen, Kathrine
    et al.
    NCRR - National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.
    Robakis, Thalia K.
    Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    Liu, Xiaoqin
    NCRR - National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.
    Momen, Natalie
    NCRR - National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dreier, Julie Werenberg
    NCRR - National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
    Kildegaard, Helene
    Hans Christian Andersen's Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark.
    Groth, Jane Bjerg
    Department of Otorhinolaryngology and Audiology, Zealand University Hospital, Universty of Copenhagen, Køge, Denmark.
    Newcorn, Jeffrey H.
    Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    Hove Thomsen, Per
    Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Research Center at the Department for Child- and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Denmark.
    Munk-Olsen, Trine
    NCRR - National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; Research Unit of Psychiatry, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.
    Bergink, Veerle
    Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.
    In utero exposure to ADHD medication and long-term offspring outcomes2023In: Molecular Psychiatry, ISSN 1359-4184, E-ISSN 1476-5578, Vol. 28, no 4, p. 1739-1746Article in journal (Refereed)
    Abstract [en]

    Attention Deficit Hyperactivity Disorder (ADHD) medication is increasingly being used during pregnancy. Concerns have been raised as to whether ADHD medication has long-term adverse effects on the offspring. The authors investigated whether in utero exposure to ADHD medication was associated with adverse long-term neurodevelopmental and growth outcomes in offspring. The population-based cohort study in the Danish national registers included 1,068,073 liveborn singletons from 1998 to 2015 followed until any developmental diagnosis, death, emigration, or December 31, 2018. Children of mothers who continued ADHD medication (methylphenidate, amphetamine, dexamphetamine, lisdexamphetamine, modafinil, atomoxetine, clonidine) during pregnancy and children of mothers who discontinued ADHD medication before pregnancy were compared using Cox regression. Main outcomes were neurodevelopmental psychiatric disorders, impairments in vision or hearing, epilepsy, seizures, or growth impairment during childhood or adolescence. In total, 898 children were exposed to ADHD medication during pregnancy compared to 1270 children whose mothers discontinued ADHD medication before pregnancy. After adjustment for demographic and psychiatric characteristics of the mother, no increased risk of any offspring developmental disorders was found combined (aHR 0.97, 95% CI 0.81 to 1.17) or for separate subcategories. Similarly, no increased risk was found for any sub-categories of outcomes in the negative control or sibling controlled analyses. Neurodevelopment and growth in offspring do not differ based on antenatal exposure to ADHD medication. These findings provide reassurance for women with ADHD who depend on ADHD medication for daily functioning and who consider continuing medication in pregnancy.

  • 323.
    Bang, Peter
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
    Kidane Andemichael, Danait
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
    Pieslinger, Johan
    Igelström, Kajsa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
    Sensory symptoms associated with autistic traits and anxiety levels in children aged 6–11 yearsManuscript (preprint) (Other academic)
    Abstract [en]

    Autism spectrum conditions (ASC) and quantitative autistic traits (QATs) are associated with sensory symptoms, which may contribute to anxiety and adversely affect social and cognitive development. Although sensory symptoms can occur across all senses, the relative roles of specific sensory modalities as contributors to the autistic phenotype and to anxiety are not well understood. The objective of this study was to examine which sensory symptoms were most predictive of high anxiety. We recruited 257 female primary caregivers of children aged 6 to 11 years (49 % girls) to a questionnaire study comprising parent-report measures for classical QATs (social, communicative, and rigid), autism-related sensorimotor symptoms (visual, auditory, tactile, olfactory, gustatory, vestibular, proprioceptive, and motor), and anxiety symptoms. First, Bayesian stochastic search variable selection (SSVS) was used to identify the most probable sensorimotor predictors of specific QATs as well as diagnosed ASC. Then, the selected predictors were used in another SSVS, using anxiety symptoms as a dependent variable, to identify which of the autism-relevant sensorimotor symptoms were most robustly predictive of anxiety. Finally, the effect sizes of anxiety-related sensory symptoms were estimated with linear regressions. We found that auditory symptoms and motor difficulties were most predictive of ASC diagnosis. Developmental motor difficulties were also strongly related to all individual QATs, whereas auditory symptoms were more selectively predictive of rigid traits. Tactile symptoms robustly predicted social interaction QATs, and proprioceptive symptoms predicted communicative QATs. Anxiety outcomes were most predicted by difficulties with auditory and olfactory processing. The results support the clinical importance of being alert to complaints about sounds and hearing in neurodevelopmental populations, and that auditory processing difficulties may be evaluated as an early marker of poor mental health in children with and without diagnosed autism. Olfactory processing differences appeared to be an anxiety marker less strongly associated with ASC or QATs, while motor difficulties were highly autism-relevant but not equally strongly associated with anxiety outcomes. We suggest that future studies may focus on the mechanisms and consequences of neurodevelopmental central auditory processing dysfunction and its potential relationship to anxiety disorders.

  • 324.
    Barchiesi, Riccardo
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Overlapping Neural Substrates of Alcohol- and Anxiety-Related Behavior in the Rat2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Alcohol use is a leading cause of death and disease worldwide. A large part of this disease burden is associated with alcohol use disorder (AUD), a diagnostic category characterized by excessive use in spite of negative consequences ("compulsive use"), a loss of control over intake, and choice of alcohol over natural rewards. These behavioral symptoms are believed to reflect the emergence of persistent neuroadaptations in key brain regions that exert control over motivated behavior. A major challenge to addressing the treatment needs of patients with AUD is the high prevalence of co-occurring psychiatric disorders, of which anxiety disorders are the most common. Both AUD and anxiety disorders are characterized by broad changes in gene expression within brain regions that include the prelimbic cortex (PL) and the amygdala complex. Although the risk for AUD has a substantial genetic component, heavy alcohol use and stress also contribute to disease risk. 

    Our lab previously identified DNA hypermethylation as a mechanism behind alcohol-induced downregulation of prelimbic Syt1 and Prdm2. In a subsequent study, our lab demonstrated a functional role of Prdm2 in alcohol-associated behaviors. In the work that constitutes this thesis, we have further investigated the behavioral consequences of Syt1 and Prdm2 downregulation. We found that Syt1 knock-down in the PL of non-dependent rats is sufficient to promote several behaviors that model critical aspects of AUD. We further identified the PL-basolateral amygdala (BLA) projection as a key brain circuit within which Syt1 knock-down promotes compulsive-like alcohol intake. In another study, we showed that Prdm2 knock-down in the PL increases the expression of fear memory, a central feature of anxiety disorders. Knock-down after memory formation (consolidation) did not increase the fear expression, indicating that Prdm2 regulates fear memory consolidation. We further showed that knock-down of Prdm2 in the PL-BLA projection was sufficient to promote the increased fear expression. Transcriptome analysis specifically in neurons projecting from the PL to the BLA showed a marked up-regulation of genes involved in synaptogenesis, suggesting that Prdm2 downregulation leads to excessive fear by strengthening fear memory consolidation in the PL-BLA circuit. 

    In a third study, we used a model of social defeat- and witness stress to investigate mechanisms of co-occurring escalated alcohol intake and increased anxiety-like behavior ("comorbidity"). We recapitulated the broad range of individual stress responses observed in human populations. With gene expression analysis, we identified a marked upregulation of Avp in the amygdala of rats with "co-morbid" characteristics, and this upregulation correlated with the magnitude of the comorbidity. 

    Together, our findings highlight the contribution of epigenetic mechanisms in regulating the behavioral consequences of alcohol-dependence, and identify specific downstream target genes whose expression is influenced by alcohol-induced epigenetic reprogramming to mediate long-term behavioral consequences. Our work also identifies amygdala Avp as a possible neurobiological substrate of individual susceptibility for stress-induced alcohol- and anxiety-related behaviors.

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  • 325.
    Barclay, Kieron
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. London School of Economics and Political Science, UK; Max Planck Institute for Demographic Research, Germany.
    Myrskylä, Mikko
    Tynelius, Per
    Berglind, Daniel
    Rasmussen, Finn
    Birth order and hospitalization for alcohol and narcotics use in Sweden2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 167, p. 15-22Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have shown that birth order is an important predictor of later life health as well as socioeconomic attainment. In this study, we examine the relationship between birth order and hospitalization for alcohol and narcotics use in Sweden. Methods: We study the relationship between birth order and hospitalization related to alcohol and narcotics use before and after the age of 20 using Swedish register data for cohorts born 1987-1994. We apply Cox proportional hazard models and use sibling fixed effects, eliminating confounding by factors shared by the siblings. Results: Before age 20 we find that later born siblings are hospitalized for alcohol use at a higher rate than first-borns, and there is a monotonic increase in the hazard of hospitalization with increasing birth order. Second-borns are hospitalized at a rate 47% higher than first-borns, and third-borns at a rate 65% higher. Similar patterns are observed for hospitalization for narcotics use. After age 20 the pattern is similar, but the association is weaker. These patterns are consistent across various sibling group sizes. Conclusions: Later born siblings are more likely to be hospitalized for both alcohol and narcotics use in Sweden. These birth order effects are substantial in size, and larger than the estimated sex differences for the risk of hospitalization related to alcohol and drug use before age 20, and previous estimates for socioeconomic status differences in alcohol and drug abuse.

  • 326. Barenbaum, Joshua
    et al.
    Ruchkin, Vladislav
    Yale University.
    Schwab-Stone, Mary
    The psychosocial aspects of children exposed to war: practice and policy initiatives.2004In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 45, no 1, p. 41-62Article in journal (Refereed)
    Abstract [en]

    The atrocities of war have detrimental effects on the development and mental health of children that have been documented since World War II. To date, a considerable amount of knowledge about various aspects of this problem has been accumulated, including the ways in which trauma impacts child mental health and development, as well as intervention techniques, and prevention methods. Considering the large populations of civilians that experience the trauma of war, it is timely to review existing literature, summarize approaches for helping war-affected children, and suggest future directions for research and policy.

  • 327. Barnevik Olsson, Martina
    et al.
    Holm, Anette
    Westerlund, Joakim
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Cognitive psychology. Gothenburg University, Sweden.
    Lundholm Hedvall, Åsa
    Gillberg, Christopher
    Fernell, Elisabeth
    Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age2017In: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 13, p. 2519-2526Article in journal (Refereed)
    Abstract [en]

    Background: Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as high-functioning, that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70-84) is limited. Methods: From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5-6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36). Results: Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84. Conclusion: None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support.

  • 328. Barnevik Olsson, Martina
    et al.
    Westerlund, Joakim
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Gothenburg University, Sweden.
    Lundstrom, Sebastian
    Giacobini, MaiBritt
    Fernell, Elisabeth
    Gillberg, Christopher
    Recovery from the diagnosis of autism - and then?2015In: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 11, p. 999-1005Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to follow up the 17 children, from a total group of 208 children with autism spectrum disorder (ASD), who recovered from autism. They had been clinically diagnosed with ASD at or under the age of 4 years. For 2 years thereafter they received intervention based on applied behavior analysis. These 17 children were all of average or borderline intellectual functioning. On the 2-year follow-up assessment, they no longer met criteria for ASD. Methods: At about 10 years of age they were targeted for a new follow-up. Parents were given a semistructured interview regarding the child's daily functioning, school situation, and need of support, and were interviewed using the Vineland Adaptive Behavior Scales (VABS) and the Autism - Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) telephone interview. Results: The vast majority of the children had moderate-to-severe problems with attention/activity regulation, speech and language, behavior, and/or social interaction. A majority of the children had declined in their VABS scores. Most of the 14 children whose parents were A-TAC-interviewed had problems within many behavioral A-TAC domains, and four (29%) had symptom levels corresponding to a clinical diagnosis of ASD, AD/HD, or both. Another seven children (50%) had pronounced subthreshold indicators of ASD, AD/HD, or both. Conclusion: Children diagnosed at 2-4 years of age as suffering from ASD and who, after appropriate intervention for 2 years, no longer met diagnostic criteria for the disorder, clearly needed to be followed up longer. About 3-4 years later, they still had major problems diagnosable under the umbrella term of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). They continued to be in need of support, educationally, from a neurodevelopmental and a medical point of view. According to parent interview data, a substantial minority of these children again met diagnostic criteria for ASD.

  • 329.
    Barrett, Elizabeth
    et al.
    Univ Coll Dublin, Ireland; Childrens Univ Hosp, Ireland.
    Jacobs, Brian
    South London and Maudsley Hosp, England; European Union Med Specialists UEMS CAP, Belgium.
    Klasen, Henrikje
    Leiden Univ, Netherlands.
    Herguner, Sabri
    Private Practice, Turkey.
    Agnafors, Sara
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences.
    Banjac, Visnja
    Univ Clin Ctr Republ Srpska, Bosnia and Herceg.
    Bezborodovs, Nikita
    Riga Stradins Univ, Latvia.
    Cini, Erica
    East London Fdn Trust, England.
    Hamann, Christoph
    Univ Bern, Switzerland.
    Huscsava, Mercedes M.
    Med Univ Vienna, Austria.
    Kostadinova, Maya
    Univ Hosp Alexandrovska, Bulgaria; DNCC CAMHS, Ireland.
    Kramar, Yuliia
    TMA PSYCHIAT, Ukraine.
    Maravic, Vanja Mandic
    Inst Mental Hlth, Serbia.
    McGrath, Jane
    Cherry Orchard Hosp, Ireland.
    Molteni, Silvia
    Univ Pavia, Italy.
    Moron-Nozaleda, Maria Goretti
    Neurodev Outpatient Clin, Spain; Hosp Infantil Univ Nino Jesus, Spain.
    Mudra, Susanne
    Univ Med Ctr Hamburg Eppendorf, Germany.
    Nikolova, Gordana
    Univ Clin Psychiat, North Macedonia.
    Vorkas, Kallistheni Pantelidou
    Cypriot Soc Child and Adolescent Psychiat, Cyprus.
    Prata, Ana Teresa
    Hosp Dona Estefania, Portugal.
    Revet, Alexis
    Univ Toulouse 3, France.
    Joseph, Judeson Royle
    Univ Hosp North Norway, Norway.
    Serbak, Reelika
    Tallinn Childrens Hosp, Estonia.
    Tomac, Aran
    CAMHS Clare, Ireland.
    Van den Steene, Helena
    Univ Antwerp, Belgium.
    Xylouris, Georgios
    Gen Childrens Hosp Agia Sophia, Greece.
    Zielinska, Anna
    Med Univ Warsaw, Poland.
    Hebebrand, Johannes
    Univ Duisburg Essen, Germany.
    Correction: The child and adolescent psychiatry: study of training in Europe (CAP-STATE) (vol 74, pg 231, 2020)2020In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 29, p. 409-411Article in journal (Other academic)
    Abstract [en]

    The original article has been corrected.

  • 330.
    Barth, Claudia
    et al.
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Kelly, Sinead
    Kings Coll London, Dept Psychosis Studies, London, England..
    Nerland, Stener
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Jahanshad, Neda
    Univ Southern Calif, Mark Mary Stevens Neuroimaging Informat Inst, Keck Sch Med, Imaging Genet Ctr, Marina Del Rey, CA USA..
    Alloza, Clara
    Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth, Dept Child & Adolescent Psychiat, IiSGM, Madrid, Spain..
    Ambrogi, Sonia
    Santa Lucia Fdn IRCCS, Lab Neuropsychiat, Rome, Italy..
    Andreassen, Ole A.
    Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway.;Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Andreou, Dimitrios
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway.;Karolinska Inst Stockholm Hlth Care Serv, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden..
    Arango, Celso
    Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth, Dept Child & Adolescent Psychiat, IiSGM, Madrid, Spain.;Univ Complutense, Sch Med, Madrid, Spain..
    Baeza, Inmaculada
    Univ Barcelona, August Pi Sunyer Biomed Res Inst IDIBAPS, Dept Child & Adolescent Psychiat & Psychol, Inst Neurosci, 2017SGR881, Barcelona, Spain..
    Banaj, Nerisa
    Santa Lucia Fdn IRCCS, Lab Neuropsychiat, Rome, Italy..
    Bearden, Carrie E.
    UCLA, Semel Inst Neurosci & Human Behav, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA.;UCLA, Dept Psychol, Los Angeles, CA USA..
    Berk, Michael
    Deakin Univ, Inst Mental & Phys Hlth & Clin Translat, Sch Med, Barwon Hlth, Geelong, Vic, Australia..
    Bohman, Hannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Child and Adolescent Psychiatry. Karolinska Inst, Dept Clin Sci & Educ Sodersjukhuset, Stockholm, Sweden..
    Castro-Fornieles, Josefina
    Univ Barcelona, August Pi Sunyer Biomed Res Inst IDIBAPS, Dept Child & Adolescent Psychiat & Psychol, Inst Neurosci, 2017SGR881, Barcelona, Spain..
    Chye, Yann
    Monash Univ, Turner Inst Brain & Mental Hlth & Sch Psychol Sci, Melbourne, Vic, Australia..
    Crespo-Facorro, Benedicto
    Univ Seville, Hosp Univ Virgen Rocio, Dept Psychiat, CIBERSAM, Seville, Spain..
    de la Serna, Elena
    Univ Barcelona, August Pi Sunyer Biomed Res Inst IDIBAPS, Dept Child & Adolescent Psychiat & Psychol, Inst Neurosci, 2017SGR881, Barcelona, Spain..
    Diaz-Caneja, Covadonga M.
    Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth, Dept Child & Adolescent Psychiat, IiSGM, Madrid, Spain.;Univ Complutense, Sch Med, Madrid, Spain..
    Gurholt, Tiril P.
    Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway.;Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Hegarty, Catherine E.
    UCLA, Dept Psychol, Los Angeles, CA USA..
    James, Anthony
    Warneford Hosp, Highfield Unit, Oxford, England.;Warneford Hosp, Highfield Unit, Oxford, England..
    Janssen, Joost
    Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth, Dept Child & Adolescent Psychiat, IiSGM, Madrid, Spain..
    Johannessen, Cecilie
    Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Jönsson, Erik G.
    Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway.;Karolinska Inst Stockholm Hlth Care Serv, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden..
    Karlsgodt, Katherine H.
    UCLA, Semel Inst Neurosci & Human Behav, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA.;UCLA, Dept Psychol, Los Angeles, CA USA..
    Kochunov, Peter
    Univ Oxford, Dept Psychiat, Oxford, England..
    Lois, Noemi G.
    Univ Maryland, Dept Psychiat, Maryland Psychiat Res Ctr, Sch Med, Baltimore, MA USA..
    Lundberg, Mathias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Child and Adolescent Psychiatry. Karolinska Inst, Dept Clin Sci & Educ Sodersjukhuset, Stockholm, Sweden..
    Myhre, Anne M.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Sect Child & Adolescent Mental Hlth Res, Oslo, Norway..
    Pascual-Diaz, Sauel
    Univ Barcelona, August Pi Sunyer Biomed Res Inst IDIBAPS, Magnet Resonance Imaging Core Facil, Barcelona, Spain..
    Piras, Fabrizio
    Santa Lucia Fdn IRCCS, Lab Neuropsychiat, Rome, Italy..
    Smelror, Runar E.
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Spalletta, Gianfranco
    Santa Lucia Fdn IRCCS, Lab Neuropsychiat, Rome, Italy.;Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX USA..
    Stokkan, Therese S.
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Sugranyes, Gisela
    Univ Barcelona, August Pi Sunyer Biomed Res Inst IDIBAPS, Dept Child & Adolescent Psychiat & Psychol, Inst Neurosci, 2017SGR881, Barcelona, Spain..
    Suo, Chao
    Monash Univ, Turner Inst Brain & Mental Hlth & Sch Psychol Sci, Melbourne, Vic, Australia..
    Thomopoulos, Sophia I.
    Univ Southern Calif, Mark Mary Stevens Neuroimaging Informat Inst, Keck Sch Med, Imaging Genet Ctr, Marina Del Rey, CA USA..
    Tordesillas-Gutierrez, Diana
    Marques Valdecilla Univ Hosp, Valdecilla Biomed Res Inst IDIVAL, Dept Radiol, Santander, Spain.;Inst Fis Cantabria UC CSIC, Advanced Comp & Sci, Santander, Spain..
    Vecchio, Daniela
    Santa Lucia Fdn IRCCS, Lab Neuropsychiat, Rome, Italy..
    Wedervang-Resell, Kirsten
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Wortinger, Laura A.
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway..
    Thompson, Paul M.
    Univ Southern Calif, Mark Mary Stevens Neuroimaging Informat Inst, Keck Sch Med, Imaging Genet Ctr, Marina Del Rey, CA USA..
    Agartz, Ingrid
    Diakonhjemmet Hosp, Dept Psychiat Res, Oslo, Norway.;Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway.;Karolinska Inst Stockholm Hlth Care Serv, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden..
    In vivo white matter microstructure in adolescents with early-onset psychosis: a multi-site mega-analysis2023In: Molecular Psychiatry, ISSN 1359-4184, E-ISSN 1476-5578, Vol. 28, p. 1159-1169Article in journal (Refereed)
    Abstract [en]

    Emerging evidence suggests brain white matter alterations in adolescents with early-onset psychosis (EOP; age of onset <18 years). However, as neuroimaging methods vary and sample sizes are modest, results remain inconclusive. Using harmonized data processing protocols and a mega-analytic approach, we compared white matter microstructure in EOP and healthy controls using diffusion tensor imaging (DTI). Our sample included 321 adolescents with EOP (median age=16.6 years, interquartile range (IQR)=2.14, 46.4% females) and 265 adolescent healthy controls (median age=16.2 years, IQR=2.43, 57.7% females) pooled from nine sites. All sites extracted mean fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) for 25 white matter regions of interest per participant. ComBat harmonization was performed for all DTI measures to adjust for scanner differences. Multiple linear regression models were fitted to investigate case-control differences and associations with clinical variables in regional DTI measures. We found widespread lower FA in EOP compared to healthy controls, with the largest effect sizes in the superior longitudinal fasciculus (Cohen's d=0.37), posterior corona radiata (d=0.32), and superior fronto-occipital fasciculus (d=0.31). We also found widespread higher RD and more localized higher MD and AD. We detected significant effects of diagnostic subgroup, sex, and duration of illness, but not medication status. Using the largest EOP DTI sample to date, our findings suggest a profile of widespread white matter microstructure alterations in adolescents with EOP, most prominently in male individuals with early-onset schizophrenia and individuals with a shorter duration of illness.

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  • 331. Bartoli, E.
    et al.
    Wadji, D. L.
    Oe, M.
    Cheng, P.
    Martin-Soelch, C.
    Pfaltz, Monique C.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Langevin, R.
    Perceived Acceptability of Child Maltreatment as a Moderator of the Association Between Experiences of Child Maltreatment and Post-Traumatic Symptoms: A Cross-Cultural Study2024In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518Article in journal (Refereed)
    Abstract [en]

    Despite the well-documented link between child maltreatment (CM) and mental health, evidence suggests substantial variability in the post-traumatic sequelae of CM across cultures. The perceived acceptability of CM in one’s community might moderate the association between CM and mental health, but little research has been conducted on it so far. This study examined how the perceived acceptability of CM may influence the relationship between CM experiences and post-traumatic symptoms in individuals from four different continents and if the pattern of associations is the same across countries. We recruited a sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122). We administered online questionnaires and performed multiple group moderation analyses for total CM, neglect, physical abuse, emotional maltreatment, sexual abuse, and exposure to domestic violence (DV). A significant positive main effect of CM on post-traumatic symptoms was found in the overall sample and in Cameroon; in Germany, only neglect and emotional maltreatment were positively associated to post-traumatic symptoms. Moderation effects were identified; the perceived acceptability of neglect in Cameroon and Germany and of exposure to DV in Cameroon had a dampening effect on the relationship between CM experiences and post-traumatic symptoms. Our findings confirm that CM experiences entail long-term post-traumatic sequelae that can vary across cultures and CM subtypes and further our understanding of this issue by showing that the perceived acceptability of CM may be an understudied moderator. 

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  • 332. Bashir, Khuram
    et al.
    Sjögren, Magnus
    Afsnit for spiseforstyrrelser, Psykiatrisk Center Ballerup, Ballerup, Danmark.
    Klit, Jakob
    Stressfraktur i bilateral rami hos en kvinde med anorexia nervosa2019In: Ugeskrift for læger, ISSN 0041-5782, E-ISSN 1603-6824, Vol. 181, no 12, article id V10180702Article in journal (Refereed)
    Abstract [en]

    This is a case report of a 51-year-old woman with bilateral stress fractures of the pelvic rami and a history of anorexia nervosa (AN). AN is a psychiatric condition of low weight caused by restricted food intake, impaired body image and an exaggerated fear of gaining weight in addition to compensating behaviour such as excessive physical activity. Among patients with AN, reduced bone density is common, and a higher risk of fractures is present. Stress fractures should be suspected in patients, who have AN and experience pain from the musculoskeletal system without a history of trauma.

  • 333. Bas-Hoogendam, Janna Marie
    et al.
    van Steenbergen, Henk
    Pannekoek, J. Nienke
    Fouche, Jean-Paul
    Lochner, Christine
    Hattingh, Coenraad J.
    Cremers, Henk R.
    Furmark, Tomas
    Månsson, Kristoffer
    Frick, Andreas
    Engman, Jonas
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Carlbring, Per
    Andersson, Gerhard
    Fredriksson, Mats
    Straube, Thomas
    Peterburs, Jutta
    Klumpp, Heide
    Phan, K. Luan
    Roelofs, Karin
    Veltman, Dick J.
    van Tol, Marie-Jose
    Stein, Dan J.
    van der Wee, Nic J. A.
    Voxel-based morphometry multi-center mega-analysis of brain structure in social anxiety disorder2017In: NeuroImage: Clinical, E-ISSN 2213-1582, Vol. 16, p. 678-688Article in journal (Refereed)
    Abstract [en]

    Social anxiety disorder (SAD) is a prevalent and disabling mental disorder, associated with significant psychiatric comorbidity. Previous research on structural brain alterations associated with SAD has yielded inconsistent results concerning the direction of the changes in graymatter (GM) in various brain regions, as well as on the relationship between brain structure and SAD-symptomatology. These heterogeneous findings are possibly due to limited sample sizes. Multisite imaging offers new opportunities to investigate SAD-related alterations in brain structure in larger samples. An international multi-center mega-analysis on the largest database of SAD structural T1-weighted 3T MRI scans to date was performed to compare GM volume of SAD-patients (n = 174) and healthy control (HC)-participants (n = 213) using voxel-based morphometry. A hypothesis-driven region of interest (ROI) approach was used, focusing on the basal ganglia, the amygdala-hippocampal complex, the prefrontal cortex, and the parietal cortex. SAD-patients had larger GM volume in the dorsal striatum when compared to HC-participants. This increase correlated positively with the severity of self-reported social anxiety symptoms. No SAD-related differences in GM volume were present in the other ROIs. Thereby, the results of this mega-analysis suggest a role for the dorsal striatum in SAD, but previously reported SAD-related changes in GM in the amygdala, hippocampus, precuneus, prefrontal cortex and parietal regions were not replicated. Our findings emphasize the importance of large sample imaging studies and the need for meta-analyses like those performed by the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium.

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  • 334. Bas-Hoogendam, Janna Marie
    et al.
    van Steenbergen, Henk
    Pannekoek, J. Nienke
    Fouche, Jean-Paul
    Lochner, Christine
    Hattingh, Coenraad J.
    Cremers, Henk R.
    Furmark, Tomas
    Månsson, Kristoffer N. T.
    Frick, Andreas
    Engman, Jonas
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Carlbring, Per
    Andersson, Gerhard
    Fredrikson, Mats
    Straube, Thomas
    Peterburs, Jutta
    Klumpp, Heide
    Phan, K. Luan
    Roelofs, Karin
    Stein, Dan J.
    van der Wee, Nic. J. A.
    Sample Size Matters: A Voxel-Based Morphometry Multi-Center Mega-Analysis of Gray Matter Volume in Social Anxiety Disorder2017In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 81, no 10, p. S7-S7Article in journal (Refereed)
  • 335.
    Bauer, A. Z.
    et al.
    University of Massachusetts, USA.
    Kriebel, D.
    University of Massachusetts, USA.
    Herbert, M. R.
    Harvard Medical School, USA.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Icahn School of Medicine at Mount Sinai, USA.
    Swan, S. H.
    Icahn School of Medicine at Mount Sinai, USA.
    Prenatal paracetamol exposure and child neurodevelopment: A review2018In: Hormones and Behavior, ISSN 0018-506X, E-ISSN 1095-6867, Vol. 101, p. 125-147Article in journal (Refereed)
    Abstract [en]

    Background: The non-prescription medication paracetamol (acetaminophen, APAP) is currently recommended as a safe pain and fever treatment during pregnancy. However, recent studies suggest a possible association between APAP use in pregnancy and offspring neurodevelopment. Objectives: To conduct a review of publications reporting associations between prenatal APAP use and offspring neurodevelopmental outcomes. Methods: Relevant sources were identified through a key word search of multiple databases (Medline, CINAHL, OVID and TOXNET) in September 2016. All English language observational studies of pregnancy APAP and three classes of neurodevelopmental outcomes (autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intelligence quotient (IQ)) were included. One reviewer (AZB) independently screened all titles and abstracts, extracted and analyzed the data. Results: 64 studies were retrieved and 55 were ineligible. Nine prospective cohort studies fulfilled all inclusion criteria. Data pooling was not appropriate due to heterogeneity in outcomes. All included studies suggested an association between prenatal APAP exposure and the neurodevelopmental outcomes; ADHD, ASD, or lower IQ. Longer duration of APAP use was associated with increased risk. Associations were strongest for hyperactivity and attention-related outcomes. Little modification of associations by indication for use was reported. Conclusions: Together, these nine studies suggest an increased risk of adverse neurodevelopmental outcomes following prenatal APAP exposure. Further studies are urgently needed with; precise indication of use and exposure assessment of use both in utero and in early life. Given the current findings, pregnant women should be cautioned against indiscriminate use of APAP. These results have substantial public health implications.

  • 336. Bauer, Amy M
    et al.
    Fielke, Ken
    Brayley, John
    Araya, Mesfin
    Alem, Atalay
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Frankel, Bernard L
    Fricchione, Gregory L
    Tackling the global mental health challenge: a psychosomatic medicine/consultation-liaison psychiatry perspective2010In: Psychosomatics, ISSN 0033-3182, E-ISSN 1545-7206, Vol. 51, no 3, p. 185-193Article in journal (Refereed)
    Abstract [en]

    C-L psychiatrists have the potential to marshal their unique skill-set to reduce the global burden of mental disorders.

  • 337.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Commentary on: Sullivan and Willis (2018). Towards Changing the Long-Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 7, p. 639-640Article in journal (Refereed)
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  • 338.
    Bayram, Gökçe
    et al.
    Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey.
    McMahan, Allison
    Karolinska Institutet, Stockholm, Sweden.
    Juth, Niklas
    Karolinska Institutet, Stockholm, Sweden.
    Rahm, Christoffer
    Karolinska Institutet, Stockholm, Sweden.
    Health care professionals’ view on pedophilic disorder: a qualitative study2021In: Sexual and Relationship Therapy, ISSN 1468-1994, E-ISSN 1468-1749, Vol. 38, no 4, p. 684-695Article in journal (Refereed)
    Abstract [en]

    In the last few years there has been a shift in the view on pedophilia and its treatment in international diagnostic manuals and expert consensus documents. This study seeks to investigate the approach of health care professionals’ on some of the topics that are mostly debated: whether pedophilia without distress or acting out should be considered a mental disorder, whether there can be a changeability of pedophilic sexual interest over life and what the main aim of treatment should be. Qualitative content analysis was used to analyze the responses in semi-structured interviews of eight Swedish health care professionals with significant clinical experience from this patient category. These results suggest that there is a lack of consensus regarding all three topics, and that the opinions of the experienced health care professionals did not fully comply with the international experts agreements. This might lead to differences in clinical practice depending on who meets the patient, it can make the patients unsure about how they will be treated if they seek help, and it demonstrates a gap between published international research and clinical practice.

  • 339.
    Bechtouli, Nadia
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Oldrati, Satu
    Mälardalen University, School of Health, Care and Social Welfare.
    Den vårdande relationen inom psykiatrisk vård.: En litteraturstudie ur sjuksköterskeperspektiv.2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund Den vårdande relationen är kärnan i omvårdnaden. Patienterna beskriver att de behöver känna trygghet innan den vårdande relationen skapas. Psykiatrisjuksköterskan är skyldig att ansvara för att patienternas behov tillgodoses. Syfte Syftet är att synliggöra hur sjuksköterskor inom psykiatrisk vård beskriver den vårdande relationen. Vidare syftar studien till att synliggöra likheter och skillnader jämfört med hur den vårdande relationen gestaltas i den teoretiska referensramen. Den metod som ansågs vara mest lämplig för att besvara studien var en kvalitativ innehållsanalys. Med en deduktiv ansats, vilket beskrivs utifrån Elo och Kyngäs, (2008). Den teoretiska referensramen som valdes till studien utgår från Kaséns (2002) fyra aspekter av den vårdande relationen. I resultatet framkommer sjuksköterskors beskrivningar av den vårdande relationer och hur den kan gestaltas utifrån Kaséns fyra aspekter. Det framkom likheter och skillnader i resultatets analys del, vad sjuksköterskor beskrev som vårdande relationer. Slutsatser som kan tas utifrån studien är att den vårdande relationen har flera liknelser med patienternas beskrivning av den vårdande relationen. Även skillnader i deras beskrivningar av den vårdande relationen visades. Den vårdande relationen berörde sjuksköterskan lika väl som den berörde patienten.  Nyckelord: 

  • 340. Becklén, Meneca
    et al.
    Orhan, Funda
    Piehl, Fredrik
    Cervenka, Simon
    Sellgren, Carl M
    Flyckt, Lena
    Erhardt, Sophie
    Fatouros-Bergman, Helena
    Plasma bilirubin levels are reduced in first-episode psychosis patients and associates to working memory and duration of untreated psychosis.2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 7527Article in journal (Refereed)
    Abstract [en]

    Schizophrenia is a severe mental disorder and one of its characteristics is cognitive impairments. Findings regarding levels of the heme metabolite and plasma antioxidant bilirubin in schizophrenia are inconclusive. However, a recently published study indicate that low levels of bilirubin may be implicated in the memory impairments seen in the disorder. The aim of this cross-sectional study was to investigate the levels of bilirubin in individuals with a first-episode psychosis (FEP) and to examine if bilirubin levels were associated to cognitive impairments, symptoms and duration of untreated psychosis (DUP). Bilirubin levels were reduced in 39 individuals with FEP compared with 20 HC (median [IQR]: 11.0 [9.0-13.0] µM vs. 15.0 [11.5-18.5] µM). In individuals with FEP, bilirubin levels were also positively correlated to two working memory tests (r = 0.40 and r = 0.32) and inversely correlated to DUP (r = - 0.36). Findings were not influenced by confounding factors. The results confirm the antioxidant deficit previously seen in schizophrenia, but also indicate that these changes may be related to DUP. The study also confirms that bilirubin may be implicated in the cognitive deficits that accompanies the disorder, here for the first time presented in individuals with FEP.

  • 341.
    Beckman, K.
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; St Goran Hosp, Stockholm City Council, Stockholm, Sweden.
    Mittendorfer-Rutz, E.
    Department of Clinical Neuroscience, Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, P.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Almqvist, C
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Runeson, B.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; St Goran Hosp, Stockholm City Council, Stockholm, Sweden.
    Dahlin, M.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; St Goran Hosp, Stockholm City Council, Stockholm, Sweden.
    Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort2016In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, no 16, p. 3397-3405Article in journal (Refereed)
    Abstract [en]

    Background: Self-harm among young adults is a common and increasing phenomenon in many parts of the world. The long-term prognosis after self-harm at young age is inadequately known. We aimed to estimate the risk of mental illness and suicide in adult life after self-harm in young adulthood and to identify prognostic factors for adverse outcome.

    Method: We conducted a national population-based matched case-cohort study. Patients aged 18-24 years (n = 13 731) hospitalized after self-harm between 1990 and 2003 and unexposed individuals of the same age (n = 137 310 ) were followed until December 2009. Outcomes were suicide, psychiatric hospitalization and psychotropic medication in short-term (1-5 years) and long-term (>5 years) follow-up.

    Results: Self-harm implied an increased relative risk of suicide during follow-up [hazard ratio (HR) 16.4, 95% confidence interval (CI) 12.9-20.9). At long-term follow-up, 20.3% had psychiatric hospitalizations and 51.1% psychotropic medications, most commonly antidepressants and anxiolytics. There was a six-fold risk of psychiatric hospitalization (HR 6.3, 95% CI 5.8-6.8) and almost three-fold risk of psychotropic medication (HR 2.8, 95% CI 2.7-3.0) in long-term follow-up. Mental disorder at baseline, especially a psychotic disorder, and a family history of suicide were associated with adverse outcome among self-harm patients.

    Conclusion: We found highly increased risks of future mental illness and suicide among young adults after self-harm. A history of a mental disorder was an important indicator of long-term adverse outcome. Clinicians should consider the substantially increased risk of suicide among self-harm patients with psychotic disorders.

  • 342. Beckman, Karin
    et al.
    Lindh, Åsa
    Waern, Margda
    Strömsten, Lotta M. J.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Runesson, Bo
    Dahlin, Marie
    Impulsive suicide attempts among young people: a prospective multicentre cohort study in Sweden2019In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 243, p. 421-426Article in journal (Refereed)
    Abstract [en]

    Background: We aimed to compare the prevalence of impulsive suicide attempts (ISA) among young adults and those over 25 who present at hospital in connection with attempted suicide. We also aimed to identify factors associated with ISA in young adults and to assess medical severity as well as the probability of repeated suicide attempts in this age group.

    Method: A prospective multicentre cohort study included hospital known cases of suicide attempt (N = 666). The prevalence of ISA was compared between young adults (18-25) and adults aged > 26. We used logistic regression models to identify factors associated with ISA, associations of ISA with high medical severity and prediction of new fatal or non-fatal suicide attempts within 6 months.

    Results: 43.7% of the young patients had made an ISA, and 30.2% among those aged > 26 (p = 0.001). Among the young, substance use disorder was associated with ISA; crude odds ratio (OR) 2.0 (1.0-4.2), and adjusted OR 2.1 (0.99-4.4). Affective disorder and unemployment/sickness absence implied lower odds of ISA. ISA resulted in injuries of high medical severity as often as more planned attempts and non-fatal or fatal repetition within 6 months was equally common (30%) in both groups.

    Limitations: The study was set in psychiatric emergency services, which limits the generalizability.

    Conclusions: Clinicians should acknowledge that suicide attempts among youth often occur without previous planning and may result in medically severe injuries. The probability of new fatal or non-fatal suicide attempts should be kept in mind also after an impulsive suicide attempt.

  • 343.
    Beckman, Karin
    et al.
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm City Council, St Göran's Hospital, Stockholm, Sweden.
    Mittendorfer-Rutz, Ellenor
    Department of Clinical Neuroscience, Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
    Waern, Margda
    Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Runeson, Bo
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm City Council, St Göran's Hospital, Stockholm, Sweden.
    Dahlin, Marie
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm City Council, St Göran's Hospital, Stockholm, Sweden.
    Method of self-harm in adolescents and young adults and risk of subsequent suicide2018In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 59, no 5, p. 948-956Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-harm is common in youth and an important risk factor for suicide. Certain self-harm methods might indicate a higher risk of suicide. The main aim of this study was to determine whether some methods of self-harm in adolescents (10-17 years) and young adults (18-24 years) are associated with a particularly high risk of suicide. A secondary aim was to ascertain how different self-harm methods might affect the probability of psychiatric follow-up.

    METHOD: Five Swedish registers were linked in a national population-based cohort study. All nonfatal self-harm events recorded in specialist health care, excluding psychiatry and primary care services, among 10-24 year olds between 2000 and 2009 were included. Methods were classified as poisoning, cutting/piercing, violent method (gassing, hanging, strangulation/suffocation, drowning, jumping and firearms), other and multiple methods. Hazard Ratios (HR) for suicide were calculated in Cox regression models for each method with poisoning as the reference. Odds Ratios (OR) for psychiatric inpatient care were determined in logistic regression models. Analyses were adjusted for important covariates and stratified by age group and treatment setting (inpatient/outpatient).

    RESULTS: Among adolescents with initial medical hospitalisation, use of a violent method was associated with a near eightfold increase in HR for suicide compared to self-poisoning in the adjusted analysis [HR 7.8; 95% confidence interval (CI) 3.2-19.0]. Among hospitalised young adult women, adjusted HRs were elevated fourfold for both cutting [4.0 (1.9-8.8)] and violent methods [3.9 (1.5-10.6)]. Method of self-harm did not affect suicide risk in young adult men. Adolescents using violent methods had an increased probability of psychiatric inpatient care following initial treatment for self-harm.

    CONCLUSIONS: Violent self-harm requiring medical hospitalisation may signal particularly high risk of future suicide in adolescents (both sexes) and in young adult women. For the latter group this is the case for cutting requiring hospitalisation as well.

  • 344.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund Univ, Skane Univ Hosp, Dept Dermatol, Jan Waldenstroms Gatan 16, S-21428 Malmo, Sweden.
    Svensson, Mikael
    Sahlgrenska Univ, Hlth Metr Unit, Box 414, S-40530 Gothenburg, Sweden..
    Determinants of Antidepressants Use and Economic Costs: A Population Based Study2017In: Journal of Mental Health Policy and Economics, Vol. 20, no Suppl.1, p. S2-S2Article in journal (Other academic)
  • 345. Beckman, Ulrika
    et al.
    Degerblad, Marie
    Dhejne, Cecilia
    Papadopoulos, Fotis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Psychiatry.
    Fällberg, Lennart
    Holmberg, Jenny
    Hård, Vierge
    Årsrapport: Könsdysforiregistret 20212022Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Könsdysforiregistret (KDR) är ett nationellt kvalitetsregister med syfte att följa upp och utveckla den könsbekräftande vården i Sverige. Könsbekräftande vård är vård och behandling vid könsdysfori: ett psykiskt lidande eller en försämrad förmåga att fungera i vardagen som orsakas av att det vid födelsen tillskrivna könet inte stämmer överens med könsidentiteten. Vård vid könsdysfori tillhör såväl specialistpsykiatrin som varierande somatiska vårdområden.

    Registret ämnar följa personer livslångt och är unikt i sitt slag i världen. Flera specialiteter är involverade under utredning och behandling. Dessa är psykiatri, endokrinologi, plastikkirurgi, gynekologi, reproduktionsmedicin, logopedi, foniatri och dermatologi. Den könsbekräftande vården i landet är för närvarande centrerad till Lund, Göteborg/Alingsås, Linköping, Stockholm, Uppsala och Umeå samt till några andra orter. Vården följer de nationella kunskapsstöd som Socialstyrelsen har tagit fram (Socialstyrelsen 2015/2021).

    Vården vid könsdysfori är multidisciplinär och multiprofessionell. Ett nationellt kvalitetsregister behöver därför spegla hela vårdområdet och KDR avser att samla data från samtliga delar. Det innebär att uppgifter registreras av vuxenpsykiatrin och barn- och ungdomspsykiatrin, barnendokrinologi och vuxenendokrinologi, logopedi och plastikkirurgi. Registret skiljer sig från övriga nationella kvalitetsregister som vanligen samlar in uppgifter från en specialitet eller möjligen två. Vi har också ambitionen att följa patienter som påbörjat kontakten med barn- och ungdomspsykiatri och barnendokrinologi i registret för att erhålla långtidsinformation om denna grupp. KDR är anslutet till Registercentrum Syd i Lund sedan 2015 och IT-plattformen är 3C.

    Data började registreras i KDR 2017 och hade år 2021 17 registrerande enheter (av 35 möjliga). Det är ett 100-tal enskilda användare som är verksamma inom psykiatri, endokrinologi, logopedi och plastikkirurgi. Totalt deltar 1994 patienter i registret, varav 266 nya registreringar gjordes under 2021. Täckningsgraden varierar påtagligt mellan olika enheter i landet. Under 2021 och var det i medeltal 21 procent av psykiatrins nybesök som registrerades och drygt 40 procent av logopedins. Den totala täckningsgraden av patienter i landet uppskattas till 32 procent för registret i sin helhet 2021. Merparten av deltagarna i registret är mellan 18 och 25 år. I åldern 0–17 år var två tredjedelar tillskrivet kvinnligt kön vid födelsen. I äldre åldersgrupper var fördelningen utifrån tillskrivet kön vid födelsen jämnare.

    Före könsbekräftande behandling krävs utredning vid någon av landets sex utredningsenheter för könsdysfori. Det är stor skillnad på varifrån remisserna för utredning av könsdysfori kommer. När 7 möjligheten till egenremiss tydligt uttrycks är det 40–50 procent som väljer att skriva en egenremiss. Av samtliga deltagare hade 79,7 procent efter utredningen fått diagnosen F64.0 (Transsexualism), 6,6 procent F64.9 (Könsidentitetsstörning, ospecificerad) och 8,5 procent F64.8 (Andra specificerade könsidentitetsstörningar).

    En central kvalitetsindikator är väntetider. Sammanfattningsvis har väntetiderna till nybesök ökat kraftigt inom psykiatrins utredningsenheter, från i medeltal 9 månader föregående år till 17 månader 2021. De totala antalet faktiskt genomförda nybesök vid landets två största utredningsenheter har samtidigt minskat, och en enhet pausade utredningsverksamheten helt. Det är sammantaget en mycket oroväckande utveckling i den del av vårdkedjan som tar emot flest remisser per år.

    Inom endokrinologin gjordes mycket få nyregistreringar under året, men underlaget tyder på att vårdgarantin om 90 dagar hålls vid två enheter, medan väntetiden är 10 månader vid en tredje enhet. Logopedin har i medeltal 5 månaders väntetid, vilket är en förbättring gentemot tidigare år. Plastikkirurgin har nyss börjat registrera vid en enhet, denna enhet hade i medel 3,5 månads väntetid till sina nybesök.

    Eftersom endast delar av landets enheter registrerar och täckningsgraden är låg ger inte den data som presenterats i rapporten någon fullständig bild av den könsbekräftande vården i Sverige och informationen behöver tolkas med försiktighet. Eftersom vården utvecklas och kunskapsläget förändras snabbt har KDR behövt revideras flera gånger sedan starten. Information om utredning och behandling av barn och ungdomar har tillkommit, vilket krävt revidering av formulären framför allt inom psykiatri och endokrinologi under år 2020 och 2021. Detta har försenat enheter att komma i gång med registrering av data.

    Vi ser nu att registreringsgraden ökar 2022 i och med att viktiga uppdateringar är gjorda och nya formulär kan tas i bruk. De nya formulären innebär både förenklingar i inmatning av data och förbättrad datakvalitet. För mer aktuell data om väntetider och registrering hänvisas till hemsidan och Delårsrapport 2022-09-15. Denna årsrapport ska läsas med Årsrapport 2018 som bakgrund vad gäller den könsbekräftande vårdens historia i Sverige samt en mera utförlig kunskapssammanställning inklusive referenser. Det har ännu inte skett någon forskning på data från Könsdysforiregistret, vilket gör att inga egna artiklar kan presenteras. Mer information finns på registrets hemsida, www.konsdysforiregistret.se

  • 346.
    Beckson, Mace
    et al.
    David Geffen Sch Med, CA USA.
    Jones, A Wayne
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    Els, Charl
    Univ Alberta, Canada.
    Hagtvedt, Reidar
    Univ Alberta, Canada.
    Cannabis, crashes and blood: challenges for observational research2020In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 115, no 3, p. 589-590Article in journal (Other academic)
    Abstract [en]

    n/a

  • 347.
    Beda, Boniface
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Recovery at Suicide Attempts: A systematic review and meta-ethnography of qualitative research2021Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Suicide attempts have increased in recent years and are far more common than suicide. Suicide attempts are a significant public health problem that requires attention because it occurs in all cultures throughout the world. Recovery can be difficult, and the risk of another suicide attempt may be imminent. The recovery process is an individual experience. It requires effort by the person who needs to learn to manage the situation and find meaning in life. The aim of the current study was to integrate and synthesize prevailing knowledge of the patient's experiences of recovery after a suicide attempt. Methods: A qualitative meta-ethnography and systematic literature study was based on published empirical research studies that follow (PRISMA) guidelines and was synthesized and exposed to quality assessments. Systematic searches were conducted in databases CINAHL, PsycINFO and PubMed as well as Manual Search. Seven qualitative studies were identified focusing on knowledge of the patient's experiences of recovery after a suicide attempt. Results: The synthesis process of data was analysed in seven stages inspired by Noblit and Hare (1988). Two analytical themes emerged regarding experience of being aware was a crucial factor and experiences of togetherness was necessary for recovery. Four meta-themes emerged that show integrate knowledge of the patient's experiences of how to maintain health after a suicide attempt. Firstly, the suicidal individual needs to think constructively and secondly to release intense emotions that lead to hopelessness. Thirdly, the suicidal individual needs to have the ability to understand the meaning in life and lastly, to strive to establish personal goals to overcome difficulties. Conclusions: The attention of healthcare professionals is required to improve the recovery process for patients after a suicide attempt. It develops a deep understanding of suicidal patients that facilitates changes in suicidal behavior. In this way, the patient strives to continue to live a peaceful life, feel safe and satisfied. Increasing knowledge about how the patient recovers and the desire to become aware related to the experience of togetherness leads to a sense of credibility. A comprehensive picture of the patient's life situation is made clear through their life experience is necessary for suicide prevention.

  • 348. Been, Frederic
    et al.
    Bifisma, Lubertus
    Benaglia, Lisa
    Berset, Jean-Daniel
    Botero-Coy, Ana M.
    Castiglioni, Sara
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Zobel, Frank
    Schaub, Michael P.
    Buecheli, Alexander
    Hernandez, Felix
    Delemont, Olivier
    Esseiva, Pierre
    Ort, Christoph
    Assessing geographical differences in illicit drug consumption-A comparison of results from epidemiological and wastewater data in Germany and Switzerland2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 161, p. 189-199Article in journal (Refereed)
    Abstract [en]

    Background: Wastewater analysis is an innovative approach that allows monitoring illicit drug use at the community level. This study focused on investigating geographical differences in drug consumption by comparing epidemiological, crime and wastewater data. Methods: Wastewater samples were collected in 19 cities across Germany and Switzerland during one week, covering a population of approximately 8.1 million people. Self-report data and consumption offences for the investigated areas were used for comparison and to investigate differences between the indicators. Results: Good agreement between data sources was observed for cannabis and amphetamine-type stimulants, whereas substantial discrepancies were observed for cocaine. In Germany, an important distinction could be made between Berlin, Dortmund and Munich, where cocaine and particularly amphetamine were more prevalent, and Dresden, where methamphetamine consumption was clearly predominant. Cocaine consumption was relatively homogenous in the larger urban areas of Switzerland, although prevalence and offences data suggested a more heterogeneous picture. Conversely, marked regional differences in amphetamine and methamphetamine consumption could be highlighted. Conclusions: Combining the available data allowed for a better understanding of the geographical differences regarding prevalence, typology and amounts of substances consumed. For cannabis and amphetamine-type stimulants, the complementarity of survey, police and wastewater data could be highlighted, although notable differences could be identified when considering more stigmatised drugs (i.e. cocaine and heroin). Understanding illicit drug consumption at the national scale remains a difficult task, yet this research illustrates the added value of combining complementary data sources to obtain a more comprehensive and accurate picture of the situation.

  • 349.
    Behnsen, Pia
    et al.
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Buil, Joanne M.
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Koot, Susanne
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Huizink, Anja
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Van Lier, Poul
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Heart rate (variability) and the association between relational peer victimization and internalizing symptoms in elementary school children2020In: Development and psychopathology (Print), ISSN 0954-5794, E-ISSN 1469-2198, Vol. 32, no 2, p. 521-529, article id PII S0954579419000269Article in journal (Refereed)
    Abstract [en]

    Relational victimization typically emerges first during the elementary school period, and has been associated with increased levels of internalizing symptoms in children. Individual differences in autonomic nervous system functioning have been suggested as a potential factor linking social stressors and internalizing symptoms. The aim of this study was therefore to examine whether heart rate and heart rate variability mediated the association between relational victimization and internalizing symptoms in 373 mainstream elementary school children. Children were assessed in 2015 (T 0 ; Grades 3-5, M age = 9.78 years, 51% boys) and reassessed in 2016 (T 1 ). Heart rate and heart rate variability were assessed during a regular school day at T 1 . A multi-informant (teacher and peer report) cross-time measure of relational victimization, and a multi-informant (self- and teacher report) measure of internalizing problems at T 1 was used. Results showed that heart rate variability, but not heart rate, mediated the association between relational victimization and internalizing symptoms. This study provides tentative support that in children from a general population sample, a psychobiological factor may mediate the association of relational victimization with internalizing symptoms.

  • 350.
    Behrens, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Blekinge Centre of Competence, Blekinge Hospital Karlskrona, Karlskrona, Sweden.
    Eklund, Anders
    Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF). Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Elgh, Eva
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Smith, Cynthia
    Williams, Michael A
    Malm, Jan
    A computerized neuropsychological test battery designed for idiopathic normal pressure hydrocephalus2014In: Fluids and Barriers of the CNS, E-ISSN 2045-8118, Vol. 11, article id 22Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A tool for standardized and repeated neuropsychological assessments in patients with idiopathic normal pressure hydrocephalus (INPH) is needed. The objective of this study was to develop a computerized neuropsychological test battery designed for INPH and to evaluate its reliability, validity and patient's ability to complete the tests.

    METHODS: Based on a structured review of the literature on neuropsychological testing in INPH, the eight tests most sensitive to the INPH cognitive profile were implemented in a computerized format. The Geriatric Depression Scale (GDS) was also included. Tests were presented on a touch-screen monitor, with animated instructions and speaker sound. The battery was evaluated with the following cohorts: A. Test-retest reliability, 44 healthy elderly; B. Validity against standard pen and pencil testing, 28 patients with various cognitive impairments; C. Ability to complete test battery, defined as completion of at least seven of the eight tests, 40 investigated for INPH.

    RESULTS: A. All except the figure copy test showed good test-retest reliability, r = 0.67-0.90; B. A high correlation was seen between conventional and computerized tests (r = 0.66-0.85) except for delayed recognition and figure copy task; C. Seventy-eight percent completed the computerized battery; Patients diagnosed with INPH (n = 26) performed worse on all tests, including depression score, compared to healthy controls.

    CONCLUSIONS: A new computerized neuropsychological test battery designed for patients with communicating hydrocephalus and INPH was introduced. Its reliability, validity for general cognitive impairment and completion rate for INPH was promising. After exclusion of the figure copy task, the battery is ready for clinical evaluation and as a next step we suggest validation for INPH and a comparison before and after shunt surgery.

    TRIAL REGISTRATION: ClinicalTrials.org NCT01265251.

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