| 41. |
- Dahlberg, Karin M, et al.
(författare)
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Mental health literacy and attitudes in a Swedish community sample - investigating the role of personal experience of mental health care.
- 2008
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mental ill health is a common condition in the general population, yet only about half of those with a mental disorder have treatment contact. Personal experience may affect attitudes, which in turn influence the help-seeking process. This study investigated differences in mental health literacy and attitudes among mentally healthy persons and in persons with symptoms of mental illness with and without treatment contact. METHOD: A postal screening questionnaire was sent to a random sample of the general population aged 20-64 in the county of Skaraborg, Sweden in order to ascertain mental health status and history of treatment contact; 3538 responded (49%). Face-to-face interviews were carried out in random sub samples of mentally healthy persons (n = 128) and in mentally ill persons with (n = 125) and without (n = 105) mental health care contact. Mental health literacy and attitudes to treatment were assessed using questions based on a vignette depicting a person with depression. Past month mental disorder was diagnosed according to the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). RESULTS: Two thirds failed to recognize depression in a vignette; recognition was equally poor in mentally healthy persons and in persons with symptoms of mental illness with and without treatment contact. In response to an open-ended question concerning appropriate interventions, one third suggested counselling and only one percent proposed antidepressant treatment. Again, proportions were similar in all groups. Persons with a history of mental health contact more often suggested that a GP would provide the best form of help. When presented with a list of possible interventions, those with a history of mental health contact were more positive to medical interventions such as antidepressants, hypnotics, and inpatient psychiatric treatment. When asked about the prognosis for the condition described in the vignette, persons with treatment contact were less likely to believe in full recovery without intervention; mentally ill without treatment contact were more optimistic. CONCLUSION: Mental health literacy, specially concerning attitudes towards interventions is associated with personal history of mental health care.
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| 42. |
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| 43. |
- Danielsson, Louise, 1979, et al.
(författare)
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Exercise in the treatment of major depression: A systematic review grading the quality of evidence
- 2013
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 29:8, s. 573-585
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the quality of evidence for exercise in the treatment of major depression, comparing specific study types; aerobic exercise vs. antidepressants, aerobic exercise vs. any physical activity, and aerobic exercise as augmentation therapy to treatment as usual vs. treatment as usual. Methods: Electronic searches for randomized controlled studies, reporting on treatment outcome in adults with major depression confirmed by a clinical interview. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development and Evaluation and an additional risk of bias-protocol. Results: Fourteen eligible studies were retrieved, of which nine had low risk of bias. We found moderate quality of evidence that aerobic exercise has no significant effect compared to antidepressants. We found moderate quality of evidence that aerobic exercise at a moderate to high intensity has no significant effect compared to other forms of physical activity. We found low quality of evidence that exercise as augmentation to treatment as usual has a small effect - depression scores were on average 0.44 of a standard deviation lower - compared to treatment as usual. Conclusion: In general, exercise appears to be beneficial in the treatment of depression when used in combination with medication. A significant issue that is not well addressed in previous studies is the risks associated with exercise. Further, this review indicates that aerobic exercise is not more effective than other types of physical activity, pointing to a need to further investigate active components.
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| 44. |
- Danielsson, Louise, 1979, et al.
(författare)
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Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study
- 2014
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 168, s. 98-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Methods: Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Results: Improvements in MADRS score (mean change= -10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4 ml oxygen/kg/min, 95% Cl (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. Limitations: The small sample size and the challenge of missing data. Participants' positive expectations regarding the exercise intervention need to be considered. Conclusions: Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
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| 45. |
- Danielsson, Louise, 1979, et al.
(författare)
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Work-directed rehabilitation or physical activity to support work ability and mental health in common mental disorders: a pilot randomized controlled trial
- 2020
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 34:2, s. 170-181
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate feasibility and potential effectiveness of work-directed rehabilitation in people with common mental disorders. Design: Pilot randomized controlled trial. Setting: Primary healthcare, Sweden. Subjects: Working adults (n = 42) of mean age 46.2 ± 11.1 years with depression or anxiety disorder. Interventions: Eight weeks of work-directed rehabilitation (n = 21) or physical activity (n = 21). Work-directed rehabilitation included sessions with a physiotherapist and/or an occupational therapist, to develop strategies to cope better at work. Physical activity included a planning session and access to a local gym. Main measures: Feasibility: attendance, discontinuation and adverse events. Measurements were the Work Ability Index, the Global Assessment of Functioning, the Montgomery–Asberg Depression Rating Scale, the Beck Anxiety Inventory and the World Health Organization—Five Well-Being Index. Results: Attendance to rehabilitation sessions was 88% (n = 147/167) and discontinuation rate was 14% (n = 3/21). No serious adverse events were reported. Within both groups, there was a significant improvement in Work Ability Index score (mean change: 3.6 (95% confidence interval (CI): 0.45, 6.7) in work-directed rehabilitation and 3.9 (95% CI: 0.9, 7.0) in physical activity) with no significant difference between groups. For the other outcomes, significant improvements were found within but not between groups. Per-protocol analysis showed a trend toward the antidepressant effect of work-directed rehabilitation compared to physical activity (mean difference in depression score −3.1 (95% CI: −6.8, 0.4), P = 0.075). Conclusion: Work-directed rehabilitation was feasible to persons with common mental disorders and improved their work ability and mental health. Comparable improvements were seen in the physical activity group. Suggested modifications for a larger trial include adding a treatment-as-usual control.
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| 46. |
- Doering, Sabrina, et al.
(författare)
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Anxiety symptoms preceding suicide: A Swedish nationwide record review.
- 2024
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Ingår i: Journal of Affective Disorders. - 0165-0327 .- 1573-2517. ; 355, s. 317-324
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Tidskriftsartikel (refereegranskat)abstract
- The literature on the relationship between anxiety and suicidal behaviors is limited and findings are mixed. This study sought to determine whether physicians noted anxiety symptoms and suicidality in their patients in the weeks and months before suicide.Data were derived from a nationwide medical record review of confirmed suicides in Sweden in 2015. Individuals with at least one documented physician consultation in any health care setting during 12 months before suicide (N = 956) were included. Clinical characteristics were compared between decedents with and without a notation of anxiety symptoms. Odds ratios were calculated to estimate associations between anxiety symptoms and suicidality in relation to suicide proximity.Anxiety symptoms were noted in half of individuals 1 week before suicide. Patients with anxiety were characterized by high rates of depressive symptoms, ongoing substance use issues, sleeping difficulties, and fatigue. After adjustment for mood disorders, the odds of having a notation of elevated suicide risk 1 week before death were doubled in persons with anxiety symptoms. Associations were similar across time periods (12 months - 1 week). Two-thirds had been prescribed antidepressants at time of death.Data were based on physicians' notations which likely resulted in underreporting of anxiety depending on medical specialty. Records were not available for all decedents.Anxiety symptoms were common in the final week before suicide and were accompanied by increases in documented elevated suicide risk. Our findings can inform psychiatrists, non-psychiatric specialists, and GPs who meet and assess persons with anxiety symptoms.
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| 47. |
- Duberstein, P R, et al.
(författare)
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Personality and risk for depression in a birth cohort of 70-year-olds followed for 15 years.
- 2008
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Ingår i: Psychological medicine. - 0033-2917. ; 38:5, s. 663-71
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The association between personality traits and the first lifetime onset of clinically significant depression has not been studied in older adults. METHOD: Experienced psychiatrists conducted interviews and chart reviews at baseline and throughout the 15-year follow-up period. Survival analyses were conducted on the presence/absence of a DSM-III-R mood disorder at follow-up. RESULTS: There were 59 cases of first lifetime episodes of depression. Analyses showed that Neuroticism [hazard ratio (HR) per one point increase in the Maudsley Personality Inventory (MPI)=1.05, 95% confidence interval (CI) 1.02-1.08] but not Extroversion (HR 1.02, 95% CI 0.97-1.06) amplified risk for mood disorder. CONCLUSIONS: This prospective study on a randomly sampled birth cohort of older adults showed that Neuroticism confers risk for a first lifetime episode of clinically significant depression. Findings have implications for understanding the etiology of late-life depression (LLD) and could also aid in the identification and treatment of people at risk.
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| 48. |
- Erlangsen, Annette, et al.
(författare)
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Key considerations for preventing suicide in older adults: consensus opinions of an expert panel.
- 2011
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Ingår i: Crisis. - : Hogrefe Publishing Group. - 0227-5910 .- 2151-2396. ; 32:2, s. 106-9
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Tidskriftsartikel (refereegranskat)abstract
- The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide.
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| 49. |
- Fredén Klenfeldt, Isak, 1980, et al.
(författare)
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Prevalence of Obsessive-compulsive Disorder in Relation to Depression and Cognition in an Elderly Population
- 2014
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481. ; 22:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives We examined the 1-month prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) not fulfilling OCD criteria in relation to sex, age, social and mental function, comorbid depression, and cognitive functioning in an elderly nondemented population. Settings and Participants Population-based sample (N = 900), stratified into two age groups: 70-year-olds (335 women and 224 men) and those aged 78 and above (341 women). Measurements Semi-structured interviews. Psychiatric symptoms were assessed with the Comprehensive Psychopathological Rating Scale and Mini-International Neuropsychiatric Interview, mental and social function with the GAF-scale, memory function with the Word Recall Task and general cognition with MMSE. OCD and Depression were diagnosed according to DSM-IV. Results The one-month prevalence of OCD was 2.9%; a further 21% had OCS. Among 70-year-olds, the prevalence of OCD was 1.3% in men and 4.5% in women. Depression was more common among those with OCD (34.6%) than among those with (12.7%) and without (8.0%) OCS. GAF-score was lower among those with OCD (74.8) and OCS (82.9) compared with individuals without obsessions and compulsions (88.2). The association between OCD and GAF-score remained after adjustment for age, sex, and depression. The OCD subgroup with checking behavior had more memory and concentration problems and did worse on Word Recall Task than other groups in our sample. Conclusions We found that OCD and OCS are common among the elderly. Both conditions are related to depression and poorer mental and social functioning. Physicians who meet elderly patients need to be aware of OCD as it is potentially treatable.
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