| 1. |
- Andersson, Christina, 1955, et al.
(author)
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Drinking context and problematic alcohol consumption in young Swedish women : Drinking context and problematic alcohol consumption
- 2013
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In: Addiction Research and Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 21:6, s. 457-468
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Journal article (peer-reviewed)abstract
- Previous research has indicated that a variety of contextual factors are involved in the development of drinking behavior. An integrated perspective can extend our understanding of the context and circumstances in which individuals drink. In this study, a person-oriented approach, cluster analysis, was used to identify drinking context clusters in a population of 20- and 25-year-old Swedish women. A further aim was to analyze how these clusters were associated with problematic alcohol consumption (high episodic drinking (HED) and alcohol use disorder (AUD)). A total of 760 respondents were interviewed, some in 1996 and some in 2001. Self-reported effects of drinking and situational factors associated with drinking alcohol were used in the cluster analysis procedure. Logistic regression models were used to analyze the associations with problematic alcohol consumption. The results revealed four distinct clusters of drinking patterns: coping drinkers, social drinkers, controlled drinkers, and moderate drinkers. Differences between clusters concerning problematic alcohol consumption were found. HED was significantly more common among the social drinkers and alcohol use disorder was more prevalent among the coping drinkers. Age differences and to a lesser extent secular trends in drinking pattern could be observed. The findings suggest that information on drinking context can help to explain differences in patterns of risky drinking and AUD. This highlights the importance of identifying groups of individuals with potentially harmful drinking patterns, which could be the target of specific preventive actions.
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| 2. |
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| 3. |
- Andersson Sundell, Karolina, 1978, et al.
(author)
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Socio-economic determinants of early discontinuation of anti-depressant treatment in young adults.
- 2013
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In: European journal of public health. - : Oxford University Press (OUP). - 1464-360X .- 1101-1262. ; 23:3, s. 433-440
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Journal article (peer-reviewed)abstract
- BACKGROUND: Early discontinuation of anti-depressant treatment is common. This study analysed whether socio-economic factors influence early discontinuation among new anti-depressant users aged 20-34 years. METHODS: Our study population included all Swedes aged 20-34 years who purchased anti-depressants in 2006 and had not purchased such drugs in the preceding 6 months (n = 25 003). We obtained prescription data from the Swedish Prescribed Drug Register. Information about demographic and socio-economic factors (country of birth, marital status, household size, education level, occupation, income and social assistance) was collected from Statistics Sweden by record linkage. We defined early discontinuation as filling only one anti-depressant prescription within a 6-month period. We used multiple logistic regression analysis to analyse the socio-economic factors associated with early discontinuation. RESULTS: We identified 6536 individuals (26.1%) as early discontinuers. Early discontinuation was less common among women [odds ratio (OR) = 0.82; 95% confidence intervals (CI) 0.75-0.87] and in those with at least two years of higher education (OR = 0.71; 95% CI 0.61-0.83), whereas it was more common among those born outside Sweden (OR = 1.76; 95% CI 1.48-2.10) and those who received social assistance (OR = 1.26; 95% CI 1.11-1.44). Compared with selective serotonin re-uptake inhibitors, SSRI, early discontinuation was more common among individuals who started treatment with a tri-cyclic anti-depressant, TCA, (OR = 2.58; 95% CI 2.24-2.98) or an anti-depressant other than SSRIs, TCAs or selective serotonin-norepinephrine re-uptake inhibitors/norepinephrine (noradrenaline) re-uptake inhibitors (OR = 2.90; 95% CI 2.05-4.10). CONCLUSION: Early discontinuation occurred more commonly among social assistance recipients and those with immigrant background, suggesting that those groups might require greater support when initiating anti-depressant therapy.
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| 4. |
- Bertilsson, Monica, et al.
(author)
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Capacity to work while depressed and anxious - a phenomenological study
- 2013
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In: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 35:20, s. 1705-1711
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Journal article (peer-reviewed)abstract
- Purpose: The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work. Method: Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed. Results: The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with ones ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost "refueling and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome. Conclusions: A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individuals capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence.
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| 5. |
- Billstedt, Eva, 1961, et al.
(author)
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Secular changes in personality: study on 75-year-olds examined in 1976-1977 and 2005-2006.
- 2013
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 28:3, s. 298-304
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Journal article (peer-reviewed)abstract
- OBJECTIVE: In order to study secular changes in personality factors neuroticism and extroversion, representative population samples of non-demented 75-year-olds underwent psychiatric examinations in 1976-1977 (total n = 223, 138 women, 85 men) and 2005-2006 (total n = 556, 322 women and 234 men). METHODS: Eysenck Personality Inventory was used at both occasions. Demographic factors (educational level, marital status, having children) were registered. RESULTS: Seventy-five-year-olds examined in 2005-2006 had higher values on extroversion and lower values on the Lie scale compared with those examined in 1976-1977. Neuroticism did not differ between the two birth cohorts. Neuroticism scores were higher in women than in men both in 1976-1977 and 2005-2006, and Lie score was higher in women than in men in 2005-2006. CONCLUSIONS: Our findings suggest that present cohorts of 75-year-olds are more extroverted and less prone to respond in a socially desirable manner than those born three decades earlier. Neuroticism levels remained unchanged, suggesting this trait may be less influenced by environmental factors than the other traits studied.
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| 6. |
- Brain, Cecilia, 1969, et al.
(author)
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Drug attitude and other predictors of medication adherence in schizophrenia : 12 months of electronic monitoring (MEMS (R)) in the Swedish COAST-study
- 2013
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In: European Neuropsychopharmacology. - : Elsevier BV. - 0924-977X .- 1873-7862. ; 23:12, s. 1754-1762
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Journal article (peer-reviewed)abstract
- The aim was to investigate clinical predictors of adherence to antipsychotics. Medication use was electronically monitored with a Medication Event Monitoring System (MEMS (R)) for 12 months in 112 outpatients with schizophrenia and schizophrenia-like psychosis according to DSM-IV. Symptom burden, insight, psychosocial function (PSP) and side effects were rated at baseline. A comprehensive neuropsychological test battery was administered and a global composite score was calculated. The Drug Attitude Inventory (DAI-10) was filled in. A slightly modified DAI-10 version for informants was distributed as a postal questionnaire. Nonadherence (MEMS (R) adherence <= 0.80) was observed in 27%. In univariate regression models low scores on DAI-10 and DAI-10 informant, higher positive symptom burden, poor function, psychiatric side effects and lack of insight predicted non-adherence. No association was observed with global cognitive function. In multivariate regression models, low patient-rated DAI-10 and PSP scores emerged as predictors of non-adherence. A ROC analysis showed that DAI-10 had a moderate ability to correctly identify non-adherent patients (AUC=0.73, p<0.001). At the most "optimal" cut-off of 4, one-third of the adherent would falsely be. identified as non-adherent. A somewhat larger AUC (0.78, p<0.001) was observed when the ROC procedure was applied to the final regression model including DAI-10 and PSP. For the subgroup with informant data, the AUC for the DAI-10 informant version was 0.68 (p=0.021). Non-adherence cannot be properly predicted in the clinical setting on the basis of these instruments alone. The DAI-10 informant questionnaire needs further testing.
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| 7. |
- Bäckman, Kristoffer, 1979, et al.
(author)
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37 years of body mass index and dementia: observations from the prospective population study of women in Gothenburg, Sweden.
- 2012
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In: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 28:1, s. 163-71
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Journal article (peer-reviewed)abstract
- Level of adiposity is linked to dementia in epidemiological studies. Overweight and obesity in mid- and late-life may increase risk for dementia, whereas decline in body weight or body mass index (BMI) and underweight in years preceding and at the time of a dementia diagnosis may also relate to dementia. Longitudinal studies with sufficient follow-up are necessary to estimate trajectories that allow better understanding of the relationship between adiposity indices and dementia over the life course. We evaluated the natural history of BMI in relationship to clinical dementia over 37 years in the Prospective Population Study of Women (PPSW) in Sweden. PPSW is a systematic sample of 1462 women born 1908, 1914, 1918, 1922, and 1930 and aged 38-60 years at baseline. Examinations occurred in 1968, 1974, 1980, 1992, 2000, and 2005. Statistical analyses were conducted using mixed effects regression models. Trajectories of BMI over 37 years as a function of age differed between women who did versus did not develop dementia. Women developing dementia evidenced a lesser increase in BMI from age 38 to 70 years. After age 70, the BMI slope decreased similarly (no "accelerated decline") irrespective of dementia status. A lower BMI before and during dementia onset was observed. Women with similar BMI at mid-life exhibited a different pattern of BMI change as they approached late-life that was related to dementia onset. BMI may be a potential marker of dementia-related neuropathologies in the brain. Dementia is related to a common risk factor, BMI, from mid-to late-life.
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| 8. |
- Börjesson-Hanson, Anne, 1959, et al.
(author)
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One-Month Prevalence of Mental Disorders in a Population Sample of 95-Year Olds.
- 2011
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In: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214. ; 19:3, s. 284-91
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Journal article (peer-reviewed)abstract
- OBJECTIVE:: To determine the 1-month prevalence of mental disorders among 95-year olds. DESIGN:: Cross-sectional population sample of 95-year olds. SETTING:: All 95-year olds born in the period 1901-1903 living in Gothenburg, Sweden, were invited. Elderly living in both community settings and nursing homes were included. PARTICIPANTS:: In total, 338 95-year olds (response rate: 65%) were examined (263 women, 75 men). MEASUREMENTS:: All participants were examined by psychiatrists using the Comprehensive Psychopathological Rating Scale and cognitive tests. Mental disorders were classified according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria. RESULTS:: Two-third of all 95-year olds had a mental disorder. In the total sample of 95-year olds, the 1-month prevalence was 52% for dementia, 8% for depression, 4% for anxiety, and 3% for psychotic disorders. Almost one-third (29%) of the nondemented 95-year olds fulfilled criteria for a psychiatric disorder: 17% had depression, 9% anxiety, and 7% psychotic disorder. CONCLUSIONS:: The combined prevalence of mental disorders was high among 95-year olds, even after excluding dementia. These findings emphasize the importance of research, care, and detection of psychiatric problems in this age group.
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| 10. |
- Danielsson, Louise, 1979, et al.
(author)
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Exercise in the treatment of major depression: A systematic review grading the quality of evidence
- 2013
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 29:8, s. 573-585
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Journal article (peer-reviewed)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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