| 91. |
- Johansson, Lena, 1972, et al.
(författare)
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Midlife psychological stress and risk of dementia: a 35-year longitudinal population study.
- 2010
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Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 133:8, s. 2217-2224
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Tidskriftsartikel (refereegranskat)abstract
- The number of people with dementia has increased dramatically with global ageing. Nevertheless, the pathogeneses of these diseases are not sufficiently understood. The present study aims to analyse the relationship between psychological stress in midlife and the development of dementia in late-life. A representative sample of females (n = 1462) aged 38-60 years were examined in 1968-69 and re-examined in 1974-75, 1980-81, 1992-93 and 2000-03. Psychological stress was rated according to a standardized question in 1968, 1974 and 1980. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. During the 35-year follow-up, 161 females developed dementia (105 Alzheimer's disease, 40 vascular dementia and 16 other dementias). We found that the risk of dementia (hazard ratios, 95% confidence intervals) was increased in females reporting frequent/constant stress in 1968 (1.60, 1.10-2.34), in 1974 (1.65, 1.12-2.41) and in 1980 (1.60, 1.01-2.52). Frequent/constant stress reported in 1968 and 1974 was associated with Alzheimer's disease. Reporting stress at one, two or three examinations was related to a sequentially higher dementia risk. Compared to females reporting no stress, hazard ratios (95% confidence intervals) for incident dementia were 1.10 (0.71-1.71) for females reporting frequent/constant stress at one examination, 1.73 (1.01-2.95) for those reporting stress at two examinations and 2.51 (1.33-4.77) at three examinations. To conclude, we found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer's disease. More studies are needed to confirm our findings and to study potential neurobiological mechanisms of these associations.
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| 92. |
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| 93. |
- Jonson, Mattias, et al.
(författare)
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Anxiety symptoms and suicidal feelings in a population sample of 70-year-olds without dementia
- 2012
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Ingår i: International Psychogeriatrics. - : Cambridge University Press (CUP). - 1041-6102 .- 1741-203X. ; 24:11, s. 1865-1871
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of anxiety in late-life suicidal behavior has received relatively little attention. The aim was to explore the association between anxiety symptoms and suicidal feelings in a population sample of 70-year-olds without dementia, and to test whether associations would be independent of depression. Methods: Face-to-face interviews (N = 560) were carried out by psychiatric nurses and past month symptoms were rated with the Comprehensive Psychopathological Rating Scale (CPRS). The Brief Scale for Anxiety (BSA) was derived from the CPRS to quantify anxiety symptom burden. Past month suicidal feelings were evaluated with the Paykel questions. Results: Anxiety symptom burden was associated with suicidal feelings and the association remained after adjusting for major depression. One individual BSA item (Inner tension) was independently associated with suicidal feelings in a multivariate regression model. The association did not remain, however, in a final model in which depression symptoms replaced depression diagnosis. Conclusions: Results from this population study suggest an association between anxiety and suicidal feelings in older adults. The role of anxiety and depression symptoms needs further clarification in the study of suicidal behavior in late life.
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| 94. |
- Jonson, Mattias, et al.
(författare)
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Life-Weariness, Wish to Die, Active Suicidal Ideation, and All-Cause Mortality in Population-Based Samples of Older Adults
- 2023
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Ingår i: American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1064-7481. ; 31:4, s. 267-276
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate potential differences in the strength of associations between different levels of passive and active suicidal ideation and all-cause mortality in older adults. Design: Prospective cohort study. Setting: Population-based samples of older adults in Gothenburg, Sweden. Participants: Older adults aged 79 and above who participated in any wave of the Gothenburg H70 Birth Cohort Studies or the Prospective Population Study of Women between 1986 and 2015 (n = 2,438; 1,737 women, 701 men; mean age 86.6). Measurements: Most intense level of passive or active suicidal ideation during the past month: life-weariness, wish to die, or active suicidal ideation. The outcome was all-cause mortality over 3 years. Results: During follow-up, 672 participants (27.6%) died. After adjustments for sex, age, and year of examination, participants who reported a wish to die (HR 2.01; 95% CI 1.55–2.60) as the most intense level of ideation, but not participants who reported life-weariness (HR 1.40; 95% CI 0.88–2.21) or active suicidal ideation (HR 1.10; 95% CI 0.69–1.76) were at increased risk of all-cause mortality. Reporting a wish to die remained associated with mortality in a fully adjusted model, including somatic conditions, dementia, depression, and loneliness (HR 1.70; 95% CI 1.27–2.26). Conclusion: In older adults, reporting a wish to die appears to be more strongly associated with all-cause mortality than either life-weariness or active suicidal ideation.
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| 95. |
- Jonson, Mattias, et al.
(författare)
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Passive and active suicidal ideation in Swedish 85-year-olds: Time trends 1986-2015
- 2021
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 290, s. 300-307
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Older adults have high suicide rates. We investigated potential time trends in the prevalence of passive and active suicidal ideation in 85-year-olds. Further, we examined factors associated with such ideation in this age group. Methods Population-based samples of 85-year-olds were interviewed in 1986 (N=347), 2008 (N=426) and 2015 (N=320). Past-month passive/active suicidal ideation was evaluated with the Paykel questions. Results Reporting any type of passive or active suicidal ideation was less common in 2008 (7.3%, p<0.001) and 2015 (7.2%, p<0.001) compared to 1986 (16.4%). The change was driven by decreases in passive ideation. Passive/active suicidal ideation was associated with higher MADRS score (OR: 1.2, 95% CI: 1.1-1.2, p<0.001), institution residence (OR: 3.9, 95% CI: 1.7-8.9, p=0.001) and feelings of loneliness (OR: 2.7, 95% CI: 1.4-5.2, p=0.003). When stratified by sex, it was associated with institution residence (OR: 3.7, 95% CI: 1.4-9.9, p=0.008) and feelings of loneliness (OR: 3.0, 95% CI: 1.4-6.3, p=0.005) in women. In men, we observed a tenfold higher risk in those without partners (OR: 9.8, 95% CI: 2.9-33.5, p<0.001). Limitations While differential three-year mortality was not observed in 1986, mortality was higher among non-participants in 2008 and 2015. This might have inflated cohort differences in passive/active suicidal ideation. Conclusion An initial decrease in the prevalence of passive/active suicidal ideation in 85-year-olds was observed but this positive trend did not persist. Results underline that preventive strategies targeting loneliness and focusing on institutional settings are needed, as are interventions for men without partners.
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| 96. |
- Jonson, Mattias, et al.
(författare)
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Time trends in depression prevalence among Swedish 85-year-olds: Repeated cross-sectional population-based studies in 1986, 2008, and 2015
- 2023
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Ingår i: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 53:6, s. 2456-2465
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Tidskriftsartikel (refereegranskat)abstract
- Background Octogenarians of today are better educated, and physically and cognitively healthier, than earlier born cohorts. Less is known about time trends in mental health in this age group. We aimed to study time trends in the prevalence of depression and psychotropic drug use among Swedish 85-year-olds. Methods We derived data from interviews with 85-year-olds in 1986-1987 (N = 348), 2008-2010 (N = 433) and 2015-17 (N = 321). Depression diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders. Symptom burden was assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). Information on psychotropic drug use, sociodemographic, and health-related factors were collected during the interviews. Results The prevalence of major depression was lower in 2015-2017 (4.7%, p < 0.001) and 2008-2010 (6.9%, p = 0.010) compared to 1986-1987 (12.4%). The prevalence of minor depression was lower in 2015-2017 (8.1%) compared to 2008-2010 (16.2%, p = 0.001) and 1986-1987 (17.8%, p < 0.001). Mean MADRS score decreased from 8.0 in 1986-1987 to 6.5 in 2008-2010, and 5.1 in 2015-2017 (p < 0.001). The reduced prevalence of depression was not explained by changes in sociodemographic and health-related risk factors for depression. While psychoactive drug use was observed in a third of the participants in each cohort, drug type changed over time (increased use of antidepressants and decreased use of anxiolytics and antipsychotics). Conclusions The prevalence of depression in octogenarians has declined during the past decades. The decline was not explained by changes in known risk factors for depression. The present study cannot answer whether changed prescription patterns of psychoactive drugs have contributed to the decline.
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| 97. |
- Karlsson, Björn, 1981, et al.
(författare)
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DSM-IV and DSM-5 Prevalence of Social Anxiety Disorder in a Population Sample of Older People
- 2016
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 24:12, s. 1237-1245
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine the prevalence of social anxiety disorders (SAD) with (DSM-IV) and without (DSM-5) the person's own assessment that the fear was unreasonable, in a population sample of older adults. Further, to determine whether clinical and sociodemographic correlates of SAD differ depending on the criteria applied. Design: Cross-sectional. Setting: General population in Gothenburg, Sweden. Participants: A random population-based sample of 75- and 85-year olds (N = 1200) without dementia. Measurements: Psychiatric research nurses carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. DSM-IV SAD was diagnosed with the Mini International Neuropsychiatric Interview. SAD was diagnosed according to DSM-IV and DSM-5 criteria. The 6-month duration criterion in DSM-5 was not applied because of lack of information. Other assessments included the Global Assessment of Functioning (GAF), the Brief Scale for Anxiety (BSA), and the Montgomery Asberg Depression Rating Scale (MADRS). Results: The 1-month prevalence of SAD was 2.5% (N = 30) when the unreasonable fear criterion was defined in accordance with DSM-IV and 5.1% (N = 61) when the DSM-5 criterion was applied. Clinical correlates (GAF, MADRS, and BSA) were worse in SAD cases identified by either procedure compared with all others, and ratings for those reporting unreasonable fear suggested greater (albeit nonsignificant) overall psychopathology. Conclusions: Shifting the judgment of how reasonable the fear was, from the individual to the clinician, doubled the prevalence of SAD. This indicates that the DSM-5 version might increase prevalence rates of SAD in the general population. Further studies strictly applying all DSM-5 criteria are needed in order to confirm these findings.
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| 98. |
- Karlsson, Björn, et al.
(författare)
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Prevalence of social phobia in non-demented elderly from a swedish population study.
- 2009
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214. ; 17:2, s. 127-35
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the prevalence of social phobia, and how the different Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic components of social phobia influence prevalence rates, among a population sample aged 70 years and older. DESIGN: A general population sample was investigated in 2000-2001 with semistructured psychiatric examinations, including the Comprehensive Psychopathological Rating Scale, the Mini International Neuropsychiatric Interview, the Global Assessment of Functioning (GAF) scale, and the Mini Mental State Examination. SETTING: General population Participants: Randomized sample of 914 nondemented elderly, response rate 68%. The sample was stratified into two age groups: 70-year olds (N = 338 women and 224 men) and aged 78 and above (N = 352 women). MEASUREMENTS: Social phobia according to DSM-IV requiring: a) fearing social situations, b) experiencing the fear as unreasonable or excessive, c) avoiding feared social situations or enduring them with intense anxiety or distress, and d) that this causes social consequences. RESULTS: The 1-month prevalence of social phobia was 1.9% (N = 17), an additional 1.6% (N = 15) fulfilled criteria a, c, and d, but not b. Thus, 3.5% had "social phobia" that caused social consequences. This was related to lower GAF-score and concurrent depression,panic attacks, and agoraphobia. Almost one fourth (N = 220) of the total sample feared social situations. This was more common in 70-year-old women compared with 70-year-old men (29.9% versus 20.5%), and to women aged 78-92 years (21.0%). CONCLUSIONS: Our results indicate that DSM-IV criteria exclude a large group of individuals with social phobia. It could be discussed whether DSM-IV criteria should be revised to also encompass these individuals.
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| 99. |
- Karlsson, Björn, et al.
(författare)
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The prognosis and incidence of social phobia in an elderly population. A 5-year follow-up.
- 2010
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Ingår i: Acta psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 122:1, s. 4-10
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Tidskriftsartikel (refereegranskat)abstract
- Karlsson B, Sigström R, Waern M, Ostling S, Gustafson D, Skoog I. The prognosis and incidence of social phobia in an elderly population. A 5-year follow-up. Objective: To examine the prognosis and incidence of social fears and phobia in an elderly population sample followed for 5 years. Method: A general population sample (N = 612) of non-demented men (baseline age 70) and women (baseline age 70 and 78-86) was investigated in 2000-2001 and in 2005-2006 with semi-structured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria. Results: Among nine individuals with DSM-IV social phobia in 2000, 5 (55.6%) had no social fears in 2005, and 1 (11.1%) still met the criteria for DSM-IV social phobia. Among individuals without DSM-IV social phobia in 2000 (N = 603), 12 (2.0%) had DSM-IV social phobia in 2005. Conclusion: These findings challenge the notion that social phobia is a chronic disorder with rare occurrence in old age.
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| 100. |
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