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- Jonsson, Lina, 1982, et al.
(författare)
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Characterisation of age and polarity at onset in bipolar disorder
- 2021
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 219:6, s. 659-669
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Tidskriftsartikel (refereegranskat)abstract
- Background Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools. Aims To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics. Method Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts. Results Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (beta = -0.34 years, s.e. = 0.08), major depression (beta = -0.34 years, s.e. = 0.08), schizophrenia (beta = -0.39 years, s.e. = 0.08), and educational attainment (beta = -0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO. Conclusions AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
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| 2. |
- Scott, J., et al.
(författare)
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Prospective cohort study of early biosignatures of response to lithium in bipolar-I-disorders: overview of the H2020-funded R-LiNK initiative
- 2019
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Ingår i: International Journal of Bipolar Disorders. - : Springer Science and Business Media LLC. - 2194-7511. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Lithium is recommended as a first line treatment for bipolar disorders. However, only 30% of patients show an optimal outcome and variability in lithium response and tolerability is poorly understood. It remains difficult for clinicians to reliably predict which patients will benefit without recourse to a lengthy treatment trial. Greater precision in the early identification of individuals who are likely to respond to lithium is a significant unmet clinical need. Structure The H2020-funded Response to Lithium Network (R-LiNK; ) will undertake a prospective cohort study of over 300 individuals with bipolar-I-disorder who have agreed to commence a trial of lithium treatment following a recommendation by their treating clinician. The study aims to examine the early prediction of lithium response, non-response and tolerability by combining systematic clinical syndrome subtyping with examination of multi-modal biomarkers (or biosignatures), including omics, neuroimaging, and actigraphy, etc. Individuals will be followed up for 24 months and an independent panel will assess and classify each participants' response to lithium according to predefined criteria that consider evidence of relapse, recurrence, remission, changes in illness activity or treatment failure (e.g. stopping lithium; new prescriptions of other mood stabilizers) and exposure to lithium. Novel elements of this study include the recruitment of a large, multinational, clinically representative sample specifically for the purpose of studying candidate biomarkers and biosignatures; the application of lithium-7 magnetic resonance imaging to explore the distribution of lithium in the brain; development of a digital phenotype (using actigraphy and ecological momentary assessment) to monitor daily variability in symptoms; and economic modelling of the cost-effectiveness of introducing biomarker tests for the customisation of lithium treatment into clinical practice. Also, study participants with sub-optimal medication adherence will be offered brief interventions (which can be delivered via a clinician or smartphone app) to enhance treatment engagement and to minimize confounding of lithium non-response with non-adherence. Conclusions The paper outlines the rationale, design and methodology of the first study being undertaken by the newly established R-LiNK collaboration and describes how the project may help to refine the clinical response phenotype and could translate into the personalization of lithium treatment.
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| 5. |
- Elvsashagen, T, et al.
(författare)
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The genetic architecture of human brainstem structures and their involvement in common brain disorders
- 2020
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1, s. 4016-
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Tidskriftsartikel (refereegranskat)abstract
- Brainstem regions support vital bodily functions, yet their genetic architectures and involvement in common brain disorders remain understudied. Here, using imaging-genetics data from a discovery sample of 27,034 individuals, we identify 45 brainstem-associated genetic loci, including the first linked to midbrain, pons, and medulla oblongata volumes, and map them to 305 genes. In a replication sample of 7432 participants most of the loci show the same effect direction and are significant at a nominal threshold. We detect genetic overlap between brainstem volumes and eight psychiatric and neurological disorders. In additional clinical data from 5062 individuals with common brain disorders and 11,257 healthy controls, we observe differential volume alterations in schizophrenia, bipolar disorder, multiple sclerosis, mild cognitive impairment, dementia, and Parkinson’s disease, supporting the relevance of brainstem regions and their genetic architectures in common brain disorders.
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| 8. |
- Carlbring, Per, et al.
(författare)
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A randomized controlled trial of an online deliberate practice course for cognitive-behavioral therapists
- 2022
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Ingår i: EABCT 2022: Re-Thinking CBT: providing startegies for a new way of living. ; , s. 61-61
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Deliberate Practice has been proposed for improving therapist effectiveness. Deliberate Practice emphasizes the importance of feedback, expert mentorship, repetition, and individualized learning objectives. The primary analysis tested whether an online, 8-week Deliberate Practice course for cognitive-behavioral therapists would influence patient-rated working alliance compared to a waiting list.Methods: Therapists (n=37) with an undergraduate diploma in cognitive behavior therapy were recruited using social media and the mailing lists of the Swedish Association of Behaviour Therapy (“Beteendeterapeutiska föreningen”). For two weeks before and two weeks after the intervention, therapists in both groups recruited their adult patients in individual therapy to complete the Session Alliance Inventory anonymously. Delayed responses the week after this period were included. Therapists were randomized to Deliberate Practice or Waitlist. The Deliberate Practice intervention consisted of one 75-minute zoom weekly workshop over eight weeks. Each workshop specified a therapist’s skill and related skill criteria (e.g., Responding to client resistance) and involved 50 minutes of focused role-plays with repetition and feedback.Results: A linear mixed model found a trend (p < .06) towards a significant group and time interaction effect. The interaction was unexpected: the Deliberate Practice group decreased their composite Session Alliance Inventory scores (d = -.40), and the waitlist group increased their scores (d = .49).Discussion: This pioneering randomized controlled study combined a comprehensive and online-based Deliberate Practice course with a patient-rated working alliance scale. Surprisingly, a close-to-significant effect indicated that the intervention had a negative impact, while the waiting list had a positive outcome. However, power requirements were not met, and methodological issues such as attrition and bias were limitations. Recommendations for future research are presented.
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| 9. |
- Carlbring, Per, et al.
(författare)
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The effect of an online Deliberate Practice course for CBT-therapists regarding patient-rated working alliance : A randomized controlled trial
- 2022
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Ingår i: Abstracts from the 11th Swedish Congress on internet interventions (SWEsrii), Gothenburg, Sweden, 23-24 May 2022. - Linköping : Linköping University Electronic Press. ; , s. 5-5
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Konferensbidrag (refereegranskat)abstract
- Background: Deliberate Practice (DP) has been proposed for improving therapist effectiveness. DP emphasizes the importance of feedback, expert mentorship, repetition, and individualized learning objectives. The primary analysis tested whether an online, 8-week Deliberate Practice course for cognitive-behavioral therapists would influence patient-rated working alliance compared to a waiting list (WL).Methods: Therapists (n=37) with an undergraduate diploma in CBT were recruited using social media and mailing lists. For two weeks before and after the intervention, therapists in both groups recruited their adult patients in individual therapy to complete the Session Alliance Inventory (SAI) anonymously. Delayed responses the week after this period were included. Therapists were randomized to DP or WL. The DP intervention consisted of one 75- minute zoom workshop per week over eight weeks. Each workshop specified a therapist’s skill and related skill criteria (e.g., Responding to client resistance) and involved 50 minutes of focused role-plays with repetition and feedback.Results: A linear mixed model found a trend (p = .054) towards a significant group and time interaction effect. The interaction was unexpected: the DP-group decreased their composite SAI scores (d = -.40), and the WL-group increased their scores (d = .49).Discussion: This pioneering randomized controlled study combined a comprehensive and online-based Deliberate Practice course with a patient-rated working alliance scale. Surprisingly, a close-to-significant effect indicated that the intervention had a negative impact, while the waiting list had a positive effect. However, power requirements were not met, and methodological issues such as attrition and bias were limitations. Recommendations for future research are presented.
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| 10. |
- Lagerberg, Johan W., et al.
(författare)
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Evaluation of the quality of blood components obtained after automated separation of whole blood by a new multiunit processor
- 2013
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 53:8, s. 1798-1807
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Reveos system (Terumo BCT) is a fully automated device able to process four whole blood (WB) units simultaneously into a plasma unit, a red blood cell (RBC) unit, and an interim platelet (PLT) unit (IPU). Multiple IPUs can be pooled to form a transfusable PLT product. The aim of our study was to evaluate the quality of components made with the Reveos system from either fresh (2-8hr) or overnight-held WB. STUDY DESIGN AND METHODS: A prototype of the Reveos system was used to process WB. RBCs were resuspended in SAGM, leukoreduced, and assayed for in vitro quality variables during a 42-day storage period at 2 to 6 degrees C. Twenty-four-hour in vivo recovery was determined on Day42. Plasma was assayed for cellular contamination and activation variables. IPUs were pooled with SSP+ additive solution for in vitro quality assessments during a 7-day storage period at room temperature. RESULTS: Reveos-produced RBCs and plasma units met the predefined requirements. RBC recovery was superior to control units. On Day42, hemolysis was below 0.8% and in vivo recovery was above 75% for all RBCs. Cellular contamination was lower for Reveos-produced plasma. PLT yield was higher with overnight-stored WB. PLT quality was well maintained during storage with no significant differences between the two groups. Conclusion: Blood components prepared with the Reveos from fresh or overnight-held WB meet quality criteria without any relevant difference between the two groups. The Reveos system has the potential to increase efficacy and standardization of blood component preparation.
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