| 1. |
- Alaie, Iman, et al.
(author)
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Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden : a 25-year longitudinal cohort study
- 2021
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In: Social Psychiatry and Psychiatric Epidemiology. - : Springer. - 0933-7954 .- 1433-9285. ; 56:11, s. 1993-2004
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Journal article (peer-reviewed)abstract
- PURPOSE: Depression at all ages is recognized as a global public health concern, but less is known about the welfare burden following early-life depression. This study aimed to (1) estimate the magnitude of associations between depression in adolescence and social transfer payments in adulthood; and (2) address the impact of major comorbid psychopathology on these associations.METHODS: This is a longitudinal cohort study of 539 participants assessed at age 16-17 using structured diagnostic interviews. An ongoing 25-year follow-up linked the cohort (n = 321 depressed; n = 218 nondepressed) to nationwide population-based registries. Outcomes included consecutive annual data on social transfer payments due to unemployment, work disability, and public assistance, spanning from age 18 to 40. Parameter estimations used the generalized estimating equations approach.RESULTS: Adolescent depression was associated with all forms of social transfer payments. The estimated overall payment per person and year was 938 USD (95% CI 551-1326) over and above the amount received by nondepressed controls. Persistent depressive disorder was associated with higher recipiency across all outcomes, whereas the pattern of findings was less clear for subthreshold and episodic major depression. Moreover, depressed adolescents presenting with comorbid anxiety and disruptive behavior disorders evidenced particularly high recipiency, exceeding the nondepressed controls with an estimated 1753 USD (95% CI 887-2620).CONCLUSION: Adolescent depression is associated with considerable public expenditures across early-to-middle adulthood, especially for those exposed to chronic/persistent depression and psychiatric comorbidities. This finding suggests that the clinical heterogeneity of early-life depression needs to be considered from a longer-term societal perspective.
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| 2. |
- Alaie, Iman, et al.
(author)
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Uppsala Longitudinal Adolescent Depression Study (ULADS)
- 2019
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:3
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Journal article (peer-reviewed)abstract
- Purpose: To present the Uppsala Longitudinal Adolescent Depression Study, initiated in Uppsala, Sweden, in the early 1990s. The initial aim of this epidemiological investigation was to study the prevalence, characteristics and correlates of adolescent depression, and has subsequently expanded to include a broad range of social, economic and health-related long-term outcomes and cost-of-illness analyses.Participants: The source population was first-year students (aged 16-17) in upper-secondary schools in Uppsala during 1991-1992, of which 2300 (93%) were screened for depression. Adolescents with positive screening and sex/age-matched peers were invited to a comprehensive assessment. A total of 631 adolescents (78% females) completed this assessment, and 409 subsequently completed a 15year follow-up assessment. At both occasions, extensive information was collected on mental disorders, personality and psychosocial situation. Detailed social, economic and health-related data from 1993 onwards have recently been obtained from the Swedish national registries for 576 of the original participants and an age-matched reference population (N=200 000).Findings to date: The adolescent lifetime prevalence of a major depressive episode was estimated to be 11.4%. Recurrence in young adulthood was reported by the majority, with a particularly poor prognosis for those with a persistent depressive disorder or multiple somatic symptoms. Adolescent depression was also associated with an increased risk of other adversities in adulthood, including additional mental health conditions, low educational attainment and problems related to intimate relationships.Future plans: Longitudinal studies of adolescent depression are rare and must be responsibly managed and utilised. We therefore intend to follow the cohort continuously by means of registries. Currently, the participants are approaching mid-adulthood. At this stage, we are focusing on the overall long-term burden of adolescent depression. For this purpose, the research group has incorporated expertise in health economics. We would also welcome extended collaboration with researchers managing similar datasets.
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| 3. |
- Håkanson, Margareta, 1950, et al.
(author)
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The horse as the healer-a study of riding in patients with back pain.
- 2009
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In: Journal of bodywork and movement therapies. - Amsterdam : Elsevier BV. - 1532-9283 .- 1360-8592. ; 13:1, s. 43-52
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Journal article (peer-reviewed)abstract
- A total of 24 patients, considerably disabled in daily activities by back pain, participated in an Equine Assisted Therapy (EAT) programme. The patients also had several health problems in addition to their current pain. The programme emphasised the principles of body awareness. The study is aimed at investigating not only whether symptom reduction would be achieved, but also at identifying qualities of EAT that were particularly beneficial for the patients' well being. The study was performed according to action research principles. The treatment reduced the pain and lessened other symptoms. The EAT also had an influence on the patients' self-image and a positive chain of effects was observed. The consequences were described according to four dimensions; the dimension of body awareness, competence, emotion and environment. The dimensions were interrelated having the simultaneous influence of a transition process and symptom reduction towards health.
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| 4. |
- Kollén, Lena, 1960-, et al.
(author)
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Benign paroxysmal positional vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds
- 2012
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In: Aging Clinical and Experimental Research. - New York, USA : Springer. - 1594-0667 .- 1720-8319. ; 24:4, s. 317-323
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Journal article (peer-reviewed)abstract
- Background and aims: Studies have shown that 65% of people with dizziness may have a vestibular etiologic diagnosis, possibly benign paroxysmal positional vertigo (BPPV). The diagnosis of BPPV is based on medical history and findings after the Dix-Hallpike test. It is sometimes difficult to perform the Dix-Hallpike test in elderly persons, due to the limited range of motion when extending the neck. In this study, we used a side-lying test to stimulate the posterior semicircular canal, while the head and neck were fully supported on the examination table. The aims of this study were to investigate the prevalence of dizziness and/or impaired balance and BPPV in a population of 75-year-olds by means of a questionnaire and clinical tests, and to compare elderly persons with and without BPPV.Methods: A representative population sample of 675 persons completed a questionnaire about dizziness and 571 persons underwent side-lying, static balance and dynamic walking tests.Results: Subjective dizziness and/or impaired balance were found in 36% of subjects, especially when walking outdoors. A significant gender difference was found, with a higher prevalence in women (40%) compared with men (30%) (p<0.01). BPPV was found in 11% and was significantly more common in women (p<0.01). Elderly individuals with BPPV also displayed significantly impaired balance in static and dynamic balance tests compared with persons without BPPV (p<0.01). Persons with BPPV reported significantly more subjective problems with dizziness and balance compared with persons without BPPV (p<0.001).Conclusions: Subjective and objective unsteadiness, dizziness and BPPV are common in the elderly.
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| 5. |
- Nordeman, Lena Margareta, et al.
(author)
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Early access to physical therapy treatment for subacute low back pain in primary health care: a prospective randomized clinical trial.
- 2006
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In: The Clinical journal of pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047. ; 22:6, s. 505-11
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To evaluate the effects of early access (EA) to physical therapy treatment for patients with subacute low back pain compared to access with a 4-week waiting list. DESIGN: A prospective, randomized clinical trial. SETTING: Primary health care. PATIENTS: Sixty consecutive patients with subacute low back pain. INTERVENTIONS: Patients were randomized either to EA within 2 days for physical examination and individualized physical therapy treatment (n=32) or a control group with a 4-week waiting list (n=28). OUTCOME MEASURES: Self-administrated questionnaires were used for assessment at inclusion, at discharge, and at 6 months. Primary outcome measure was pain intensity assessed by Borg category scale for ratings of perceived pain. Secondary outcomes included the Orebro musculoskeletal pain screening questionnaire, the Roland and Morris disability questionnaire, sick-leave, visits to health care, and physical therapy. RESULTS: The results showed no significant differences in pain between the groups at discharge. At 6 months, the reduction of pain was significantly greater in the EA group compared to the control group (P=0.025). Changes in secondary outcome measures were not significantly different between groups. CONCLUSIONS: This study indicated that EA to physical therapy resulted in greater improvement in perceived pain at 6 months compared to later access. In this study, EA to physical therapy could be introduced by reorganization without additional resources.
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| 6. |
- Ssegonja, Richard, et al.
(author)
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Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood : A longitudinal cost-of-illness study
- 2019
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In: Journal of Affective Disorders. - : ELSEVIER. - 0165-0327 .- 1573-2517. ; 258, s. 33-41
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Journal article (peer-reviewed)abstract
- Background: Depression in adolescence is associated with increased healthcare consumption in adulthood, but prior research has not recognized the heterogeneity of depressive disorders. This paper investigated the additional healthcare usage and related costs in mid-adulthood for individuals with adolescent depression, and examined the mediating role of subsequent depression in early adulthood.Methods: This study was based on the Uppsala Longitudinal Adolescent Depression Study, initiated in Sweden in the early 1990s. Depressive disorders were assessed in adolescence (age 16-17) and early adulthood (age 19-30). Healthcare usage and related costs in mid-adulthood (age 31-40) were estimated using nationwide population-based registries. Participants with specific subtypes of adolescent depression (n = 306) were compared with matched non-depressed peers (n = 213).Results: Women with persistent depressive disorder (PDD) in adolescence utilized significantly more healthcare resources in mid-adulthood. The association was not limited to psychiatric care, and remained after adjustment for individual and parental characteristics. The total additional annual cost for a single age group of females with a history of PDD at a population level was estimated at 3.10 million USD. Depression recurrence in early adulthood mediated the added costs for psychiatric care, but not for somatic care.Limitations: Primary health care data were not available, presumably resulting in an underestimation of the true healthcare consumption. Estimates for males had limited precision due to a relatively small male proportion.Conclusions: On a population level, the additional healthcare costs incurred in mid-adulthood in females with a history of adolescent PDD are considerable. Early treatment and prevention should be prioritized.
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| 7. |
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| 8. |
- Arvidsson, Bo, 1962-, et al.
(author)
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Reference data for bone mineral density in Swedish women using digital X-ray radiometry
- 2013
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In: Journal of clinical densitometry. - New York, USA : Elsevier. - 1094-6950 .- 1559-0747. ; 16:2, s. 183-188
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Journal article (peer-reviewed)abstract
- During the last decade, digital X-ray radiometry (DXR) has been used to measure bone mineral density (BMD) in the metacarpal bones. The aim of this study was to establish Swedish reference material for bone mass in women, measured in the metacarpal bones with DXR, and compare these data with the data from the manufacturer. A sample of 1440 women aged 20-79yr living in Örebro County was randomly assigned from the population register. Microdose mammography was used (Sectra MDM L30; Sectra Imtec AB, Linköping, Sweden) to measure BMD. Cole's LMS method was used to calculate DXR. Six hundred sixty-nine (48.3%) women participated. Peak bone mass occurred at the age of 43.4yr with a BMD of 0.597g/cm(2) (standard deviation: 0.050). Our Swedish data correlated well with the manufacturer's material. Only among women aged 50-59yr did BMD differ, where the Swedish sample had lower values. The LMS method can be used to describe the DXR data and provide a more detailed picture of bone density distribution. DXR-BMD in Swedish women aged 20-79yr is equivalent to findings from other studies, showing the same distribution of BMD in most age groups except for ages 50-59yr.
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| 9. |
- Duberg, Anna, 1976-, et al.
(author)
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Adolescent girls with internalizing problems : Can dance intervention improve health? A randomized, controlled trial with cost-utility analysis
- 2012
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In: Journal of Science and Medicine in Sport. - : Elsevier. - 1440-2440 .- 1878-1861. ; 15:Suppl. 1, s. S345-S346
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Journal article (other academic/artistic)abstract
- Introduction: The increasing prevalence of psychological health problems among adolescent girls is alarming. Knowledge of beneficial effects of physical activity on psychological health are widespread. Dance is a popular form of exercise also known to increase a sense of self-control which can contribute to reduced stress. The purpose of this study was to investigate if dance intervention for adolescent girls with internalizing problems influenced self-rated health. A secondary aim was to assess the cost-effectiveness of the intervention in addition to usual school health services, compared with usual school health services alone.Methods: Randomized controlled intervention trial with follow-up measures of self-rated health at 8, 12 and 20 months after baseline. A total of 112 girls, 13–18 years old, with internalizing problems, i.e. stress and psychosomatic symptoms, were randomized to intervention group or control group. The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance. Costs for the stakeholder of the intervention, treatment effect and healthcare costs were considered. Gained quality-adjusted life-years (QALY) were used to measure the effects. Quality of life (QOL) was measured with the Health Utility Index Mark 3 (HUI 3). Cost-effectiveness ratios were based on the changes in QALY and net costs for the intervention group compared with the control group. Net monetary benefit (NMB) was also calculated.Results: A year after baseline 65% of the girls in the intervention group and 32% of the girls in the control group had increased their self-rated health. The differences in change score between groups were significant at all follow-ups. After 8-months U = 895.5 (P = .037), after 12-months U = 680.0 (P = .001), and after 20-months U = 801 (P = .022).Cost effectiveness showed that after 20 months, QOL had increased by 0.083 units more in the intervention group than in the control group (P = .04), translating to 0.095 gained QALY. The cost-effectiveness ratio was $7187.4 and the NMB was $3846.0 (Willingness to pay $50 000 for a gained QALY).Discussion: This study suggests that an 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention. The intervention in addition to usual school health services showed cost-effectiveness compared with usual school health services alone. The cost-effectiveness ratio was far below the recommended threshold value.
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