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Sökning: WFRF:(Hultman Christina M)

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71.
  • Song, Huan, et al. (författare)
  • Waiting time for cancer treatment and mental health among patients with newly diagnosed esophageal or gastric cancer : A nationwide cohort study
  • 2017
  • Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 17:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Except for overall survival, whether or not waiting time for treatment could influences other domains of cancer patients' overall well-being is to a large extent unknown. Therefore, we performed this study to determine the effect of waiting time for cancer treatment on the mental health of patients with esophageal or gastric cancer. Methods: Based on the Swedish National Quality Register for Esophageal and Gastric Cancers (NREV), we followed 7,080 patients diagnosed 2006-2012 from the time of treatment decision. Waiting time for treatment was defined as the interval between diagnosis and treatment decision, and was classified into quartiles. Mental disorders were identified by either clinical diagnosis through hospital visit or prescription of psychiatric medications. For patients without any mental disorder before treatment, the association between waiting time and subsequent onset of mental disorders was assessed by hazard ratios (HRs) with 95% confidence interval (CI), derived from multivariable-adjusted Cox model. For patients with a preexisting mental disorder, we compared the rate of psychiatric care by different waiting times, allowing for repeated events. Results: Among 4,120 patients without any preexisting mental disorder, lower risk of new onset mental disorders was noted for patients with longer waiting times, i.e. 18-29 days (HR 0.86; 95% CI 0.74-1.00) and 30-60 days (HR 0.79; 95% CI 0.67-0.93) as compared with 9-17 days. Among 2,312 patients with preexisting mental disorders, longer waiting time was associated with more frequent psychiatric hospital care during the first year after treatment (37.5% higher rate per quartile increase in waiting time; p for trend = 0.0002). However, no such association was observed beyond one year nor for the prescription of psychiatric medications. Conclusions: These data suggest that waiting time to treatment for esophageal or gastric cancer may have different mental health consequences for patients depending on their past psychiatric vulnerabilities. Our study sheds further light on the complexity of waiting time management, and calls for a comprehensive strategy that takes into account different domains of patient well-being in addition to the overall survival.
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72.
  • Stålberg, Gabriella, et al. (författare)
  • Video-based assessment of interpersonal problem solving skills in patients with schizophrenia, their siblings and non-psychiatric controls
  • 2008
  • Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 49:1, s. 77-82
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to analyze social functioning in patients with schizophrenia and their biological relatives with a Swedish version of the video-based vignette test Assessment of Interpersonal Problem Solving Skills (AIPSS). In a new video production with simulated "real life" situations we tested the ability to receive, process and send social information in 25 individuals with a DSM-IV diagnosis of schizophrenia, 20 siblings to patients with schizophrenia and 25 randomly selected non-psychiatric controls. The test proved to have good validity and interrater reliability. After controlling for positive or negative symptoms, patients had poor performance especially in acting out solutions leading to effective problem solving. Siblings generally did not differ from controls, but showed some deficiencies in non-verbal language. To conclude, AIPSS is appropriate for use in a Swedish-speaking context and might be useful in research on vulnerability indicators and in assessment of treatment interventions.
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73.
  • Stålberg, Karin, et al. (författare)
  • Prenatal ultrasound exposure and children’s school performance at age 15-16; follow-up of a randomised controlled trial
  • 2009
  • Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 34:3, s. 297-303
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To evaluate the association between prenatal ultrasound exposure and school performance at 15-16 years of age. Methods The study population consisted of children born to women who participated in a randomized controlled trial on the second-trimester ultrasound examination in Sweden from 1985 to 1987. Information about the children's grades when graduating from primary school and information on socioeconomic factors was obtained from Swedish nationwide registers. Comparisons were made using linear and logistic regression analyses according to randomization to ultrasound, ultrasound exposure in the second trimester and ultrasound exposure at an), time during pregnancy. Boys and girls were analyzed separately. Results Of the 4756 singleton children from the randomized trial, we identified 4458 (94%) in the National School Register. There were no statistically significant differences in school performance for boys or girls according to randomization or exposure to ultrasound in the second trimester. Compared to those who were unexposed, boys exposed to ultrasound at least once at any time during fetal life bad a tendency towards lower mean school grades in general (-4.39 points; 95% CI, -9.59 to 0.81. (max possible, 320) points) and in physical education (-0.45 points; 95% CI, -0.91 to 0.01 (max possible, 20) points), but the differences did not reach significance. Conclusion In general, routine ultrasound examination in the second trimester bad no effect on overall school performance in teenagers.
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74.
  • Stålberg, Karin, et al. (författare)
  • Prenatal ultrasound scanning and the risk of schizophrenia and other psychoses
  • 2007
  • Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 18:5, s. 577-582
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Prenatal ultrasound exposure has been associated with increased prevalence of left-hand or mixed-hand preference, and has been suggested to affect the normal lateralization of the fetal brain. Atypical lateralization is more common in patients with schizophrenia. We evaluated possible associations of prenatal ultrasound with schizophrenia and other psychoses. METHODS: We identified a cohort of individuals born in Sweden 1973-1978. During this period, one Swedish hospital (Malmö University Hospital) performed prenatal ultrasound on a routine basis, and all individuals born at that hospital were considered exposed to ultrasound. Children born at hospitals where ultrasound was not used routinely or selectively were considered unexposed. We used Poisson regression analysis to estimate the effect of ultrasound exposure on the incidence of schizophrenia and other psychoses. RESULTS: In all, 370,945 individuals were included in the study, of whom 13,212 were exposed to ultrasound. The exposed group demonstrated a tendency toward a higher risk of schizophrenia (among men, crude incidence rate ratio = 1.58 [95% confidence interval = 0.99-2.51]; among women, 1.26 [0.62-2.55]). However, men and women born in several of the 7 tertiary level hospitals without ultrasound scanning also had higher risks of schizophrenia compared with those born in other hospitals. For other psychoses there were no differences between groups. CONCLUSIONS: No clear associations between prenatal ultrasound exposure and schizophrenia or other psychoses were found. Other factors related to place of birth might have influenced the results.
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75.
  • Sundelin, Heléne E. K., et al. (författare)
  • Autism and epilepsy : A population-based nationwide cohort study
  • 2016
  • Ingår i: Neurology. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 87:2, s. 192-197
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the risk of autism spectrum disorder (ASD) in individuals with epilepsy and in their first-degree relatives to determine shared etiology.Methods: Through the Swedish Patient Register, we identified 85,201 individuals with epilepsy, as well as all their siblings (n = 80,511) and offspring (n = 98,534). Each individual with epilepsy was compared with 5 controls, matched for age, sex, calendar period, and county, while siblings and offspring were compared with siblings and offspring of controls. We excluded siblings and offspring with epilepsy. Using Cox regression, we calculated hazard ratios (HRs) for future diagnosis of ASD. Logistic regression was applied to calculate odds ratios (ORs) for prior diagnosis of ASD.Results: During follow-up, 1,381 (1.6%) individuals with epilepsy and 700 (0.2%) controls were diagnosed with ASD. Individuals with epilepsy were therefore at increased risk of future ASD (HR 10.49, 95% confidence interval [CI] 9.55-11.53), with the highest risk seen in individuals diagnosed with epilepsy in childhood. Both siblings (HR 1.62, 95% CI 1.43-1.83) and offspring (HR 1.64, 95% CI 1.46-1.84) of epilepsy patients were at increased risk of ASD. The risk in the offspring was particularly high in mothers with epilepsy (HR 1.91; 95% CI 1.63-2.23). Epilepsy was also associated with a prior diagnosis of ASD (OR 4.56, 95% CI 4.02-5.18).Conclusions: Individuals with epilepsy are at increased risk of ASD, especially if epilepsy appears in childhood. Further, ASD is more common in the siblings and offspring of individuals with epilepsy, suggesting shared etiology.
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76.
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77.
  • Sundelin, Heléne, et al. (författare)
  • Pregnancy outcomes in women with autism : a nationwide population-based cohort study
  • 2018
  • Ingår i: Clinical Epidemiology. - : DOVE Medical Press Ltd.. - 1179-1349 .- 1179-1349. ; 10, s. 1817-1826
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The consequences of autism in pregnancy outcomes have not been explored before, although it is of crucial importance because of the frequent comorbidities and medication in this group of women.Objectives: To estimate the risk of adverse pregnancy outcomes in women diagnosed with autism.Design: Nationwide population-based cohort study.Setting: Sweden.Participants: Singleton births identified in the Swedish Medical Birth Registry, 2006-2014. A total of 2,198 births to women diagnosed with autism registered in the Swedish National Patient Registry were compared to 877,742 singleton births to women without such a diagnosis.Main outcome and measures: Preterm delivery. Secondary measures were cesarean delivery (emergency and elective), Apgar score <7 at 5 minutes, small for gestational age, large for gestational age, stillbirth, gestational diabetes, and preeclampsia. ORs were calculated through logistic regression, adjusted for maternal age at delivery, maternal country of birth, smoking, maternal body mass index, parity, calendar year of birth, and psychotropic and antiepileptic medication during pregnancy.Results: Women with autism were at increased risk of preterm birth (OR=1.30; 95% CI=1.10-1.54), especially medically indicated preterm birth (OR=1.41; 95% CI=1.08-1.82), but not with spontaneous preterm birth. Maternal autism was also associated with an increased risk of elective cesarean delivery (OR=1.44; 95% CI=1.25-1.66) and preeclampsia (OR=1.34; 95% CI=1.08-1.66), but not with emergency cesarean delivery, low Apgar score (<7), large for gestational age, gestational diabetes, and stillbirth. In women with medication during pregnancy, there was no increased risk of adverse pregnancy outcome except for induction of delivery (OR=1.33; 95% CI=1.14-1.55).Conclusion and relevance: Maternal autism is associated with preterm birth, likely due to an increased frequency of medically indicated preterm births, but also with other adverse pregnancy outcomes, suggesting a need for extra surveillance during prenatal care.
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78.
  • Svensson, Anna C., et al. (författare)
  • Familial aggregation of schizophrenia : The moderating effect of age at onset, parental immigration, paternal age and season of birth
  • 2012
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 40:1, s. 43-50
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: An abundance of evidence has firmly established the familial aggregation of schizophrenia. The aim of this study was to examine how age at onset, parental characteristics and season of birth modify the familiality in schizophrenia. Methods: A population-based cohort was created by linking the Swedish Multi-Generation and Hospital Discharge Registers. Among 5,075,998 full siblings born between 1932 through to 1990, 16,346 cases of schizophrenia were identified. Familial aggregation was measured by the sibling recurrence-risk ratio, defined as the risk of schizophrenia among full siblings of schizophrenia patients compared with the risk among siblings of unaffected people. Results: We found a statistically significantly lower recurrence-risk ratio in siblings of later onset cases (7.2; 95% confidence interval (95% CI) 6.7-7.9) than of early onset cases (10.8; 95% CI 9.4-12.2). A lower recurrence-risk ratio was observed among offspring to fathers above 40 years (6.3; 95% CI 5.3-7.3) as compared with offspring of younger fathers (8.6; 95% CI 8.0-9.3). Further, among offspring to parents born outside Sweden the recurrence-risk ratio was statistically significantly lower (maternal immigrants 4.8; 95% CI 4.0-5.7, paternal immigrants 5.7; 95% CI 4.6-6.9) than among offspring to parents born in Sweden. Conclusions: The familial aggregation of schizophrenia was reduced by higher age at onset, advancing paternal age and immigrant status of parents.
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79.
  • Svensson, Anna C., et al. (författare)
  • Fertility of first-degree relatives of patients with schizophrenia : A three generation perspective
  • 2007
  • Ingår i: Schizophrenia Research. - : Elsevier BV. - 0920-9964 .- 1573-2509. ; 91:1-3, s. 238-245
  • Tidskriftsartikel (refereegranskat)abstract
    • We explored the fertility in three generations; fertility of parents, siblings and offspring to patients with schizophrenia, to test the hypothesis that the decreased reproductive rate in the patients is compensated by an increased rate in their first-degree relatives. A population-based national database was created by linking the Swedish Multi-Generation and Hospital Discharge Registers. To maximize follow-up time for schizophrenia and reproductive history, three birth cohorts were selected: parental generation, born 1918–1927 (n=274464); affected generation, born 1932–1941 (n=108502) and offspring to affected generation, born 1951–1960 (n=103105). Ratios of estimated mean number of offspring were measured (fertility ratios), comparing the study subjects to the general population. The fertility among males with schizophrenia was decreased by over 70% (fertility ratiopatients/population=0.29, 95% CI 0.25–0.35), whereas female patients had less than half as many offspring as the general female population (fertility ratiopatients/population=0.48, 95% CI 0.42–0.55). When accounting for selection bias of larger families, no statistically significant difference was found among parents of patients with and without a diagnosis of schizophrenia. Further, the fertility among siblings of schizophrenic patients did not differ from the general population. A reduction in fertility was found among offspring to patients with schizophrenia, male offspring had 12% fewer offspring (fertility ratiooffspring/population=0.88, 95%CI 0.77–1.01), while female offspring had 6% fewer offspring (fertility ratiooffspring/population=0.94, 95% CI 0.84–1.05). In conclusion, we found reduced fertility in patients with schizophrenia and among their offspring that was not compensated by higher parental or sibling fertility.
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80.
  • Svensson, C, et al. (författare)
  • Maternal Effects for Preterm Birth : A Genetic Epidemiologic Study of 630,000 Families
  • 2009
  • Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 170:11, s. 1365-1372
  • Tidskriftsartikel (refereegranskat)abstract
    • This study was undertaken to disentangle the maternal genetic from the fetal genetic effects for preterm birth and to study the possibility of these effects being explained by known risk factors. By cross-linking of the population-based Swedish Multigeneration and Medical Birth registers, 989,027 births between 1992 and 2004 were identified. Alternating logistic regression was applied to model the familial clustering with pairwise odds ratios (PORs), and covariates were included to evaluate if the familial aggregation was explained by exposure to shared risk factors. Generalized linear mixed models were used to estimate the contribution of genetic and environmental effects. Sisters of women who had a preterm delivery had themselves an increased odds of having a preterm delivery (POR = 1.8, 95% confidence interval: 1.5, 2.1), while there was no corresponding increase in odds in families joined by brothers (POR = 1.1, 95% confidence interval: 0.9, 1.4). Twenty-five percent of the variation in preterm birth was explained by maternal genetic factors, whereas fetal genetic factors only marginally influenced the variation in liability. The increased odds ratio between offspring of sisters was independent of maternal risk factors for preterm birth, suggesting that the relative importance of maternal effects is not explained by these well-known risk factors.
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