| 5411. |
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| 5412. |
- Lemón, Linda, et al.
(författare)
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Eating disorder in gambling disorder : A group with increased psychopathology
- 2021
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Ingår i: Journal of Behavioral Addictions. - : Akademiai Kiado Zrt.. - 2062-5871 .- 2063-5303. ; 10:3, s. 540-545
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Theoretical background and previous data provide some similarities between problematic gambling and eating behaviors, and a theoretically increased clinical severity in individuals suffering from both conditions. However, large datasets are lacking, and therefore, the present study aimed to study, in a nationwide register material, psychiatric comorbidity, age and gender in gambling disorder (GD) patients with or without eating disorder (ED). Methods: Diagnostic data from a nationwide register were used, including all individuals with a GD diagnosis in specialized health care in Sweden, in the years 2005-2016 (N = 2,099). Patients with GD and an ED diagnosis (n = 57) were compared to GD patients without ED. Results: Patients with GD+ED were significantly more likely than other GD patients to also have a diagnosis of drug use disorder, depressive disorders, bipolar disorders, other mood disorder, anxiety disorders, personality disorders, and neuropsychiatric disorders, when controlling for gender. In logistic regression, a comorbid ED in GD was associated with female gender, younger age, depressive disorder and personality disorders. Discussion and conclusion: In nationwide register data, despite the low number of GD+ED patients, GD patients with ED appear to have a more severe psychiatric comorbidity than GD patients without ED. The combined GD+ED conditions may require particular screening and clinical attention, as well as further research in larger and longitudinal studies.
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| 5413. |
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| 5414. |
- Lenhard, Fabian, et al.
(författare)
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Prediction of outcome in internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder : A machine learning approach
- 2018
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Ingår i: International Journal of Methods in Psychiatric Research. - : Wiley. - 1049-8931 .- 1557-0657. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are no consistent predictors of treatment outcome in paediatric obsessive–compulsive disorder (OCD). One reason for this might be the use of suboptimal statistical methodology. Machine learning is an approach to efficiently analyse complex data. Machine learning has been widely used within other fields, but has rarely been tested in the prediction of paediatric mental health treatment outcomes.Objective: To test four different machine learning methods in the prediction of treatment response in a sample of paediatric OCD patients who had received Internet-delivered cognitive behaviour therapy (ICBT).Methods: Participants were 61 adolescents (12–17 years) who enrolled in a randomized controlled trial and received ICBT. All clinical baseline variables were used to predict strictly defined treatment response status three months after ICBT. Four machine learning algorithms were implemented. For comparison, we also employed a traditional logistic regression approach.Results: Multivariate logistic regression could not detect any significant predictors. In contrast, all four machine learning algorithms performed well in the prediction of treatment response, with 75 to 83% accuracy.Conclusions: The results suggest that machine learning algorithms can successfully be applied to predict paediatric OCD treatment outcome. Validation studies and studies in other disorders are warranted.
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| 5415. |
- Lenhard, Fabian, et al.
(författare)
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The Internet Intervention Patient Adherence Scale for Guided Internet-Delivered Behavioral Interventions: Development and Psychometric Evaluation.
- 2019
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Ingår i: Journal of medical Internet research. - : JMIR Publications Inc.. - 1438-8871. ; 21:10
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Tidskriftsartikel (refereegranskat)abstract
- Patient adherence is defined as the extent to which a patient complies with medical or health advice. At present, there is a lack of reliable and valid measures specifically designed to measure adherence to internet-delivered behavioral interventions.The objective of this study was to develop and psychometrically evaluate a novel measure of adherence to guided internet-delivered behavioral interventions.In collaboration with experienced clinicians and researchers in the field, a 5-item, clinician-rated internet intervention Patient Adherence Scale (iiPAS) was developed. The initial scale was tested in a sample of children and adolescents (N=50) participating in internet-delivered cognitive behavioral therapy (ICBT) studies. A revised version of the iiPAS was then administered to a larger sample of children and adolescents (N=148) with various behavioral problems participating in ICBT trials. The scale was evaluated according to a classical test theory framework.The iiPAS demonstrated excellent internal consistency. Factor analyses revealed one underlying factor, explaining about 80% of the variance, suggesting that the scale captures a homogeneous adherence construct. The iiPAS was strongly associated with objective measures of patient activity in ICBT (number of logins, number of written characters, and completed modules). Furthermore, mid- and posttreatment ratings of the iiPAS were significantly correlated with treatment outcomes. By contrast, objective measures of patient activity in the Web-based platform did not correlate with treatment outcomes.The iiPAS could be a useful tool to measure adherence in a broad range of internet-delivered behavioral interventions.
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| 5416. |
- Lennartsson, Anna-Karin, et al.
(författare)
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DHEA and DHEA-S response to acute psychosocial stress in healthy men and women
- 2012
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Ingår i: Biological Psychology. - : Elsevier BV. - 0301-0511 .- 1873-6246. ; 90:2, s. 143-149
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the effect of acute psychosocial stress on serum concentrations of DHEA and DHEA-S in healthy men and women. Twenty men and 19 women (age 30-50 years) underwent Trier Social Stress Test (TSST). Physiological measurements were performed before, directly after the stress test and after 30 mins of recovery. In both men and women, significantly elevated DHEA and DHEA-S levels were observed in response to the stressor. There was a large inter-individual variation in the magnitude of the response, especially for DHEA but no statistical difference between men and women. Magnitude of the change in the levels of DHEA was found to be positively associated with the magnitude of the changes in ACTH, cortisol and heart rate. Furthermore, the results of this study suggest that the capacity to secrete DHEA and DHEA-S during acute psychosocial stress declines with age. (C) 2012 Elsevier B.V. All rights reserved.
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| 5417. |
- Lennartsson, Anna-Karin, et al.
(författare)
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Low Levels of Dehydroepiandrosterone Sulfate in Younger Burnout Patients
- 2015
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveDehydroepiandrosterone sulphate (DHEA-s) is an anabolic protective hormone of importance for maintenance of health. DHEA-s levels peak in young adults and decline thereafter with age. DHEA-s has previously been shown to be lower in individuals reporting prolonged stress. This study investigates DHEA-s levels in patients with clinical burnout, a disorder caused by long-term psychosocial stress.Methods122 patients (51% men) and 47 controls (51% men) in the age 25-54 years were included in the study. DHEA-s levels were compared between patients and controls in the whole sample and within each of the three 10-year-interval age groups.ResultsIn the youngest age group (25-34 years), DHEA-s levels were on average 25% lower in the patients (p = 0.006). The differences in DHEA-s levels between patients and controls were more pronounced among female than male participants (on average 32% and 13% lower, respectively). There were no differences in DHEA-s levels between patients and controls in the age group 35-44 years (p = 0.927) or 45-54 years (p = 0.897) or when analyzing all age groups together (p = 0.187).ConclusionThe study indicates that levels of the health promoting "youth" hormone DHEA-s are low in younger burnout patients. The fact that younger adults have much higher DHEA-s levels and more pronounced inter-subject variability in DHEA-s levels than older individuals might explain why burnout status differentiates patients from controls only among the youngest patients included in this study.
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| 5418. |
- Lenninger, Sofia, et al.
(författare)
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Changes in patterns of alcohol consumption in young psychiatric outpatients : two comparable samples assessed with 10 years apart
- 2023
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 77:8, s. 747-753
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Over the past 20 years, a trend towards non-drinking and less use of alcohol has been reported among young adults. This study aimed to investigate if a similar trend in alcohol consumption can be seen among young adult psychiatric outpatients.METHODS: This was a cross-sectional study based on two comparable samples of young adult (18-25 years) psychiatric outpatients recruited approximately 10 years apart in 2002-2003 (N = 197) and 2012-2016 (N = 380). The Swedish version of the Alcohol Use Disorders Identification Test (AUDIT) was used to assess alcohol consumption. Psychiatric diagnoses were based on diagnostic interviews. Differences between the two samples in alcohol consumption and a number of alcohol-use disorder diagnoses were analysed. Cramer's V was chosen as the effect size measure.RESULTS: Mean AUDIT scores and prevalence of diagnosed alcohol-use disorder in the two samples did not differ significantly. The number of non-drinkers was larger among patients in the mid-2010s (15.8% vs. 8.1%; χ2 = 6.76, p < 0.01, Φ = 0.11), but when non-drinkers were excluded, the alcohol consumption was higher among females in the later sample.CONCLUSION: The mean level of alcohol consumption seems not to have changed to the same extent among young psychiatric patients as in the general population. However, some young psychiatric patients have followed the trend of non-drinking, while others consume more alcohol. Further studies on both non-drinking and high alcohol consumption in psychiatric patients are needed to understand their mechanisms.
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| 5419. |
- Leone, Marica, et al.
(författare)
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Association of severe childhood infections with depression and intentional self-harm in adolescents and young adults
- 2022
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Ingår i: Brain, behavior, and immunity. - : Elsevier. - 0889-1591 .- 1090-2139. ; 99, s. 247-255
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Tidskriftsartikel (refereegranskat)abstract
- Early-life infections have been linked with subsequent depression and self-harm. Examination of specific groups of infections and the role of familial factors may elucidate this observed relationship. We addressed these considerations in our investigations of the association of severe childhood infections with the risks of depression and self-harm in adolescence and early-adulthood. This population-based cohort study included all individuals born in Sweden between 1982 and 1996, with follow-up through 2013 (N = 1,506,070). Severe childhood infections were identified using inpatient and outpatient diagnoses from birth through age 12. Any infection as well as specific groups of infections were investigated. We examined diagnoses of depression and self-harm within inpatient and outpatient care and death by self-harm between ages 13 and 31. Cox proportional hazards regression models were used to estimate absolute risks, hazard ratios (HRs), and 95% CIs. When adjusting for sex and birth year, individuals exposed to any childhood infection demonstrated increased absolute risk differences for both outcomes (2.42% [95% CI, 0.41%-4.43%] of being diagnosed with depression up until age 31, and 0.73% [-2.05%-3.51%] of self-harm up until age 31) and increased relative risks (HR, 1.22 [1.20-1.24] for depression and HR, 1.29 [1.25-1.32] for self-harm). When controlling for unmeasured factors shared between family members by comparing discordant siblings, no strong association persisted. Our findings show that childhood infections may not be involved in the etiology of later depression and self-harm, and highlight the importance of identifying these genetic and environmental familial risk factors, which may serve as targets for interventions.
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| 5420. |
- Leone, Marica, et al.
(författare)
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Association of Youth Depression With Subsequent Somatic Diseases and Premature Death
- 2021
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Ingår i: JAMA psychiatry. - : American Medical Association. - 2168-6238 .- 2168-622X. ; 78:3, s. 302-310
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Early-onset depression has been linked to poor health outcomes. However, it is unclear the extent to which this disorder is associated with specific diseases and premature death and whether these associations remain after controlling for psychiatric comorbidity.Objective: To quantify the association of youth depression with subsequent diagnoses of numerous somatic diseases and mortality.Design, Setting, and Participants: A population-based cohort study was conducted using Swedish national registers containing data on all individuals born in Sweden between 1982 and 1996. A total of 1 487 964 participants were followed up from age 5 years through 2013 if no censoring occurred. Data analysis was performed from January 15, 2019, to August 10, 2020.Exposures: Youth depression was defined as having received at least 1 diagnosis of depression from inpatient or outpatient care between ages 5 and 19 years.Main Outcomes and Measures: This study examined 69 somatic conditions diagnosed after youth depression, as well as all-cause and cause-specific mortalities. Overall and sex-specific hazard ratios (HRs), together with 95% CIs, were estimated using Cox proportional hazards regression with attained age as underlying timescale and time-varying exposure, and adjusted for birth year and sex. All analyses were repeated controlling for psychiatric comorbidities. Absolute risk differences were calculated using standardization with Cox proportional hazards regression.Results: Of 1 487 964 individuals included in the analysis, 51.2% were male. A total of 37 185 patients (2.5%; 67.4% female) had an inpatient or outpatient contact for depression between ages 5 and 19 years (mean [SD] age at first recorded diagnosis of depression, 16.7 [2.1] years for males and 16.7 [1.8] years for females). Age at the end of follow-up ranged between 17 and 31 years. Individuals with youth depression had higher relative risks for 66 of the 69 somatic diagnoses. Strong associations were observed for certain injuries, especially self-harm in females (HR, 14.4; 95% CI, 13.8-15.1), sleep disorders (HR, 8.1; 95% CI, 7.6-8.7), viral hepatitis (HR, 6.1; 95% CI, 5.4-6.8), all-cause mortality (HR, 5.9; 95% CI, 5.3-6.6), and cause-specific mortalities, especially death by intentional self-harm (HR, 14.6; 95% CI, 12.6-16.9). Most associations were attenuated but persisted after adjusting for psychiatric comorbidity. The absolute risk difference of a specific disease within 12 years from the first diagnosis of depression during youth ranged from -0.2% (95% CI, -1.0% to 0.6%) for arthropathies among males to 23.9% (95% CI, 22.7%-25.0%) for the broader category of injuries among females.Conclusions and Relevance: In this Swedish population cohort study, patients with depression diagnosed during their youth appeared to have increased risks for many somatic diseases as well as for mortality, even after controlling for other psychiatric disorders. These findings suggest that several medical conditions should be considered when investigating youth depression.
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