| 1. |
- Kaldo, Viktor, et al.
(författare)
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Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression : two subgroup analyses.
- 2018
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 75:1, s. 52-58
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745).METHODS: After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months.RESULTS: For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found.CONCLUSIONS: No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored.
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| 2. |
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| 3. |
- Vasiljevic, Zoran, et al.
(författare)
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Incremental validity of ambulatory assessment of acute dynamic risk in predicting time to recidivism among prisoners on parole
- 2020
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Ingår i: Psychology, Crime and Law. - : Taylor & Francis. - 1068-316X .- 1477-2744. ; 26:6, s. 614-630
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the incremental validity of changes in ten stress-related acute dynamic risk factors, collected through automated telephony over 30 consecutive days following parole, for predicting time to recidivism during the following year. Before release, the participants completed self-report assessment of some stable risk factors–impulsiveness and history of problematic substance use–as well as an assessment of symptoms of anxiety experienced during the weeks prior to release. Analysis of the baseline assessments showed that impulsiveness and a history of problematic substance use, but not pre-release symptoms of anxiety, were associated with recidivism during the parole year. Growth modelling using a linear mixed model was used to assess whether inmates on parole showed changes in acute dynamic risk factors during the first month following release. Individual growth model slopes and intercept were then extracted and used as covariates in a series of Cox regression analyses to test whether changes in acute dynamic risk factors could provide incremental predictive validity beyond baseline stable risk factors. Changes in five dynamic risk factors were associated with an increased risk of recidivism, of which daily drug use and daily summary score showed incremental predictive improvement beyond impulsiveness and history of problematic drug use.
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| 5. |
- Andersson, Claes, et al.
(författare)
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Interactive voice response with feedback intervention in out-patient treatment of substance use problems in adolescents: a randomized controlled trial on substance use, stress and psychiatric symptoms.
- 2017
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 24:5, s. 789-797
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Substance use disorders and problematic substance use are common problems in adolescence and young adulthood. Brief personalized feedback has been suggested for treatment of alcohol and drug problems and poor mental health. This repeated measurement randomized controlled trial examines the effect of an interactive voice response (IVR) system for assessing stress, depression, anxiety and substance use. Methods: The IVR system was used twice weekly over 3 months after treatment initiation, with or without addition of a personalized feedback intervention on stress and mental health symptoms. Both IVR assessment only (control group) and IVR assessment including feedback (intervention group) were provided as an add-on to treatment-as-usual procedures (TAU) in outpatient treatment of substance use problems in adolescents and young adults (N = 73). Results: By using a mixed models approach, differences in change scores were analyzed over the three-month assessment period. Compared to the control group, the intervention group demonstrated significantly greater improvement in the Arnetz and Hasson stress score (AHSS, p = 0.019), the total Symptoms Checklist 8 score (SCL-8D, p = 0.037), the SCL-8D anxiety sub-score (p = 0.017), and on a summarized feedback score (p = 0.026), but not on the depression subscale. There were no differences in global substance use scores between the intervention group (feedback on mental health symptoms) and the control group. Conclusion: In conclusion, IVR may be useful for follow-up and repeated interventions as an add-on to regular treatment, and personalized feedback could potentially improve mental health in adolescents and young adults with problematic substance use.
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| 6. |
- Cruce, Gunilla, et al.
(författare)
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Experiences of alcohol and other drugs in individuals with severe mental illness and concomitant substance use disorders
- 2008
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Ingår i: Mental Health and Substance Use. - 1752-3281. ; 1:3, s. 228-241
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is well known that severe mental illness (SMI) with concurrent substance use disorders (SUD) commonly occurs. This comorbidity has distressing social, psychological, psychiatric and somatic consequences. Aim: To gain greater understanding of how individuals with SMI and SUD experience the roles of alcohol and other drugs for their health and in their life situation. Method: Eight individuals were interviewed on two occasions. The semi-structured interviews, which were based on an interview guide, were transcribed verbatim and analysed thematically. Results: Alcohol and drug use influenced the individuals’ own experiences of their health and life situation both in a positive and negative way. Substance use had meaning for their 1) experience of themselves – well-being and discomfort, energy and lack of energy, meaningfulness and disorientation, identity and personality change; 2) experiences of relationships – affiliation and alienation; 3) experiences of mental health – decreased and increased symptom levels. Conclusions: When providing treatment and support it seems important to be aware of a person’s own motives for using alcohol and drugs. From the individuals’ point of view their misuse appeared as a reasonable, but misguided effort to obtain control over his/her health and life situation.
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| 7. |
- Gustafsson, Carina, et al.
(författare)
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Effects of Psychosocial Interventions for People With Intellectual Disabilities and Mental Health Problems : A Survey of Systematic Reviews
- 2009
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Ingår i: Research on social work practice. - : Sage Publications. - 1049-7315 .- 1552-7581. ; 19:3, s. 281-290
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Forskningsöversikt (refereegranskat)abstract
- The aim of this study is to provide a survey of systematic reviews that have evaluated the effects of psychosocial interventions for adult people with intellectual disabilities and/or an autistic syndrome with concurrent mental health problems. Reviews for inclusion were identified through searches of 10 electronic databases. The authors found that 3 out of 126 published reviews met the inclusion criteria for interventions, population, and being considered a systematic review. The results imply a weak scientific support for behavioral therapy, cognitive-behavioral therapy, and some forms of integrated care and support. However, the primary studies included in the reviews have several methodological shortcomings. The results suggest future research initiatives in the direction of more effectiveness studies of good quality and reproduction of high-quality systematic reviews.
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| 8. |
- Perseius, Kent-Inge, et al.
(författare)
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Treatment of suicidal and deliberate self-harming patients with borderline personality disorder using dialectical behavioral therapy : the patients’ and the therapists’ perceptions.
- 2003
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Ingår i: Archives of Psychiatric Nursing. - : Saunders Elsevier. - 0883-9417 .- 1532-8228. ; 17:5, s. 218-227
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate patients and therapists perception of receiving and giving dialectical behavioral therapy (DBT). Ten deliberate self-harm patients with borderline personality disorder and four DBT-therapists were interviewed. The interviews were analyzed with qualitative content analysis. The patients unanimously regard the DBT-therapy as life saving and something that has given them a bearable life situation. The patients and the therapists are concordant on the effective components of the therapy: the understanding, respect, and confirmation in combination with the cognitive and behavioral skills. The experienced effectiveness of DBT is contrasted by the patient's pronouncedly negative experiences from psychiatric care before entering DBT.
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| 9. |
- Strid, Catharina, et al.
(författare)
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Changes in alcohol consumption after treatment for depression : A secondary analysis of the Swedish randomised controlled study REGASSA
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:11
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Mental health problems and hazardous alcohol consumption often co-exist. Hazardous drinking could have a negative impact on different aspects of health and also negatively influence the effect of mental health treatment. The aims of this study were to examine if alcohol consumption patterns changed after treatment for depression and if the changes differed by treatment arm and patient sex. Methods This study of 540 participants was conducted in a large randomised controlled trial (RCT) that aimed to compare the effect of internet-based cognitive behavioural therapy, physical exercise and treatment as usual on 945 participants with mild-to-moderate depression. Treatment lasted for 12 weeks; alcohol consumption (Alcohol Use Disorder Identification Test (AUDIT)) and depression (Montgomery Åsberg Depression Rating Scale (MADRS)) were assessed at baseline and 12-month follow-up. Changes in alcohol consumption were examined in relation to depression severity, treatment arm and patient sex. Results The AUDIT distribution for the entire group remained unchanged after treatment for depression. Hazardous drinkers exhibit decreases in AUDIT scores, although they remained hazardous drinkers according to the cut-off scores. Hazardous drinkers experienced similar improvements in symptoms of depression compared with non-hazardous drinkers, and there was no significant relation between changes in AUDIT score and changes in depression. No differences between treatment arm and patient sex were found. Conclusion The alcohol consumption did not change, despite treatment effects on depression. Patients with depression should be screened for hazardous drinking habits and offered evidence-based treatment for hazardous alcohol use where this is indicated. Trial registration number DRKS00008745.
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| 10. |
- Öjehagen, Agneta, et al.
(författare)
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Psychiatric symptoms in alcoholics attending outpatient treatment
- 1991
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Ingår i: Alcoholism: Clinical and Experimental Research. - : Wiley. - 0145-6008 .- 1530-0277. ; 15:4, s. 6-640
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Tidskriftsartikel (refereegranskat)abstract
- The importance of psychiatric symptomatology for the treatment course of alcoholics was analyzed in a long-term outpatient treatment study. Seventy-two patients, 60 men and 12 women, were personally interviewed during treatment and after 3 years. Before treatment psychiatric symptoms were rated according to the Comprehensive Psychopathological Rating Scale (CPRS). Women had significantly higher scores than men. Men with many symptoms and women had more psychological benefits from drinking and a more impaired personality structure than men with few symptoms. Men with many symptoms also had a lower level of social functioning. The severity of abuse did not differ between the three groups. Men with many symptoms had a less favorable outcome between 25 and 36 months after start of treatment than men with few symptoms and women. Among men who completed treatment, those with many symptoms showed a less successful course after 6 months and during the 3rd year after start of treatment, while differences after 3 months and during later stages of treatment were less pronounced. It is suggested that before start of treatment a psychiatric evaluation should be performed including psychiatric diagnosis, personality analysis, and an assessment of psychological benefits from drinking.
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