| 1. |
- Markström, Urban, et al.
(författare)
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Developing sustainable service user involvement practices in mental health services in Sweden : the “Userinvolve” research program protocol
- 2023
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Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 14, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this paper is to outline the protocol for the research program “UserInvolve,” with the aim of developing sustainable, service user involvement practices in mental health services in Sweden. Methods: This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects. These six research projects form the core of the UserInvolve-program and will be carried out during a six-year period (2022–2027). The projects are focused on examining articulations of experiential knowledge in user collectives, on four specific user involvement interventions (shared decision-making, peer support, user-focused monitoring, and systemic involvement methods) and on developing theory and method on co-production in mental health research and practice. Results or conclusion: The knowledge gained through the co-production approach will be disseminated throughout the program years, targeting service users, welfare actors and the research community. Based on these research activities, our impact goals relate to strengthening the legitimacy of and methods for co-production in the mental health research and practice field. Copyright © 2023 Markström, Näslund, Schön, Rosenberg, Bejerholm, Gustavsson, Jansson, Argentzell, Grim, Engdahl, Nouf, Lilliehorn and Svedberg.
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| 2. |
- Grim, Katarina, 1971-, et al.
(författare)
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Legitimizing user knowledge in mental health services : Epistemic (in)justice and barriers to knowledge integration
- 2022
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Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Including the voices and knowledge of service users is essential for developing recovery-oriented and evidence-based mental health services. Recent studies have however, suggested that challenges remain to the legitimization of user knowledge in practice. To further explore such challenges, a co-production study was conducted by a team of researchers and representatives from user organizations in Sweden. The aim of the study was to explore the barriers and facilitators to the legitimacy of user knowledge, as a central factor in sustainably implementing user influence in mental health practice. A series of workshops, with representatives of mental health services and user organizations were conducted by the research team to explore these issues. The analysis built on the theoretical framework of epistemic injustice, and the underlying aspects, testimonial, hermeneutic and participation-based injustice, were utilized as a framework for a deductive analysis. Results suggest that this is a useful model for exploring the complex dynamics related to the legitimacy of user knowledge in mental health systems. The analysis suggests that the legitimacy of user knowledge is related to the representativeness of the knowledge base, the systematic formulation of this knowledge inapplicable methods, access to resources and positions within the mental health system and participation in the process of integrating this knowledge-base in mental health contexts. Legitimizing user knowledge in practice additionally challenges mental health systems to support readiness for change in working environments and to address the power and role issues that these changes involve. Copyright © 2022 Grim, Näslund, Allaskog, Andersson, Argentzell, Broström, Jenneteg, Jansson, Schön, Svedberg, Svensson, Wåhlstedt and Rosenberg.
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| 3. |
- Jansson, Mårten
(författare)
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Genetic studies of depressive symptoms
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is focused on depressive symptoms particularly in late fife. Depressive symptoms are associated with serious negative outcomes a greater level of disability and with excess morbidity and mortality. This thesis includes a series of studies that explore the importance of genetic components on current and past depressive symptoms in a large sub-sample of the Swedish Twin Registry. More specifically gender differences, genetic risk factors, and the role of some genetic variants of candidate genes in the serotonergic system were investigated. The relative importance of genetic and environmental variance components for depressive symptoms was investigated by means of a twin design. The sex specific heritability estimates (b2) for depressive symptom-, were 14% for males and 29% for females and 23% when constrained to be equal across the sexes. The prevalence of the dichotomous depressed mood variable was 16%. for men and 24% for women with corresponding heritability estimates of 7% for males and 49% for females in the full model and 33% in the best fitting (AE) model constrained to be equal across sexes. These results show that depressive symptoms and depressed mood in the elderly are heritable, with an indication of a higher heritability for women than men. The novel real-time sequencing method, Pyrosequencing - was evaluated for genotyping of single nucleotide polymorphisms (SNPs) and the first large-scale effort at genotyping using this method was performed. Pyrosequencing genotypes were validated through duplicate analysis of 1022 genotypes against the TaqMan® 5'-nuclease assays. The Pyrosequencing method was highly efficient, robust and accurate in the analysis of SNPs. The serotonergic system is profoundly associated with mood disorders and there are several serotonergic functions that could contribute to symptoms of depression. Associations between depressed mood and polymorphic variants in the HTR2A gene and the SLC6A4 gene in a sample of 1592 twins were investigated. An increased risk (OR = 2.4) for depressed mood in males associated with a genetic variant of the HTR2A gene was found. These findings might be indicative of a gender difference in the generic composition of depressive symptoms. Monoamine oxidases deaminate biogenic amines like serotonin. The two different forms of the enzyme, MAOA and MAOB are both encoded by genes on the X chromosome. A linkage disequilibrium (LD) map was created by use of nine SNPs to determine the LD structure of the MAO locus. The locus holds two distinct LD blocks, one for each gene, with very few haplotype variants. There was an association with haplotype variants of the MAOA gene and trbc-MAO activity. However, there was no association between either, MAOA or MAOB with depressive symptoms, but an interesting additive effect was observed in females. Thus, this thesis has demonstrated that genetic variance is important for variation in depressive symptoms and that this variation appears to differ for men and women. Variants of the HTR2A receptor are associated with depressed mood in men but not women. Haplotypes of the MAOA gene are associated with levels of trbc-MAO activity but there was no clear association between variants of the MAO locus with depressive symptoms. Nonetheless, an increased number of symptoms were found with increasing numbers of alleles of certain haplotypes.
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