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Sökning: L773:0924 9338 OR L773:1778 3585 > (2020-2021)

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1.
  • Carpiniello, B, et al. (författare)
  • European Psychiatric Association policy paper on ethical aspects in communication with patients and their families
  • 2020
  • Ingår i: European psychiatry : the journal of the Association of European Psychiatrists. - : Royal College of Psychiatrists. - 1778-3585. ; 63:1, s. e36-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background.Establishing a valid communication is not only a basic clinical need to be met but also a relevant ethical commitment.Methods.On the basis of the relevant literature, ethical issues arising from specific, important situations in clinical practice were identified.Results.The main ethical problems regarding communication about the disorder, both in general and in relation to prodromal stages, were described and discussed together with those regarding communication about voluntary and involuntary treatments, “dual roles” enacted in clinical practice, genetic counseling, and end-of-life conditions; on the basis of what emerged, ethically driven indications and suggestions were provided.Conclusions.Several situations put the psychiatrist in front of relevant dilemmas and doubts which are no easy to face with; an ethically driven approach based upon the principle of the best interest of patients may support clinicians in their decisions.
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2.
  • Coviello, D, et al. (författare)
  • Essential information on genetic testing methods that each clinician needs to know/understand
  • 2021
  • Ingår i: EUROPEAN PSYCHIATRY. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 64, s. S49-S50
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Genetic testing is well established in many areas of clinical medicine, is increasingly used in clinical psychiatry and it becomes increasingly important to understand the scope and limitations of the different genetic tests applied. The recommended genetic work-up of patients with neurodevelopmental disorders (such as intellectual disability or autism spectrum disorders) includes conventional karyotyping (low resolution) able to detect chromosomal rearrangement and structural variants (>5Mb, 5 million-bp), testing for fragile X-Syndrome, screening for deletions and duplications down to 20 Kb by Comparative Genomic Hybridisation (CGH), able to detect Copy Number Variation (CNVs; gain or loss of genetic material compared to the reference genome). Sanger sequencing is used for mapping of single base pair genetic variants in single genes but unable to identify deletions or duplications. The more advanced Next Generation Sequencing (NGS) have enabled to detect variants in panels of 10-100 (or more) genes, or in all coding regions using Whole Exome Sequencing (WES; 23.000 genes). Whole Genome Sequencing (WGS) analysis enables also the detection of all size range and types of genetic variation including CNVs, trinucleotide repeats and translocations. All this led to an impressive change in interpreting genomic variants that need to be strictly linked to clinical information before it can be used by clinicians to improve diagnosis or care. Bioinformatic tools to annotate variants, predict their effects and select the genes and genomic regions of interest are needed to guide the clinical work followed with careful evaluation of the prioritized variants based on the clinical knowledge (https://www.cost.eu/actions/CA17130/#tabs|Name:overview).No significant relationships.
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3.
  • Dobrosavljevic, Maja, 1986-, et al. (författare)
  • Attention-deficit/hyperactivity disorder as a risk factor for dementia and mild cognitive impairment : a population-based register study
  • 2021
  • Ingår i: European psychiatry. - : Cambridge University Press. - 0924-9338 .- 1778-3585. ; 65:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous research has indicated that attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk for dementia, but studies are scarce and inconclusive. We aimed to investigate the association between ADHD, and dementia and mild cognitive impairment (MCI). Additionally, we aimed to investigate the impact of comorbid conditions, educational attainment, head injuries, other developmental disorders, and sex on the association.Methods: The study population consisted of 3,591,689 individuals born between 1932 and 1963, identified from Swedish population-based registers. Cases of ADHD, dementia and MCI were defined according to ICD diagnostic codes and ATC codes for medication prescriptions. A Cox proportional hazards model was used to test the associations between ADHD, and dementia and MCI.Results: Individuals with ADHD had an increased risk for dementia and MCI. After adjusting for sex and birth year, a hazard ratio (HR) was 2.92 (95% confidence interval 2.40-3.57) for dementia, and 6.21 (5.25-7.35) for MCI. Additional adjustment for psychiatric disorders (depression, anxiety, substance use disorder, and bipolar disorder) substantially attenuated the associations, HR = 1.62 (1.32-1.98) for dementia, and 2.54 (2.14-3.01) for MCI. Common metabolic disorders (hypertension, type 2 diabetes, and obesity), sleep disorders, head injuries, educational attainment, and other developmental disorders, had a limited impact on the association. The association between ADHD and dementia was stronger in men.Conclusions: ADHD is a potential risk factor for dementia and MCI, although the risk significantly attenuates after controlling for psychiatric disorders. Further research is needed to confirm these findings and to explore underlying mechanisms of the associations.
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4.
  • Fagerberg, T, et al. (författare)
  • Thirteen year follow up of long term treated psychotic disorder: Personality aspects
  • 2021
  • Ingår i: EUROPEAN PSYCHIATRY. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 64, s. S512-S512
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Psychotic disorders often cause a drastic change in the life situation of the affected individual. Personality is an aspect that can affect the symptoms and social function in psychotic disorders.ObjectivesNo study has examined stability of personality traits exceeding five years in patients with schizophrenia. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with psychotic disorder and healthy individuals and to evaluate case-control differences.MethodsAt three occasions during a 13-year period patients with psychotic disorders (n=28) and non-psychotic individuals (n=57) completed Swedish universities Scales of Personality (SSP). For all the individuals within- and between-subject analyses were performed at three occasions for all 13 subscales and the three overall factors of SSP. Correlations, means and SDs were calculated.ResultsTests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age and Physical Trait Aggression, where patients ratings were stable, whereas controls rated themselves less aggressive at higher age. Between-subjects correlations showed differences regarding any of the parameters diagnosis, time, age, gender or age x gender in nine of the 13 subscales as well as in factor Neuroticism.ConclusionsLong term follow-up showed a generally high stability of personality traits measured with SSP, especially among patients. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment, which is in accordance with previous studies.
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5.
  • Glans, Martin, 1985-, et al. (författare)
  • Association between adult adhd and generalised joint hypermobility, with and without systemic manifestations : A case-control study
  • 2021
  • Ingår i: European psychiatry. - : Cambridge University Press. - 0924-9338 .- 1778-3585. ; 64:Suppl. 1, s. S89-S89
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: There is growing evidence that generalised joint hypermobility (GJH) is associated with several psychiatric conditions. There are no previous studies on adult ADHD.Objectives: To evaluate, in a large Swedish sample, if generalised joint hypermobility and adult ADHD are associated.Methods: 431 adults with ADHD and 417 controls were included. GJH was assessed by the Beighton Score, a physical examination, and the 5PQ, a self-report screening tool. Exploratively, reported musculoskeletal symptoms and abnormal skin manifestations suggestive of symptomatic GJH (e.g. Ehlers-Danlos syndrome), were assessed to differentiate this group from the general GJH group. Logistic regressions determined the influence of an ADHD diagnosis and known covariates (age, sex and ethnicity) on GJH and symptomatic GJH respectively.Results: ADHD was associated to GJH, as defined by the Beighton Score and the 5PQ, with adjusted odds ratios of 4.65 (CI 95% 3.01-7.18, p<.005) and 1.86 (CI 95% 1.39-2.48, p<.005), respectively. Likewise, ADHD and symptomatic GJH were associated withadjusted odds ratios of 6.94 (CI 95% 4.05-11.89, p<.005) and 2.66 (CI 95% 1.94-3.66, p<.005).Conclusions: GJH and adult ADHD are associated conditions. Symptomatic GJH, defined as additional symptoms of pain and/or skin manifestations, has a considerably stronger link to adult ADHD than unspecific GJH has. GJH may represent a marker of an underlying systemic disorder with physical manifestations in connective tissue as well as behavioural manifestations including hyperactivity, impulsiveness and inattentiveness. Future studies should investigate if this represents a novel subtype of ADHD and if symptomatic GJH affects the ADHD management.
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6.
  • Han, Fei-Fei, et al. (författare)
  • Depressive symptoms and cognitive impairment : A 10-year follow-up study from the Survey of Health, Ageing and Retirement in Europe
  • 2021
  • Ingår i: European psychiatry. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 64:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Depressive symptoms and cognitive impairment often coexisted in the elderly. This study investigates the effect of late-life depressive symptoms on risk of mild cognitive impairment (MCI).Methods. A total of 14,231 dementia- and MCI free participants aged 60+ from the Survey of Health, Ageing, and Retirement in Europe were followed-up for 10 years to detect incident MCI. MCI was defined as 1.5 standard deviation (SD) below the mean of the standardized global cognition score. Depressive symptoms were assessed by a 12-item Europe-depression scale (EURO-D). Severity of depressive symptoms was grouped as: no/minimal (score 0–3), moderate (score 4–5), and severe (score 6–12). Significant depressive symptoms (SDSs) were defined as EURO-D score ≥ 4.Results. During an average of 8.2 (SD = 2.4)-year follow-up, 1,352 (9.50%) incident MCI cases were identified. SDSs were related to higher MCI risk (hazard ratio [HR] = 1.26, 95% confidence intervals [CI]: 1.10–1.44) in total population, individuals aged 70+ (HR = 1.35, 95% CI: 1.14–1.61) and women (HR = 1.28, 95% CI: 1.08–1.51) in Cox proportional hazard model adjusting for confounders. In addition, there was a dose–response association between the severity of depressive symptoms and MCI incidence in total population, people aged ≥70 years and women (p-trend <0.001).Conclusions. Significant depressive symptoms were associated with higher incidence of MCI in a dose–response fashion, especially among people aged 70+ years and women. Treating depressive symptoms targeting older population and women may be effective in preventing MCI.
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7.
  • Hogstrom, J, et al. (författare)
  • Restricted visual scanpaths and hyperarousal during emotion recognition in childhood social anxiety disorder
  • 2021
  • Ingår i: EUROPEAN PSYCHIATRY. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 64, s. S84-S84
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Social anxiety disorder (SAD) typically develops during late childhood or early adolescence, and often runs a chronic course if left untreated. Maladaptive processing of social information has been suggested to contribute to the etiology and maintenance of SAD. Scanpaths are a succession of visual fixations and saccades through which individuals extract information during face perception. Atypically long scanpaths have previously been reported in adults with SAD but no studies have been conducted on youth samples. SAD has previously also been linked to atypical arousal during face processing.ObjectivesThis study aimed to investigate differences in visual attention and arousal to emotional faces comparing children and adolescents with SAD to a non-psychiatric population of youths.MethodsIn one of the largest eye-tracking studies of pediatric SAD to date, children and adolescents with SAD (n = 62) and healthy controls (n = 39) completed a task where they were meant to recognise different emotional expressions in pictures of faces while their eye movements were recorded. The visual scanpath and the pupil dilation response were examined.ResultsYouth with SAD showed restricted scanpaths, suggesting they scanned a more limited part of the face during face perception. Higher pupil dilation was also observed in the children and adolescents with SAD.ConclusionsThe restricted pattern of scanpath observed in youth with SAD is contrary to findings among adults, but similar to what has been reported in neurodevelopmental disorders associated with social interaction impairments such as autism. Restricted scanpaths may partially contribute to the maintencance of social anxiety disorder.DisclosureNo significant relationships.
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8.
  • Kaldo, V., et al. (författare)
  • AI-driven adaptive treatment strategies in internet-delivered CBT
  • 2021
  • Ingår i: European psychiatry. - : Cambridge University Press. - 0924-9338 .- 1778-3585. ; 64, s. S20-S20
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Adaptive Treatment Strategies warns therapists of patients at risk of treatment failure to prompt an adaption of the intervention. Internet-delivered Cognitive Behavioural Therapy (ICBT) collects a wide range of data before and during treatment and can quickly be adapted by adjusting the level of therapist support. Objectives: To evaluate how accurate machine learning algorithms can predict a single patient’s final outcome and evaluate the opportunities for using them within an Adaptive Treatment Strategy. Methods: Over 6000 patients at the Internet Psychiatry Clinic in Stockholm receiving ICBT for major depression, panic disorder or social anxiety disorder composed a training data set for eight different machine learning methods (e.g. k-Nearest Neighbour, random forest, and multilayer perceptrons). Symptom measures, messages between therapist and patient, homework reports, and other data from baseline to treatment week four was used to predict treatment success (either 50% reduction or under clinical cut-off) for each primary symptom outcome. Results: The Balanced Accuracy for predicting failure/success always were significantly better than chance, varied between 56% and 77% and outperformed the predictive precision in a previous Adaptive Treatment Strategy trial. Predictive power increased when data from treatment weeks was cumulatively added to baseline data. Conclusions: The machine learning algorithms outperformed a predictive algorithm previously used in a successful Adaptive Treatment Strategy, even though the latter also received input from a therapist. The next steps are to visualize what factors contributes most to a specific patient’s prediction and to enhance predictive power even further by so called Ensemble Learning.No significant relationships.
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9.
  • Kleberg, J, et al. (författare)
  • Social orienting is reduced in williams syndrome
  • 2021
  • Ingår i: EUROPEAN PSYCHIATRY. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 64, s. S124-S125
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Williams syndrome (WS) is a rare genetic disorder caused by a deletion at chromosome 7q1123. WS is associated with high empathy, relatively good face memory and low social anxiety. Despite these strengths, WS individuals typically have an intellectual disability, difficulties with visuospatial perception, non-social anxiety and complex social cognition. Attention to other’s eyes is crucial for adaptive social understanding. Consequently, eyes trigger quick and automatic gaze shifts in typically developing individuals. It is not known whether this process is atypical in WS.ObjectivesTo examine visual attention to other’s eyes in Williams syndrome.MethodsIndividuals with WS (n = 35; mean age 23.5 years) were compared to controls (n = 167) in stratified age groups (7 month, 8-12 years, 13-17 years, adults). Participants were primed to look at either the eyes or the mouth of human faces. The latency and likelihood of a first gaze shift from, or to the eyes, was measured with eye tracking.ResultsWS individuals were less likely, and slower to orient to the eyes than typically developing controls in all age groups from eight years of age (all p <.001), but did not differ from 7 months old infants. In contrast to healthy individuals from eight years and above, WS individuals did not show a preference to orient towards the eyes relative to the mouth.ConclusionsDespite the hyper-social behavioral phenotype, WS is associated with reduced attention to other’s eyes during early stages of processing. This could contribute to the difficulties with complex social cognition observed in this group.DisclosureNo significant relationships.
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10.
  • Kraepelien, M (författare)
  • Individually tailored digital self-care, with and without therapist-guidance
  • 2021
  • Ingår i: EUROPEAN PSYCHIATRY. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 64, s. S19-S19
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Digital mental health services have been a part of routine care at a few locations worldwide since almost 15 years, most often in the form of Internet-based Cognitive Behavioural Therapy (ICBT) with scheduled weekly therapist-guidance. Personalization in the form of individual tailoring of treatment content is promising in ICBT. Digital Self-care, interventions constructed to be self-guided, would need to be constructed carefully to achieve equal levels of adherence and symptom reductions compared to therapist-guided interventions, especially when including individually tailored content. Objectives: To construct an individually tailored self-care intervention including a technical solution, acting as a proof of concept that self-guided digital interventions for mental health can be administered in a safe, effective, personalized and cost-effective way. Methods: In step I, a new digital platform is created based on the experience from previous successful implementations of ICBT together with experts on user experience. A series of digital mental health tools based on ICBT are tested for safety, usability and credibility. In step II these tools are combined into individually tailored package interventions for different conditions and optimized for greater efficiency. In step III these optimized interventions would be compared to their counterpart therapist-guided interventions in randomized trials. Results: Preliminary results from step I will be presented, including the current development of the digital platform and feasibility data from the first three studies.No significant relationships.
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