| 1. |
- Chermá, Maria D., et al.
(författare)
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Methylphenidate for Treating ADHD : A Naturalistic Clinical Study of Methylphenidate Blood Concentrations in Children and Adults With Optimized Dosage.
- 2017
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Ingår i: European journal of drug metabolism and pharmacokinetics. - : Springer Science and Business Media LLC. - 0378-7966 .- 2107-0180. ; 42:2, s. 295-307
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Methylphenidate (MPH), along with behavioral and psychosocial interventions, is the first-line medication to treat attention-deficit hyperactivity disorder (ADHD) in Sweden. The dose of MPH for good symptom control differs between patients. However, studies of MPH concentration measurement in ADHD treatment are limited.OBJECTIVE: To describe blood and oral fluid (OF) concentrations of MPH after administration of medication in patients with well-adjusted MPH treatment for ADHD, and to identify the most suitable matrix for accurate MPH concentration during treatment.METHODS: Patients were recruited from Child and Adolescent Psychiatry (CAP), General Psychiatry (GP), and the Department of Dependency (DD). Blood and OF samples were collected in the morning before MPH administration as well as 1 and 6 h after administration of the prescribed morning dose of MPH.RESULTS: Fifty-nine patients aged between 9 and 69 years, 76 % males. The daily dose of MPH varied from 18 to 180 mg, but the median daily dose per body weight was similar, approximately 1.0 mg/kg body weight. The median MPH concentration in blood 1 and 6 h after the morning dose was 5.4 and 9.3 ng/mL, respectively. Highly variable OF-to-blood ratios for MPH were found at all time points for all three groups.CONCLUSIONS: Weight is a reliable clinical parameter for optimal dose titration. Otherwise, MPH blood concentration might be used for individual dose optimization and for monitoring of the prescribed dose. Relying only on the outcome in OF cannot be recommended for evaluation of accurate MPH concentrations for treatment monitoring.
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| 2. |
- Gustafsson, Berit M., 1966-, et al.
(författare)
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Hyperactivity precedes conduct problems in preschool children : a longitudinal study.
- 2018
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Ingår i: BJPsych Open. - : Cambridges Institutes Press. - 2056-4724. ; 4:4, s. 186-191
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Tidskriftsartikel (refereegranskat)abstract
- Background: Externalising problems are among the most common symptoms of mental health problems in preschool children.Aims: To investigate the development of externalising problems in preschool children over time, and the way in which conduct problems are linked to hyperactivity problems.Method: In this longitudinal study, 195 preschool children were included. Latent growth modelling of conduct problems was carried out, with gender and hyperactivity at year 1 as time-invariant predictors.Results: Hyperactivity was a significant predictor for the intercept and slope of conduct problems. Children with more hyperactivity at year 1 had more conduct problems and a slower reduction in conduct problems. Gender was a significant predictor for the slope of conduct problems.Conclusions: Children with more initial hyperactivity have less of a reduction in conduct problems over time. It is important to consider the role of hyperactivity in studies of the development of conduct problems.Declaration of interest: None.
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| 3. |
- Gustafsson, Berit M., 1966-
(författare)
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Identifying Patterns of Emotional and Behavioural Problems in Preschool children : Facilitating Early Detection
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Mental health problems often debut in early childhood and may last throughout adulthood, thereby making early detection and intervention especially important. The overarching aim of the present thesis was to identify patterns of emotional and behavioural problems indicating mental health problems in preschool children. To facilitate the detection of such problems early on, one available screening instrument Strengths and Difficulties Questionnaire (SDQ), was validated. The development and interaction of externalising problems in preschool children were studied over time. Functioning and behaviour and their relations to protective and risk indicators in both environmental and personal characteristics were explored. The long-term goal was to increase knowledge about early identification of emotional and behavioural problems in preschool children in order to facilitate early intervention.In Study I (n=690), the subscales Hyperactivity and Conduct Problems were shown to be valid for children in the age group 1–3 years. A reasonable level of validity was found for the age group 4–5 years when using the original SDQ four-factor solution. The preschool teachers considered most of the SDQ items relevant and possible to rate. Based on the results of Study II (n=815), a score of ≥12 on the SDQ Total Problems Scale is recommended as a cut-off for Swedish preschool children. There were significant differences between boys and girls on all subscales except for the Emotional subscale. The Swedish norms for SDQ are to a large extent similar to findings from other European countries. Study III (n=195) showed that preschool children’s conduct problems decrease over time. Children exhibiting more initial hyperactivity (at year 1) have less reduction in conduct problems over time, i.e. the more hyperactivity early in life, the more conduct problems at year 3. In Study IV (n=197), children high in engagement and social interaction function well over time, even in the presence of hyperactivity, while children with low engagement and interaction alone or in combination with hyperactivity and conduct problems continue to have problems. Stability was related to the existence of a larger number of protective or risk indicators respectively.Taken together, this thesis has shown that the SDQ can be used to identify preschool children at risk of developing mental health problems later in life.
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| 4. |
- Klingberg, Torkel, et al.
(författare)
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Computerized training of working memory in children with ADHD--a randomized, controlled trial.
- 2005
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567 .- 1527-5418. ; 44:2, s. 177-186
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Deficits in executive functioning, including working memory (WM) deficits, have been suggested to be important in attention-deficit/hyperactivity disorder (ADHD). During 2002 to 2003, the authors conducted a multicenter, randomized, controlled, double-blind trial to investigate the effect of improving WM by computerized, systematic practice of WM tasks. METHOD: Included in the trial were 53 children with ADHD (9 girls; 15 of 53 inattentive subtype), aged 7 to 12 years, without stimulant medication. The compliance criterion (>20 days of training) was met by 44 subjects, 42 of whom were also evaluated at follow-up 3 months later. Participants were randomly assigned to use either the treatment computer program for training WM or a comparison program. The main outcome measure was the span-board task, a visuospatial WM task that was not part of the training program. RESULTS: For the span-board task, there was a significant treatment effect both post-intervention and at follow-up. In addition, there were significant effects for secondary outcome tasks measuring verbal WM, response inhibition, and complex reasoning. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post-intervention and at follow-up. CONCLUSIONS: This study shows that WM can be improved by training in children with ADHD. This training also improved response inhibition and reasoning and resulted in a reduction of the parent-rated inattentive symptoms of ADHD.
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| 5. |
- Annerbäck, Eva-Maria, 1948-, et al.
(författare)
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Severe child abuse: a study of cases reported to the police
- 2007
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 96:12, s. 1760-1764
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the characteristics of severe abuse of children and possible differences in comparison with less severe abuse. Method: Cases of abuse reported to the police within a single police district (n = 142) in Sweden were studied. The severe cases were compared to all the remaining cases. Results: Severe abuse constituted 14% of the total cases and was reported by agencies to a greater degree than minor cases. The suspected perpetrators were socially disadvantaged people in both groups. Half of the most serious cases led to conviction in the courts, compared to 8% in the reference group. The children who had been subjected to abuse were often already known to social services and reports of child abuse had frequently been made. Conclusion: In comparison between cases of severe and minor child abuse reported to the police, the results did not show any crucial differences except the pattern of reporting and a higher occurrence of prosecution/conviction in the severe cases. This finding places a responsibility on agencies outside of the justice system to consider all cases of reported abuse as serious warning signals and to make independent evaluations to identify risks and the possible need for child protection.
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| 6. |
- Bhalerao, Rupali, et al.
(författare)
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Gene expression in autumn leaves
- 2003
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Ingår i: Plant Physiology. - : Oxford University Press (OUP). - 0032-0889 .- 1532-2548. ; 131:2, s. 430-442
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Tidskriftsartikel (refereegranskat)abstract
- Two cDNA libraries were prepared, one from leaves of a field-grown aspen (Populus tremula) tree, harvested just before any visible sign of leaf senescence in the autumn, and one from young but fully expanded leaves of greenhouse-grown aspen (Populus tremula X tremuloides). Expressed sequence tags (ESTs; 5,128 and 4,841, respectively) were obtained from the two libraries. A semiautomatic method of annotation and functional classification of the ESTs, according to a modified Munich Institute of Protein Sequences classification scheme, was developed, utilizing information from three different databases. The patterns of gene expression in the two libraries were strikingly different. In the autumn leaf library, ESTs encoding metallothionein, early light-inducible proteins, and cysteine proteases were most abundant. Clones encoding other proteases and proteins involved in respiration and breakdown of lipids and pigments, as well as stress-related genes, were also well represented. We identified homologs to many known senescence-associated genes, as well as seven different genes encoding cysteine proteases, two encoding aspartic proteases, five encoding metallothioneins, and 35 additional genes that were up-regulated in autumn leaves. We also indirectly estimated the rate of plastid protein synthesis in the autumn leaves to be less that 10% of that in young leaves.
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| 7. |
- Broberg, AG, et al.
(författare)
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Self-reported competencies and problems among Swedish adolescents : A normative study of the YSR
- 2001
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Ingår i: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 10:3, s. 186-193
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to provide a standardisation of self-reported competencies and emotional/behavioural problems among Swedish adolescents, using the Youth Self-Report (YSR). The YSR was completed by 2522 adolescents aged 13-18 years, recruited from secondary and upper secondary schools in different regions in Sweden. The results showed that effects of gender and age were small but significant with girls scoring higher than boys on most problem scales, and 15- to 16-year-olds scoring higher than younger and older adolescents on the problem scales. Small effects were also found for residence as well as for parental SES. The correlations between internalising and externalising problems were 0.51 for boys and 0.49 for girls, whereas the correlation between competence and problem scores was low. We conclude that the individual variation in YSR-scores is much greater than can be attributed to factors such as gender, age, SES, or residential area. Consequently, the YSR has the potential to serve as an instrument for assessing individual adolescents' self-reported competencies and problems in Sweden. Given the almost orthogonal relation between self-reported competencies and problems, the competence scale is surprisingly little used in psychopathology research.
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| 8. |
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| 9. |
- Emilsson, Maria, 1966-, et al.
(författare)
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Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder
- 2016
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Ingår i: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; , s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Adherence to attention deficit hyperactivity disorder (ADHD) treatment is important because, when untreated, it may have serious consequences with lifelong effects. In the case of adolescents on long-term medicine prescription, more knowledge is needed regarding adherence and factors influencing adherence, which was the purpose of this study. Adolescents (n = 101) on ADHD medication ≥6 months were administrated questionnaires at amonitoring appointment: Medication Adherence Report Scale (MARS), beliefs about medicines (BMQ) and the Brief Illness Perception Questionnaire (B-IPQ). Adherencewas high, the mean value was 88% of the maximum MARS score, and correlated positively with the "BMQ necessity-concerns differential" but negatively with "BMQ concerns"and "BMQ-side effects". Adolescents with more belief in the necessity of the medication, less concerns and less experience of side effects tended to be more adherent to medication prescription ("intentional non-adherence"),while "unintentional non-adherence" (forgetfulness) was associated with how much they perceived that their ADHD affected their lives. In a multiple regression model, the variance of MARS total (R2 = 0.21) and “intentional nonadherence” (R2 = 0.24) was explained by the “BMQ-necessity–concern differential” and “BMQ-experienced side effects”. The variance of “unintentional non-adherence” (R2 = 0.12) was explained by the “BMQ-necessity–concern differential” and “B-IPQ-consequences of ADHD”. In conclusion, adolescents on long-term medication reported good adherence, mainly influenced by more beliefs in the necessity versus concerns of the medications, less experienced side effects and more perceived consequences of ADHD. BMQ could be useful to identify risks of low adherence, which should be counteracted by partially gender-specific interventions.
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| 10. |
- Emilsson, Maria, 1966-, et al.
(författare)
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Impact of personality on adherence to and beliefs about ADHD medication, and perceptions of ADHD in adolescents
- 2020
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Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 20:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background Adherence to attention deficit hyperactivity disorder (ADHD) medication can prevent serious consequences, possibly with lifelong effects. Numerous factors have been observed that influence adherent behaviour, but the impact of personality traits has been inadequately explored. The purpose of this study was to explore the associations between personality traits and adherence to ADHD medication, beliefs about the medication, and perceptions of ADHD. Method Adolescents (n = 99) on ADHD medication were administered: Health-Relevant Personality Traits Five-Factor Inventory, Medication Adherence Report Scale, Beliefs about Medicines Specific and Brief Illness Perceptions Questionnaires. Results The personality trait Antagonism correlated with adherence behaviour (r = - 0.198, p = 0.005) and perceived personal control of ADHD (r = - 0.269, p = 0.007). Negative Affectivity correlated with beliefs regarding necessity (r = 0.319, p = 0.001), concerns (r = 0.344, p = 0.001), and experienced side effects of medication (r = 0.495, p = 0.001), alongside perceptions regarding duration (r = 0.272, p = 0.007), identity (r = 0.388, p < 0.001), being emotionally affected (r = 0.374, p < 0.01), personal control (r = - 0.287, p = 0.004) and concerns about ADHD (r = 0.465, p < 0.001). Impulsivity correlated with perceived consequences (r = - 0.226, p = 0.0255) and personal control of ADHD (r = - 0.379, p < 0.001). Hedonic Capacity correlated with concerns about medication (r = - 0.218, p = 0.0316) and perceived identification with ADHD (r = - 0.203, p = 0.045). Conclusion Personality traits are related to adherence, beliefs about ADHD medicines and perceptions of ADHD. Antagonism is associated with adherence, especially intentional non-adherence, while Negative Affectivity correlates with numerous perceptions of ADHD and beliefs about medications. Personality assessments could be useful in the care and treatment of adolescents with ADHD.
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