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| 2. |
- Ekman, Carl Johan, et al.
(författare)
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Outcome of transcranial magnetic intermittent theta-burst stimulation in the treatment of depression - A Swedish register-based study
- 2023
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 329, s. 50-54
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an established treatment of depression. The more recently introduced intermittent Theta-burst stimulation (iTBS) has shown significant superiority over sham-stimulation and equal effect sizes to a 10 Hz protocol in one clinical trial. The aim of the current study was to investigate the effectiveness and tolerability of iTBS in a naturalistic, clinical setting. Further, we explored demographical and clinical predictors of response.METHODS: Data was collected from seventeen rTMS-sites in Sweden between January 2018 and May 2021, through the Swedish National Quality register for repetitive Transcranial Magnetic Stimulation (Q-rTMS). We included 542 iTBS-treated patients with unipolar or bipolar depression. Outcome was assessed with Clinical Global Impression Severity and Improvement scores in an intention to treat analysis.RESULTS: The response rate was 42.1 % and 16.1 % reached remission. The response rate was significantly larger in the oldest age group compared to the youngest (odds ratio 3.46, 95 % confidence interval 1.65-7.22). Less severe level of depression (Montgomery-Åsberg depression rating scale self-assessment < 36) at baseline predicted response and remission. Only <1 % were much or very much worse after treatment. Drop-out rate was 10.9 %. No serious adverse events were reported.LIMITATIONS: Retrospective analysis of register data. No comparison group.CONCLUSIONS: In a clinical setting, iTBS was shown to be safe and tolerable and the response rate was similar to that reported from clinical trials. Older age-group and less severe illness predicted response.
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| 3. |
- Güney, Pelin, et al.
(författare)
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Electroconvulsive Therapy in Depression : Improvement in Quality of Life Depending on Age and Sex
- 2020
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Ingår i: Journal of ECT. - : Lippincott Williams & Wilkins. - 1095-0680 .- 1533-4112. ; 36:4, s. 242-246
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: It is uncertain if there are variations in the improvement of quality in life between sexes and age groups after electroconvulsive therapy (ECT). The aim of this study was to investigate how health-related quality of life changed after treatment and to examine differences in the results between sex and age groups.METHODS: This register-based study used data from the Swedish national quality register for ECT. The study population was patients diagnosed with depression who had received ECT. Health-related quality of life was quantified using the 3-level version the EuroQol 5-dimensional questionnaire (EQ-5D 3 L). Analysis of variance was used to compare change in EQ-5D score from pretreatment to posttreatment between sex and age groups.RESULTS: There was a statistically significant improvement in EQ-5D index score and EQ visual analog scale (VAS) score in all patient groups after ECT. The mean improvement in EQ-5D index score and EQ-VAS score ranged from 0.31 to 0.46 and 28.29 to 39.79, respectively. Elderly patients had greater improvement in EQ-5D index score and EQ-VAS score than younger patients. There was no significant difference in improvement between the sexes. The mean improvement in EQ-5D index score was 0.40 for male patients and 0.41 for female patients.CONCLUSIONS: Electroconvulsive therapy had a considerable effect on health-related quality of life in patients with depression of both sexes and all age groups. The improvement was greatest in elderly patients, who more often had psychotic features. More studies are needed to investigate the long-term effects of ECT and to further explain the varying treatment results between elderly and younger patients.
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| 4. |
- Göterfelt, Linda, et al.
(författare)
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The Incidence of Dental Fracturing in Electroconvulsive Therapy in Sweden
- 2020
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Ingår i: Journal of ECT. - : Lippincott Williams & Wilkins. - 1095-0680 .- 1533-4112. ; 36:3, s. 168-171
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: One adverse effect of electroconvulsive therapy (ECT) is dental fracture; thus, a bite guard and muscle relaxants are used to prevent it. Earlier research reported varying rates of dental fracture, but there is no large-scale study on the incidence of dental fracture during ECT. This study aimed to examine the incidence of dental fracture during ECT and to investigate whether the incidence differs between different sexes, age groups, diagnosis groups, electrode placements, or number of treatment sessions.METHODS: This register-based study used data from the Swedish national quality register for ECT. All hospitals offering ECT report to this register, and the coverage ratio is about 90%. All registered patients who started an ECT series between January 2012 and January 2019 were included in this study, with the data representing 16,681 individuals, 38,862 series, and 254,906 sessions.RESULTS: Forty-six dental fractures were identified, giving an incidence of dental fracture of 0.2% per series, 0.02% per session, and 0.3% per individual. We did not find any significant associations between dental fracture rates and male or female populations, age, or different diagnosis groups, nor was there any significant difference between dental fracture rates and electrode placement. The mean number of treatments was significantly higher in the dental fracture group than in patients without dental fracture.CONCLUSIONS: There is a minimal risk of dental fracture during ECT. Our findings, together with those of other studies, provide further motivation for the use of a bite guard and muscle relaxant.
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| 5. |
- Strandberg, Pontus, et al.
(författare)
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Electroconvulsive Therapy Versus Repetitive Transcranial Magnetic Stimulation in Patients With a Depressive Episode : A Register-Based Study
- 2023
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Ingår i: Journal of ECT. - : Lippincott Williams & Wilkins. - 1095-0680 .- 1533-4112.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) are both effective in treating depression. Although rTMS induces fewer adverse effects, its effectiveness relative to ECT is not well established. The aim of this study was to investigate the treatment outcomes of ECT and rTMS in patients who have received both interventions.METHODS: This was a register-based observational crossover study in patients with depression who had undergone ECT and rTMS in Sweden between 2012 and 2021. Primary outcome was reduction in the Montgomery-Åsberg Depression Rating Scale-Self-report (MADRS-S) score. Secondary outcome was response defined as a 50% or greater decrease in the MADRS-S score. Subgroup analyses were performed to identify factors that predicted differential responses between rTMS and ECT. Continuous and categorical variables were analyzed using paired-samples t tests and McNemar tests, respectively.RESULTS: In total, 138 patients across 19 hospitals were included. The MADRS-S score after ECT and rTMS was reduced by 15.0 and 5.6 (P = 0.0001) points, respectively. Response rates to ECT and rTMS were 38% and 15% (P = 0.0001), respectively. Electroconvulsive therapy was superior across all subgroups classified according to age and severity of depression.CONCLUSIONS: Our results suggest that ECT is more effective than rTMS in treating depression among patients who have received both interventions. Age and baseline depression severity did not predict who would similarly benefit from rTMS and ECT.
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| 6. |
- Tornhamre, Elsa, et al.
(författare)
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The Effect of Pulse Width on Subjective Memory Impairment and Remission Rate 6 Months After Electroconvulsive Therapy
- 2020
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Ingår i: Journal of ECT. - : Lippincott Williams & Wilkins. - 1095-0680 .- 1533-4112. ; 36:4, s. 272-278
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to compare the 0.5-millisecond pulse width with broader brief width stimulus and ultrabrief pulse width stimulus in respect to rates of subjective memory impairment and remission 6 months after completion of electroconvulsive therapy (ECT).METHODS: This study used data from the Swedish National Quality Register for ECT. Inclusion criteria were bipolar or unipolar depression with or without psychosis, ECT with unilateral electrode placement, and data on the Montgomery-Åsberg Depression Rating Scale-Self-Assessment and the memory item of the Comprehensive Psychopathological Rating Scale (CPRS-M) before and 6 months after ECT. The primary outcomes were the distributions of patients with a maximum of 10 on the Montgomery-Åsberg Depression Rating Scale-Self-Assessment (remission) and a minimum of 2-step worsening in CPRS-M score according to the ECT pulse widths of <0.5, 0.5, and >0.5 millisecond.RESULT: This study included 312 patients. The distributions of patients with remission or a minimum of 2-step worsening on the CPRS-M 6 months after completion of ECT showed no significant differences between the 3 pulse width groups. Older age was associated with a significantly higher rate of remission 6 months after ECT.CONCLUSIONS: In this cohort of patients, no support was found for the previous research finding of lower rates of subjective memory disturbances 6 months after ultrabrief pulse width ECT in comparison with brief pulse width ECT. Older age was associated with higher remission rate 6 months after ECT. Large randomized studies are required to exclude the possibility of long-term differential effects between pulse widths.
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| 7. |
- Amnå, Erik, et al.
(författare)
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En halv miljard av statens pengar riskerar att slösas bort
- 2007
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Ingår i: Göteborgs-Posten. ; 2007-09-13, s. 47-47
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Minskade anslag gör att den årliga undersökningen om våra levnadsförhållanden hotas att halveras. Det kan drabba redan svaga grupper som äldre, invandrare och ensamstående föräldrar.
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| 8. |
- Andersson Järnberg, Linda, 1969-, et al.
(författare)
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Kommunal bolagisering : ett ständigt aktuellt ämne
- 2024
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Ingår i: Kommunal ekonomi. - : Kommunalekonomernas förening. - 0282-0099 .- 2002-3995. ; :1, s. 41-42
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Så länge kommuner har funnits har de även haft bolag och ständigt har detta varit ett ämne för debatt, där farhågor för demokratin och konkurrens lyfts. I en nyligen publicerad rapport studerar vi framväxten av kommunala bolag och granskar produktivitetsutvecklingen i dessa, som enligt beslutsfattare är ett av de viktigaste motiven till verksamhet i bolagsform.
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| 9. |
- Andersson Järnberg, Linda, 1969-, et al.
(författare)
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Kommunala bolag i Sverige : att förstå framväxten av dessa och produktivitetsutvecklingen över tid
- 2023
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Rapport (populärvet., debatt m.m.)abstract
- Svenska kommuner äger och bedriver sedan länge verksamhet i bolagsform, men står ut i internationell jämförelse genom det stora antalet kommunala bolag och storleken på dessa. Antalet bolag fortsätter dessutom att öka och spelar en viktig roll i kommunsektorns utveckling och de välfärdstjänster som sektorn tillhandahåller. Vad kan förklara denna utveckling? Baserat på data för perioden 2000-2020 finner vi att befolkningststorleken är positivt korrelerad med antalet bolag. Det tenderar alltså att vara så att stora kommuner har fler bolag än små kommuner, men befolkningsstorleken förklarar däremot inte varför bolagen i en genomsnittlig kommun växer i omfång i termer av antal anställda per invånare. Vidare finns det samband som indikerar att de kommunala bolagen i en genomsnittlig kommun blir fler och växer i termer av andel sysselsatta när skatteunderlaget ökar och den lokala arbetslösheten stiger. Vad gäller de strukturella mönstren tycks det existera lokala kluster av geografiskt närliggande kommuner med många kommunala bolag. Detta kan tyda på att kommuner imiterar varandra. När vi studerar produktiviteten i de enskilda bolagen så finner vi att de presterar ungefär lika bra som sina privata motsvarigheter. Produktivitetsutvecklingen i ett genomsnittligt kommunalt bolag skiljer sig i de flesta fall inte från ett privat bolag i samma bransch, med undantag för en bransch där den är lägre och en annan bransch där den är högre.
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| 10. |
- Andersson, Linda, et al.
(författare)
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Regional effects of military base closures : the case of Sweden
- 2007
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Ingår i: Defence and Peace Economics. - : Informa UK Limited. - 1024-2694 .- 1476-8267. ; 18:1, s. 87-97
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this paper is to investigate regional effects of military base closures in Sweden during the last decades. Our analysis is based on a regional growth model, where two equations are estimated; one equation describing the average income growth rate and one equation describing the net migration rate. The data set is a panel of 31 Swedish municipalities covering the period 1983-1998. Our main finding is that a closure of a military base has not had any significant impact on the subsequent average income growth rate nor the net migration rate in the affected municipalities. One potential explanation for these results relates to the labor market and the composition of the labor force.
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