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- Blom, Helena, 1970-
(författare)
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Violence exposure among Swedish youth
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundViolence is a global public health problem and violence among youth is a matter of high priority. Adolescence and young adulthood are important periods for the foundation of future health. Youth victimization may have serious health consequences, making it important to address the occurrence and socio-medical context for possible interventions against violence.AimsTo analyze prevalence, risk patterns and gender differences in emotional, physical, sexual, and multiple-violence victimizations and the associations between violence victimization and sexual ill health, sexual risk behaviors and mental health in Swedish youth.MethodsA cross sectional study using two samples, a national sample from nine youth health centers in Sweden and a population-based sample from a middle-sized Swedish city. The questionnaire included standardized instruments addressing violence exposure (NorAQ), socio-demographics, mental and sexual ill-health and sexual risk behaviors, alcohol and substance use. Proportions and crude and adjusted odds ratios with a 95% CI were calculated.ResultsA total of 2,250 young women and 920 men, aged 15-23, answered the questionnaire at the youth health centers. In upper secondary school, 1,658 women and 1,589 men, aged 15-22, answered the questionnaire.High prevalence rates with gendered differences both in rates and in co-occurrence of different types of violence were found. Women were more often exposed to emotional violence and sexual violence than men, while men were more often physically victimized. For both women and men, violence victimization before the age of 15 was strongly associated with all types of violence victimizations during the past year.Strong associations were found between multiple-violence victimization and poor mental health in both genders. Among the sexually experienced students, consistent associations between lifetime multiple-violence victimization and various sexual ill-health and sexual risk behaviors were found in both genders, except for non-contraceptive use.ConclusionsHigh prevalence of violence victimization in youth and strong associations between victimization, especially multiple victimization, and poor mental and sexual health were found. This needs to be recognized and addressed in social and medical settings.
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- Lundin, Cecilia, et al.
(författare)
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Combined oral contraceptive use is associated with both improvement and worsening of mood in the different phases of the treatment cycle-A double-blind, placebo-controlled randomized trial
- 2017
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 76, s. 135-143
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Ever since the introduction of combined oral contraception (COC), one of the major reasons for discontinuing the pill use has been mood-related side effects. Moreover, women who discontinue the pill turn to less effective methods whereby the probability of an unintended conception increases. Approximately 4-10% of COC users complain of depressed mood, irritability or increased anxiety, but drug-related causality has been difficult to prove. Given the lack of randomized controlled trials in this area, we aimed to prospectively estimate the severity of adverse mood in COC users that would be as representative of general users as possible. Methods: This investigator-initiated, multi-center, randomized, double-blinded, placebo-controlled study included 202 healthy women. Women were randomized to a COC (1.5 mg estradiol and 2.5 mg nomegestrolacetate) or placebo for three treatment cycles. Main outcome measure was the Daily Record of Severity of Problems (DRSP), which was filled out daily during one baseline cycle and the final treatment cycle. Results: Results from 84 women in the COC group and 94 women in the placebo group were analysed. COC use was associated with small, but statistically significant, increases in mean anxiety (0.22; 95% CI: 0.07-0.37, p = 0.003), irritability (0.23; 95% CI: 0.07-0.38, p = 0.012), and mood swings scores (0.15; 95% CI: 0.00-0.31, p = 0.047) during the intermenstrual phase, but a significant premenstrual improvement in depression (-0.33; 95% CI: -0.62 to -0.05, p = 0.049). Secondary analyses showed that women with previous adverse hormonal contraceptive experience reported significantly greater mood worsening in the intermenstrual phase in comparison with healthy women, p <0.05. The proportion of women who reported a clinically relevant mood deterioration did not differ between those allocated to COC (24.1%) or placebo (17.0%), p = 0.262. Conclusion: COC use is associated with small but statistically significant mood side effects in the inter menstrual phase. These findings are driven by a subgroup of women who clearly suffer from COC-related side effects. However, positive mood effects are noted in the premenstrual phase and the proportion of women with clinically relevant mood worsening did not differ between treatment groups. (C) 2016 Elsevier Ltd. All rights reserved.
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- Lundin, Cecilia, et al.
(författare)
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Sexual function and combined oral contraceptives : a randomised, placebo-controlled trial
- 2018
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Ingår i: Endocrine Connections. - : Bioscientifica. - 2049-3614. ; 7:11, s. 1208-1216
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The effect of combined oral contraceptives (COCs) on female sexuality has long been a matter of discussion, but placebo-controlled studies are lacking. Thus, the aim of the present study was to investigate if an oestradiol-containing COC influences sexual function.Design: Investigator-initiated, randomised, double-blinded, placebo-controlled clinical trial where 202 healthy women were randomised to a combined oral contraceptive (1.5 mg oestradiol and 2.5 mg nomegestrol acetate) or placebo for three treatment cycles.Methods: Sexual function at baseline and during the last week of the final treatment cycle was evaluated by the McCoy Female Sexuality Questionnaire. Serum and hair testosterone levels were assessed at the same time points.Results: Compared to placebo, COC use was associated with a small decrease in sexual interest (COC median change score: -2.0; interquartile range (IQR): -5.0 to 0.5 vs placebo: -1.0; IQR: -3.0 to 2.0, P=0.019), which remained following adjustment for change in self-rated depressive symptoms (B= -0.80 +/- 0.30, Wald =7.08, P=0.008). However, the proportion of women who reported a clinically relevant deterioration in sexual interest did not differ between COC or placebo users (COC 18 (22.2%) vs placebo 16 (17.8%), P=0.47). Change in other measured aspects of sexual function as well as total score of sexual function did not differ between the two treatments.Conclusions: This study suggests that use of oestradiol-based COCs is associated with reduced sexual interest. However, the changes are minute, and probably not of clinical relevance.
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