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1.
  • Afzelius, Maria, et al. (författare)
  • Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
  • 2018
  • Ingår i: Nordic Journal of Psychiatry. - 0803-9488. ; 72:1, s. 31-38
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A parental mental illness affects all family members and should warrant a need for support. Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration. Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients’ main diagnoses, comorbidity, children below the age of 18, and child-focused interventions. Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care. Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.
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2.
  • Afzelius, Maria, et al. (författare)
  • Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
  • 2018
  • Ingår i: Nordic Journal of Psychiatry. - TAYLOR & FRANCIS LTD. - 0803-9488 .- 1502-4725. ; 72:1, s. 31-38
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.</p>
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3.
  • Beggiato, Anita, et al. (författare)
  • Gender differences in autism spectrum disorders: Divergence among specific core symptoms
  • 2017
  • Ingår i: Autism Research. - John Wiley and Sons Inc.. - 1939-3806. ; 10:4, s. 680-689
  • Tidskriftsartikel (refereegranskat)abstract
    • Community-based studies have consistently shown a sex ratio heavily skewed towards males in autism spectrum disorders (ASD). The factors underlying this predominance of males are largely unknown, but the way girls score on standardized categorical diagnostic tools might account for the underrecognition of ASD in girls. Despite the existence of different norms for boys and girls with ASD on several major screening tests, the algorithm of the Autism Diagnosis Interview-Revised (ADI-R) has not been reformulated. The aim of our study was to investigate which ADI-R items discriminate between males and females, and to evaluate their weighting in the final diagnosis of autism. We then conducted discriminant analysis (DA) on a sample of 594 probands including 129 females with ASD, recruited by the Paris Autism Research International Sibpair (PARIS) Study. A replication analysis was run on an independent sample of 1716 probands including 338 females with ASD, recruited through the Autism Genetics Resource Exchange (AGRE) program. Entering the raw scores for all ADI-R items as independent variables, the DA correctly classified 78.9% of males and 72.9% of females (P<0.001) in the PARIS cohort, and 72.2% of males and 68.3% of females (P<0.0001) in the AGRE cohort. Among the items extracted by the stepwise DA, four belonged to the ADI-R algorithm used for the final diagnosis of ASD. In conclusion, several items of the ADI-R that are taken into account in the diagnosis of autism significantly differentiates between males and females. The potential gender bias thus induced may participate in the underestimation of the prevalence of ASD in females.
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4.
  • Depienne, Christel, et al. (författare)
  • Screening for genomic rearrangements and methylation abnormalities of the 15q11-q13 region in autism spectrum disorders.
  • 2009
  • Ingår i: Biological Psychiatry. - 0006-3223. ; 66:4, s. 349-359
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Maternally derived duplications of the 15q11-q13 region are the most frequently reported chromosomal aberrations in autism spectrum disorders (ASD).Prader-Willi and Angelman syndromes, caused by 15q11-q13 deletions or abnormal methylation of imprinted genes, are also associated with ASD. However, the prevalence of these disorders in ASD is unknown. The aim of this study was to assess the frequency of 15q11-q13 rearrangements in a large sample of patients ascertained for ASD. METHODS: A total of 522 patients belonging to 430 families were screened for deletions, duplications, and methylation abnormalities involving 15q11-q13 with multiplex ligation-dependent probe amplification (MLPA). RESULTS: We identified four patients with 15q11-q13 abnormalities: a supernumerary chromosome 15, a paternal interstitial duplication, and two subjects with Angelman syndrome, one with a maternal deletion and the other with a paternal uniparental disomy. CONCLUSIONS: Our results show that abnormalities of the 15q11-q13 region are a significant cause of ASD, accounting for approximately 1% of cases. Maternal interstitial 15q11-q13 duplications, previously reported to be present in 1% of patients with ASD, were not detected in our sample. Although paternal duplications of chromosome 15 remain phenotypically silent in the majority of patients, they can give rise to developmental delay and ASD in some subjects, suggesting that paternally expressed genes in this region can contribute to ASD, albeit with reduced penetrance compared with maternal duplications. These findings indicate that patients with ASD should be routinely screened for 15q genomic imbalances and methylation abnormalities and that MLPA is a reliable, rapid, and cost-effective method to perform this screening.
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5.
  • Dinkler, Lisa, et al. (författare)
  • Association of etiological factors across the extreme end and continuous variation in disordered eating in female Swedish twins
  • ????
  • Ingår i: Psychological Medicine. - Cambridge University Press. - 0033-2917.
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundAccumulating evidence suggests that many psychiatric disorders etiologically represent the extreme end of dimensionally distributed features rather than distinct entities. The extent to which this applies to eating disorders (EDs) is unknown.MethodsWe investigated if there is similar etiology in (a) the continuous distribution of the Eating Disorder Inventory-2 (EDI-2), (b) the extremes of EDI-2 score, and (c) registered ED diagnoses, in 1481 female twin pairs at age 18 years (born 1992-1999). EDI-2 scores were self-reported at age 18. ED diagnoses were identified through the Swedish National Patient Register, parent-reported treatment and/or self-reported purging behavior of a frequency and duration consistent with DSM-IV criteria. We differentiated between anorexia nervosa (AN) and other EDs.ResultsThe heritability of the EDI-2 score was 0.65 (95% CI 0.61-0.68). The group heritabilities in DeFries-Fulker extremes analyses were consistent over different percentile-based extreme groups [0.59 (95% CI 0.37-0.81) to 0.65 (95% CI 0.55-0.75)]. Similarly, the heritabilities in liability threshold models were consistent over different levels of severity. In joint categorical-continuous models, the twin-based genetic correlation was 0.52 (95% CI 0.39-0.65) between EDI-2 score and diagnoses of other EDs, and 0.26 (95% CI 0.08-0.42) between EDI-2 score and diagnoses of AN. The non-shared environmental correlations were 0.52 (95% CI 0.32-0.70) and 0.60 (95% CI 0.38-0.79), respectively.ConclusionsOur findings suggest that some EDs can partly be conceptualized as the extreme manifestation of continuously distributed ED features. AN, however, might be more distinctly genetically demarcated from ED features in the general population than other EDs.
6.
  • Ghaderi, Ata, et al. (författare)
  • Psychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis
  • 2018
  • Ingår i: Peerj. - 2167-8359. ; 6
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To systematically review the efficacy of psychological, pharmacological, and combined treatments for binge eating disorder (BED). Method: Systematic search and meta-analysis. Results: We found 45 unique studies with low/medium risk of bias, and moderate support for the efficacy of cognitive behavior therapy (CBT) and CBT guided selfhelp (with moderate quality of evidence), and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine (with low quality of evidence) in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. The results on weight loss were disappointing. Only lisdexamfetamine showed a very modest effect on weight loss (low quality of evidence).While there is limited support for the longterm effect of psychological treatments, we have currently no data to ascertain the long-term effect of drug treatments. Some undesired side effects are more common in drug treatment compared to placebo, while the side effects of psychological treatments are unknown. Direct comparisons between pharmaceutical and psychological treatments are lacking as well as data to generalize these results to adolescents. Conclusion: We found moderate support for the efficacy of CBT and guided selfhelp for the treatment of BED. However, IPT, SSRI, and lisdexamfetamine received only modest support in terms of cessation of or reduction in the frequency of binge eating. The lack of long-term follow-ups is alarming, especially with regard to medication. Long-term follow-ups, standardized assessments including measures of quality of life, and the study of underrepresented populations should be a priority for future research.
7.
  • Gillberg, I Carina, et al. (författare)
  • The cognitive profile of anorexia nervosa: a comparative study including a community-based sample
  • 1996
  • Ingår i: Cemprehensive Psychiatry. - Elsevier. ; 37:1, s. 23-30
  • Tidskriftsartikel (refereegranskat)abstract
    • A community-based sample of adolescent-onset anorexia nervosa (AN) cases (n = 51) was contrasted with an age-, sex-, and school-matched comparison group [comp] (n = 51) on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) at a mean age of 21 years. There were no study dropouts. Fewer than 10% of AN cases were underweight at the time of testing. Overall, there were few differences across the two groups, even though the COMP group performed significantly better on the object assembly subtest. A small subgroup of AN cases showed autism-spectrum disorders. This subgroup tended toward test profiles similar to those observed in autism and Asperger syndrome. These findings are discussed in relation to the clinical need for subgrouping of AN cases with a view to improving treatment programs/interviews.
8.
  • Haglund, Nils, et al. (författare)
  • The Observation Scale for Autism (OSA): A New Screeening Method to Detect Autism Spectrum Disorder before Age Three Years
  • 2015
  • Ingår i: Journal of Intellectual Disability - Diagnosis and Treatment. - Lifescience Global. - 2292-2598. ; 3:4, s. 230-237
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract: Background: There is an increasing body of evidence that early interventions for children with Autism Spectrum Disorder (ASD) promote a positive development of social interaction. Thus, tools for early detection of ASD are warranted. Aim: Development of, and deciding cut-off-levels for, a new screening tool for ASD, the Observation Scale for Autism (OSA). The OSA was designed to be used at the free health check-up at 30 months, offered to all children in Sweden. Method: The OSA consists of 12 observations and takes less than 10 minutes to use. The performance of the test was investigated by assessing 37 children previously diagnosed ASD, 23 with Down Syndrome (DS) and 26 typically developing children (TD). Results: Children diagnosed with ASD showed statistically significant higher scores in all 12 items compared to TD children, and significantly higher in 10 items compared to the children with DS. Most of the observations in OSA seemed to cover specific symptoms of ASD, but two of the observations were more related to developmental level. The nine most discriminative items for ASD were identified, and among those, a cut-off limit was chosen (≥3 items). Among children with ASD, 34/37 reached the proposed cut off, compared to 0/26 and 4/23 among children in the TD and DS groups, respectively. Conclusion: The results suggest that the OSA discriminates children with ASD from TD children and children with DS. Using the suggested cut off, OSA provides high sensitivity for ASD (92%) with a very low false positive rate.
9.
  • Johansson, Maria, et al. (författare)
  • Autism spectrum conditions in individuals with Mobius sequence, CHARGE syndrome and oculo-auriculo-vertebral spectrum: diagnostic aspects.
  • 2010
  • Ingår i: Research in Developmental Disabilities. - 0891-4222. ; 31:1, s. 9-24
  • Tidskriftsartikel (refereegranskat)abstract
    • As part of multidisciplinary surveys of three Behavioural Phenotype Conditions (BPCs); Möbius sequence (Möbius), CHARGE syndrome (CHARGE) and oculo-auriculo-vertebral spectrum (OAV), autism spectrum conditions (ASCs) was diagnosed in 45%, 68% and 42% of the individuals, respectively. Diagnostic difficulties due to additional dysfunctions such as mental retardation (MR), impaired vision, reduced hearing and cranial nerve dysfunction, were experienced in all three BPC groups. The applicability of current autism diagnostic instruments, such as the Autism Diagnostic Interview-Revised (ADI-R), the Childhood Autism Rating Scale (CARS) and the Autistic Behaviour Checklist (ABC), in individuals with ASCs and Möbius/CHARGE/OAV was analysed. Use of an extensive battery of diagnostic instruments, including both observational schedules and parent interviews, and, if possible, independent judgements from two clinicians, is essential in the diagnostics of ASCs in these individuals. Further, in individuals who are deaf and blind the applicability of current autism diagnostic instruments is highly questionable.
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10.
  • Johansson, Maria, et al. (författare)
  • Autism spectrum disorder and underlying brain mechanism in the oculoauriculovertebral spectrum.
  • 2007
  • Ingår i: Developmental Medicine and Child Neurology. - 0012-1622. ; 49:4, s. 280-288
  • Tidskriftsartikel (refereegranskat)abstract
    • As part of a multidisciplinary study, the rate of autism spectrum disorder (ASD), learning disability (LD), and brain abnormalities was examined in 20 participants (12 males, 8 females; age range 8mo-17y, mean age 8y 1mo) diagnosed as falling within the oculoauriculovertebral spectrum (OAV). A neuropsychiatric examination was performed, including standardized autism diagnostic interviews. Two individuals met diagnostic criteria for autism, one for autistic-like condition, and five for autistic traits. Four patients had mild LD, three severe LD, two profound LD, and two borderline intellectual functioning. Neuroimaging indicated cerebral abnormalities in more than half of the patients. Abnormalities of white/grey matter were found in more than half of examined individuals; enlargement of ventricles in more than a third. Results indicate that at least a subgroup of ASD may be associated with errors in early embryonic brain development. Awareness of the coexistence of OAV/ASD is important in habilitation care of individuals with OAV.
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