| 11. |
- Bergen, S. E., et al.
(författare)
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Genome-wide association study in a Swedish population yields support for greater CNV and MHC involvement in schizophrenia compared with bipolar disorder
- 2012
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Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 17:9, s. 880-886
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Tidskriftsartikel (refereegranskat)abstract
- Schizophrenia (SCZ) and bipolar disorder (BD) are highly heritable psychiatric disorders with overlapping susceptibility loci and symptomatology. We conducted a genome-wide association study (GWAS) of these disorders in a large Swedish sample. We report a new and independent case-control analysis of 1507 SCZ cases, 836 BD cases and 2093 controls. No single-nucleotide polymorphisms (SNPs) achieved significance in these new samples; however, combining new and previously reported SCZ samples (2111 SCZ and 2535 controls) revealed a genome-wide significant association in the major histocompatibility complex (MHC) region (rs886424, P = 4.54 x 10(-8)). Imputation using multiple reference panels and meta-analysis with the Psychiatric Genomics Consortium SCZ results underscored the broad, significant association in the MHC region in the full SCZ sample. We evaluated the role of copy number variants (CNVs) in these subjects. As in prior reports, deletions were enriched in SCZ, but not BD cases compared with controls. Singleton deletions were more frequent in both case groups compared with controls (SCZ: P = 0.003, BD: P = 0.013), whereas the largest CNVs (>500 kb) were significantly enriched only in SCZ cases (P = 0.0035). Two CNVs with previously reported SCZ associations were also overrepresented in this SCZ sample: 16p11.2 duplications (P = 0.0035) and 22q11 deletions (P = 0.03). These results reinforce prior reports of significant MHC and CNV associations in SCZ, but not BD.
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| 12. |
- Bergmann, O., et al.
(författare)
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The Age of Olfactory Bulb Neurons in Humans
- 2012
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Ingår i: Neuron. - : Elsevier BV. - 0896-6273 .- 1097-4199. ; 74:4, s. 634-639
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Tidskriftsartikel (refereegranskat)abstract
- Continuous turnover of neurons in the olfactory bulb is implicated in several key aspects of olfaction. There is a dramatic decline postnatally in the number of migratory neuroblasts en route to the olfactory bulb in humans, and it has been unclear to what extent the small number of neuroblasts at later stages contributes new neurons to the olfactory bulb. We have assessed the age of olfactory bulb neurons in humans by measuring the levels of nuclear bomb test-derived C-14 in genomic DNA. We report that C-14 concentrations correspond to the atmospheric levels at the time of birth of the individuals, establishing that there is very limited, if any, postnatal neurogenesis in the human olfactory bulb. This identifies a fundamental difference in the plasticity of the human brain compared to other mammals.
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| 13. |
- Butwicka, Agnieszka, et al.
(författare)
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Hypospadias and increased risk for neurodevelopmental disorders
- 2014
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Ingår i: Journal of Child Psychology and Psychiatry. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0021-9630 .- 1469-7610.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hypospadias (aberrant opening of the urethra on the underside of the penis) occurs in 1 per 300 newborn boys. It has been previously unknown whether this common malformation is associated with increased psychiatric morbidity later in life. Studies of individuals with hypospadias also provide an opportunity to examine whether difference in androgen signaling is related to neurodevelopmental disorders. To elucidate the mechanisms behind a possible association, we also studied psychiatric outcomes among brothers of the hypospadias patients. METHODS: Registry study within a national cohort of all 9,262 males with hypospadias and their 4,936 healthy brothers born in Sweden between 1973 and 2009. Patients with hypospadias and their brothers were matched with controls by year of birth and county. The following outcomes were evaluated (1) any psychiatric (2) psychotic, (3) mood, (4) anxiety, (5) eating, and (6) personality disorders, (7) substance misuse, (8) attention-deficit hyperactivity disorder (ADHD), (9) autism spectrum disorders (ASD), (10) intellectual disability, and (11) other behavioral/emotional disorders with onset in childhood. RESULTS: Patients with hypospadias were more likely to be diagnosed with intellectual disability (OR 3.2; 95% CI 2.8-3.8), ASD (1.4; 1.2-1.7), ADHD (1.5; 1.3-1.9), and behavioral/emotional disorders (1.4; 1.2-1.6) compared with the controls. Brothers of patients with hypospadias had an increased risk of ASD (1.6; 1.3-2.1) and other behavioral/emotional disorders with onset in childhood (1.2; 0.9-1.5) in comparison to siblings of healthy individuals. A slightly higher, although not statistically significant, risk was found for intellectual disability (1.3; 1.0-1.9). No relation between other psychiatric diagnosis and hypospadias was found. CONCLUSIONS: This is the first study to identify an increased risk for neurodevelopmental disorders in patients with hypospadias, as well as an increased risk for ASD in their brothers, suggesting a common familial (genetic and/or environmental) liability.
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| 14. |
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| 15. |
- Bäck, Annika, et al.
(författare)
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The Medication Adherence Report Scale (MARS-5) in a Swedish sample with bipolar disorder - a pilot study
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 2:2, s. 263-270
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test the acceptability and reliability of the Swedish translation of the Medication Adherence Report Scale-5 (MARS-5) in a sample of patients who use mood stabilising medicines for bipolar disorder. A further aim was to compare the Swedish translation of the MARS-5 with the Swedish translation of the four-item scale Morisky Medication Adherence Scale (MMAS-4). Method: The study population (n=47, 70% women) was recruited through patient education sessions, at a Patient Association meeting, in Gothenburg, Sweden, as well as through advertisements on the home pages and newsletters of the Swedish patient associations. Participants received the Swedish translations of the MARS-5 and the MMAS-4, and questions on age, education, and country of birth. Reliability was examined for internal consistency (Cronbach’s α) and test-retest (intraclass correlation (ICC), MARS-5: Pearson’s correlation coefficient (r), MMAS-4: Spearman’s rho (ρ)). The acceptability of the MARS-5 was examined with a correlation analysis between the MARS-5 and the MMAS-4 and for face validity. Results: In the study population 53.3% were categorised as adherent with the MARS-5 and 82.6% using the MMAS-4. The value of Cronbach’s α was 0.66 for the MARS-5 and 0.37 for the MMAS-4. The test-retest of the MARS-5 resulted in r=0.90 and ICC=0.91. Corresponding values for the MMAS-4 were ρ=0.84 and ICC=0.85. The correlation between the MARS-5 and the MMAS-4 was 0.55. The face validity resulted in four comments regarding difficulties in answering the MARS-5. Conclusion: The Swedish translation of the MARS-5 ought to be used instead of the MMAS-4 to measure self-reported adherence in a Swedish sample with bipolar disorder. The MARS-5 showed good psychometric properties.
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| 16. |
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| 17. |
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| 18. |
- Ekman, Mattias, et al.
(författare)
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Kostnader för bipolär sjukdom, depression, schizofreni och ångest. Rätt behandlingar kan få stora positiva samhällsekonomiska effekter. : Costs of bipolar disorder, depression, schizophrenia and anxiety. The right treatments can have significant positive socio-economic effects.
- 2014
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Ingår i: Läkartidningen. - 0023-7205. ; 111:34-35, s. 1362-4
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Tidskriftsartikel (refereegranskat)abstract
- Kunskap om både kostnader och hälsoeffekter behövs för att samhället ska kunna prioritera hur begränsade hälso- och sjukvårdsresurser bäst ska användas. Den totala samhällsekonomiska kostnaden för de fyra studerade psykiatriska sjukdomarna uppgick till 75 miljarder kronor. Kostnaden per patient var 259 000 kronor för bipolär sjukdom, 159 000 kronor för depression, 156 000 kronor för ångest och 509 000 kronor för schizofreni under år 2008. De indirekta kostnaderna för sjukfrånvaro svarade för hela 75 procent av den totala samhällskostnaden, vilket troligen ändå är en underskattning. Behandlingar som förbättrar funktionsnivå och arbetsförmåga kan få stora positiva samhällsekonomiska effekter.
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| 19. |
- Ekman, M., et al.
(författare)
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PMH30 The Societal Cost of Depression: Evidence from 10,000 Swedish Patients in Psychiatric Care
- 2012
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Ingår i: Value in Health. - 1098-3015. ; 15:4
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Konferensbidrag (refereegranskat)abstract
- Objectives Depression is a major health problem. Previous studies on the cost of depression have mainly taken a primary care perspective. Such studies do not include all patients with depression, and should be completed by cost estimates from psychiatric care. The objectives of this study were to estimate the annual societal cost of depression per patient in psychiatric care in Sweden, and to relate costs to disease severity, depressive episodes, hospitalization, and patient functioning. Methods Retrospective resource use data in inpatient and outpatient care for 2006-2008, as well as ICD-10 diagnoses and Global Assessment of Functioning (GAF), were obtained from Northern Stockholm psychiatric clinic with a catchment area including 47% of the adult inhabitants in Stockholm city. This data set was combined with national register data on prescription pharmaceuticals and sick leave to estimate the societal cost of depression. Results The study included 10,593 patients (63% women). The average annual societal cost per patient was around USD 21,000 in 2006-2008. The largest cost item was indirect costs due to productivity losses (89%), and the second largest was outpatient care (6%). Patients with mild, moderate or severe depression had an average cost of approximately USD 18,000, USD 21,000, and USD 29,000, respectively. Total costs were significantly higher during depressive episodes, for patients with co-morbid psychosis or anxiety, for hospitalized patients, and for patients with low GAF scores. Conclusions The largest share of societal costs for patients with depression in psychiatric care is indirect. The total costs were higher than previously reported from a primary care setting, and strongly related to hospitalization, episodes of active depression, and global functioning. This suggests that effective treatment and rehabilitation that avoid depressive episodes and hospitalization may not only improve patient health, but also reduce the societal cost of depression.
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| 20. |
- Ekman, M., et al.
(författare)
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The societal cost of bipolar disorder in Sweden
- 2013
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 48:10, s. 1601-1610
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of comprehensive cost-of-illness studies in bipolar disorder, in particular studies based on patient-level data. The purpose of this study was to estimate the societal cost of bipolar disorder and to relate costs to disease severity, depressive episodes, hospitalisation and patient functioning. Retrospective resource use data in inpatient and outpatient care during 2006-2008, as well as ICD-10 diagnoses and Global Assessment of Functioning (GAF) scores, were obtained from the Northern Stockholm psychiatric clinic with a catchment area including 47 % of the adult inhabitants in Stockholm. This dataset was combined with national register data on prescription pharmaceuticals and sick leave to estimate the societal cost of bipolar disorder. The study was conducted from a societal perspective, with indirect costs valued according to the human capital method. The average annual cost per patient was a,not sign28,011 in 2008 (n = 1,846). Indirect costs due to sick leave and early retirement represented 75 %, inpatient costs 13 %, outpatient costs 8 %, pharmaceuticals 2 % and community care another 2 % of the total cost. Total costs were considerably higher during mood episodes (six times higher than in remission), for hospitalised patients (a,not sign55,500 vs. a,not sign22,200) and for patients with low GAF scores. The high cost of bipolar disorder is driven primarily by indirect costs. Costs were strongly associated with mood episodes, hospitalisations and low GAF scores. This suggests that treatment that reduces the risk for relapses and hospitalizations and improve functioning may decrease both the societal cost of bipolar disorder and patient suffering.
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