| 1. |
- Ekström, Anne-Berit, 1960, et al.
(författare)
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Cognition and adaptive skills in myotonic dystrophy type 1: a study of 55 individuals with congenital and childhood forms.
- 2009
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Ingår i: Dev Med Child Neurol. - : Wiley. - 1469-8749 .- 0012-1622. ; 51:12, s. 982-90
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Tidskriftsartikel (refereegranskat)abstract
- Aims To investigate cognitive abilities and adaptive skills in children and adolescents with myotonic dystrophy type 1 (DM1) and correlate the findings to the cytosine-thymine-guanine (CTG) repeat expansion size. Method Cognitive level was assessed in 55 children and adolescents with DM1 (31 males, 24 females; mean age 12y 1mo, SD 5y 1mo; range 2y 7mo–21y 5mo) divided into the following categories: severe congenital DM1 (n=19), mild congenital DM1 (n=18), and childhood DM1 (n=18). The Griffiths Mental Developmental Scale, the Wechsler Scales, and the Vineland Adaptive Behavior Scales (VABS) for adaptive skills were used for this purpose. Results Learning disability was found in 95% of the severe congenital group, 83% of the mild congenital group, and 89% of the childhood DM1 group. The more severe the form of DM1, the lower the full-scale IQ (FSIQ; rs=0.28, p=0.044). The individuals with severe congenital and childhood DM1 had a significantly higher verbal IQ than performance IQ (severe congenital: mean difference 5.7, SD 5.7, p=0.008; childhood DM1: mean difference 9.8, SD 18.0, p=0.038). CTG repeat expansion correlated negatively with FSIQ (rs=−0.63, p<0.006). Almost all participants showed poor results on the VABS. There was a positive relationship between cognitive level and adaptive skills in the mild congenital (rs=0.95, p<0.01) and childhood DM1 groups (rs=0.92, p<0.01). Interpretation Children and adolescents with DM1 exhibit significant cognitive and adaptive problems.
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| 2. |
- Anckarsäter, Henrik, 1966, et al.
(författare)
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The impact of ADHD and autism spectrum disorders on temperament, character, and personality development.
- 2006
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Ingår i: The American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 163:7, s. 1239-1244
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The authors describe personality development and disorders in relation to symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders. METHOD: Consecutive adults referred for neuropsychiatric investigation (N=240) were assessed for current and lifetime ADHD and autism spectrum disorders and completed the Temperament and Character Inventory. In a subgroup of subjects (N=174), presence of axis II personality disorders was also assessed with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). RESULTS: Patients with ADHD reported high novelty seeking and high harm avoidance. Patients with autism spectrum disorders reported low novelty seeking, low reward dependence, and high harm avoidance. Character scores (self-directedness and cooperativeness) were extremely low among subjects with neuropsychiatric disorders, indicating a high overall prevalence of personality disorders, which was confirmed with the SCID-II. Cluster B personality disorders were more common in subjects with ADHD, while cluster A and C disorders were more common in those with autism spectrum disorders. The overlap between DSM-IV personality disorder categories was high, and they seem less clinically useful in this context. CONCLUSIONS: ADHD and autism spectrum disorders are associated with specific temperament configurations and an increased risk of personality disorders and deficits in character maturation.
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| 3. |
- Ekström, Anne-Berit, 1960, et al.
(författare)
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Autism spectrum conditons in myotonic dystrophy type 1: A study on 57 individuals with congenital and childhood forms
- 2008
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Ingår i: American Journal of Medical Genetics Part B: Neuropsychiatric Genetics. - : Wiley. - 1552-4841 .- 1552-485X. ; 147B:6, s. 918-926
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Tidskriftsartikel (refereegranskat)abstract
- Myotonic dystrophy type 1 (DM1) is an autosomal dominant disorder, caused by an expansion of a CTG triplet repeat in the DMPK gene. The aims of the present study were to classify a cohort of children with DM1, to describe their neuropsychiatric problems and cognitive level, to estimate the size of the CTG expansion, and to correlate the molecular findings with the neuropsychiatric problems. Fifty-seven children and adolescents (26 females; 31 males) with DM1 (CTG repeats > 40) were included in the study. The following instruments were used: Autism Diagnostic Interview-Revised (ADI-R), 5-15, Griffiths Mental Development Scales, and the Wechsler Scales. Based on age at onset and presenting symptoms, the children were divided into four DM1 groups; severe congenital (n = 19), mild congenital (n = 18), childhood (n = 18), and classical DM1 (n = 2). Forty-nine percent had an autism spectrum disorder (ASD) and autistic disorder was the most common diagnosis present in 35% of the subjects. Eighty-six percent of the individuals with DM1 had mental retardation (MR), most of them moderate or severe MR. ASD was significantly correlated with the DM1 form; the more severe the form of DM1, the higher the frequency of ASD. The frequency of ASD increased with increasing CTG repeat expansions. ASD and/or other neuropsychiatric disorders such as attention deficit hyperactivity disorder, and Tourette's disorder were found in 54% of the total DM1. group. In conclusion, awareness of ASD comorbidity in DM1. is essential. Further studies are warranted to elucidate the molecular etiology causing neurodevelopmental symptoms such as ASD and MR in DM1. (c) 2008 Wiley-Liss, Inc.
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| 4. |
- Gillberg, Christopher, 1950, et al.
(författare)
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The Asperger Syndrome (and high-functioning autism) Diagnostic Interview (ASDI): a preliminary study of a new structured clinical interview
- 2001
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Ingår i: Autism. - 1362-3613. ; 5:1, s. 57-66
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Tidskriftsartikel (refereegranskat)abstract
- The development of the Asperger Syndrome (and high-functioning autism) Diagnostic Interview (ASDI) is described. Preliminary data from a clinical study suggest that inter-rater reliability and test-retest stability may be excellent, with kappas exceeding 0.90 in both instances. The validity appears to be relatively good. No attempt was made in the present study to validate the instrument as regards the distinction between Asperger syndrome and high-functioning autism.
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| 5. |
- Gillberg, I Carina, 1949, et al.
(författare)
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Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder.
- 2007
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Ingår i: Journal of Clinical and Experimental Neuropsychology. - : Informa UK Limited. - 1380-3395 .- 1744-411X. ; 29:2, s. 170-178
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Tidskriftsartikel (refereegranskat)abstract
- In a longitudinal study, the authors explore the course of general cognition in anorexia nervosa (AN) over time and compare general cognitive problems, executive function deficits, attentional problems and visuomotor dysfunctions across AN individuals and healthy controls. A community-based sample of adolescent onset AN cases (n=40-47) was contrasted with an age-, sex- and school matched comparison group (n=47-51) on the Wechsler Adult Intelligence Scale-Revised, the Wisconsin Card Sorting Test and Luria word recall test at a mean age of 24 years. Only two of the cases tested were underweight at the time of the study. The Wechsler scale had also been administered when the groups had a mean age of 21 years. There were few differences across the two groups even though the comparison group performed significantly better on the Object Assembly subtest of the WAIS-R. IQ increased slightly but significantly over time in both groups. There was no relationship between level of starvation and poor results on tests in the AN group. A subgroup of the subjects had autism spectrum disorders. In this subgroup there were cases with test profiles similar to those observed in autism and Asperger syndrome, just as there had been on testing three years previously. Ten years after AN onset, the former AN cases showed no major neuropsychological deficits. A subgroup with autistic features had test profiles similar to those observed in autism spectrum disorders. The AN group as a whole showed poor results on the object assembly subtest indicating weak central coherence with a tendency to focus on details at the expense of configural information. This cognitive style may account for their obsession with details, with implications for psychoeducational approaches in treatment programmes/interventions.
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| 6. |
- Hofvander, Björn, et al.
(författare)
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Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders.
- 2009
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Ingår i: BMC Psychiatry. - 1471-244X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Individuals with autism spectrum disorders (ASDs) often display symptoms from other diagnostic categories. Studies of clinical and psychosocial outcome in adult patients with ASDs without concomitant intellectual disability are few. The objective of this paper is to describe the clinical psychiatric presentation and important outcome measures of a large group of normal-intelligence adult patients with ASDs. METHODS: Autistic symptomatology according to the DSM-IV-criteria and the Gillberg & Gillberg research criteria, patterns of comorbid psychopathology and psychosocial outcome were assessed in 122 consecutively referred adults with normal intelligence ASDs. The subjects consisted of 5 patients with autistic disorder (AD), 67 with Asperger's disorder (AS) and 50 with pervasive developmental disorder not otherwise specified (PDD NOS). This study group consists of subjects pooled from two studies with highly similar protocols, all seen on an outpatient basis by one of three clinicians. RESULTS: Core autistic symptoms were highly prevalent in all ASD subgroups. Though AD subjects had the most pervasive problems, restrictions in non-verbal communication were common across all three subgroups and, contrary to current DSM criteria, so were verbal communication deficits. Lifetime psychiatric axis I comorbidity was very common, most notably mood and anxiety disorders, but also ADHD and psychotic disorders. The frequency of these diagnoses did not differ between the ASD subgroups or between males and females. Antisocial personality disorder and substance abuse were more common in the PDD NOS group. Of all subjects, few led an independent life and very few had ever had a long-term relationship. Female subjects more often reported having been bullied at school than male subjects. CONCLUSION: ASDs are clinical syndromes characterized by impaired social interaction and non-verbal communication in adulthood as well as in childhood. They also carry a high risk for co-existing mental health problems from a broad spectrum of disorders and for unfavourable psychosocial life circumstances. For the next revision of DSM, our findings especially stress the importance of careful examination of the exclusion criterion for adult patients with ASDs.
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| 7. |
- Ivarsson, Tord, 1946, et al.
(författare)
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Depressive disorders in teenage-onset anorexia nervosa: a controlled longitudinal, partly community-based study.
- 2000
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Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X. ; 41:5, s. 398-403
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Tidskriftsartikel (refereegranskat)abstract
- The study objective was to examine the prevalence and course of depressive disorders (DDs) in teenage-onset anorexia nervosa (AN) over a period of 10 years. Fifty-one adolescents with AN and a sex- and age-matched control group (n = 51) were assessed at ages 16, 21, and 24 years. Probands and controls were examined in depth using semistructured and structured interviews. Their parents were interviewed on the occasion of the first examination. DDs were assessed using DSM-III-R criteria. Subjects with AN had a greatly increased rate of DDs (85%) of all kinds and at all ages as compared with control subjects. The risk of DD during the follow-up period from 21 up to and including 24 years could be predicted by diagnostic group status and the presence of DD during the period from 16 to 21 years, while the risk of DD during the follow-up period from 16 up to and including 21 years was solely predicted by the presence of AN at age 16 years. Long-term resolution of the eating disorder (ED) was associated with the absence of mood disorder or vice versa. Bipolar disorder (BP) occurred at roughly the expected rate (11%) among subjects (probands and controls) with major depression (MDD). In conclusion, depression is a very common comorbid problem in AN: more than four of five individuals with teenage-onset AN had at least one episode of DSM-III-R depression (MD or dysthymia [DT]) within 10 years after onset of the ED. AN appears to trigger the first episode of depression, but once it is manifest, depression predicts further depressive episodes.
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| 8. |
- Johansson, Maria E I, 1961, et al.
(författare)
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) Autistic spectrum disorders in Mobius sequence: a comprehensive study of 25 individuals
- 2001
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Ingår i: Developmental Medicine and Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 43:5, s. 338-345
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of autistic disorder was analysed in 25 individuals with Möbius sequence, a disorder with brain-stem dysfunction. The sample consisted of 18 males and seven females (20 participants were aged 2 to 22 years, and five were aged 1, 19 and 23 months, and 55 years old). Participants were recruited after a nationwide call and were part of a multidisciplinary study of individuals with Möbius sequence. They were given a meticulous neuropsychiatric examination including standardized autism diagnostic interviews. Ten individuals had an autistic spectrum disorder. Six of these met all diagnostic criteria for autism. In 23 individuals cognitive development could be assessed. Eight of those 23 patients had clear learning disability and six individuals were functioning in the normal but subaverage range. Autistic spectrum disorder and learning disability occurred in more than a third of the examined patients. Considering the hospital-based nature of the sample, these findings may be overestimates. Nevertheless, awareness of this coexistence is important in the diagnosis and habilitation care of children with Möbius sequence. Moreover, the results provide further support for the notion of a subgroup of autistic spectrum disorders being caused by first trimester brain-stem damage.
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| 9. |
- Lundberg, Bertil, et al.
(författare)
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Are stigma experiences among persons with mental illness, related to perceptions of self-esteem, empowerment and sense of coherence?
- 2009
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Ingår i: Journal of psychiatric and mental health nursing. - : Wiley. - 1365-2850 .- 1351-0126. ; 16:6, s. 516-22
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to explore the relationship between stigmatizing rejection experiences and self-related variables. Our hypothesis was that rejection experiences would be negatively associated with perceptions of self-esteem, empowerment and sense of coherence. A cross-sectional study assessing rejection experiences, empowerment, sense of coherence and self-esteem was performed, including 200 persons in current or earlier contact with mental health services. The results showed that experiences of rejection were negatively associated with sense of coherence, empowerment and self-esteem. This exploratory investigation suggests that experiences of rejection might be a target for coping interventions. Mental health nurses are in a key position to identify patients' experiences of stigma and by that to understand what consequences of devaluation/discrimination can have for the afflicted.
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| 10. |
- Lundberg, Bertil, et al.
(författare)
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Sociodemographic and clinical factors related to devaluation/discrimination and rejection experiences among users of mental health services.
- 2007
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Ingår i: Social psychiatry and psychiatric epidemiology. - : Springer Science and Business Media LLC. - 1433-9285 .- 0933-7954. ; 42:4, s. 295-300
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A major goal in mental health research and policy is to identify ways to reduce stigma among persons with mental illness. AIMS: The aims of the present study were to (1) investigate the prevalence of rejection and devaluation/discrimination in a cross-sectional sample of 200 individuals with experiences of mental illness and (2) investigate the relationship between sociodemographic and clinical, client characteristics and perceived devaluation/discrimination and experiences of rejection. METHODS: A total of 200 subjects in current contact with mental health services or with earlier experiences of this were interviewed regarding beliefs about devaluation/discrimination and rejection experiences. RESULTS: The results showed that subjects with a higher degree of global functioning perceived less devaluation/discrimination. With regard to rejections experiences associations were found between rejection experiences and global functioning, number of admissions to inpatient psychiatric care and current contact with social services. CONCLUSION: Further research should investigate the causal relationship between stigma experiences and psychosocial functioning. To understand what consequences perceived devaluation/discrimination has for the afflicted, a psychological and social approach in the research must be taken into consideration.
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