| 1. |
- Dahlberg, Karin M, et al.
(författare)
-
Mental health literacy and attitudes in a Swedish community sample - investigating the role of personal experience of mental health care.
- 2008
-
Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 8
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mental ill health is a common condition in the general population, yet only about half of those with a mental disorder have treatment contact. Personal experience may affect attitudes, which in turn influence the help-seeking process. This study investigated differences in mental health literacy and attitudes among mentally healthy persons and in persons with symptoms of mental illness with and without treatment contact. METHOD: A postal screening questionnaire was sent to a random sample of the general population aged 20-64 in the county of Skaraborg, Sweden in order to ascertain mental health status and history of treatment contact; 3538 responded (49%). Face-to-face interviews were carried out in random sub samples of mentally healthy persons (n = 128) and in mentally ill persons with (n = 125) and without (n = 105) mental health care contact. Mental health literacy and attitudes to treatment were assessed using questions based on a vignette depicting a person with depression. Past month mental disorder was diagnosed according to the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). RESULTS: Two thirds failed to recognize depression in a vignette; recognition was equally poor in mentally healthy persons and in persons with symptoms of mental illness with and without treatment contact. In response to an open-ended question concerning appropriate interventions, one third suggested counselling and only one percent proposed antidepressant treatment. Again, proportions were similar in all groups. Persons with a history of mental health contact more often suggested that a GP would provide the best form of help. When presented with a list of possible interventions, those with a history of mental health contact were more positive to medical interventions such as antidepressants, hypnotics, and inpatient psychiatric treatment. When asked about the prognosis for the condition described in the vignette, persons with treatment contact were less likely to believe in full recovery without intervention; mentally ill without treatment contact were more optimistic. CONCLUSION: Mental health literacy, specially concerning attitudes towards interventions is associated with personal history of mental health care.
|
|
| 2. |
- Olsson, Petter, et al.
(författare)
-
Attention deficit hyperactivity disorder in adults who present with self-harm : a comparative 6-month follow-up study
- 2022
-
Ingår i: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: ADHD is common in psychiatric populations. This study aimed to compare clinical characteristics in adults with and without ADHD who presented with self-harm, and to compare later risk of suicidal behaviour within 6 months.Methods: Eight hundred four adults presented with self-harm (with and without suicidal intent) at psychiatric emergency services at three Swedish hospitals. Persons with a discharge ICD-10 diagnosis F90.0-F90.9 or a prescription for ADHD medication were considered to have ADHD (n = 93). Medical records were reviewed for evidence of subsequent suicide attempts (SA) within 6 months; suicides were identified by national register.Results: Recent relationship problems were more prevalent in the ADHD group. While the index episodes of those with ADHD were more often non-suicidal, and actual SAs more often rated as impulsive, medical lethality at presentation did not differ in attempters with and without ADHD. Subsequent SAs (fatal or non-fatal) were observed in 29% of the ADHD group and 20% in all others (P = .005). A logistic regression model showed elevated risk of suicidal behaviour during follow-up in the ADHD group (OR = 1.70, CI 1.05–2.76), although a final regression model suggested that this association was partly explained by age and comorbid emotionally unstable personality disorder.Conclusions: Findings highlight the need for clinicians to take self-harm seriously in adults with ADHD.
|
|
| 3. |
- Tidemalm, Dag, et al.
(författare)
-
Excess mortality in persons with severe mental disorder in Sweden: a cohort study of 12 103 individuals with and without contact with psychiatric services.
- 2008
-
Ingår i: Clinical practice and epidemiology in mental health : CP & EMH. - 1745-0179. ; 4
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Investigating mortality in those with mental disorder is one way of measuring effects of mental health care reorganisation. This study's aim was to investigate whether the excess mortality in those with severe mental disorder remains high in Sweden after the initiation of the Community Mental Health Care Reform. We analysed excess mortality by gender, type of mental health service and psychiatric diagnosis in a large community-based cohort with long-term mental disorder. METHODS: A survey was conducted in Stockholm County, Sweden in 1997 to identify adults with long-term disabling mental disorder (mental retardation and dementia excluded). The 12 103 cases were linked to the Hospital Discharge Register and the Cause of Death Register. Standardised mortality ratios (SMRs) for 1998-2000 were calculated for all causes of death, in the entire cohort and in subgroups based on treatment setting and diagnosis. RESULTS: Mortality was increased in both genders, for natural and external causes and in all diagnostic subgroups. Excess mortality was greater among those with a history of psychiatric inpatient care, especially in those with substance use disorder. For the entire cohort, the number of excess deaths due to natural causes was threefold that due to external causes. SMRs in those in contact with psychiatric services where strikingly similar to those in contact with social services. CONCLUSION: Mortality remains high in those with long-term mental disorder in Sweden, regardless of treatment setting. Treatment programs for persons with long-term mental disorder should target physical as well as mental health.
|
|
| 4. |
|
|
| 5. |
- Wiktorsson, Stefan, 1955, et al.
(författare)
-
Clinical Characteristics in Older, Middle-Aged and Young Adults Who Present With Suicide Attempts at Psychiatric Emergency Departments : A Multisite Study
- 2022
-
Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 30:3, s. 342-351
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study age group differences in clinical characteristics in older, middle-aged and younger adults with actual suicide attempts (SA).Design: Cross-sectional cohort study.Setting: 3 Swedish university hospitals.Participants: 821 persons who presented with self-harm at psychiatric emergency departments participated. Those with non-suicidal self-injury according to the Columbia Suicide Severity Rating Scale (C-SSRS) were excluded, leaving a total of 683 with an actual SA (18–44 years, n = 423; 45-64 years, n = 164; 65+, n = 96).Measurements: Suicidal behavior was characterized with the C-SSRS and the Suicide Intent Scale (SIS); symptoms associated with suicide were rated with the Suicide Assessment Scale (SUAS). Diagnoses were set using the Mini-International Neuropsychiatric Interview. Patients self-rated their symptoms with the Karolinska Affective and Borderline Symptoms Scale (KABOSS).Results: Older adults scored higher than the younger group on SIS total score and on the subjective subscale, but no age group differences were detected for the objective subscale. Half of the 65+ group fulfilled criteria for major depression, compared to 3-quarters in both the middle-aged and young groups. Anxiety disorders, as well as alcohol and substance use disorders were also less prevalent in the 65+ group, while serious physical illness was more common. Older adults scored lower on all symptom scales; effect sizes were large.Conclusions: While older adults with an SA showed higher suicide intent than young adults, they had lower scores on all ratings of psychiatric symptomatology. Low ratings might interfere with clinicians’ assessments of the needs of older adults with intentional self-harm.
|
|
| 6. |
- Wiktorsson, Stefan, 1955, et al.
(författare)
-
Prospective cohort study of suicide attempters aged 70 and above: One-year outcomes.
- 2011
-
Ingår i: Journal of affective disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 134:1-3
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Most elderly persons who attempt suicide suffer from depression. This study aimed to investigate one-year outcomes in suicide attempters aged 70+, and to identify predictors of these outcomes. METHODS: 101 persons (mean age 80) who were hospitalized after a suicide attempt were interviewed at baseline and followed for one year by record linkage. Face-to-face interviews were carried out with 71% of those who were alive after one year (60 out of 85). Outcome measures included major/minor depression, Montgomery-Asberg Depression Rating Scale (MADRS) score, repeat non-fatal/fatal suicidal behavior and all-cause mortality. RESULTS: One half (52%) of all those who were interviewed scored <10 on the MADRS at follow-up. Among those with major depression at baseline, two thirds (26 out of 39) no longer fulfilled criteria for this disorder. Factors associated with non-remission of major depression (MADRS ≥10) included higher baseline depression and anxiety scores, higher suicide intent and lower Sense of Coherence. There were two suicides and six non-fatal repeat attempts. The relative risk of death (any cause) was 2.53 (95% CI=1.45-4.10, p<0.001). LIMITATIONS: This is a naturalistic study; participants received non-uniform treatment as usual. The proportion with repeat suicidal behavior was lower than anticipated and the study was thus underpowered with regard to this outcome. CONCLUSIONS: Half of the surviving attempters were free from depressive symptoms at one-year follow-up and there were relatively few repeat attempts. However, all cause mortality remained high in this elderly cohort.
|
|
