| 1. |
- Levander, Sten, et al.
(författare)
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Clinical decision-making during 5 years of antipsychotic treatment
- 2007
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 17-26
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Explore how clinicians select drug treatment based on symptoms, side effects and patient factors, including patient participation in the process, and the association between these factors and attitudes towards drugs. Method: A cohort of 166 patients initially treated with risperidone was followed with yearly assessments over 5 years. At the end of the study, 101 patients were evaluated of whom 58 were still treated with risperidone. Results: More women than men remained in the study, and on the initial medication. The most common reason for medication switch was lack of efficacy. Clinicians and patients agreed well in their global ratings of medication effects and side effects. Robust associations between switch decisions and patient characteristics including symptoms and side effects could not be identified. The effects of switches were rated as better by the clinicians than by the patients. Negative drug attitudes were associated with pronounced positive symptoms (threshold effect), whereas the corresponding association with 'lack of judgment and insight' was linear over the whole range. Conclusion: The decision-making process appears to have many unknown components, and may benefit from more active patient involvement by using structured clinician and patient rating scales for monitoring the treatment. Such shared decision-making may improve compliance.
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| 2. |
- Levander, Sten, et al.
(författare)
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Nicotine use and its correlates in patients with psychosis
- 2007
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine nicotine use and its correlates among psychotic patients. Method: Longitudinal naturalistic study of 176 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders, and treated with risperidone at study entry. Levels of nicotine use (smoking, snuffing) were measured along with other relevant ratings and measurements (symptoms, drug treatment, side effects, weight, cognitive functions and outcome) at baseline and once yearly for 5 years. Results: Nicotine use was twice as common as in the general population. Only few nicotine users had started after onset of psychoses. We could not find any differences among nicotine users and non-users in diagnosis, symptoms, side effects, weight, cognitive functions, personality and outcome, cross-sectionally and longitudinally, ruling against the 'self-medication' hypothesis. Conclusion: A parsimonious interpretation of the findings is that patients suffering from psychosis fail to desist from nicotine rather than experience significant positive effects of the usage.
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| 3. |
- Lindström, Eva, et al.
(författare)
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Five-year follow-up during antipsychotic treatment : efficacy, safety, functional and social outcome
- 2007
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 5-16
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Explore the long-term course of schizophrenia and related disorders. Method: Naturalistic study of 225 patients initially treated with risperidone (monotherapy or in combination with other psychotropic drugs) over 5 years. Results: Stable symptomatology and side effects were observed. Clinician GAF scores were 55-61, but patients' self-ratings were higher. Clinician and patient CGI scores were at the same level. Annual in-patient days decreased but days in sheltered accommodations increased still more. Only 12% of the patients studied or worked fulltime. One in four had no social contacts except with staff. Eight patients died during the 5 years. Conclusion: The findings underline the chronicity and seriousness of psychotic disorders in terms of social outcome and, indirectly, the low quality of life of this group of persons. Patients were generally well aware of their illness and able to sort out symptoms from drug side effects. This opens for more active involvement of patients in monitoring their own treatment.
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| 4. |
- Alem, Atalay, et al.
(författare)
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Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour. A key informant study in Butajira, Ethiopia.
- 1999
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Ingår i: Acta Psychiatrica Scandinavica Supplementum. - : Wiley. - 0065-1591 .- 1600-5473 .- 0001-690X .- 1600-0447. ; 100:S397, s. 65-69
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Tidskriftsartikel (refereegranskat)abstract
- One hundred key informants were interviewed regarding their awareness and attitudes toward suicidal behaviour. Eighty-eight informants were male, 58 were Muslim and 42 were Christian. Informants on average, claimed to know more persons who had completed suicide than those who had attempted suicide. Almost all informants mentioned more than one cause for suicide. Of these, frustration was the most frequently mentioned cause. Most informants believed that suicide attempters are cruel, feared and not trustworthy. Their attitude toward suicide completers was expressed as condemned sinners, do not deserve funeral ceremony, and should be buried separately from others. Christians gave importance to the funeral issue more than did the Muslims. Generally, the attitudes of informants were punitive and disapproving.
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| 5. |
- Alem, Atalay, et al.
(författare)
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How are mental disorders seen and where is help sought in a rural Ethiopian community? A key informant study in Butajira, Ethiopia.
- 1999
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Ingår i: Acta Psychiatrica Scandinavica Supplementum. - : Wiley. - 0065-1591 .- 1600-5473 .- 0001-690X .- 1600-0447. ; 100:S397, s. 40-47
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Tidskriftsartikel (refereegranskat)abstract
- One hundred key informants were interviewed about their awareness, attitudes and practices regarding mental illness using the Key Informant Questionnaire developed by WHO. Case vignettes of seven common neuropsychiatric disorders were presented to the key informants. Informants' awareness about these disorders and help-seeking practices for mental and physical symptoms or conditions were assessed. An additional question on the prototype symptoms of mental disorders was also posed. Among the presented seven conditions, epilepsy was perceived as the most common condition and major depression was regarded as the least common one. Schizophrenia was judged as the most severe problem, and mental retardation was considered the second most severe condition. Talkativeness, aggression and strange behaviour were the most frequently perceived prototype symptoms of mental illness. Traditional treatment methods were preferred more often for treating symptoms of mental disorders and modern medicine was preferred more often for treating physical diseases or symptoms. Findings of this study are similar to other studies conducted in socio-culturally different communities. Working in close connection with traditional healers would give the primary health care worker a better opportunity to gain acceptance from the community and modify certain harmful practices.
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| 6. |
- Alem, Atalay, et al.
(författare)
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Suicide attempts among adults in Butajira, Ethiopia.
- 1999
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Ingår i: Acta Psychiatrica Scandinavica Supplementum. - : Wiley. - 0065-1591 .- 1600-5473 .- 0001-690X .- 1600-0447. ; 100:S397, s. 70-76
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Tidskriftsartikel (refereegranskat)abstract
- In a cross-sectional survey, 10,468 adults of a rural and semi-urban community were interviewed to determine lifetime suicide attempts. Among the study population, 58% were female, 74.4% were Muslim and 79.3% had had no formal education. The majority of the population were in the age group 25-59 years. Lifetime suicide attempt was reported by 3.2% (n = 332) of the study population. Of these, 63% (n = 208) were women. The most frequent age of attempt was between 15 and 24 years and the frequency of attempt decreased with increasing age. Hanging and poisoning were the most frequently reported methods of attempting suicide. Marital or family conflict was the most frequently reported cause for attempting suicide and most of those who reported this cause were women (Chi-square = 17.42; P < 0.001). Men were significantly more likely to use hanging to attempt suicide than women (Chi-square = 8.21; P < 0.001). Among Christians 3.9% had a lifetime suicide attempt compared to 2.9% among Muslims (Chi-square = 6.15; P < 0.05). People who currently had mental distress and problem drinking reported lifetime suicide attempt more often than others.
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| 7. |
- Alem, Atalay, et al.
(författare)
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The epidemiology of problem drinking in Butajira, Ethiopia.
- 1999
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Ingår i: Acta Psychiatrica Scandinavica Supplementum. - : Wiley. - 0065-1591 .- 1600-5473 .- 0001-690X .- 1600-0447. ; 100:S397, s. 77-83
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Tidskriftsartikel (refereegranskat)abstract
- In order to determine the prevalence and socio-demographic correlates of problem drinking, a total of 10,468 persons aged 15 and above, most residing in a rural district, were interviewed using the CAGE questionnaire as an important element of a general mental health survey. Twenty-three per cent of the respondents admitted that they currently drank alcohol. The prevalence of alcohol drinking was 15% for women and 36% for men. Among those who drank, 16% met the criterion for problem drinking as defined by two or more positive responses to the CAGE. The overall prevalence for problem drinking was found to be 3.7%. Stratified analysis for sex showed that Christian religion, male sex, being ethnically non-Gurage, and smoking were strongly associated with problem drinking in both sexes. Marital status, mental distress and income were found to be associated factors with problem drinking only in men.
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| 8. |
- Alem, Atalay, et al.
(författare)
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The prevalence and socio-demographic correlates of khat chewing in Butajira, Ethiopia.
- 1999
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Ingår i: Acta Psychiatrica Scandinavica Supplementum. - : Wiley. - 0065-1591 .- 1600-5473 .- 0001-690X .- 1600-0447. ; 100:S397, s. 84-91
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Tidskriftsartikel (refereegranskat)abstract
- A house-to-house survey was carried out in a rural Ethiopian community to determine the prevalence and socio-demographic correlates of khat use. A total of 10,468 adults were interviewed. Of these, 58% were female, and 74% were Muslim. More than half of the study population (55.7%) reported lifetime khat chewing experience and the prevalence of current use was 50%. Among current chewers, 17.4% reported taking khat on a daily basis; 16.1% of these were male and 3.4% were female. Various reasons were given for chewing khat; 80% of the chewers used it to gain a good level of concentration for prayer. Muslim religion, smoking and high educational level showed strong association with daily khat chewing.
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| 9. |
- Alem, Atalay, et al.
(författare)
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The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia.
- 1999
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Ingår i: Acta Psychiatrica Scandinavica Supplementum. - : Wiley. - 0065-1591 .- 1600-5473 .- 0001-690X .- 1600-0447. ; 100:S397, s. 48-55
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Tidskriftsartikel (refereegranskat)abstract
- A cross-sectional survey was conducted on 10,468 rural and semi-urban adults in an Ethiopian district using the Self Reporting Questionnaire (SRQ) to detect the prevalence of mental distress and its association with socio-demographic risk factors. Fifty-eight per cent of the study population were women, 74% were Muslim, 79% were illiterate. Those experiencing 11 or more symptoms out of the 20 SRQ items were considered as having mental distress. Accordingly, the prevalence of mental distress was 17%, which is comparable with the previous hospital-based studies in Ethiopia and elsewhere. However, it was higher than the previous community-based studies in Ethiopia. Mental distress was more prevalent among women. Part of the explanation was that women in the study population were older and that they were more often widowed or divorced, which were factors associated with mental distress. Illiteracy, which was more common among women and older individuals, was also independently associated with mental distress.
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| 10. |
- Mustelin, L., et al.
(författare)
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Risk of eating disorders in immigrant populations
- 2017
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Ingår i: Acta Psychiatrica Scandinavica. - Stockholm : Wiley. - 0001-690X .- 1600-0447. ; 136:2, s. 156-165
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differs from native-born Danes and Swedes. Method: All individuals born 1984–2002 (Danish cohort) and 1989–1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the development of eating disorders based on out-patient and in-patient data. Results: The risks of all eating disorder types were lower among first-generation immigrants compared to the native populations: Incidence-rate ratio (95% confidence interval) was 0.39 (0.29, 0.51) for anorexia nervosa, 0.60 (0.42, 0.83) for bulimia nervosa, and 0.62 (0.47, 0.79) for other eating disorders in Denmark and 0.27 (0.21, 0.34) for anorexia nervosa, 0.30 (0.18, 0.51) for bulimia nervosa, and 0.39 (0.32, 0.47) for other eating disorders in Sweden. Likewise, second-generation immigrants by both parents were at lower risk, whereas those with only one foreign-born parent were not. Conclusion: The decreased risk of eating disorders among immigrants is opposite to what has been observed for other psychiatric disorders, particularly schizophrenia. Possible explanations include buffering sociocultural factors and underdetection in health care.
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