| 1. |
- Björk, Anna, et al.
(författare)
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High prevalence of neurodevelopmental problems in adolescents eligible for bariatric surgery for severe obesity
- 2021
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Ingår i: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:5, s. 1534-1540
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To assess the prevalence of neurodevelopmental problems in adolescents with severe obesity and their associations with binge eating and depression. Methods: Data were collected at inclusion in a randomised study of bariatric surgery in 48 adolescents (73% girls; mean age 15.7 ± 1.0 years; mean body mass index 42.6 ± 5.2 kg/m2). Parents completed questionnaires assessing their adolescents’ symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder and reported earlier diagnoses. Patients answered self-report questionnaires on binge eating and depressive symptoms. Results: The parents of 26/48 adolescents (54%) reported scores above cut-off for symptoms of the targeted disorders in their adolescents, but only 15% reported a diagnosis, 32% of adolescents reported binge eating, and 20% reported symptoms of clinical depression. No significant associations were found between neurodevelopmental problems and binge eating or depressive symptoms. Only a third of the adolescents reported no problems in either area. Conclusion: Two thirds of adolescents seeking surgical weight loss presented with substantial mental health problems (reported by themselves or their parents). This illustrates the importance of a multi-professional approach and the need to screen for and treat mental health disorders in adolescents with obesity.
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| 2. |
- Dahlgren, Annika, 1964, et al.
(författare)
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Linking the Klein-Bell ADL Scale to the International Classification of Functioning, Disability, and Health (ICF) : Linking an ADL scale to the ICF
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 45:4, s. 351-7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The main objective of this study was to link the Klein-Bell Activities of Daily Living (KB) Scale to the International Classification of Functioning, Disability and Health (ICF), in order to validate the KB Scale content-wise. Design: A qualitative approach was used with directed content analysis. Methods: Concepts in the KB Scale items were linked to ICF categories according to established rules. This was followed by 4 analyses: examination of the linked categories' frequency distribution; comparison of these categories with Core Sets for spinal cord injury (SCI) and occupational therapists; calculation of content density, content diversity and range of linked categories; and calculation of agreement between two independent linkage versions. Results: All except one identified KB Scale concept could be linked to ICF categories. The occupational therapists Core Sets were most consistent with linked categories in the KB Scale. Content density, content diversity and range varied between the different KB Scale dimensions. Agreement was reliable for the whole KB Scale and for 5 of 6 dimensions. Conclusion: The ICF has provided a valuable reference to identify and quantify the concepts in the KB Scale. Furthermore, comparison between the KB Scale and ICF Core Sets provides insights into areas covered by these instruments.
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| 3. |
- Janson, Annika, et al.
(författare)
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Metabolic and Bariatric Surgery in Adolescents: For Whom, When, and How?
- 2023
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Ingår i: HORMONE RESEARCH IN PAEDIATRICS. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 96:6, s. 609-619
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Forskningsöversikt (refereegranskat)abstract
- Severe obesity in adolescence profoundly impacts health and social well-being. Lifestyle modifications are seldom successful in maintaining sufficient weight loss to mitigate the risk of complications. Metabolic and bariatric surgery (MBS) is a standard treatment for adult patients and has emerged as an option for adolescent patients. Several high-quality studies of adolescent MBS show substantial and sustained improvements both in weight and cardiometabolic parameters, as well as a safety profile similar to that seen in adult patients. Patients report improvements in health- and weight-related quality of life. Concerns around adolescent MBS can be attributed to a fear of side effects on growth and puberty, risk of nutritional deficiencies and osteoporosis, alcohol abuse, psychosocial vulnerability, and the ability to consent in the decision process. Guidelines give somewhat different recommendations, but the most comprehensive guidelines from the American Society for Metabolic and Bariatric Surgery recommend MBS for class III obesity or class II obesity with comorbidity. This mini-review aimed to pre-sent published data on MBS in adolescents. We discuss indications for MBS and the optimal timing in the young person's life, the choice of surgical method, and MBS in relation to the new anti-obesity medications. Based on data primarily from the USA and Sweden, we conclude that MBS is a valuable treatment option for adolescents with severe obesity that appears underutilized against the backdrop of the poor prognosis of severe obesity. We argue for continued research, development of guidelines, multi-professional teamwork, long-term follow-up, and centralization of adolescent MBS.
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| 4. |
- Järvholm, Kajsa, et al.
(författare)
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Cognitive functioning in adolescents with severe obesity undergoing bariatric surgery or intensive non-surgical treatment in Sweden (AMOS2): a multicentre, open-label, randomised controlled trial
- 2024
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Ingår i: ECLINICALMEDICINE. - : ELSEVIER. - 2589-5370. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- Background Severe obesity during childhood is associated with cognitive deficits. Studies in adults have suggested improvements in executive functioning and memory after bariatric surgery. Our aim was to explore changes in cognitive function in adolescents over two years after bariatric surgery or intensive non-surgical treatment. Methods The Adolescent Morbid Obesity Surgery 2 (AMOS2) is a multicentre, open-label, randomised controlled trial in which adolescents (aged 13-16 years) with severe obesity (defined as body mass index (BMI) >= 35 kg/m(2)) at three specialised obesity centres in Sweden, were randomly assigned to receive bariatric surgery or intensive non-surgical treatment. Herein we report the results of the prespecified exploratory endpoint of change in cognitive functioning. Inclusion in AMOS2 required Tanner pubertal stage >= 3, previous participation in lifestyle obesity treatment for at least one year, and passed assessment form a paediatrician and a paediatric psychologist. Adolescents with severe intellectual disability or other severe, pervasive developmental disorder were excluded. Participants underwent baseline assessment of general intellectual ability, executive functioning, and memory before randomisation. Tests were administrated by clinical psychologists and repeated at one- and two-year follow-up timepoints. Differences in means between groups during follow-up are provided with confidence intervals. The trial is registered at ClinicalTrials.gov, NCT02378259. Findings Between October 28 2015 and June 7 2017, 46 adolescents (74% girls), with a mean age of 15.8 (+/- 0.92) years and a mean BMI of 42.8 (+/- 5.4) kg/m(2), were included and randomised (23 to bariatric surgery and 23 to intensive non-surgical treatment). At baseline 23/46 (50%) of the adolescents had general intellectual functioning classified as borderline or below. For 15/18 (83%) aspects of cognitive functioning, no significant differences in change over two years were identified between groups; Immediate (average difference during follow-up 1.0 [95% CI: -2.6 to 4.6]) and Delayed (0.5 [95% CI: -0.6 to 1.6]) Verbal Recall, Category Fluency (1.1 [95% CI: -1.6 to 3.8]) and Switching (1.5 [95% CI: -0.0 to 2.9]), Number (-6.0 [95% CI: -12.3 to 0.3]) and Letter (0.1 [95% CI: -5.2 to 5.3]) Sequencing, Number-Letter Switching (-10.3 [95% CI: -26.4 to 5.8]), Motor Speed (-8.3 [95% CI: -17.5 to 0.9]), Colour Naming (-1.9 [95% CI: -4.2 to 0.3]), Inhibition (-3.6 [95% CI: -9.6 to 2.5]), Inhibition Switching (-6.7 [95% CI: -15.3 to 1.9]), Mazes (-0.5 [95% CI: -4.9 to 3.9]), Digit Span Forward (0.1 [95% CI: -0.6 to 0.9 ]) and Backward (0.6 [95% CI: -0.4 to 1.6 ]), and Estimated IQ (0.4 [95% CI: -3.9 to 4.8]; all p > 0.05). Three sub-tests assessing fundamental cognitive skills improved more over two years in operated adolescents than in intensive non-surgical treatment; Letter Fluency (average difference during follow-up 3.8 [95% CI: 0.1-7.5]; p = 0.046), Visual Scanning (-6.5 [95% CI: -11.6 to -1.5]; p = 0.011), and Word Reading (-1.9 [95% CI: -3.3 to -0.4]; p = 0.011). Interpretation In contrast to non-randomised studies in adults, we could not demonstrate an association of bariatric surgery and its accompanying significant weight loss with overall greater improvement in executive functions and memory in adolescents over two years compared with a non-surgical group without weight loss. However, lack of statistical power is a potential limitation. The clinical relevance of greater improvements in basic cognitive skills needs to be explored. Funding Sweden's innovation agency (VINNOVA), Swedish Research Council, Joanna Cocozza foundation for paediatric research, The Skane University Hospital Psychology Research and Development Grant, Tore Nilsson's Foundation, SUS Foundations and Donations, and Mary von Sydow's Foundation. (c) 2024 The Author(s). Published by Elsevier Ltd.
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| 5. |
- Nydén, Agneta, 1945, et al.
(författare)
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Adults with Asperger syndrome with and without a cognitive profile associated with “non-verbal learning disability.” A brief report
- 2010
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Ingår i: Research in Autism Spectrum Disorders. - : Elsevier BV. - 1750-9467. ; 4:4, s. 612-618
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Tidskriftsartikel (refereegranskat)abstract
- Asperger syndrome (AS) and non-verbal learning disability (NLD) are both characterized by impairments in motor coordination, visuo-perceptual abilities, pragmatics and comprehension of language and social understanding. NLD is also defined as a learning disorder affecting functions in the right cerebral hemisphere. The present study investigates if individuals with AS and a cognitive profile consistent with NLD (i.e. verbal IQ > performance IQ) would also have other problems inherent in NLD, visual memory and attention, reading/writing ability and arithmetic in the presence of preserved verbal memory and attention. Forty-four individuals with AS were assessed with a battery of neuropsychological tests. Reading/writing and arithmetic abilities were investigated. Education and global social adaptive levels were studied. Very few AS participants, even though with NLD cognitive profile showed problems with any of the neurocognitive abilities or academic achievements. However, all had poor global social adaptive functioning and few had paid employment, regardless of their cognitive profile. The present study suggests that AS and NLD are two different conditions even though some individuals in both groups have the verbal IQ > performance IQ profile that has been proposed to be typical of both AS and NLD.
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| 6. |
- Rangmar, Jenny, et al.
(författare)
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A retrospective register study on psychosocial functioning in adults with fetal alcohol syndrome.
- 2010
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Ingår i: First European Conference on Fetal Alcohol Syndrome, Kerkrade, the Netherlands.
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Konferensbidrag (refereegranskat)abstract
- Few studies focus on psychosocial functioning in adults with fetal alcohol syndrome (FAS). A previous follow-up study of Swedish children with FAS showed that they had severe problems with social relationships and education, problems that remained throughout childhood. The aim of this register study is to further investigate the past and present social and psychosocial demographics of these children who now are adults (n = 79, mean age 29 [18-49 years], 37 % women and 63 % men). A swedish longitudinal integrated database for health insurance and labour market studies (LISA by Swedish acronym) is used for this purpose. Examples of data that will be utilized from the database LISA are employment, income (e.g. parental leave, unemployment, labour market activity, rehabilitation, early retirement, social assistance), place of residence (county, municipality, parish and property) and highest level of education. Obtained data will be compared to a gender and age matched comparison group, also retreived from the database LISA. Preliminary results show that almost 30 % of the adults with FAS had been subjected to the Swedish enforcement authority and the Social services. Moreover, about 70 % of the individuals had been regularly in contact with the Swedish public employment services. The results indicate that FAS have a major impact on the adult daily life, especially on social and psychosocial demographics.
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| 7. |
- Rangmar, Jenny, et al.
(författare)
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Childhood placement in out-of-home care in relation to psychosocial outcomes in adults with fetal alcohol syndrome.
- 2016
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Ingår i: European journal of public health. - : Oxford University Press (OUP). - 1464-360X .- 1101-1262. ; 26:5, s. 856-861
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Tidskriftsartikel (refereegranskat)abstract
- Even in adulthood, the disabilities associated with fetal alcohol spectrum disorders (FASD) may have a major impact on life, but different environmental circumstances during childhood may also be influential. This study aimed to investigate placements in out-of-home care, and number of early separations from caregivers, related to psychosocial outcomes in adults with fetal alcohol syndrome (FAS). Additional analyses were then done on a subgroup's cognitive development and mental health.
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| 8. |
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| 9. |
- Rangmar, Jenny, et al.
(författare)
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Cognitive and executive functions, social cognition and sense of coherence in adults with fetal alcohol syndrome.
- 2015
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 69:6, s. 472-478
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Tidskriftsartikel (refereegranskat)abstract
- Background: Primary disabilities in children with fetal alcohol syndrome (FAS) are the results of alcohol’s teratogen effect on the fetal brain. Reduced cognitive and executive functions and social cognition are examples of such disabilities. Little is known about primary disabilities in adults with FAS as well as their sense of coherence (SoC). There is thus a need for knowledge about FAS in adulthood. Aims: To investigate cognitive and executive functions, social cognition and SoC in adults with FAS. Methods: Twenty adults with FAS (mean age: 30 years) were compared with 20 individuals matched on gender and age. Berg’s Card-sorting Test-64, the Tower of Hanoi, Raven’s Coloured Progressive Matrices, Digit Span, Faux Pas and the Swedish version of Antonovsky’s Sense of Coherence Scale (SoC-29) were used. Results: The FAS group had a weak SoC and displayed deficits in the neuropsychological tests sensitive to cognitive and executive functions and social cognition. The FAS group’s median SoC score was 112, lower than the comparison group’s median of 133 (P0.001). The FAS group had median scores of 29.0 on Raven’s Matrices. The median for Digit Span was 5 forwards and 3 backwards, lower than in the comparison group (P0.001). Conclusions: Reduced cognitive and executive functions and impaired social cognition are assumed to have a major impact on life for adults with FAS. We suggest that the findings showing that adults with FAS had a weak SoC, with particularly low scores on the manageability scale, reflect their experiences of living with those primary disabilities. Clinical implications: This study may enhance healthcare for individuals prenatally exposed to alcohol. In general, it contributes with knowledge about this group of individuals who need to be more visible in healthcare, and particularly, it demonstrates some of the neuropsychological disabilities they might have.
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| 10. |
- Rangmar, Jenny, et al.
(författare)
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Self-reported health, use of alcohol and illicit drugs, and criminality among adults with foetal alcohol syndrome
- 2017
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 34:3, s. 255-266
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate self-reported physical and psychiatric problems, use of alcohol and illicit drugs, as well as conviction, and being a victim, of crime in adults with foetal alcohol syndrome (FAS). Methods: Interviews with 20 adults, aged 30 +/- 8 years with FAS diagnosis (65% female) and an age-and-gender-matched comparison group. Measures used were the Addiction Severity Index interview, the Beck Depression Inventory Scale and the Beck Anxiety Inventory Scale. Results and conclusions: Adults with FAS need healthcare for depression and suicidal ideation, which occurred commonly, but problems with use of alcohol and illicit drugs were not more common in the FAS group. Although self-reported physical health problems were not more common in the FAS group, their number of days with sickness leave indicated that they are often in too poor a physical condition to work. A majority of the FAS group had been victims of crime, which makes this an important topic for further research. The groups did not differ in crime conviction rates. Everyone in the study group had been diagnosed with FAS; a diagnosis may give access to social welfare interventions. More individuals within the FAS disorders spectrum need to be identified to be given access to efficient interventions.
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