| 1. |
- Pérez-Vigil, Ana, et al.
(författare)
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Association of Obsessive-Compulsive Disorder With Objective Indicators of Educational Attainment : A Nationwide Register-Based Sibling Control Study
- 2018
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Ingår i: JAMA psychiatry. - Chicago, USA : American Medical Association. - 2168-6238 .- 2168-622X. ; 75:1, s. 47-55
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Tidskriftsartikel (refereegranskat)abstract
- Importance: To our knowledge, the association of obsessive-compulsive disorder (OCD) and academic performance has not been objectively quantified.Objective: To investigate the association of OCD with objectively measured educational outcomes in a nationwide cohort, adjusting for covariates and unmeasured factors shared between siblings.Design, Setting, And Participants: This population-based birth cohort study included 2 115 554 individuals who were born in Sweden between January 1, 1976, and December 31, 1998, and followed up through December 31, 2013. Using the Swedish National Patient Register and previously validated International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, we identified persons with OCD; within the cohort, we identified 726 198 families with 2 or more full siblings, and identified 11 482 families with full siblings discordant for OCD. Data analyses were conducted from October 1, 2016, to September 25, 2017.Main Outcomes and Measures: The study evaluates the following educational milestones: eligibility to access upper secondary school after compulsory education, finishing upper secondary school, starting a university degree, finishing a university degree, and finishing postgraduate education.Results: Of the 2 115 554 individuals in the cohort, 15 120 were diagnosed with OCD (59% females). Compared with unexposed individuals, those with OCD were significantly less likely to pass all core and additional courses at the end of compulsory school (adjusted odds ratio [aOR] range, 0.35-0.60) and to access a vocational or academic program in upper secondary education (aOR, 0.47; 95% CI, 0.45-0.50 and aOR, 0.61; 95% CI, 0.58-0.63, for vocational and academic programs, respectively). People with OCD were also less likely to finish upper secondary education (aOR, 0.43; 95% CI, 0.41-0.44), start a university degree (aOR, 0.72; 95% CI, 0.69-0.75), finish a university degree (aOR, 0.59; 95% CI, 0.56-0.62), and finish postgraduate education (aOR, 0.52; 95% CI, 0.36-0.77). The results were similar in the sibling comparison models. Individuals diagnosed with OCD before age 18 years showed worse educational attainment across all educational levels compared with those diagnosed at or after age 18 years. Exclusion of patients with comorbid neuropsychiatric disorders, psychotic, anxiety, mood, substance use, and other psychiatric disorders resulted in attenuated estimates, but patients with OCD were still impaired across all educational outcomes.Conclusions and Relevance: Obsessive-compulsive disorder, particularly when it has an early onset, is associated with a pervasive and profound decrease in educational attainment, spanning from compulsory school to postgraduate education.
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| 2. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Joint Hypermobility in Paediatric Acute-Onset Neuropsychiatric Syndrome : A Preliminary Case-Control Study
- 2021
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Individuals with generalised joint hypermobility (GJH, present in 10–20% of the general population) are at increased risk of being diagnosed with a range of psychiatric and rheumatological conditions. It is unknown whether Paediatric acute-onset neuropsychiatric syndrome (PANS), characterised by childhood onset obsessive-compulsive disorder or restricted eating and typically associated with several comorbid neuropsychiatric symptoms, is associated with GJH. It is also unknown whether extensive psychiatric comorbidity is associated with GJH.Method: This is a case-control study including 105 participants. We compared three groups: Individuals with PANS, individuals with other mental disorders and healthy controls. Joint mobility was assessed with the Beighton scoring system, psychiatric comorbidity with the M.I.N.I. or MINI-KID interview and symptoms of PANS with the PsychoNeuroInflammatory related Signs and Symptoms Inventory (PNISSI).Results: Hypermobility was similar across groups, and high rates of psychiatric comorbidity was not associated with higher Beighton scores.Conclusion: Although GJH is associated with several psychiatric conditions, such as ADHD and anxiety, this does not seem to be the case for PANS according to this preliminary study.
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| 3. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Neuromyelitis optica spectrum disorder with increased aquaporin-4 microparticles prior to autoantibodies in cerebrospinal fluid : a case report
- 2019
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Ingår i: Journal of Medical Case Reports. - : BioMed Central (BMC). - 1752-1947. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Neuromyelitis optica spectrum disorders are severe autoimmune inflammatory diseases of the central nervous system associated with the presence of immunoglobulin G antibodies against the water channel protein aquaporin-4. During exacerbation, specific aquaporin-4 immunoglobulin G may be produced intrathecally. We measured extracellular aquaporin-4 microparticles in the cerebrospinal fluid of a patient who later developed the typical symptoms and signs of a neuromyelitis optica spectrum disorder.CASE PRESENTATION: A 17-year-old South American girl developed acute severe motor and vocal tics and difficulties in walking, peripheral numbness, muscle pain, and bilateral headache. At age 22, she had a multitude of motor and psychiatric symptoms. Over the years, she fulfilled the diagnostic criteria for anorexia nervosa, depression, sleep disorder, obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, development coordination disorder, attention-deficit/hyperactivity disorder, hypomania, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, conversion disorder, psychosis, and schizotypal personality syndrome. At age 24, she was found to have elevated titers of aquaporin-4 antibodies in serum, suggestive of probable neuromyelitis optica. She subsequently developed visual impairment, and swollen optic nerves were verified by magnetic resonance imaging. She was thus treated with a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20 (rituximab), and almost all symptoms, including the psychiatric symptoms, rapidly decreased. We found a significant increase of extracellular microparticles of aquaporin-4 in cerebrospinal fluid sampled from our patient when she was 22 years old, 2 years before the full clinical development of neuromyelitis optica.CONCLUSIONS: Microparticles of aquaporin-4 represent subcellular arrangements that may influence the pathogenesis of neuromyelitis optica spectrum disorders and may serve as biomarkers for the underlying cellular disturbances. The increase of aquaporin-4 microparticles in cerebrospinal fluid may be used for early diagnostic purposes; for prevention; and for evaluation of effective treatment, long-term follow-up studies, and elucidating the pathophysiology in neuromyelitis optica spectrum disorders. Further studies of aquaporin-4 microparticles in cerebrospinal fluid of patients with neuromyelitis optica and similar neuropsychiatric disorders are thus called for.
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| 4. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Schizotypal traits in Swedish speaking psychiatric patients and non-psychiatric controls
- 2020
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 74:5, s. 327-331
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Recently, schizotypal personality traits were measured in a multinational sample recruited from 14 countries, however no Scandinavian cohort was included. The aim of this study was, therefore, to measure schizotypal personality traits in Swedish-speaking populations, with and without psychiatric disorders, and to investigate the psychometric properties of the Swedish version of the Schizotypal Personality Questionnaire-Brief (SPQ-B).Methods: The SPQ-B results from 50 psychiatric patients were compared to controls (n = 202). An additional sample of 25 controls completed the full SPQ twice and we calculated test-retest reliability for SPQ and SPQ-B. We estimated the internal consistency for SPQ-B and SPQ-B factors with omega. We compared the results of SPQ-B (M and SD) in patient and control groups to corresponding results worldwide.Results: We found similarity between our SPQ-B scores and those from other published samples. SPQ-B showed good internal consistency and acceptable test-retest correlations. The results indicate that the Swedish version of the instrument is valid and can differentiate psychiatric cohorts from non-psychiatric controls.Conclusion: The Swedish version of the SPQ-B exhibit good psychometric properties and is useful for assessing schizotypal traits in clinical and non-clinical populations.
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| 5. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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The Cunningham Panel : concerns remain
- 2019
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Ingår i: Translational Psychiatry. - : Nature Publishing Group. - 2158-3188. ; 9:1
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Tidskriftsartikel (refereegranskat)
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| 6. |
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| 7. |
- Hesselmark, Eva, et al.
(författare)
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Autism Spectrum Disorders and Self-reports : Testing Validity and Reliability Using the NEO-PI-R
- 2015
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Ingår i: Journal of autism and developmental disorders. - New York, USA : Springer. - 0162-3257 .- 1573-3432. ; 45:5, s. 1156-1166
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Tidskriftsartikel (refereegranskat)abstract
- Although self-reported measures are frequently used to assess adults with autism spectrum disorders (ASD), the validity of self-reports is under-researched in ASD. The core symptoms of ASD may negatively affect the psychometric properties of self-reported measures. The aim of the present study was to test the validity and reliability of self-reported data using the NEO personality inventory-revised (NEO-PI-R). Forty-eight adults with ASD and 53 controls completed the NEO-PI-R and a psychiatric interview. Results indicate satisfactory internal consistency of the NEO-PI-R, a satisfactory factor structure, predicted correlations with clinician ratings in the ASD group, and predicted differences in personality between the ASD group and controls. In conclusion, the present results support the use of self-reported measures when assessing adults with ASD.
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| 8. |
- Hesselmark, Eva, et al.
(författare)
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Biomarkers for diagnosis of Pediatric Acute Neuropsychiatric Syndrome (PANS) : Sensitivity and specificity of the Cunningham Panel
- 2017
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Ingår i: Journal of Neuroimmunology. - Amsterdam, Netherlands : Elsevier. - 0165-5728 .- 1872-8421. ; 312, s. 31-37
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Pediatric Acute Neuropsychiatric Syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are conditions marked by sudden onset of obsessive-compulsive disorder (OCD), tics, or avoidant/restrictive food intake in combination with multiple psychiatric symptoms. A diagnosis of PANS or PANDAS may be supported by the Cunningham Panel, a commercially available set of immunologic assays currently in clinical use. However, the relationship between Cunningham Panel results and patient symptoms remains unclear. This study was done to assess the diagnostic accuracy of the Cunningham Panel in patients with suspected PANS or PANDAS.METHOD: All Swedish patients who had taken the Cunningham Panel prior to June 2014 (n=154) were invited and 53 patients participated in the study. Based on comprehensive psychiatric assessment (the reference standard of diagnosis), subjects were classified as PANS, PANDAS, or neither. Prior Cunningham Panel test results were collected from patient records, and new blood samples were similarly analyzed within the scope of this study. In addition, results were compared to healthy controls (n=21) and a test-retest reliability analysis was performed.RESULTS: Sensitivities of individual biomarkers in the Cunningham Panel ranged from 15 to 60%, and specificities from 28 to 92%. Positive predictive values ranged from 17 to 40%, and negative predictive values from 44 to 74%. A majority of the healthy controls had pathological Cunningham Panel results and test-retest reliability proved insufficient.CONCLUSION: Clinical use of the Cunningham Panel in diagnosing PANS or PANDAS is not supported by this study.
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| 9. |
- Hesselmark, Eva, et al.
(författare)
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Clinical features of paediatric acute-onset neuropsychiatric syndrome : findings from a case-control study
- 2019
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Ingår i: BJPsych Open. - : Royal College of Psychiatrists. - 2056-4724. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Paediatric acute-onset neuropsychiatric syndrome (PANS), an umbrella term that includes PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) is suggested to be a psychiatric disorder of autoimmune aetiology. PANS is characterised by an acute onset of obsessive-compulsive disorder or restricted eating with multiple comorbid symptoms. The specificity of the PANS criteria is not fully understood.AimsTo describe a cohort of patients with PANS and to determine if PANS features relating to symptoms, onset and course are more common in PANS than in other psychiatric conditions.METHOD: A case-control study comparing patients with interview-confirmed PANS with patients with suspected PANS and patients with a psychiatric condition but with no suspicion of PANS. Validated and non-validated measures of symptoms, onset and episodic course were used.RESULTS: Illness in patients with interview-confirmed PANS featured an episodic course and multiple symptoms present at onset compared with the psychiatric controls. However, individuals with interview-confirmed PANS did not present a specific symptom profile.CONCLUSIONS: PANS may be a distinct clinical entity featuring an acute onset, an episodic course and multiple symptoms at onset.Declaration of interestNone.
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