| 1. |
- Nager, Anna, et al.
(författare)
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High lifelong relapse rate of psychiatric disorders among women with postpartum psychosis
- 2013
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 67:1, s. 53-58
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Tidskriftsartikel (refereegranskat)abstract
- Nager A, Szulkin R, Johansson S-E, Johansson L-M, Sundquist K. High lifelong relapse rate of psychiatric disorders among women with postpartum psychosis. Nord J Psychiatry 2013;67:53-58. Background: The relapse rate for psychiatric disorders after postpartum psychosis is high. Apart from subsequent puerperal periods, previous studies have not examined when relapses in psychiatric disorders occur. In addition, little is known about the impact of certain individual factors on the risk of non-puerperal readmission among women with previous postpartum psychosis. Aims: The first aim was to examine the association between non-puerperal readmission due to psychiatric disorders and years of follow-up (in total, 30 years) in women with postpartum psychosis. The second aim was to examine the impact of age, type of psychosis, previous hospitalization for psychiatric disorders and level of education on the risk of non-puerperal readmission due to psychiatric disorders. Methods: All Swedish women aged 20-44 with postpartum psychosis (n = 3140) were followed between 1975 and 2004 for non-puerperal readmission due to psychiatric disorders. A Cox frailty regression model was used to estimate hazard ratios for non-puerperal readmission. Results: The risk of non-puerperal readmission, although gradually decreasing with time, remained high many years after the postpartum psychosis. The risk of non-puerperal readmission was significantly higher among women with schizophrenia, lower levels of education and previous psychiatric hospitalization. Conclusions: Postpartum psychosis is often part of a lifelong recurrent psychiatric disorder. Women with schizophrenia, lower levels of education and hospitalization due to a psychiatric disorder prior to postpartum psychosis have a higher risk of non-puerperal readmission. Clinical implications: The findings constitute important knowledge for all healthcare workers encountering women with a previous postpartum psychosis.
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| 2. |
- Speliotes, Elizabeth K., et al.
(författare)
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Association analyses of 249,796 individuals reveal 18 new loci associated with body mass index
- 2010
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 42:11, s. 937-948
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Tidskriftsartikel (refereegranskat)abstract
- Obesity is globally prevalent and highly heritable, but its underlying genetic factors remain largely elusive. To identify genetic loci for obesity susceptibility, we examined associations between body mass index and ~2.8 million SNPs in up to 123,865 individuals with targeted follow up of 42 SNPs in up to 125,931 additional individuals. We confirmed 14 known obesity susceptibility loci and identified 18 new loci associated with body mass index (P < 5 × 10−8), one of which includes a copy number variant near GPRC5B. Some loci (at MC4R, POMC, SH2B1 and BDNF) map near key hypothalamic regulators of energy balance, and one of these loci is near GIPR, an incretin receptor. Furthermore, genes in other newly associated loci may provide new insights into human body weight regulation.
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| 3. |
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| 4. |
- Do, Ron, et al.
(författare)
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Common variants associated with plasma triglycerides and risk for coronary artery disease
- 2013
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 45:11, s. 1345-
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Tidskriftsartikel (refereegranskat)abstract
- Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiological studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P < 5 x 10(-8) for each) to examine the role of triglycerides in risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, and we show that the direction and magnitude of the associations with both traits are factors in determining CAD risk. Second, we consider loci with only a strong association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol (HDL-C) levels, the strength of a polymorphism's effect on triglyceride levels is correlated with the magnitude of its effect on CAD risk. These results suggest that triglyceride-rich lipoproteins causally influence risk for CAD.
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| 5. |
- Johansson, Leena Maria
(författare)
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Migration, mental health and suicide : an epidemiological, psychiatric and cross-cultural study
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In spite of restrictions in Swedish immigration policy during the 1990s, the foreign-born population (10.7% in 1996) is steadily increasing because of immigration of relatives of refugees and labor migrants. Migration forced by violence, war or economic factors, the encounter with a new society and acculturation might cause stress and result in mental illness with suicide as an ultimate action. Existential questions about life and death, meaning and meaninglessness are always present in every human life and are specially activated during migration, and this activation influences thoughts and actions concerning mental health, illness and suicidal behavior. Aims: The central aim of the work is to study migration, health, suicide and their relation to each other from epidemiological, psychiatric and cross-cultural perspectives. This complex relationship is influenced by many other dimensions, such as existential, cultural and social aspects, which are also taken into consideration in the research project. Methods: In the first part of the thesis, suicide is analyzed from an epidemiological perspective. Ethnicity, defined as being foreign-born, and its relation to suicides investigated. Foreign-born individuals have been mostly treated as a group, but they are also divided into particular ethnic subgroups. The health status, based on self-reported long-term illness, of those who later committed suicide is also examined. The data are obtained from the Cause of Death Register, from the 1985 census, and from interviews. In the second part, hospitalized foreign-born individuals and native Swedes are compared concerning internal migration, number of admissions, days of care and the risk of a second admission. In the final part, a qualitative study is in focus concentrating the data gathering process in two areas: (1) suicidal patients' meaning making systems (religion, view of life) and (2) interactions between self- and object-relations among these patients. Ten female patients with depression and suicidal behavior have been included. Results: The main finding in the first part is that ethnicity is a significant risk factor for suicide in both sexes and in all age groups except for males aged 30-49. The highest risk ratios for suicide in Sweden, adjusted for age, have been found among males born in Russia and Finland. They also show increased suicide risks compared with their countries of birth. Females born in Hungary, Russia, Finland and Poland all have an increased risk of committing suicide in Sweden, and they also have higher risks than in their countries of birth. Foreign-born individuals run a twofold risk of committing suicide compared to Swedes and adjusted for socioeconomic factors. Foreign-born males and females under 45 and 35 respectively have significantly increased hospital admission rates compared with native-born Swedes. Native Swedes in nearly all age groups were hospitalized for a longer time than foreign-born persons. The last part confirms the common risk factors for suicide (such as psychiatric disorder, especially depression and earlier suicide attempts) but points to the need for these factors to be assessed in relation to a lack of self-esteem and a limited sense of self-identity. An essential finding of this research is that intervention and support, especially coupled with the individual's development of self-identity, self-esteem and a sense of relating and belonging, can effectively motivate the movement of a "suicidal" person toward the "healthy" person category. This happens when there is an internal and existential change whereby the individual is able to find and have respect for him/herself as a person worthy of self-care. Conclusions: Ethnicity is an independent risk factor for suicide and for high psychiatric hospital admission rates. Specific subgroups, e.g. Finnish males, have higher suicide rates in Sweden than in their country of origin. Access to patients' meaning-making systems provides culture specific information of value for diagnostic and therapeutic assessment processes.
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| 6. |
- Locke, Adam E, et al.
(författare)
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Genetic studies of body mass index yield new insights for obesity biology.
- 2015
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 197-401
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Tidskriftsartikel (refereegranskat)abstract
- Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.
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| 7. |
- Sundquist, Jan, et al.
(författare)
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Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial.
- 2015
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 206:2, s. 128-135
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Tidskriftsartikel (refereegranskat)abstract
- Background Individual-based cognitive-behavioural therapy (CBT) is in short supply and expensive. Aims The aim of this randomised controlled trial (RCT) was to compare mindfulness-based group therapy with treatment as usual (primarily individual-based CBT) in primary care patients with depressive, anxiety or stress and adjustment disorders. Method This 8-week RCT (ClinicalTrials.gov ID: NCT01476371) was conducted during spring 2012 at 16 general practices in Southern Sweden. Eligible patients (aged 20-64 years) scored ⩾10 on the Patient Health Questionnaire-9, ⩾7 on the Hospital Anxiety and Depression Scale or 13-34 on the Montgomery-Åsberg Depression Rating Scale (self-rated version). The power calculations were based on non-inferiority. In total, 215 patients were randomised. Ordinal mixed models were used for the analysis. Results For all scales and in both groups, the scores decreased significantly. There were no significant differences between the mindfulness and control groups. Conclusions Mindfulness-based group therapy was non-inferior to treatment as usual for patients with depressive, anxiety or stress and adjustment disorders.
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| 8. |
- Turcot, Valerie, et al.
(författare)
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Protein-altering variants associated with body mass index implicate pathways that control energy intake and expenditure in obesity
- 2018
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Ingår i: Nature Genetics. - : Nature Publishing Group. - 1061-4036 .- 1546-1718. ; 50:1, s. 26-41
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Tidskriftsartikel (refereegranskat)abstract
- Genome-wide association studies (GWAS) have identified >250 loci for body mass index (BMI), implicating pathways related to neuronal biology. Most GWAS loci represent clusters of common, noncoding variants from which pinpointing causal genes remains challenging. Here we combined data from 718,734 individuals to discover rare and low-frequency (minor allele frequency (MAF) < 5%) coding variants associated with BMI. We identified 14 coding variants in 13 genes, of which 8 variants were in genes (ZBTB7B, ACHE, RAPGEF3, RAB21, ZFHX3, ENTPD6, ZFR2 and ZNF169) newly implicated in human obesity, 2 variants were in genes (MC4R and KSR2) previously observed to be mutated in extreme obesity and 2 variants were in GIPR. The effect sizes of rare variants are similar to 10 times larger than those of common variants, with the largest effect observed in carriers of an MC4R mutation introducing a stop codon (p.Tyr35Ter, MAF = 0.01%), who weighed similar to 7 kg more than non-carriers. Pathway analyses based on the variants associated with BMI confirm enrichment of neuronal genes and provide new evidence for adipocyte and energy expenditure biology, widening the potential of genetically supported therapeutic targets in obesity.
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| 9. |
- Willer, Cristen J., et al.
(författare)
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Discovery and refinement of loci associated with lipid levels
- 2013
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 45:11, s. 1274-1283
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Tidskriftsartikel (refereegranskat)abstract
- Levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol are heritable, modifiable risk factors for coronary artery disease. To identify new loci and refine known loci influencing these lipids, we examined 188,577 individuals using genome-wide and custom genotyping arrays. We identify and annotate 157 loci associated with lipid levels at P < 5 x 10(-8), including 62 loci not previously associated with lipid levels in humans. Using dense genotyping in individuals of European, East Asian, South Asian and African ancestry, we narrow association signals in 12 loci. We find that loci associated with blood lipid levels are often associated with cardiovascular and metabolic traits, including coronary artery disease, type 2 diabetes, blood pressure, waist-hip ratio and body mass index. Our results demonstrate the value of using genetic data from individuals of diverse ancestry and provide insights into the biological mechanisms regulating blood lipids to guide future genetic, biological and therapeutic research.
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