| 1. |
- Knez, Rajna, 1969, et al.
(författare)
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Medical residents' and teachers' perceptions of the digital format of nation-wide didactic courses for psychiatry residents in Sweden: a survey-based observational study
- 2023
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Ingår i: Bmc Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background : This study aimed to explore residents' and teachers' perceptions of the digital format of Metis (a national education network in Sweden) didactic courses for psychiatry residents in Sweden to guide post-pandemic curriculum development.Methods : An online attitude survey was developed and sent out to 725 residents in psychiatry and 237 course directors/teachers. Data were examined descriptively and group differences were analysed with independent sample t-tests.Results : The survey was completed by 112 residents and 72 course directors/teachers. Perceptions of digital formats were quite similar between the two groups with some significant differences i.e., residents agreed more strongly than directors/teachers with the statement that Metis courses in digital format were of the same quality (or better) than the classroom-based format. Residents perceived the positive effects of using interactive tools more than directors/teachers. More than 40% of the responders in both groups preferred a return to classroom-based course meetings. Responders in both groups suggested that different forms of digital elements (e.g., video-based and sound-recorded lectures, digital-group discussions, virtual patients) could be incorporated into different phases in the courses.Conclusions : The study represents the current largest survey among residents in psychiatry and a teaching faculty in Sweden, to understand the impact of digitalization on the quality of residents' education during the pandemic. The results point towards applying a mixed format for training and education going forward, incorporating digital aspects into the national curriculum.
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| 2. |
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| 3. |
- Gibbs, Anna, et al.
(författare)
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COVID-19-associated mortality in individuals with serious mental disorders in Sweden during the first two years of the pandemic : a population-based register study
- 2024
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Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reports at the beginning of the COVID-19 pandemic suggested differences in COVID-19-associated mortality between individuals with serious mental disorders (SMD) and the population at large.Aim: To compare the pattern of COVID-19-associated mortality in individuals with and without SMD in Sweden over the two main pandemic years.Methods: We compared the pattern of COVID-19-associated mortality in individuals with and without SMD in Sweden during 2020 and 2021. For SMD, we included psychotic disorder, bipolar disorder, and severe depression. The analysis was based on summary data from the Swedish Board of Health and Welfare covering the entire adult Swedish population.Results: The overall relative risk (RR) for experiencing a COVID-19-associated death was 1.66 (CI 1.50–1.83; p < 0.001) for individuals with SMD versus individuals without SMD. The corresponding RRs were 3.25 (CI 2.84–3.71; p < 0.001) for individuals with psychotic disorder, 1.06 (CI 0.88–1.26; p = 0.54) for individuals with bipolar disorder, and 1.03 (CI 0.80–1.32; p = 0.80) for individuals with severe depression. Compared to their respective counterparts in the non-SMD group, in the psychotic disorder and severe depression group, the RR were higher in women than in men. In the bipolar disorder group, the RR was higher in men than in women. The RR of COVID-19-associated death was generally higher in younger individuals with SMD. Individuals with psychosis between 18 and 59 years had the highest RR of COVID-19-associated death with 7.25 (CI 4.54–11.59; p<0.001).Conclusions: Individuals with SMD, and particularly those with psychotic disorders, had a higher risk of COVID-19-associated death than the general population. As this is a pattern also seen with other infections, people with SMD may be similarly vulnerable in future pandemics.
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| 4. |
- Karling, Pontus, et al.
(författare)
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Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder
- 2016
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Ingår i: World Journal of Gastroenterology. - : Baishideng. - 1007-9327 .- 2219-2840. ; 22:38, s. 8540-8548
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To study if anxiety, depression and experience of stress are associated with gastrointestinal (GI) symptoms in patients with bipolar disorder.METHODS: A total of 136 patients with bipolar disorder (mean age 49.9 years; 61% women) and 136 controls from the general population (mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome (GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale (HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS: In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls (GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex (adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score (adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores (29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls (25% vs 17%, P = 0.108).CONCLUSION: Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.
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| 6. |
- Lassas, Anders, et al.
(författare)
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Bipolar disorder and bone mineral density z-scores in relation to clinical characteristics and lithium medication
- 2022
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 11:23
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Tidskriftsartikel (refereegranskat)abstract
- Bipolar disorder is associated with a long range of medical comorbidities, including migraine, diabetes, and cardiovascular disease. Bipolar disorder has also been associated with an increased risk of bone fractures. Osteoporosis is a reduction in bone mineral density, which leads to an increased risk for fragility fractures. Currently there is limited research on the association between bipolar disorder and osteoporosis. We aimed to study the association between high and low bone mineral density in relation to disease and treatment history in a sample of bipolar patients. We found that bipolar patients with high bone mineral density were more often on lithium medication, had a more active lifestyle and expressed lower current disease burden. Low mineral density was not associated with any of the addressed aspects of disease and treatment history. In conclusion our results support that patients on lithium treatment have higher bone mineral density; further studies are needed to address if lithium medication causes an increase in bone mineral density, and lowers the risk of bone fractures in bipolar disorder.
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| 7. |
- Lilja-Lund, Otto, 1981-
(författare)
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A population-based study on neuropsychological and morphological signs of idiopathic normal pressure hydrocephalus
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is typically manifested in people over 65 years. The condition of gait disturbances, incontinence, and cognitive dysfunction can be reversed in up to 80% of the cases by ventricular shunting. Neuropsychological testing and standardized brain imaging of signs of iNPH are essential to detect and define the progression. The aims of this thesis were to develop a radiological iNPH scale, examine how morphological features relate to symptoms of iNPH, investigate if dual-task testing (e.g., walking and talking) is helpful in detecting iNPH, and monitor developing symptoms over two years.METHOD: The studies include 168 participants (median [range] age 73 [66–92]) at baseline (2014/2015) and 104 participants (age 75 [68–91]) at follow-up (2016/2017) from the general population. Neuropsychological tests of executive functions, memory, and motor performance, and computed tomography (CT) for brain imaging were used.RESULTS: Seven morphological features were combined into a scoring scale for iNPH. The total score correlated with clinical symptoms (r = -0.40, p <.001). All core symptoms were associated to wider temporal horns (TH) (p <.01). Participants with iNPH stopped walking to talk more frequently (p = .044). Participants who developed iNPH during the study worsened more on declarative memory (ES -0.37).DISCUSSION: The Radscale was related to symptoms of iNPH and the TH to all main clinical features. Difficulties walking while recalling a previous event, worsened declarative memory, and expanding ventricular space surrounding the hippocampus were noticeable signs of iNPH. Memory functions are important to recognize in iNPH.
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| 8. |
- Lilja-Lund, Otto, et al.
(författare)
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Dual-Task Performance in Older Adults With and Without Idiopathic Normal Pressure Hydrocephalus
- 2022
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media S.A.. - 1663-4365. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Two of the main features of idiopathic normal pressure hydrocephalus (iNPH) are disturbed gait and cognition. These features are typically investigated separately, but here we combined walking with a cognitive task to investigate if older adults with iNPH were more susceptible to dual-task interference on walking than those without iNPH. In total, 95 individuals from the general population participated in our study. Of these, 20 were classified as Possible iNPH (median [interquartile range, IQR] 80 years [75–82.5]) and 75 as Unlikely iNPH (74 years [72–78]). Conversation, 10-m walking, semantic and phonemic verbal fluency were performed either combined or independently. “Stopping walking while talking” was noted. Pairwise comparisons and multiple logistic regression analyses were used. We found that the Possible iNPH group was older, stopped walking more frequently during the conversation, and had a slower single-task pace. The dual-task pace was slower for both groups. Only single-task walking pace could predict Possible iNPH when adjusted for age. We could establish a dual-task cost on gait performance in this sample of older adults from the general population, but the cost was not exclusive for individuals with Possible iNPH. To further assess the value of dual-task testing in iNPH, including observations of stopping walking while talking, a study of a clinical iNPH material with more severe symptoms would be valuable.
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| 9. |
- Lilja-Lund, Otto, 1981-, et al.
(författare)
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Longitudinal neuropsychological trajectories in idiopathic normal pressure hydrocephalus : a population–based study
- 2023
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive syndrome affecting gait, incontinence, and cognition in a significant number of older adults. Still, prospective studies on early development of symptoms are scarce.Aim: To investigate how neuropsychological functions develop before and in already diagnosed iNPH over a two-year period in a population-based material.Method: A sample of 104 participants (median [IQR] 75 [72–80] years old) from the general population underwent CT-imaging and clinical assessment at baseline and follow-up. We used the iNPH symptom scale covering four domains (Neuropsychology, Gait, Balance, Incontinence) and additional tests of executive functions. Morphological signs were rated with the iNPH Radscale. Non-parametric statistics with Bonferroni corrections and a significance-level of p < 0.05 were used.Results: Median (IQR) time to follow-up was 25 (23–26) months. Effect size (ES) for individuals who developed iNPH (n = 8) showed a large (ES r = -0.55) decline in the Gait domain and on the Radscale (ES r = -0.60), with a medium deterioration in declarative memory (ES r = -0.37). Those having iNPH at baseline (n = 12) performed worse on one executive sub-function i.e., shifting (p = 0.045).Conclusion: Besides deterioration in gait and radiology, our results suggest that a neuropsychological trajectory for those developing iNPH includes a reduction in declarative memory. Executive dysfunction was limited to those already having iNPH at baseline. These findings could suggest that memory impairments are included in the early development of iNPH.
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