| 1. |
- Cederlöf, Erik, et al.
(författare)
-
Antipsychotic medications and sleep problems in patients with schizophrenia
- 2024
-
Ingår i: Schizophrenia Research. - : Elsevier. - 0920-9964 .- 1573-2509. ; 267, s. 230-238
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep problems are common and related to a worse quality of life in patients with schizophrenia. Almost all patients with schizophrenia use antipsychotic medications, which usually increase sleep. Still, the differences in subjective sleep outcomes between different antipsychotic medications are not entirely clear.Methods: This study assessed 5466 patients with schizophrenia and is part of the nationwide Finnish SUPER study. We examined how the five most common antipsychotic medications (clozapine, olanzapine, quetiapine, aripiprazole, and risperidone) associate with questionnaire-based sleep problems in logistic regression analyses, including head-to-head analyses between different antipsychotic medications. The sleep problems were difficulties initiating sleep, early morning awakenings, fatigue, poor sleep quality, short (≤6 h) and long sleep duration (≥10 h).Results: The average number of antipsychotic medications was 1.59 per patient. Clozapine was associated with long sleep duration (49.0 % of clozapine users vs 30.2 % of other patients, OR = 2.05, 95 % CI 1.83–2.30, p < .001). Olanzapine and risperidone were in head-to-head analyses associated with less sleep problems than patients using aripiprazole, quetiapine, or no antipsychotic medication. Aripiprazole and quetiapine were associated with more insomnia symptoms and poorer sleep quality. Patients without antipsychotic medications (N = 159) had poorer sleep quality than patients with antipsychotic use, and short sleep duration was common (21.5 % of patients using antipsychotics vs 7.8 % of patients using antipsychotics, OR = 2.97, 95 % CI 1.98–4.44, p < .001).Conclusions: Prevalence of sleep problems is markedly related to the antipsychotic medication the patient uses. These findings underline the importance of considering and assessing sleep problems when treating schizophrenia patients with antipsychotics.
|
|
| 2. |
- Chen, Lingjing, et al.
(författare)
-
Labour market integration among young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) at working age
- 2024
-
Ingår i: Psychological Medicine. - : Cambridge University Press. - 0033-2917 .- 1469-8978. ; 54:1, s. 148-158
-
Tidskriftsartikel (refereegranskat)abstract
- METHODS: Multiple Swedish nationwide registers were used to identify 8045 individuals, aged 20-29, with an incident diagnosis of ADHD 2006-2011. Labour market integration was conceptualized according to the core-peripheral model as a continuum from a strong (core) to a weak (peripheral) connection to the labour market. Sequence analyses categorized clusters of labour market integration, from 1 year before to 5 years after their ADHD diagnosis for individuals diagnosed with ADHD and a matched control group without ADHD. Multinomial logistic regression computed odds ratios (ORs) with 95% confidence intervals (CIs) between sociodemographic factors and comorbid disorders and the identified clusters.RESULTS: About one-fourth of the young adults diagnosed with ADHD belonged to clusters characterized by a transition to a mainly peripheral labour market position, which was approximately four-times higher compared to controls without ADHD. Foremost, those living in small cities/villages (OR 1.9; CI 1.5-2.2), those having comorbid autism-spectrum disorder (OR 13.7; CI 6.8-27.5) or schizophrenia/psychoses (OR 7.8; CI 3.8-15.9) were associated with a transition towards a peripheral labour market position throughout the study period. Those with a high educational level (OR 0.1; CI 0.1-0.1), and men (OR 0.7; CI 0.6-0.8) were less likely to have a peripheral labour market position.CONCLUSIONS: Young adults diagnosed with ADHD are four-times more likely to be in the peripheral labour market position compared to those without ADHD. To increase labour market participation, special attention is warranted to those with low educational level, those living outside big cities and those with comorbid mental disorders.
|
|
| 3. |
- Chen, Lingjing, et al.
(författare)
-
Risk Factors for Disability Pension among Young Adults Diagnosed with Attention-deficit Hyperactivity Disorder (ADHD) in Adulthood.
- 2022
-
Ingår i: Journal of Attention Disorders. - : SAGE Publications. - 1087-0547 .- 1557-1246. ; 26:5, s. 723-734
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate risk factors of disability pension (DP) in young adults diagnosed with ADHD in Sweden.METHOD: In total, 9718 individuals diagnosed with incident ADHD in young adult age (19-29 years) 2006 to 2011, were identified through national registers. They were followed for 5 years and Cox regression models were applied to analyze the DP risk (overall and by sex), associated with socio-demographics, work-related factors, and comorbid disorders.RESULTS: Twenty-one percent of all received DP. Being younger at diagnosis (hazard ratio [HR] = 1.54; 95%confidence interval [CI] 1.39-1.71); low educational level (HR = 1.97; 95%CI 1.60-2.43 for <10 years); work-related factors at baseline (no income from work [HR = 2.64; 95%CI 2.35-2.98] and sickness absence >90 days [HR = 2.48; 95%CI2.17-2.83]); and schizophrenia/psychoses (HR = 2.16; 95%CI 1.66-2.80), autism (HR = 1.87; 95%CI 1.42-2.46), anxiety (HR = 1.34; 95%CI 1.22-1.49) were significantly associated with an increased risk of DP. Similar risk patterns were found in men and women.CONCLUSION: Work-related factors and comorbid mental disorders need to be highlighted in early vocational rehabilitation for individuals with ADHD.
|
|
| 4. |
- Cullen, Alexis E., et al.
(författare)
-
Patient factors associated with receipt of psychological and pharmacological treatments among individuals with common mental disorders in a Swedish primary care setting
- 2023
-
Ingår i: BJPsych Open. - : Cambridge University Press. - 2056-4724. ; 9:2
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPsychological and pharmacological therapies are the recommended first-line treatments for common mental disorders (CMDs) but may not be universally accessible or utilised. AimsTo determine the extent to which primary care patients with CMDs receive treatment and the impact of sociodemographic, work-related and clinical factors on treatment receipt. MethodNational registers were used to identify all Stockholm County residents aged 19-64 years who had received at least one CMD diagnosis (depression, anxiety, stress-related) in primary care between 2014 and 2018. Individuals were followed from the date of their first observed CMD diagnosis until the end of 2019 to determine treatment receipt. Associations between patient factors and treatment group were examined using multinomial logistic regression. ResultsAmong 223 271 individuals with CMDs, 30.6% received pharmacotherapy only, 16.5% received psychological therapy only, 43.1% received both and 9.8% had no treatment. The odds of receiving any treatment were lower among males (odds ratio (OR) range = 0.76 to 0.92, 95% CI[minimum, maximum] 0.74 to 0.95), individuals born outside of Sweden (OR range = 0.67 to 0.93, 95% CI[minimum, maximum] 0.65 to 0.99) and those with stress-related disorders only (OR range = 0.21 to 0.51, 95% CI[minimum, maximum] 0.20 to 0.53). Among the patient factors examined, CMD diagnostic group, prior treatment in secondary psychiatric care and age made the largest contributions to the model (R-2 difference: 16.05%, 1.72% and 1.61%, respectively). ConclusionsAlthough over 90% of primary care patients with CMDs received pharmacological and/or psychological therapy, specific patient groups were less likely to receive treatment.
|
|
| 5. |
- Gemes, Katalin, et al.
(författare)
-
Occupational Branch and Labor Market Marginalization among Young Employees with Adult Onset of Attention Deficit Hyperactivity Disorder-A Population-Based Matched Cohort Study
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:12
-
Tidskriftsartikel (refereegranskat)abstract
- We compared labor market marginalization (LMM), conceptualized as days of unemployment, sickness absence and disability pension, across occupational branches (manufacturing, construction, trade, finance, health and social care, and education), among young employees with or without attention deficit hyperactivity disorder (ADHD) and examined whether sociodemographic and health-related factors explain these associations. All Swedish residents aged 19-29 years and employed between 1 January 2005 and 31 December 2011 were eligible. Individuals with a first ADHD diagnosis (n = 6030) were matched with ten controls and followed for five years. Zero-inflated negative binomial regression was used to model days of LMM with adjustments for sociodemographic and health-related factors. In total, 20% of those with ADHD and 59% of those without had no days of LMM during the follow-up. The median of those with LMM days with and without ADHD was 312 and 98 days. Having an ADHD diagnosis was associated with a higher incidence of LMM days (incident rate ratios (IRRs) 2.7-3.1) with no differences across occupational branches. Adjustments for sociodemographic and health-related factors explained most of the differences (IRRs: 1.4-1.7). In conclusion, young, employed adults with ADHD had a higher incidence of LMM days than those without, but there were no substantial differences between branches, even after adjusting for sociodemographic and health-related factors.
|
|
| 6. |
- Gémes, Katalin, et al.
(författare)
-
The role of sociodemographic and clinical factors in the initiation and discontinuation of attention deficit hyperactivity disorder medication among young adults in Sweden
- 2023
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 14
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Long-term medication use is a recommended treatment for attention-deficit/hyperactivity disorder (ADHD), however, discontinuation is common. Non-medical factors which might influence initiation and discontinuation are understudied. Therefore, we investigated how different sociodemographic factors and comorbidities were associated with the initiation and discontinuation of ADHD medication use among young adults.Methods and results: We conducted a population-based prospective cohort study using individually linked administrative register data, in which we included all individuals residing in Sweden, between the age of 19 and 29 who were first diagnosed with ADHD between January 2006 and December 2016 (n = 59224). ADHD medication initiation was defined as the first prescription of ADHD medication in the period from 3 months before to 6 months after the cohort entry date. Those who initiated ADHD medication were followed up for medication use until discontinuation, death/emigration, or until 2019. Logistic and Cox regression models were used to investigate the associations between sociodemographics, health-related predictors and initiation, as well as discontinuation. Overall, 48.7% of the 41399 individuals initiated ADHD medication, most often methylphenidate (87%). Among the initiators, 15462 (77%) discontinued medication use during the follow-up (median time: 150 days). After mutually adjusting all other predictors, initiation was positively associated with older age, male sex, higher level of education, and negatively associated with living at home with parents, immigrant status, being unemployed during the year before inclusion, being on disability pension, having autism, substance use, schizophrenia-spectrum disorders, other mental disability/developmental disorders, cardiovascular diseases or previous accidents. Discontinuation was positively associated with being born abroad, living in big cities, being unemployed during the year before inclusion, having cancer, and negatively associated with a higher educational level, having depression, anxiety or stress-related disorder, autism spectrum disorder or diabetes.Conclusion: Besides medical factors, sociodemographics, such as educational attainment and immigrant status might also play a role in the initiation and discontinuation of ADHD medication use among young adults newly diagnosed with ADHD.
|
|
| 7. |
- Helgesson, Magnus, et al.
(författare)
-
Labour market marginalisation in young adults diagnosed with attention-deficit hyperactivity disorder (ADHD) : a population-based longitudinal cohort study in Sweden
- 2023
-
Ingår i: Psychological Medicine. - : Cambridge University Press. - 0033-2917 .- 1469-8978. ; 53:4, s. 1224-1232
-
Tidskriftsartikel (refereegranskat)abstract
- Background The objective of this population-based register study was (1) to investigate the association between young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and subsequent labour market marginalisation (LMM) in two comparison groups, i.e. matched young adults from the general population without ADHD and unaffected siblings to persons with ADHD and (2) to assess the role of comorbid disorders. Methods This study included all young adults in Sweden, aged 19-29 years, with an incident diagnosis of ADHD 2006-2011 (n = 9718). Crude and multivariate sex-stratified hazard ratios (HRs) with 95% confidence intervals (CIs) were measured 5 years after the diagnosis of ADHD for the risk of disability pension, long-term sickness absence (SA) (>90 days), long-term unemployment (>180 days) and a combined measure of all three in young adults with ADHD compared to their siblings without ADHD and a matched comparison group. Results In the adjusted analyses young adults with ADHD had a 10-fold higher risk of disability pension (HR = 10.2; CI 9.3-11.2), a nearly three-fold higher risk of long-term SA (HR = 2.7; CI 2.5-2.8) and a 70% higher risk of long-term unemployment (HR = 1.7; CI 1.6-1.8) compared to the matched comparison group. The risk estimates were lower compared to siblings for disability pension (HR = 9.0; CI 6.6-12.3) and long-term SA (HR = 2.5; CI 2.1-3.1) but higher in the long-term unemployed (HR = 1.9; CI 1.6-2.1). Comorbid disorders explained about one-third of the association between ADHD and disability pension, but less regarding SA and long-term unemployment. Conclusions Young adults with ADHD have a high risk for different measures of LMM and comorbidities explain only a small proportion of this relationship.
|
|
| 8. |
- Helgesson, Magnus, Medicine Doktor, 1974-, et al.
(författare)
-
Sustainable labour market participation among working young adults with diagnosed attention deficit/hyperactivity disorder (ADHD)
- 2023
-
Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 23
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The aims were to study the sustainability of labour-market participation five years after an incident diagnosis of attention-deficit/hyperactivity disorder (ADHD) among young adults with gainful employment, and to examine the impact of sociodemographic-, work-and health-related factors on these findings.Methods: Swedish registers identified 2517 individuals, 19-29 years old, with an incident diagnosis of ADHD and gainful employment during 2006-2011. Labour-market participation was measured by the core-peripheral model, a model that measures the connection to the labour market from a weak connection (peripheral) to a strong connection (core). Sequence analysis analysed clusters of labour-market participation, from one year before and up to five years after diagnosis. Odds ratios (OR) with 95% confidence intervals (CI) between soci-odemographic factors, comorbid disorders, and the identified clusters were analysed by multinomial logistic regression.Results: Five clusters of labour-market participation were identified: 60% of individuals belonged to a cluster that maintained labour-market participation throughout the study period (core, close to core); 20% belonged to a cluster with a transition to a weak connection to the labour market (close to peripheral, peripheral); and 20% belonged to a cluster with "middle" labour-market participation, characterised by having long periods of sick leave and unemployment. Individuals with elementary school as highest attained education (OR:4.03; CI:2.35-6.93), comorbid mental disorders (OR:2.77;CI:2.10-3.66), or living in villages/small cities (OR:1.77; CI:1.25-2.51) were most likely to belong to a cluster transitioning towards a "peripheral" labour-market participation. Men were less likely to have peripheral labour-market participation than women (OR:0.55; CI:0.40-0.75).Conclusions: Over half of working individuals with ADHD maintain a strong attachment to the labour market several years after their first diagnosis of ADHD. Therefore, it is important to target those who have problems maintaining a position in the labour market, including women, those with low educational levels, and those living outside large cities.
|
|
| 9. |
- Karppinen, Mikko, et al.
(författare)
-
Integration of 150 Gbps/fiber optical engines based on multicore fibers and 6-channel VCSELs and PDs
- 2016
-
Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. - 9781628419887 ; 9753, s. Art. no. 97530S-
-
Konferensbidrag (refereegranskat)abstract
- Multicore fiber enables a parallel optic data link with a single optical fiber, thus providing an attractive way to increase the total throughput and the integration density of the interconnections. We study and present photonics integration technologies and optical coupling approaches for multicore transmitter and receiver subassemblies. Such optical engines are implemented and characterized using multimode 6-core fibers and multicore-optimized active devices: 850-nm VCSEL and PD arrays with circular layout and multi-channel driver and receiver ICs. They are developed for bit-rates of 25 Gbps/channel and beyond, i.e.
|
|
| 10. |
- Koponen, Marjaana, et al.
(författare)
-
Incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease among community-dwelling persons
- 2015
-
Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 207:5, s. 444-449
-
Tidskriftsartikel (refereegranskat)abstract
- Background Behavioural and psychological symptoms of dementia are frequently treated with antipsychotics. Aims To determine the incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease. Method Cohort of all community-dwellers in Finland diagnosed with Alzheimer's disease in 2005 and matched controls. All antipsychotics dispensed between 1995 and 2009 were extracted from the Finnish National Prescription Register. Results Altogether 1996/6087 (32.8%) persons with Alzheimer's disease initiated antipsychotic use. The incidence of antipsychotic use was fivefold among persons with Alzheimer's disease compared with controls, started to increase 2-3 years before diagnosis and was highest during the first 6 months after diagnosis. Conclusions A distinct increase in antipsychotic initiations occurs in the same time window as Alzheimer's disease diagnosis.
|
|
