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1.
  • Bejerot, Susanne, 1955-, et al. (författare)
  • Low prevalence of smoking among patients with obsessive-compulsive disorder
  • 1999
  • Ingår i: Comprehensive Psychiatry. - Philadelphia, USA : Saunders Elsevier. - 0010-440X .- 1532-8384. ; 40:4, s. 268-272
  • Tidskriftsartikel (refereegranskat)abstract
    • Tobacco smoking is common among psychiatric patients, especially among those with schizophrenia, where the prevalence is extremely high, 74% to 88%, compared with 45% to 70% in patients with other psychiatric diagnoses. Patients with anxiety disorders are less well investigated in this respect, particularly obsessive-compulsive disorder (OCD) patients. Eighty-three psychiatric outpatients with OCD and 110 members of the Swedish OCD Association responded to questions concerning their smoking habits. Among OCD patients, 14% were current smokers (compared with 25% in the general population of Sweden), 72% had never smoked, and 11 previous smokers had stopped, mostly without any difficulties. Since a decreased smoking rate among OCD subjects was confirmed, the smoking prevalences in schizophrenia and OCD, respectively, seem to represent either end of a continuum, and OCD may also differ significantly from other anxiety disorders in this respect. Possible implications of this finding for the purported frontal lobe dysregulation in OCD are discussed.
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2.
  • Brändström, Sven, 1952-, et al. (författare)
  • Swedish normative data on personality using the Temperament and Character Inventory
  • 1998
  • Ingår i: Comprehensive Psychiatry. - 0010-440X .- 1532-8384. ; 39:3, s. 122-128
  • Tidskriftsartikel (refereegranskat)abstract
    • The Temperament and Character Inventory (TCI) is a self-report personality questionnaire based on Cloninger's psychobiological model of personality, which accounts for both normal and abnormal variation in the two major components of personality, temperament and character. Normative data for the Swedish TCI based on a representative Swedish sample of 1,300 adults are presented, and the psychometric properties of the questionnaire are discussed. The structure of the Swedish version replicates the American version well for the means, distribution of scores, and relationships within the between scales and subscales. Further, the Swedish inventory had a reliable factor structure and test-retest performance. The results of this study confirm the theory of temperament and character as a seven-factor model of personality.
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4.
  • Nilsson, Elisabet W, et al. (författare)
  • Familial factors in anorexia nervosa: a community-based study.
  • 1998
  • Ingår i: Comprehensive Psychiatry. - 0010-440X. ; 39:6, s. 392-399
  • Tidskriftsartikel (refereegranskat)abstract
    • A group of 51 cases with teenage anorexia nervosa (AN; including a total population of cases from one birth cohort) were compared with a sex-, age-, and school-matched group of 51 cases on familial factors. The subjects were examined at age 16 and 21 years. In the first study, mothers of both groups were interviewed regarding physical and psychiatric disorders among first-degree relatives. In the followup study, the subjects were interviewed according to the same structured interview schedule. The data from these interviews were deidentified, and case notes were prepared by a clinician blind to group status. The randomly assorted case notes were then submitted to an experienced psychiatrist who also was blind to group status. There were more relatives with a history and symptoms suggestive of pervasive developmental disorders (PDD) and major depression in the AN group. There was also significantly more death in first-degree relatives of anorexia nervosa cases. In respect to many axis I DSM-IV diagnoses, including eating disorders and substance abuse, there were no significant differences across groups. Instead we found PDD symptoms, major depression, and death in first-degree relatives to be important in the AN group.
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5.
  • Alenius, Malin, et al. (författare)
  • Treatmentresponse in psychotic patients classified according to social and clinical needs, drug side effects, and previous treatment; a method to identify functional remission
  • 2009
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 50:5, s. 453-462
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Various approaches have been made over the years to classify psychotic patients according to inadequate treatment response, using terms such as treatment resistant or treatment refractory. Existing classifications have been criticized for overestimating positive symptoms; underestimating residual symptoms, negative symptoms, and side effects; or being to open for individual interpretation. The aim of this study was to present and evaluate a new method of classification according to treatment response and, thus, to identify patients in functional remission. METHOD: A naturalistic, cross-sectional study was performed using patient interviews and information from patient files. The new classification method CANSEPT, which combines the Camberwell Assessment of Need rating scale, the Udvalg for Kliniske Undersøgelser side effect rating scale (SE), and the patient's previous treatment history (PT), was used to group the patients according to treatment response. CANSEPT was evaluated by comparison of expected and observed results. RESULTS: In the patient population (n = 123), the patients in functional remission, as defined by CANSEPT, had higher quality of life, fewer hospitalizations, fewer psychotic symptoms, and higher rate of workers than those with the worst treatment outcome. CONCLUSION: In the evaluation, CANSEPT showed validity in discriminating the patients of interest and was well tolerated by the patients. CANSEPT could secure inclusion of correct patients in the clinic or in research.
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8.
  • Andersson, Johan, 1988-, et al. (författare)
  • Examining heterogeneity: A systematic review of quantitative person-centered studies on adversity, mental health, and resilience in children and young adults with refugee backgrounds
  • 2024
  • Ingår i: Comprehensive Psychiatry. - : W B SAUNDERS CO-ELSEVIER INC. - 0010-440X .- 1532-8384. ; 135
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Child and young adult refugees are a heterogeneous group comprising both vulnerable and resilient individuals. Person-centered statistical methods could help disentangle this heterogeneity, enabling tailored interventions. This systematic review examined person-centered studies on adversity, mental health, and resilience in children and young adults with refugee backgrounds to identify subgroups and assess their theoretical and practical relevance. Methods: The strategy included three search blocks: 1) refugee, 2) child and/or youth, and 3) person-centered method. Studies were identified through searches of PubMed, Academic Search Complete, Scopus, PsycINFO, CINAHL, ERIC, and Cochrane. The search included all published studies until December 2023. Studies were eligible for review if they used adversity, mental health or resilience variables as indicators in a person-centered analysis. The study population needed to have a refugee background with a mean age of <= 25. The reporting quality of the studies was assessed using the adapted version of the Guidelines for Reporting on Latent Trajectory Studies (GRoLTS) checklist. The results were analyzed in a narrative format and using summary tables. Results: A total of 6706 studies were initially identified, of which seven were eligible for review. The studies included 2409 individuals and were conducted in refugee camps, communities, and institutional and clinical settings across Africa, the Middle East, Europe, Asia, and North America. Five of the seven studies included adversity as an indicator, and three articles mental ill-health. Only one article specifically investigated resilience. All studies identified subgroups, but the findings regarding predictors of group membership were inconclusive. Risks for adverse outcomes, such as mental health problems, also varied across subgroups. The studies generally displayed inadequate reporting of important methodological aspects of the data analysis, a lack of theoretical consideration, and an absence of reliability testing. Conclusions: The use of person-centered approaches in research on children and young adults with refugee backgrounds, focusing on adversity, mental health, and resilience, is currently limited. Nevertheless, the reviewed studies provided valuable insights into subgroups within this population, indicating that personcentered approaches can be employed when studying this group. Future research should consider theory and prior knowledge in the selection of the final number of groups, thoroughly report quality criteria, and rigorously test the reliability of classes.
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9.
  • Asp, Marie, et al. (författare)
  • Differences in antipsychotic treatment between depressive patients with and without a suicide attempt
  • 2021
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 109
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Depressed suicide attempters are, according to some earlier studies, treated more often with antipsychotics than depressive non-suicide attempters. Cluster B personality disorders, especially borderline personality disorder, are associated with a high suicide risk, and antipsychotics are commonly used for the reduction of symptoms. However, no previous study has taken comorbid personality disorders into account when assessing the use of antipsychotics in patients with unipolar depression. Therefore, the aim of this study was to investigate the clinical selection of pharmacotherapy in unipolar depression with and without a previous suicide attempt, taking into account potential confounders such as cluster B personality disorders. Methods: The study sample consisted of 247 patients with unipolar depression. The study was approved by the Regional Ethical Review Board in Lund, Sweden. Study participants were recruited from 4 different secondary psychiatric care clinics in Sweden and were diagnosed according to the DSM-IV-TR with the MINI and SCID II. Previous and ongoing psychiatric treatments were investigated in detail and medical records were assessed. Results: Thirty percent of the patients had made previous suicide attempts. Depressed suicide attempters underwent both lifetime treatment with antipsychotics and an ongoing antipsychotic treatment significantly more often than non-attempters. Significances remained after a regression analysis, adjusting for cluster B personality disorders, symptom severity, age at the onset of depression, and lifetime psychotic symptoms. Conclusions: This is the first study to consider the effect of comorbidity with cluster B personality disorders when comparing treatment of depressive suicide and non-suicide attempters. Our findings suggest that suicide attempters are more frequently treated with antipsychotics compared to non-suicide attempters, regardless of cluster B personality disorder comorbidity. These findings are important for clinicians to consider and would also be relevant to future studies evaluating reduction of suicide risk with antipsychotics in patients with psychiatric comorbidity and a history of attempted suicide.
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10.
  • Brohede, Sabina, et al. (författare)
  • Prevalence of body dysmorphic disorder among Swedish women: A population-based study
  • 2015
  • Ingår i: Comprehensive Psychiatry. - : WB Saunders. - 0010-440X .- 1532-8384. ; 58, s. 108-115
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Body dysmorphic disorder (BDD) is characterized by a highly distressing and impairing preoccupation with nonexistent or slight defects in appearance. Patients with BDD present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in representative samples of the general population and have demonstrated that this disorder is relatively common. Our primary objective was to assess the prevalence of BDD in the Swedish population because no data are currently available. Methods: In the current cross-sectional study, 2891 randomly selected Swedish women aged 18-60 years participated. The occurrence of BDD was assessed using the Body Dysmorphic Disorder Questionnaire (BDDQ), which is a validated self-report measure derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for BDD. In addition, symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of BDD among Swedish women was 2.1%. The women with BDD had significantly more symptoms of depression and anxiety than the women without BDD. Depression (HADS depression score greater than= 8) and anxiety (HADS anxiety score greater than= 8) were reported by 42% and 72% of the women with BDD, respectively. Conclusions: The results of the present study indicate that BDD is relatively common among Swedish women (2.1%) and that it is associated with significant morbidity.
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11.
  • Chotai, Jayanti, et al. (författare)
  • Novelty seeking among adult women is lower for the winter borns compared to the summer borns : replication in a large Finnish birth cohort
  • 2009
  • Ingår i: Comprehensive Psychiatry. - : Elsevier. - 0010-440X .- 1532-8384. ; 50:6, s. 562-566
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Earlier general population studies have shown that novelty seeking (NS) of the Temperament and Character Inventory (TCI) of personality is lower for persons born in winter compared to those born in summer, particularly for women. Here, we investigate if this result can be replicated in another population. METHOD: The Northern Finland 1966 Birth Cohort, comprising 4968 subjects (2725 women, 2243 men), was investigated with regard to the temperament dimensions of the TCI and the season of birth. RESULTS: Novelty seeking and reward dependence (RD) showed significant variations according to the month of birth. We found that women born during winter have significantly lower levels of NS compared to women born during summer, with a minimum for the birth month November and maximum for May. These results are similar to those found in a previous Swedish study. Furthermore, our study showed that men born during spring had significantly lower mean scores of RD compared to men born during autumn, with a minimum for birth month March. This was in contrast to the Swedish study, where the minimum of RD was obtained for the birth month December. CONCLUSION: Women born in winter have lower NS as adults compared to women born in summer. Because NS is modulated by dopamine, this study gives further support to the studies in the literature that show that dopamine turnover for those born in winter is higher than for those born in summer.
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12.
  • Dubol, Manon, et al. (författare)
  • Acute nicotine exposure blocks aromatase in the limbic brain of healthy women : A [11C]cetrozole PET study
  • 2023
  • Ingår i: Comprehensive Psychiatry. - : Elsevier. - 0010-440X .- 1532-8384. ; 123
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Of interest to women's mental health, a wealth of studies suggests sex differences in nicotine addiction and treatment response, but their psychoneuroendocrine underpinnings remain largely unknown. A pathway involving sex steroids could indeed be involved in the behavioural effects of nicotine, as it was found to inhibit aromatase in vitro and in vivo in rodents and non-human primates, respectively. Aromatase regulates the synthesis of oestrogens and, of relevance to addiction, is highly expressed in the limbic brain.Methods: The present study sought to investigate in vivo aromatase availability in relation to exposure to nicotine in healthy women. Structural magnetic resonance imaging and two [11C]cetrozole positron emission tomography (PET) scans were performed to assess the availability of aromatase before and after administration of nicotine. Gonadal hormones and cotinine levels were measured. Given the region-specific expression of aromatase, a ROI -based approach was employed to assess changes in [11C]cetrozole non-displaceable binding potential.Results: The highest availability of aromatase was found in the right and left thalamus. Upon nicotine exposure, [11C]cetrozole binding in the thalamus was acutely decreased bilaterally (Cohen's d =-0.99). In line, cotinine levels were negatively associated with aromatase availability in the thalamus, although as non-significant trend.Conclusions: These findings indicate acute blocking of aromatase availability by nicotine in the thalamic area. This suggests a new putative mechanism mediating the effects of nicotine on human behaviour, particularly relevant to sex differences in nicotine addiction.
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13.
  • Eberhard, Jonas, et al. (författare)
  • Remission in schizophrenia: analysis in a naturalistic setting.
  • 2009
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 50:3, s. 200-208
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the recently defined Positive and Negative Syndrome Scale for Schizophrenia remission criteria in a naturalistic setting of psychotic patients; to identify causal factors that change remission status; and to validate the criteria against global indices of illness, cognitive functions, and social outcome. METHODS: This was a longitudinal naturalistic study of 162 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders (mean illness duration, 11 years) and treated with risperidone at study entry. Symptoms, drug treatment, cognitive function, and social outcome were measured at baseline and annually for 5 years. Remission was constructed retrospectively with only indirect data on stability over time. RESULTS: At study entry, 40% of the patients with schizophrenia were in symptomatic remission, stabilizing between 55% and 60% after a few years. The need for hospitalization became less frequent over time; initially 31%, dropping to 7% by years 4 and 5. Many patients went in and out of remission. Remission was strongly associated with global indices of illness, with intact insight and with social outcome (except work/studies) but not with cognition or medication. CONCLUSIONS: In spite of certain weaknesses of the study, we may conclude that current definition of remission is primarily a symptomatic measure, covering a subset of symptoms, some of which are not schizophrenia-specific. Although the definition may be clinically relevant, we must be aware of the risk that the connotation of the word could induce too much focus on symptom control.
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  • Flakierska-Praquin, Natalia, et al. (författare)
  • School phobia with separation anxiety disorder: a comparative 20- to 29-year follow-up study of 35 school refusers.
  • 1997
  • Ingår i: Comprehensive Psychiatry. - 0010-440X. ; 38:1, s. 17-22
  • Tidskriftsartikel (refereegranskat)abstract
    • The outcome of school phobia after age 30 years was studied with the hypothesis that school phobia cases would have persisting psychiatric problems, but would function better than nonschool refusal psychiatric patients. The subjects consisted of three groups. Thirty-five individuals treated for school phobia at ages 7 to 12 years were compared with age- and sex-matched nonschool refusal child psychiatric patients (n = 35) and a sample from the general population (n = 35). School phobia cases had had more psychiatric consultation, lived with their parents more often than the general population group, and had fewer children than both comparison groups. The nonschool refusal child psychiatric patients had poorer psychosocial adjustment and higher rates of criminal offenses. The implications of the findings are discussed.
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  • Green, Johan, et al. (författare)
  • A latent class analysis of mental disorders, substance use, and aggressive antisocial behavior among Swedish forensic psychiatric patients
  • 2023
  • Ingår i: Comprehensive Psychiatry. - 0010-440X .- 1532-8384. ; 127
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the ‘triply troubled’. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB. Methods: A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB. Results: A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression. Conclusions: The present study helps disentangle the heterogeneity of the ‘triply troubled’ patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.
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18.
  • Ilkjaer, K, et al. (författare)
  • Personality disorders in a total population twin cohort with eating disorders.
  • 2004
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X. ; 45:4, s. 261-267
  • Tidskriftsartikel (refereegranskat)abstract
    • Findings regarding the occurrence of personality disorders (PDs) in eating disorders (EDs) have been contradictory. Most previous studies have been clinic-based. The aims of the current study were to assess the prevalence of PD in ED in a population-based twin group and to establish the distribution of PD in three subgroups of ED. A two-step screening and diagnostic study of ED was performed in a large Danish twin population. Axis I and axis II DSM-III-R and DSM-IV ED diagnoses were made on the basis of results obtained at clinical investigations and interviews. Forty-nine percent of the participants with ED had at least one PD, compared to 26% in those with no ED (P <.001). Cluster C PD was the most common type of PD in all subgroups of ED, and cluster B PD was found only in participants with bulimic symptoms. Genetic factors appeared to contribute significantly to the variance of cluster C PD in ED, which was evaluated as a possibly important background factor in ED.
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19.
  • Ivarsson, Tord, 1946, et al. (författare)
  • Depressive disorders in teenage-onset anorexia nervosa: a controlled longitudinal, partly community-based study.
  • 2000
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X. ; 41:5, s. 398-403
  • Tidskriftsartikel (refereegranskat)abstract
    • The study objective was to examine the prevalence and course of depressive disorders (DDs) in teenage-onset anorexia nervosa (AN) over a period of 10 years. Fifty-one adolescents with AN and a sex- and age-matched control group (n = 51) were assessed at ages 16, 21, and 24 years. Probands and controls were examined in depth using semistructured and structured interviews. Their parents were interviewed on the occasion of the first examination. DDs were assessed using DSM-III-R criteria. Subjects with AN had a greatly increased rate of DDs (85%) of all kinds and at all ages as compared with control subjects. The risk of DD during the follow-up period from 21 up to and including 24 years could be predicted by diagnostic group status and the presence of DD during the period from 16 to 21 years, while the risk of DD during the follow-up period from 16 up to and including 21 years was solely predicted by the presence of AN at age 16 years. Long-term resolution of the eating disorder (ED) was associated with the absence of mood disorder or vice versa. Bipolar disorder (BP) occurred at roughly the expected rate (11%) among subjects (probands and controls) with major depression (MDD). In conclusion, depression is a very common comorbid problem in AN: more than four of five individuals with teenage-onset AN had at least one episode of DSM-III-R depression (MD or dysthymia [DT]) within 10 years after onset of the ED. AN appears to trigger the first episode of depression, but once it is manifest, depression predicts further depressive episodes.
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20.
  • Jiménez-Murcia, Susana, et al. (författare)
  • Typologies of young pathological gamblers based on sociodemographic and clinical characteristics.
  • 2013
  • Ingår i: Comprehensive Psychiatry. - : Elsevier. - 0010-440X .- 1532-8384. ; 54:8, s. 1153-60
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study is to explore empirical clusters within the population of young Spanish individuals attending outpatient pathological gambling treatment.METHOD: The South Oaks Gambling Screen (SOGS), the Symptom Checklist (SCL-90-R), the Temperament and Character Inventory-R (TCI-R) and other clinical and psychopathological measures were administered to 154 patients (between 17 and 25 years old). The two-step cluster analysis explored the presence of empirical heterogeneous groups based on clinical and socio-demographic characteristics.RESULTS: Three clusters of young pathological gambling patients emerged. Type I showed less psychopathology and more functional personality traits. Type II showed a profile characterized by major emotional distress, shame, immaturity, hostility and negative feelings. Type III showed the most severe psychopathological profile and most psychopathological disturbances and schizotypal traits.CONCLUSIONS: These results suggest that three distinct endophenotypes exist, and that environmental factors have a stronger influence in the first, while in the second and third, individual factors related to deficits of emotional regulation stand out.
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21.
  • Karjalainen, Louise, 1980, et al. (författare)
  • Eating disorders and eating pathology in young adult and adult patients with ESSENCE
  • 2016
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X. ; 66, s. 79-86
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Little is known about the prevalence and incidence of traditional eating disorders (EDs, e.g., anorexia nervosa (AN), bulimia nervosa and binge eating disorder (BED)) in individuals with childhood onset neuropsychiatric disorders, including attention-deficit/ hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). The aim of the present study was to examine the prevalence of EDs and eating pathology in young adults and adults with ADHD and/or ASD, and to investigate the relationship between EDs and associated symptoms, on the one hand, and other psychiatric disorders, intelligence, and BMI, on the other hand, in this population. Methods: In an outpatient setting, 228 consecutively referred adults were neuropsychiatrically evaluated and assessed with regard to intelligence (WAIS-III), psychiatric comorbidities (SCID-I), personality disorders (SCID-II), eating disorders (SCID-I) and eating pathology (Eating Attitudes Test (EAT)). Results: For the entire sample, a total of 18 individuals (7.9%) had a current or previous eating disorder, with AN and BED being the most frequent. The male:female ratio was 1:2.5. According to EAT, 10.1% of the individuals scored within the range of severely disturbed eating behavior, and 13% moderately disturbed eating behavior. Individuals with ADHD more often affirmed eating pathology such as focusing on thoughts of calories and body dissatisfaction compared to individuals with ASD. Conclusions: Eating disorder symptomatology seems to be overrepresented in adults with neuropsychiatric disorders compared with the general population. The gender ratio for EDs in adults with neuropsychiatric disorders is not nearly as skewed as in the general population.
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  • Kerekes, Nóra, et al. (författare)
  • The protective effect of character maturity in child aggressive antisocial behavior
  • 2017
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 76, s. 129-137
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Childhood aggressive antisocial behavior (CD) is one of the strongest predictors of mental health problems and criminal behavior in adulthood. The aims of this study were to describe personality profiles in children with CD, and to determine the strength of association between defined neurodevelopmental symptoms, dimensions of character maturity and CD. Methods: A sample of 1886 children with a close to equal distribution of age (9 or 12) and gender, enriched for neurodevelopmental and psychiatric problems were selected from the nationwide Child and Adolescent Twin Study in Sweden. Their parents rated them according to the Junior Temperament and Character Inventory following a telephone interview during which information about the children's development and mental health was assessed with the Autism-Tics, AD/HD and other Comorbidities inventory. Result: Scores on the CD module significantly and positively correlated with scores on the Novelty Seeking temperament dimension and negatively with scores on character maturity (Self-Directedness and Cooperativeness). In the group of children with either neurodevelopmental or behavioral problems, the prevalence of low or very low character maturity was 50%, while when these two problems coexisted the prevalence of low or very low character maturity increased to 70%. Neurodevelopmental problems (such as: oppositional defiant disorder, symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder) and low scores on character maturity emerged as independently significant predictors of CD; in a multivariable model, only oppositional defiant symptoms and impulsivity significantly increased the risk for coexisting CD while a mature self-agency in a child (Self-Directedness) remained a significant protective factor. Conclusion: These results suggest that children's willpower, the capacity to achieve personally chosen goals may be an important protective factor even in the presence of neurodevelopmental and psychiatric problems against progressing into persistent negative outcomes, such as aggressive antisocial behaviors. (C) 2017 Elsevier Inc. All rights reserved.
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  • Klötz, Fia, et al. (författare)
  • The significance of anabolic androgenic steroids in a Swedish prison population
  • 2010
  • Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 51:3, s. 312-318
  • Tidskriftsartikel (refereegranskat)abstract
    • Use of anabolic androgenic steroids (AAS) has been associated with adverse psychiatric effect, violent behavior, and criminality. The aim of this study was to further investigate the motives for and consequences of AAS use, with focus on violent and antisocial behavior. Fifty-nine prisoners were interviewed on their use of AAS, and their history was mapped with Addiction Severity Index interviews. Of these prisoners, 56% admitted previous use of AAS, of whom 24% declared to have committed violent crimes in connection with use of AAS. However, the only significant difference between users and nonusers with regard to criminal history when measured with the Addiction Severity Index was that the AAS users more often stated that they had been prosecuted for crimes labeled as “other crimes,” which did not include violent crimes. The reported side effects of AAS corresponded well to those previously reported. These results indicate that use of AAS is common among Swedish prisoners and that the motives and consequences of such use are similar to what has been observed in other AAS-using populations. Furthermore, this study supports earlier notions that misuse of AAS might cause violent behavior, but only in certain individuals and mainly in combination with other substances.
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