| 1. |
- Barnevik Olsson, Martina, et al.
(författare)
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Children with borderline intellectual functioning and autism spectrum disorder : developmental trajectories from 4 to 11 years of age
- 2017
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 13, s. 2519-2526
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as high-functioning, that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70-84) is limited. Methods: From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5-6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36). Results: Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84. Conclusion: None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support.
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| 2. |
- Barnevik Olsson, Martina, et al.
(författare)
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Recovery from the diagnosis of autism - and then?
- 2015
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 11, s. 999-1005
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to follow up the 17 children, from a total group of 208 children with autism spectrum disorder (ASD), who recovered from autism. They had been clinically diagnosed with ASD at or under the age of 4 years. For 2 years thereafter they received intervention based on applied behavior analysis. These 17 children were all of average or borderline intellectual functioning. On the 2-year follow-up assessment, they no longer met criteria for ASD. Methods: At about 10 years of age they were targeted for a new follow-up. Parents were given a semistructured interview regarding the child's daily functioning, school situation, and need of support, and were interviewed using the Vineland Adaptive Behavior Scales (VABS) and the Autism - Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) telephone interview. Results: The vast majority of the children had moderate-to-severe problems with attention/activity regulation, speech and language, behavior, and/or social interaction. A majority of the children had declined in their VABS scores. Most of the 14 children whose parents were A-TAC-interviewed had problems within many behavioral A-TAC domains, and four (29%) had symptom levels corresponding to a clinical diagnosis of ASD, AD/HD, or both. Another seven children (50%) had pronounced subthreshold indicators of ASD, AD/HD, or both. Conclusion: Children diagnosed at 2-4 years of age as suffering from ASD and who, after appropriate intervention for 2 years, no longer met diagnostic criteria for the disorder, clearly needed to be followed up longer. About 3-4 years later, they still had major problems diagnosable under the umbrella term of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). They continued to be in need of support, educationally, from a neurodevelopmental and a medical point of view. According to parent interview data, a substantial minority of these children again met diagnostic criteria for ASD.
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| 3. |
- Boden, Robert, et al.
(författare)
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A comparison of cardiovascular risk factors for ten antipsychotic drugs in clinical practice
- 2013
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 9, s. 371-377
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Tidskriftsartikel (refereegranskat)abstract
- It is well known that abdominal obesity, dyslipidemia, and insulin resistance are highly prevalent in patients receiving maintenance treatment with antipsychotics, but there is limited knowledge about the association between cardiovascular risk factors and treatment with antipsychotic drugs. In this naturalistic study we investigated a sample of 809 antipsychotic-treated patients from Swedish psychosis outpatient teams. Cardiovascular risk factors (eg, metabolic syndrome, homeostasis model assessment of insulin resistance, and low-density lipoprotein values) were measured, and their associations to current antipsychotic pharmacotherapy were studied. Ten antipsychotic drugs were compared in a stepwise logistic regression model. For the patients, the presence of the components of metabolic syndrome ranged from 35% for hyperglycemia to 64% for elevated waist circumference. Hypertriglyceridemia was associated with clozapine (odds ratio [OR] = 1.81, 95% confidence interval [CI] 1.08-3.04), reduced high-density lipoprotein with both clozapine and olanzapine (OR = 1.73, 95% CI 1.01-2.97; and OR = 2.03, 95% CI 1.32-3.13), hypertension with perphenazine (OR = 2.00, 95% CI 1.21-3.59), and hyperglycemia inversely with ziprasidone (OR = 0.21, 95% CI 0.05-0.89) and positively with haloperidol (OR = 2.02, 95% CI 1.18-3.48). There were no significant relationships between any of the antipsychotic drugs and increased waist circumference, homeostasis model assessment of insulin resistance, or low-density lipoprotein levels. In conclusion, treatment with antipsychotic drugs is differentially associated with cardiovascular risk factors, even after adjusting for waist circumference, sex, age, and smoking.
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| 4. |
- Constantinescu, Radu, 1966
(författare)
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Update on the use of pramipexole in the treatment of Parkinson's disease.
- 2008
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Ingår i: Neuropsychiatric disease and treatment. - 1176-6328. ; 4:2, s. 337-52
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Tidskriftsartikel (refereegranskat)abstract
- Pramipexole is a non-ergot dopamine agonist shown to be efficacious in the treatment of Parkinson's disease (PD). This review addresses the literature concerning pramipexole's efficacy in treating motor and non-motor symptoms in PD, its impact on the development of dyskinesias and response fluctuations, the issue of neuroprotection, and the risk for developing adverse events such as increased somnolence, attacks of sudden onset of sleep, cardiac valvulopathy and impulse control disturbances.
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| 5. |
- Eberhard, Jonas, et al.
(författare)
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Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms : A naturalistic study
- 2016
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 12, s. 2265-2271
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Patients with a bipolar I disorder (BD-I) manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), criteria for "with mixed features" have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA) symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study. Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 "with mixed features" specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts. Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6%) met the criteria for the DSM-5 "with mixed features" specifier (three or more depressive symptoms). These patients were further stratified according to the severity of their AIA symptoms: "mild AIA" (zero or one AIA symptom above a severity threshold; 105 patients) or "severe AIA" (all three AIA symptoms above a severity threshold; 167 patients). A greater incidence of suicidal ideation was observed in the severe AIA group (71.9%) than in the mild AIA group (47.6%). Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P,0.05) and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively). Conclusion: The high risk of suicide among BD-I mania patients with depressive symptoms is further increased when they experience severe AIA symptoms. Recognizing AIA symptoms in BD-I mania could provide a means of identifying patients with depressive symptoms, as well as those who may be suicidal, thereby allowing for appropriate, tailored treatment.
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| 6. |
- Ek, Ulla, et al.
(författare)
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General versus executive cognitive ability in pupils with ADHD and with milder attention problems
- 2013
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 9, s. 163-168
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to analyze two main types of cognitive domains in school children with different types and severities of attention-related problems. The cognitive domains examined were general cognitive ability and executive abilities. Methods: Three different clinical samples of pupils with school problems were analyzed to assess their cognitive Wechsler Intelligence Scale for Children profiles. In particular, the general cognitive ability index and the executive markers (ie, verbal memory index and processing speed index) were of interest. Of the total sample (n = 198), two main groups were contrasted; one met the full criteria for attention deficit hyperactivity disorder (ADHD)/subthreshold ADHD, and one was comprised of those with milder attention problems, insufficient to meet the criteria for ADHD/subthreshold ADHD. Results: It could be demonstrated that both groups had a significantly higher score on the general cognitive ability index than on measures of working memory and processing speed. This difference was more pronounced for boys. Conclusion: These types of cognitive differences need to be considered in children with different kinds of learning, behavior, and attention problems; this is also true for children presenting with an average general intelligence quotient and with milder attention problems. Current educational expectations are demanding for children with mild difficulties, and such cognitive information will add to the understanding of the child's learning problems, hopefully leading to a better adapted education than that conventionally available.
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| 7. |
- Ek, Ulla, 1948-, et al.
(författare)
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Teenage outcomes after speech and language impairment at preschool age
- 2012
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 8, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Ten years ago, we published developmental data on a representative group of children (n = 25) with moderate or severe speech and language impairment, who were attending special preschools for children. The aim of this study was to perform a follow-up of these children as teenagers. Methods: Parents of 23 teenagers participated in a clinical interview that requested information on the child's current academic achievement, type of school, previous clinical assessments, and developmental diagnoses. Fifteen children participated in a speech and language evaluation, and 13 participated in a psychological evaluation. Results: Seven of the 23 teenagers had a mild intellectual disability, and another three had borderline intellectual functioning. Nine had symptoms of disorders on the autism spectrum; five of these had an autism spectrum disorder, and four had clear autistic traits. Six met criteria for attention-deficit hyperactivity disorder (ADHD)/subthreshold ADHD. Thirteen of 15 teenagers had a moderate or severe language impairment, and 13 of 15 had a moderate or severe reading impairment. Overlapping disorders were frequent. None of the individuals who underwent the clinical evaluation were free from developmental problems. Conclusion: A large number of children with speech and language impairment at preschool age had persistent language problems and/or met the criteria for developmental diagnoses other than speech and language impairment at their follow-up as teenagers. Language impairment in young children is a marker for several developmental disorders, particularly intellectual disability and autism spectrum disorder.
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| 8. |
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| 9. |
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| 10. |
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| 11. |
- Gauffin, Helena, et al.
(författare)
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Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy
- 2014
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press. - 1176-6328 .- 1178-2021. ; 10, s. 2183-2189
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Tidskriftsartikel (refereegranskat)abstract
- Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs). Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures. Children can also be affected by PNESs. It is essential to notice especially those children of parents with epilepsy who live under difficult psychosocial circumstances and offer extra support when necessary.
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| 12. |
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| 13. |
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| 14. |
- Jonsson Gauffin, Helena, et al.
(författare)
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Being parents with epilepsy : thoughts on its consequences and difficulties affecting their children
- 2015
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press. - 1176-6328 .- 1178-2021. ; 11, s. 1291-1298
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Parents with epilepsy can be concerned about the consequences of epilepsy affecting their children. The aim of this paper is to describe aspects of what it means being a parent having epilepsy, focusing the parents’ perspectives and their thoughts on having children.Methods:Fourteen adults aged 18–35 years with epilepsy and subjective memory decline took part in focus-group interviews. The interviews were conducted according to a semi-structured guideline. Material containing aspects of parenthood was extracted from the original interviews and a secondary analysis was done according to a content-analysis guideline. Interviews with two parents for the Swedish book Leva med epilepsi [To live with epilepsy] by AM Landtblom (Stockholm: Bilda ide; 2009) were analyzed according to the same method.Results:Four themes emerged: (1) a persistent feeling of insecurity, since a seizure can occur at any time and the child could be hurt; (2) a feeling of inadequacy – of not being able to take full responsibility for one’s child; (3) acknowledgment that one’s children are forced to take more responsibility than other children do; and (4) a feeling of guilt – of not being able to fulfill one’s expectations of being the parent one would like to be.Conclusion:The parents with epilepsy are deeply concerned about how epilepsy affects the lives of their children. These parents are always aware that a seizure may occur and reflect on how this can affect their child. They try to foresee possible dangerous situations and prevent them. These parents were sad that they could not always take full responsibility for their child and could not live up to their own expectations of parenthood. Supportive programs may be of importance since fear for the safety of the child increases the psychosocial burden of epilepsy. There were also a few parents who did not acknowledge the safety issue of their child – the authors believe that it is important to identify these parents and provide extra information and support to them.
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| 15. |
- Jönsson, Bengt, et al.
(författare)
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Factors associated with failure to achieve remission and with relapse after remission in patients with major depressive disorder in the PERFORM study
- 2017
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press. - 1176-6328. ; 13, s. 2151-2165
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder (PERFORM) study has been initiated to better understand the course of a depressive episode and its impact on patient functioning. This analysis aimed to identify sociodemographic and clinical factors associated with failure to achieve remission at month 2 after initiating or switching antidepressant monotherapy and with subsequent relapse at month 6 for patients in remission at month 2. Materials and methods: This was a 2-year observational cohort study in 1,159 outpatients aged 18–65 years with major depressive disorder initiating or undergoing the first switch of antidepressant monotherapy. Factors with P8 weeks (OR 0.51), being in psychotherapy (OR 0.51), sexual dysfunction (OR 0.62), and severity of depression (OR 0.87). Factors significantly associated with relapse at month 6 were male sex (OR 2.47), being married or living as a couple (OR 2.73), residual patient-reported cognitive symptoms at 2 months (OR 1.12 per additional unit of Perceived Deficit Questionnaire-5 score) and residual depressive symptoms at 2 months (OR 1.27 per additional unit of Patient Health Questionnaire-9 score). Conclusion: Different factors appear to be associated with failure to achieve remission in patients with major depressive disorder and with subsequent relapse in patients who do achieve remission. Patient-reported cognitive dysfunction is an easily measurable and treatable characteristic that may be associated with an increased likelihood of relapse at 6 months in patients who have achieved remission.
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| 16. |
- Kallstrand, Johan, et al.
(författare)
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A new method for analyzing auditory brain-stem response waveforms using a moving-minimum subtraction procedure of digitized analog recordings
- 2014
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 10, s. 1011-1016
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Tidskriftsartikel (refereegranskat)abstract
- The auditory brain-stem response (ABR) waveform comprises a set of waves (labeled I-VII) recorded with scalp electrodes over 10 ms after an auditory stimulation with a brief click sound. Quite often, the waves are fused (confluent) and baseline-irregular and sloped, making wave latencies and wave amplitudes difficult to establish. In the present paper, we describe a method, labeled moving-minimum subtraction, based on digitization of the analog ABR waveform (154 data points/ms) in order to achieve alignment of the ABR response to a straight baseline, often with clear baseline separation of waves and resolution of fused waves. Application of the new method to groups of patients showed marked differences in ABR waveforms between patients with schizophrenia versus patients with adult attention deficit/hyperactivity disorder versus healthy controls. The findings show promise regarding the possibility to identify ABR markers to be used as biomarkers as support for clinical diagnoses of these and other neuropsychiatric disorders.
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| 17. |
- Kindgren, Erik, 1977-, et al.
(författare)
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Prevalence of ADHD and Autism Spectrum Disorder in Children with Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome: A Retrospective Study
- 2021
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Ingår i: Neuropsychiatric Disease and Treatment. - : DOVE MEDICAL PRESS LTD. - 1176-6328 .- 1178-2021. ; 17, s. 379-388
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) are both characterized by generalized hypermobility, in combination with pain, affected proprioception, and pronounced fatigue. Clinical observation indicates that behavioral problems, hyperactivity, and autistic traits are overrepresented in children with those conditions. The purpose of this retrospective study was to establish the prevalence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) among children with HSD and hEDS treated in our clinic since 2012. Subjects and Methods: Since Ehlers-Danlos syndrome (EDS) diagnostic criteria and international classification were changed in 2017, we equate the older diagnosis EDS hypermobility type with the newer hEDS and the older hypermobility syndrome with HSD. A registry search from the computerized medical record system found 201 children (88 boys, 113 girls) aged 6– 18 years who were treated at our pediatrics department with the diagnoses HSD or EDS. All medical records (113 with HSD, 88 with EDS) were reviewed, and key symptoms such as fatigue and pain, as well as diagnosis of ADHD/ASD, were recorded. Results: All EDS cases could be classified as hEDS. Of the entire study cohort, 16% had a verified ADHD diagnosis and a further 7% were undergoing ADHD diagnostic investigation. Significantly more children with hEDS had ADHD compared to children with HSD (p=0.02). In the age group 15– 16 years, 35% of those with hEDS had ADHD and, among those aged 17– 18 years, ADHD was present in 46%. Children with coexisting ADHD showed a significantly higher proportion of associated symptoms such as fatigue, sleep-problems, and urinary tract problems. ASD had been verified in 6% of the children. Of those with ASD, 92% had sleep problems. Conclusion: This study shows a strong association between HSD or hEDS and ADHD or ASD. Therefore, children with HSD or hEDS may need to be routinely screened for neuropsychiatric symptoms.
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| 18. |
- Kjellmer, Liselotte, et al.
(författare)
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Speech and language profiles in 4-to 6-year-old children with early diagnosis of autism spectrum disorder without intellectual disability
- 2018
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 14, s. 2415-2427
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to present speech and language data from a community-representative group of 4- to 6-year-old children with early-diagnosed autism spectrum disorder (ASD) without intellectual disability (ID). Methods: The study group comprised 83 children 4-6 years of age with ASD without ID. They had been diagnosed with ASD before age 4.5 years and had received intervention at a specialized habilitation center. At 2-year follow-up, their language abilities were evaluated comprehensively by two speech-language pathologists using a battery of assessments. Receptive and expressive language and phonology were examined. The phonology evaluation included measures of phonological speech production and of phonological processing. Results: Results revealed that almost 60% had moderate-severe language problems. Nearly half exhibited combined expressive and receptive language problems, of which a majority also had phonology problems. Phonological speech problems were found in 21% of the total group. Conclusion: The findings underscore the importance of considering speech/language disorders in children with ASD without ID, since they usually attend mainstream classes but need specific educational adaptations.
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| 19. |
- Knez, Rajna, et al.
(författare)
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Orexin/Hypocretin System Dysfunction in ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations)
- 2022
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press Ltd. - 1176-6328 .- 1178-2021. ; 18, s. 2683-2702
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Tidskriftsartikel (refereegranskat)abstract
- Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) is an umbrella term covering a wide range of neurodevelopmental difficulties and disorders. Thus, ESSENCE includes attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other neurodevelopmental disorders (NDDs) and difficulties, with a variety of symptoms in cognitive, motor, sensory, social, arousal, regulatory, emotional, and behavioral developmental domains, frequently co-occurring and likely having partly common neurobiological substrates. The ESSENCE concept is a clinical paradigm that promotes organizing NDDs in everyday clinical practice according to their coexistence, symptom dimensions overlapping, and treatment possibilities. Despite increased knowledge regarding NDDs, the neurobiological mechanisms that underlie them and other ESSENCE-related problems, are not well understood. With its wide range of neural circuits and interactions with numerous neurotransmitters, the orexin/hypocretin system (Orx-S) is possibly associated with a variety of neurocognitive, psychobiological, neuroendocrine, and physiological functions and behaviors. Dysfunction of Orx-S has been implicated in various psychiatric and neurological disorders. This article provides an overview of Orx-S dysfunctions' possible involvement in the development, presentation, and maintenance of ESSENCE. We provide a focused review of current research evidence linking orexin neuropeptides with specific clinical NDDs symptoms, mostly in ADHD and ASD, within the Research Domain Criteria (RDoC) framework. We propose that Orx-S dysfunction might have an important role in some of these neurodevelopmental symptom domains, such as arousal, wakefulness, sleep, motor and sensory processing, mood and emotional regulation, fear processing, reward, feeding, attention, executive functions, and sociability. Our perspective is presented from a clinical point of view. Further, more thorough systematic reviews are needed as well as planning of extensive new research into the Orx-S’s role in ESSENCE, especially considering RDoC elements.
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| 20. |
- Knez, Rajna, 1969, et al.
(författare)
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The impact of methylphenidate on performance of children with ADHD: A retrospective clinical QbTest study.
- 2021
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 17, s. 19-32
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The Quantified behavior Test (QbTest), which combines a continuous performance task (CPT) and motion tracking, provides data for the core signs of attention-deficit/hyperactivity disorder (ADHD): attention, hyperactivity, and impulsivity. This study aimed to evaluate the performance of children and adolescents with ADHD on the QbTest before and after a single methylphenidate (MPH) dose. Subjects and Methods: This retrospective chart review study included data from 149 children and 215 adolescents who completed the QbTest. A summary index of the CPT and motion capture data on the QbTest is provided by three cardinal parameters: QbActivity, QbImpulsivity, and QbInattention. The test was performed twice on the same day, before and up to three hours after MPH intake. A decrease by ≥ 0.5 in a cardinal parameter score was considered an improvement, whereas an increase by ≥ 0.5 a deterioration. Results: QbActivity improvement after MPH intake was present in 71.7% and 76.2% of the children and adolescents, respectively. QbImpulsivity improvement was observed in 50.4% of the children and 44.7% of the adolescents, and QbInattention improvement in 85.1% and 91.1% of the children and adolescents, respectively. All three parameters improved simultaneously in 27.7% of the children and 28.7% of the adolescents. The likelihood that one parameter deteriorated after MPH use was greater if that parameter was within the normal range before medication. This was most pronounced for QbImpulsivity. Among male adolescents, QbInattention improvement was often accompanied by QbImpulsivity deterioration. Conclusion: The QbTest inattention and motor activity parameters improved markedly after a single MPH dose in children and adolescents with ADHD, while less so for impulsivity. Improvement of one parameter is not necessarily associated with improvement of the other two, and deterioration, especially regarding impulsivity, may occur. If confirmed, these results highlight the need for optimization and individualization of MPH treatment, while monitoring all aspects of the ADHD symptomatology based on the QbTest performance.
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| 21. |
- Källstrand, Johan, et al.
(författare)
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Abnormal auditory forward masking pattern in the brainstem response of individuals with Asperger syndrome.
- 2010
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 6, s. 289-296
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Tidskriftsartikel (refereegranskat)abstract
- Abnormal auditory information processing has been reported in individuals with autism spectrum disorders (ASD). In the present study auditory processing was investigated by recording auditory brainstem responses (ABRs) elicited by forward masking in adults diagnosed with Asperger syndrome (AS). Sixteen AS subjects were included in the forward masking experiment and compared to three control groups consisting of healthy individuals (n = 16), schizophrenic patients (n = 16) and attention deficit hyperactivity disorder patients (n = 16), respectively, of matching age and gender. The results showed that the AS subjects exhibited abnormally low activity in the early part of their ABRs that distinctly separated them from the three control groups. Specifically, wave III amplitudes were significantly lower in the AS group than for all the control groups in the forward masking condition (P < 0.005), which was not the case in the baseline condition. Thus, electrophysiological measurements of ABRs to complex sound stimuli (eg, forward masking) may lead to a better understanding of the underlying neurophysiology of AS. Future studies may further point to specific ABR characteristics in AS individuals that separate them from individuals diagnosed with other neurodevelopmental diseases.
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| 22. |
- Landgren, Magnus, 1955, et al.
(författare)
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Blood pressure and anthropometry in children treated with stimulants: a longitudinal cohort study with an individual approach.
- 2017
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Ingår i: Neuropsychiatric disease and treatment. - 1176-6328. ; 13, s. 499-506
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge about the long-term effects on blood pressure (BP) and body mass index (BMI) when treating young patients for attention-deficit/hyperactivity disorder (AD/HD) with stimulants is limited. Most of the studies have reported mean and not individual values for anthropometrics and BP in treatment with stimulants. This seems to be the first study of changes based on the analyses of individual data measured over time.Seventy young patients (aged 8-18 years) diagnosed with AD/HD and responding well to treatment with stimulants were followed for a mean period of 3 years and 3 months. BP, heart rate, height, weight, and BMI were transformed to standard deviations or z-scores from before treatment to the last registered visit.The mean dose of methylphenidate was 0.95 mg/kg. The mean increase of systolic and diastolic BP was 0.4 z-score and 0.1 z-score, respectively. The systolic BP was associated with BMI; a higher BMI at baseline increased the risk for an increase in systolic BP. Ten percent of the total group had a weight at follow-up of <-1.5 standard deviation (SD) and 12% had a height of <-1.5 SD. Mean height at follow-up was -0.2 SD, but 40% had a reduced height of at least 0.5 SD during the treatment period. BMI on a group level was reduced from +0.8 SD to +0.3 SD. Of the 19 patients with a BMI >+1.5 SD at baseline, 50% had a significantly reduced BMI.Consequences of stimulant treatment must be evaluated individually. Besides significant effects on core AD/HD symptoms, some patients have lower BMI and BP and some increase/maintain their BMI and/or increase their systolic BP. The risk of reduced height trajectory needs further research.
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| 23. |
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| 24. |
- Millischer, Vincent, et al.
(författare)
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Twelve-week physical exercise does not have a long-lasting effect on kynurenines in plasma of depressed patients
- 2017
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press. - 1176-6328 .- 1178-2021. ; 13, s. 967-972
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical exercise has well-characterized positive effects on depressive symptoms. The underlying biologic mechanisms are, however, far from established. A recently discovered mechanism has linked the enhanced conversion of kynurenine to kynurenic acid (KYNA) to an increased resilience toward stress-induced depression in mice. The aim of this study was to translate these findings to humans.Materials and methods: Kynurenine and KYNA levels were measured by high-performance liquid chromatography in plasma samples from 117 patients affected by mild-to-moderate depression before and within a week after a 12-week training period at three different intensities. The patients were part of the Regassa study.Results: No differences in plasma levels of kynurenine and KYNA or in their ratio could be detected between before and after training. No effect of the intensity group could be observed. No correlation with the improvement in cardiovascular fitness (Åstrand score) or the improvement in mood (Montgomery Åsberg Depression Rating Scale score) could be observed.Limitations: As the Regassa study is based on an intention-to-treat protocol, the exact time and the exact intensity of the physical exercise are not known. Analyses of pulse data as well as personal interviews, however, were used to control the exercise protocols. Furthermore, the observations reflect chronic changes.Conclusion: Physical exercise positively affects mood and cardiovascular fitness, but does not lead to long-lasting changes in plasma levels of kynurenine and KYNA in patients affected by mild-to-moderate depression.
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| 25. |
- Neider, Daniel, et al.
(författare)
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Risk factors for suicide among patients with schizophrenia : a cohort study focused on cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid
- 2016
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 12, s. 1711-1714
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of this study was to investigate the association between 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) in cerebrospinal fluid (CSF), bullying, and later suicide among patients with schizophrenia. Methods: Ninety-nine patients with schizophrenia were included. Correlations of clinical factors, 5-HIAA and HVA, and later suicide were investigated. Results: Twelve patients committed suicide (12%) during a 28-year follow-up period. Later suicide was correlated to bullying in childhood (P=0.02) and a lower quotient of HVA/5-HIAA in CSF (P<0.05). Conclusion: Suicide in schizophrenia is related to childhood exposedness and CSF neurotransmitter levels.
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| 26. |
- Pipan, Eva, et al.
(författare)
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Vagal Nerve Stimulation in Epilepsy : Experiences of Participants with Cognitive Deficits
- 2020
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Ingår i: Neuropsychiatric Disease and Treatment. - Auckland, New Zealand : DOVE MEDICAL PRESS LTD. - 1176-6328 .- 1178-2021. ; 16, s. 1181-1188
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The purpose of this study was to examine patients experiences of vagal nerve stimulation (VNS) with a special interest in patients with cognitive deficit (CD). Materials and Methods: An open, retrospective study was conducted on 82 patients with pharmacoresistant epilepsy, who were treated with VNS for at least 10 months. Based on the inability to live independently, they were divided into two groups: patients with cognitive deficit (CD group) and patients without cognitive deficit (non-CD group). A specially designed questionnaire was used for semi-structured interviews about patients experiences of VNS treatment. Results: Approximately one-third described a continuous reduction of seizure frequency of 50% or more and were regarded as responders. Fewer subjects in the CD group were responders than in the non-CD group. Approximately one-third of all subjects had no positive effect of VNS treatment. More CD patients described additional improvements and the most common were milder seizures and improved alertness. The most commonly reported adverse effect was hoarseness. Discussion: VNS treatment in patients without CD had better effect on seizure frequency reduction than in patients with CD, but many patients with CD reported other benefits from the treatment.
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| 27. |
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| 28. |
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| 29. |
- Russo, M. J., et al.
(författare)
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Predicting episodic memory performance using different biomarkers: Results from Argentina-Alzheimer’s disease neuroimaging initiative
- 2016
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 12, s. 2199-2206
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Argentina-Alzheimer’s Disease Neuroimaging Initiative (Arg-ADNI) is the first ADNI study to be performed in Latin America at a medical center with the appropriate infrastructure. Our objective was to describe baseline characteristics and to examine whether biomarkers related to Alzheimer’s disease (AD) physiopathology were associated with worse memory performance. Patients and methods: Fifteen controls and 28 mild cognitive impairment and 13 AD dementia subjects were included. For Arg-ADNI, all biomarker parameters and neuropsychological tests of ADNI-II were adopted. Results of positron emission tomography (PET) with fluorodeoxyglucose and11C-Pittsburgh compound-B (PIB-PET) were available from all participants. Cerebrospinal fluid biomarker results were available from 39 subjects. Results: A total of 56 participants were included and underwent baseline evaluation. The three groups were similar with respect to years of education and sex, and they differed in age (F=5.10, P=0.01). Mean scores for the baseline measurements of the neuropsychological evaluation differed significantly among the three groups at P<0.001, showing a continuum in their neuropsychological performance. No significant correlations were found between the principal measures (long-delay recall, C-Pittsburgh compound-B scan, left hippocampal volume, and APOEε4) and either age, sex, or education (P>0.1). Baseline amyloid deposition and left hippocampal volume separated the three diagnostic groups and correlated with the memory performance (P<0.001). Conclusion: Cross-sectional analysis of baseline data revealed links between cognition, structural changes, and biomarkers. Follow-up of a larger and more representative cohort, particularly analyzing cerebrospinal fluid and brain biomarkers, will allow better characterization of AD in our country. © 2016 Russo et al.
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| 30. |
- Sabir Rashid, Avan, et al.
(författare)
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Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke : The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers
- 2022
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press LTD. - 1176-6328 .- 1178-2021. ; 18, s. 1993-2002
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early neurological deterioration (END) in acute ischemic stroke (AIS) can be associated with poor outcome. The aim of this study was to investigate the association between infarction subtypes, biomarkers and END, and to identify patients with risk of unfavorable functional outcome.Materials and Methods: This prospective study enrolled 101 patients with AIS. Neurological status was evaluated according to NIHSS at acute onset, on days 2, 3, and 90. END was defined as >= 2-point increase of NIHSS within 72 hours. Functional outcome was assessed using NIHSS and the modified Rankin Scale (mRS) at day 90.Results: END was observed in 20, 8%. Patients with large artery disease had higher risk of developing END compared with patients with cardioembolism or small vessel disease (p <0.01). Significant higher blood glucose level and leukocytes were observed in the END group. Patients with END had higher scores of mRS at day 90 (p <0.01). Levels of NSE, IL-6, hsCRP and NT-proBNP were higher in the patients with unfavorable compared with favorable functional outcome.Conclusion: Large artery disease, high blood glucose and leukocytes levels are associated with END. Elevated levels of blood markers NSE, IL-6, HsCRP and NT-proBNP indicate poor functional outcome at 90 days after AIS. These patients must be identified and be offered treatment immediately in order to improve the functional outcome after AIS.
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| 31. |
- Schachinger-Lorentzon, Ulrika, 1969, et al.
(författare)
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Children screening positive for language delay at 2.5 years: Language disorder and developmental profiles
- 2018
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 14, s. 3267-3277
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Tidskriftsartikel (refereegranskat)abstract
- © 2018 Schachinger-Lorentzon et al. Purpose: To characterize language disorder and developmental profiles in children who screened positive for language delay but negative for autism at 2.5 years of age. Patients and methods: The first 100 children who screened positive for language delay – but negative for autism – in 2016 were assessed in detail by speech language pathologists. Parents completed a newly developed questionnaire covering eight domains – Motor, Executive functions, Perception, Memory, Language, Learning, Social skills and Child’s behaviour – with impairment scored for each domain. Results: ICD-10 language disorder diagnoses were made in 87/100 children (29 girls, 58 boys). Of 52 children with mixed receptive–expressive language disorder, 32% had problems in other developmental areas according to the “global rating” in the impairment questions of the questionnaire. Of the 35 with expressive language disorder, 21% had problems in other areas according to the impairment questions. Thirteen children had isolated language delay with no other diagnoses according to the speech and language pathologists’ assessment; however, 23% of them had problems according to the parental rating on the impairment questions. Conclusion: Most children screening positive for language delay but negative for autism at age 2.5 years were diagnosed with ICD-10 language disorder diagnoses. Parents in about one in four cases reported impairing problems within other developmental areas. Possible explanations for the findings are discussed.
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| 32. |
- Skogar, Örjan, et al.
(författare)
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Parkinson’s disease patients’ subjective descriptions of characteristics of chronic pain, sleeping patterns and health-related quality of life
- 2012
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 8, s. 435-442
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Nonmotor symptoms are common in Parkinson’s disease (PD). Health-related quality of life (HRQoL) is negatively affected by different factors, of which pain and sleep disturbances are important contributors. This study was performed to evaluate and describe subjective experiences of pain, sleeping patterns, and HRQoL in a cohort of PD patients with chronic pain.Methods: A total of 45 participants with established PD for more than 2 years, and PD-related pain for the preceding three months, were recruited from three sites in Sweden. Data regarding time point for onset, duration and degree of pain parameters, body localization of pain, external influences, and treatments were obtained. HRQoL was evaluated with the Short Form-36® Health Survey, and sleeping patterns were registered with the Parkinson’s disease Sleep Scale, both completed along with a questionnaire.Results: In one-third of participants, pain preceded the PD diagnosis. Median pain score measured with a visual analog scale was 6.6 and 5.9 (for females and males, respectively) the week before the study. In almost half of the participants, pain was present during all their waking hours. Significantly more females described their pain as troublesome, while more males described their pain as irritating. Feelings of numbness and creeping sensations at night were strongly associated with the maximal visual analog scale scores. Polypharmacy was common; 89% used medication for anxiety/insomnia, and 18% used antidepressants. Only one-third of patients who reported pain relief with analgesics had these prescribed on their drug lists. Sleep was characterized by frequent awakenings. Urinary urgency and restless legs were frequently reported as troublesome. Patients rated HRQoL as significantly worse in all items compared with a healthy reference population matched for age and sex.Conclusions: Experiences of chronic PD-related pain are complex; there is substantial sleep fragmentation and negative impact on HRQoL.
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| 33. |
- Spjut Jansson, Birgitta, et al.
(författare)
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Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study
- 2016
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 2016:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods: Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results: There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion: The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period.
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| 34. |
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| 35. |
- Stålnacke, Britt-Marie, et al.
(författare)
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Post-traumatic stress in patients with injury-related chronic pain participating in a multimodal rehabilitation program
- 2010
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press. - 1176-6328 .- 1178-2021. ; 6, s. 59-66
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate post-traumatic stress, pain intensity, depression, and anxiety in patients with injury-related chronic pain before and after participating in multimodal pain rehabilitation.Methods: Twenty-eight patients, 21 women and seven men, who participated in the multimodal rehabilitation programs (special whiplash program for whiplash injuries within 1.5 years after the trauma or ordinary program) answered a set of questionnaires to assess post-traumatic stress (Impact of Event Scale [IES], pain intensity [Visual Analogue Scale (VAS)], depression, and anxiety (Hospital Anxiety and Depression Scale [HAD] before and after the programs.Results: Both pain intensity and post-traumatic stress decreased significantly after the rehabilitation programs in comparison with before (VAS: 57.8 ± 21.6 vs. 67.5 ± 21.9; P = 0.009, IES total score 21.8 ± 13.2 vs. 29.5 ± 12.9; P < 0.001). Patients younger than 40 years reported a statistically higher level of post-traumatic stress compared with patients older than 40 years both before (P = 0.037) and after rehabilitation (P = 0.023). No statistically significant differences were found on the HAD scores.Conclusion: The multimodal rehabilitation programs were effective in reducing both pain intensity and post-traumatic stress. The experience of higher levels of post-traumatic stress in younger persons has to be taken into account when managing patients with injury-related chronic pain.
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| 36. |
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| 37. |
- Wallin, Åsa, et al.
(författare)
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Galantamine treatment in Alzheimer's disease: response and long-term outcome in a routine clinical setting.
- 2011
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 7, s. 565-576
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the absence of long-term, placebo-controlled studies of cholinesterase inhibitors in Alzheimer's disease (AD), analysis of the results of open-label trials becomes crucial. This study aimed to explore the three-year effects of galantamine treatment, as well as subgroups of response and adherence to treatment. METHODS: Two hundred and eighty patients with a clinical diagnosis of AD were included in the prospective, open-label, multicenter Swedish Alzheimer Treatment Study, and received galantamine treatment. Efficacy measures included cognitive tests, ie, the Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-cog), functional rating (Instrumental Activities of Daily Living Scale [IADL]), and global rating. Assessments were carried out before treatment and every six months for a period of three years. K-means cluster analysis was used to identify response subgroups. RESULTS: After three years of treatment, the mean change from baseline was 2.6 points in MMSE and 5.6 points in ADAS-cog scores. Globally, half of the patients improved or remained unchanged for two years. Cluster analysis identified two response clusters. Cluster 1 included patients with low ability in ADAS-cog and IADL scores at baseline. Even though the patients in cluster 1 were older and less educated, they responded better at six months compared with patients in cluster 2. Cluster 2 included patients with better ADAS-cog and IADL scores at baseline. Patients in cluster 2 had a higher frequency of the APOE ɛ4 allele, a slower pretreatment progression rate, and remained in the study longer than those in cluster 1. Three-year completers (n = 129, 46%) received higher doses of galantamine compared with dropouts. CONCLUSION: AD patients who received long-term galantamine treatment were cognitively and globally stabilized. Subgroup response analysis identified a better short-term response in older patients with lower cognitive and functional abilities at baseline, a faster pretreatment progression rate, and a lower incidence of the APOE ɛ4 allele. The galantamine dose was higher in the population of completers.
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| 38. |
- Wenngren, Anna, et al.
(författare)
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Computerized assessment of pain drawing area : A pilot study.
- 2009
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Ingår i: Neuropsychiatric disease and treatment. - : Dove Press. - 1176-6328. ; 5, s. 451-456
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate if pain area in patients with chronic pain could be measured by a computerized assessment on previously marked pain drawings on paper figures and to analyze the further application of the method. METHODS: Seventy-two patients (54 women and 18 men) who were admitted to Umeå University Hospital during 2003 for assessment of chronic pain answered a set of questionnaires (pain intensity on the visual analog scale [VAS], disability on the Disability Rating Index [DRI], life satisfaction on the LiSat-11) and filled in pain drawings on paper figures of the human body. The pain drawings were later analyzed by using computerized assessment. RESULTS: Women marked a greater pain area than men, but the difference was not significant (p =0.433). No significant difference was shown for the previous seven days between men and women on the VAS (p =0.914), DRI (p =0.493), or LiSat-11 (p =0.124). A statistically significant correlation was found between pain area and VAS for the previous seven days (r =0.250; p =0.046). Pain area was statistically significantly correlated to the DRI (r =0.336; p =0.014) and close to negatively correlated to the LiSat-11 (r =0.687; p =0.057). CONCLUSION: This pilot study shows that pain drawing area could be measured by a computerized assessment of pain drawings. The method points to the possibility of relating pain area with other instruments. In the present study, an association between the patients' pain drawing area and pain intensity and between pain area and level of activity was shown.
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| 39. |
- Wester Oxelgren, Ulrika, 1960-, et al.
(författare)
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An intervention targeting social, communication and daily activity skills in children and adolescents with Down syndrome and autism : a pilot study
- 2019
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 15, s. 2049-2056
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate whether an intervention, targeting deficits in social communication, interaction and restricted activities in children and adolescents with Down syndrome and autism could lead to enhanced participation in family and school activities.Methods: The intervention included education for parents and school staff about autism, and workshops to identify social-communication and daily living activities that would be meaningful for the child to practice at home and at school. Thereafter, a three-month period of training for the child followed. Outcome measures comprised evaluation of goal achievement for each child, the Family Strain Index questionnaire and a visual scale pertaining to the parents' general opinion about the intervention.Results: On average, more than 90% of the goals were (to some extent or completely) achieved at home and at school. The mean scores of the Family Strain Index were almost identical at the follow-up to those before intervention. The evaluation supported that the use of strategies, intended to facilitate activities and communication, remained largely 18 months after start of the intervention.Conclusion: Despite the group involved in this study being composed of older children and adolescents, most of whom had severe and profound intellectual disability, the goal achievements and parents' views on the intervention were encouraging.
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| 40. |
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| 41. |
- Westman Andersson, Gunilla, et al.
(författare)
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Parents of Children Diagnosed with Autism Spectrum Disorder: What Do They Expect and Experience from Preschools?
- 2021
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 17, s. 3025-3037
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden, children diagnosed with autism spectrum disorders (ASD) as well as other children in need of special support, according to the law should be provided stimulation and support for their development in their preschools. Parents of children diagnosed with ASD have been shown to struggle to ensure the right to support for their child from society, including in preschool. This study reports parent expectations and experiences when having a child diagnosed with ASD in preschool. Methods: A questionnaire with 12 open-ended and 9 multiple-choice questions was completed by parents of 26 children (3 girls, 23 boys, mean age 4:3 years). The children had been diagnosed with ASD within the last year. The data were analyzed using a qualitative inductive approach with a content analysis of the open-ended questions. Findings and Conclusions: This study shows that parents expect competence and knowledge about ASD among preschool staff, including the principal. They need continuous dialogue between parents and the preschool staff and expect individualized support for their child. Concerns about their child in preschool frequently occurred.
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| 42. |
- White, Matthew P., et al.
(författare)
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A prescription for “nature” – The potential of using virtual nature in therapeutics
- 2018
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328. ; 14, s. 3001-3013
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Tidskriftsartikel (refereegranskat)abstract
- Many studies suggest that increased exposure to urban greenness is associated with better population health. Accessing nature can in some circumstances, however, be difficult, especially for individuals with mobility constraints. Therefore, a growing body of work is investigating the ways to replace the in vivo experience with forms of “virtual” contact, in order to provide these individuals with at least some benefits of the natural environment. The aim of this paper is to provide a review of previous use of virtual reality (VR) nature in health and care settings and contemplate the potential use of this technology in future. Our central question is whether engaging with virtual nature can contribute to enhanced physical and emotional well-being in housebound or mobility-constrained individuals. We conclude that while contact with real-world nature is preferred, VR use can be an alternative in cases when in vivo contact with nature is not possible. There are many possibilities for the use of VR technology in psychiatric and medical care; however, the risks, benefits, and cost efficiency of these attempts should be carefully assessed and the outcomes should be measured in a scientifically valid manner. The current review has nonetheless demonstrated that VR nature could play a role in each of the proposed mediating mechanisms linking natural environments and health.
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| 43. |
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| 44. |
- Åhman, Sofia, et al.
(författare)
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Post-traumatic stress, depression, and anxiety in patients with injury-related chronic pain : a pilot study
- 2008
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 4:6, s. 1245-1249
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate, in patients with injury-related chronic pain, pain intensity, levels of post-traumatic stress, anxiety and depressions. Methods: One hundred and sixty patients aged 17–62 years, admitted for assessment to the Pain Rehabilitation Clinic at the Umeå University Hospital, Umeå Sweden, for chronic pain caused by an injury, answered a set of questionnaires to assess post-traumatic stress (Impact of Event Scale [IES]), pain intensity (VAS), depression, and anxiety (Hospital Anxiety and Depression Scale [HAD]). Results: Moderate to severe post-traumatic stress was reported by 48.1% of the patients. Possible–probable anxiety on the HAD was scored by 44.5% and possible–probable depression by 45.2%. Pain intensity (VAS) was significantly correlated to post-traumatic stress (r = 0.183, p = 0.022), the HAD-scores anxiety (r = 0.186, p = 0.0021), and depression (r = 0.252, p = 0.002). No statistically significant differences were found between genders for post-traumatic stress, pain intensity, anxiety, or depression. Participants with moderate to severe stress reaction reported statistically significant higher anxiety scores on the HAD (p = 0.030) in comparison with patients with mild stress. Conclusion: The findings of relationships between pain intensity, post-traumatic stress, depression, and anxiety may have implications for clinicians and underline the importance of considering all these factors when managing patients with injury-related chronic pain.
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