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| 2. |
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| 3. |
- Bejerot, Eva, et al.
(författare)
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Svenska läkares arbetsmiljö 1992 och 2010 – en profession i fritt fall? : Programnummer AR28, 2/12 2011
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- En jämförelse av två enkätstudier med läkare från 1992 och 2010 visar att det har skett avsevärda försämringar över tid, särskilt avseende känslan av att ha ett verksamhetsansvar och i upplevelsen av stöd från närmaste chef. Indikationer på att läkares villkor är problematiska har funnits i Arbetsmiljöverkets och SCBs återkommande arbetsmiljöundersökningar under 2000-talet. Läkare har här identifierats som ett yrke där man rapporterar hög arbetstakt samt brist på stöd och uppmuntran från chefer. För att analysera om det skett förändringar i läkares arbetsvillkor gjordes en enkätstudie under 2010/2011 där det ingick ett antal frågor om arbetsmiljö som också ställts i en enkät år 1992. Utifrån detta material har jämförelser gjorts av läkares position i verksamheten, krav, kontroll och stöd i arbetet, samt frågor som belyser tid för fortbildning, press att följa med i kunskapsutvecklingen och arbetstillfredsställelse. Båda studierna är baserade på ett slumpmässigt urval ur Sveriges läkarförbunds medlemsregister. Antal respondenter år 1992 (n=362) och år 2010 (n=1955), svarsfrekvensen var 70 respektive 68 procent. Andelen läkare som upplever sig ha något verksamhetsansvar har minskat med 45 procentandelar över tid, från 76 procent år 1992 till 31 procent år 2010. Läkarnas inflytande över det egna arbetet har minskat något över tid, framför allt har inflytande över beslut på avdelningen minskat över tid. I frågor som avhandlar krav i arbetet rapporterades försämringar avseende mängden arbetsuppgifter, medan tidspress och nödvändig avskildhet för vissa arbetsuppgifter var oförändrad över tid. Resultaten visar också på försämringar avseende arbetsklimat, och att den tid som läggs på forskning och fortbildning har minskat. I området stöd och återkoppling från närmaste chef är förändringarna snudd på dramatiska, exempelvis instämde 45 procent av respondenterna helt i att de hade möjlighet att diskutera svårigheter i arbetet med närmaste chef 1992, jämfört med 14 procent 2010.
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| 4. |
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| 5. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Teaching psychiatry to large groups in society
- 2019
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Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need to educate a range of professionals in caring for individuals with long-term mental disability who reside within our communities. Empathy alone is insufficient. The Kognus 4-Step Education Program was developed to achieve this goal.METHOD: The program consisted of independent courses, including an 18-session basic course on psychiatric disability (on-site or online), advanced courses, and highly specialized training programs (Nidotherapy/Peer Consultation). Experts lectured together with clients with psychiatric disabilities. We first report Swedish reforms in which institutionalized patients were relocated to semi-independent individual households. We then describe the design and implementation of the education program. Approximately 50% of participants who were younger than 36 years old lacked any healthcare education. The participants' backgrounds, perceptions, participation in the education program, and costs are presented.RESULTS: Between 2009 and 2014, 8959 participants attended the Kognus psychiatry courses online or on-site in Stockholm (basic on-site course, n = 2111; online course, n = 4480; advanced courses, n = 2322; highly specialized programs, n = 46). A total of 73% of the participants satisfactorily attended the basic sessions on-site compared with 11% of the online participants. The developers conducted the education program for the first 3 years. Thereafter, another course provider continued the program with other types of participants. The program was perceived to be equally interesting and meaningful to participants with low and high levels of education, demonstrating the generalizability of the program. The quality of the basic and advanced courses was rated as 4.4 and 4.3, respectively, on a 5-point Likert scale.CONCLUSIONS: Personnel without appropriate education who work with people with psychiatric/intellectual disabilities can be educated in large numbers. The Kognus program represents a novel and successful way of training people who have no formal education about some essentials of good mental healthcare. Moreover, the model can be easily implemented elsewhere.
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| 6. |
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| 7. |
- Andersen, Lisa M. J., et al.
(författare)
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The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R) : A Validation Study of a Rating Scale for Adults
- 2011
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Ingår i: Journal of autism and developmental disorders. - New, York, USA : Springer. - 0162-3257 .- 1573-3432. ; 41:12, s. 1635-1645
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Tidskriftsartikel (refereegranskat)abstract
- There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75 adults with ASD and 197 comparison cases. Also, a subset completed the Autism Spectrum Quotient (AQ). Three out of four subscales had high internal consistency. Sensitivity was 91% and specificity was 93%. The ASD subjects had significantly higher mean scores on all subscales. ASD females had higher scores than ASD males on the sensory motor subscale, a dimension not included in the AQ. RAADS-R showed promising test re-test reliability.
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| 8. |
- Bejerot, Susanne, 1955-
(författare)
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An autistic dimension : a proposed subtype of obsessive-compulsive disorder
- 2007
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Ingår i: Autism. - London, United Kingdom : Sage Publications. - 1362-3613 .- 1461-7005. ; 11:2, s. 101-110
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute mis-perceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.
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| 9. |
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| 10. |
- Bejerot, Susanne, et al.
(författare)
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Asperger's syndrome or schizophrenia
- 1995
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 49:2, s. 145-145
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Tidskriftsartikel (refereegranskat)
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| 11. |
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| 12. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Autismspektrumsyndrom ersätter Aspergers syndrome och autism : [Autism spectrum syndrome replaces Asperger syndrome and autism]
- 2014
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidingen Förlag AB. - 0023-7205 .- 1652-7518. ; 111:39, s. 1660-1663
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Tidskriftsartikel (refereegranskat)abstract
- Autism spectrum disorder describes a behaviourally defined impairment in social interaction and communication, along with the presence of restricted interests and repetitive behaviours. Although the etiology is mostly unknown, it is evident that biological factors affect the brain and result in the autistic clinical presentation. Assessment for diagnosing autism spectrum disorder should be comprehensive in order to cover all sorts of problems related to the disorder. Knowledge and experience from working with neurological and psychiatric disorders are a prerequisite for quality in the examination. Up to now, there is no cure for autism spectrum disorder, but support and adaptations in education are nevertheless important for obtaining sufficient life quality for the patients and the family.
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| 13. |
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| 14. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Autistic traits in obsessive-compulsive disorder
- 2001
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Ingår i: Nordic Journal of Psychiatry. - Oslo, Norway : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 55:3, s. 169-176
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Tidskriftsartikel (refereegranskat)abstract
- In contrast to other non-psychotic psychiatric populations, subjects with obsessive-compulsive disorder (OCD) are more prone to have personality disorder from cluster A (the odd and eccentric cluster). The present study aims at further investigating the relationship between these and other personality traits in OCD subjects and their relation to high functioning autism (HFA) and Asperger disorder. Sixty-four subjects with OCD were included. Personality traits were assessed with the Karolinska Scales of Personality (KSP), and personality disorders with DSM-adapted questionnaires. In addition, autistic traits were assessed in 29 videotaped subjects, by 3 independent raters. Twenty percent of the subjects with OCD were identified as also having autistic traits. These subjects scored higher on KSP scales measuring muscular tension, psychasthenia, and inhibition of aggression and lower on socialization as compared with OCD subjects without autistic traits. Additionally, subjects with autistic traits fulfilled criteria for anxious personality disorders and paranoid personality disorders significantly more often than subjects without autistic traits. We propose that OCD is often related to HFA and Asperger disorder. Self-report questionnaires may be useful in establishing the diagnosis. However, those with the most obvious autistic features seem to be less able to identify these traits in themselves.
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| 15. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Below average motor skills predict victimization from childhood bullies : A study of adults with ADHD
- 2022
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Ingår i: Journal of Psychiatric Research. - : Elsevier. - 0022-3956 .- 1879-1379. ; 153, s. 269-275
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Tidskriftsartikel (refereegranskat)abstract
- Children with ADHD are frequently clumsy and involved in bullying, both as victims and perpetrators. The relationship between motor skills and bully status is poorly understood. The aim of the current study was to evaluate the effect of motor skills in childhood on bully victimization/perpetration in those with ADHD. In this cross-sectional study, 403 adults diagnosed with ADHD filled out a questionnaire on their recall of bully victimization, bully perpetration, performance in physical education (PE) (defined as performance below average in i.e., ball dexterity, coordination or agility) as a proxy for motor skills, and academic skills at age 12, as compared to their peers. Of the current sample, 63% remembered being victimized and 31% noted they were perpetrators. Thirty-two percent recalled that they performed below average in PE. Being diagnosed with ADHD and having poor motor skills was strongly associated with bully victimization (OR = 2.63; 95% CI:1.62, 4.27, p < .001). Victimization was more common during all measured time periods, from nursery school until the age of 15, among those with poor performance in PE as compared to those without poor performance. No relationship was found between poor motor skills and bully perpetration. CONCLUSION: A crucial role of the cerebellum is coordination and the linking of sequenced motor actions through milli-second timing. Aberrations in this ability makes a person present as "different", which was stated as the most common reason for social exclusion by other children. Therefore, subtle clumsiness (presumed by poor performance in PE class) is suggested to mirror deficits in social skills, which is intuitively observed by peers, leading to victimization.
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| 16. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Childhood clumsiness and peer victimization : a case-control study of psychiatric patients
- 2013
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Ingår i: BMC Psychiatry. - London, United Kingdom : BioMed Central. - 1471-244X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Poor motor and social skills as well as peer victimization are commonly reported in both ADHD and autism spectrum disorder. Positive relationships between poor motor and poor social skills, and between poor social skills and peer victimization, are well documented, but the relationship between poor motor skills and peer victimization has not been studied in psychiatric populations.Method: 277 patients (133 males, 144 females), mean age 31 years, investigated for ADHD or autism spectrum disorder in adulthood and with normal intelligence, were interviewed about childhood peer victimization and examined for gross motor skills. The parents completed a comprehensive questionnaire on childhood problems, the Five to Fifteen. The Five to Fifteen is a validated questionnaire with 181 statements that covers various symptoms in childhood across eight different domains, one of them targeting motor skills. Regression models were used to evaluate the relationship between motor skills and the risk and duration of peer victimization, adjusted for sex and diagnosis.Results: Victims were described as more clumsy in childhood than their non-victimized counterparts. A significant independent association was found between reportedly poor childhood gross motor skills and peer victimization (adjusted odds ratio: 2.97 [95% confidence interval: 1.46-6.07], n = 235, p = 0.003). In adulthood, the victimized group performed worse on vertical jumps, a gross motor task, and were lonelier. Other factors that were expected to be associated with peer victimization were not found in this highly selected group.Conclusion: Poor gross motor skills constitute a strong and independent risk factor for peer victimization in childhood, regardless of sex, childhood psychiatric care and diagnosis.
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| 17. |
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| 18. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Comorbidity between obsessive-compulsive disorder (OCD) and personality disorders
- 1998
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Ingår i: Acta Psychiatrica Scandinavica. - Copenhagen, Denmark : Munksgaard Forlag. - 0001-690X .- 1600-0447. ; 97:6, s. 398-402
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to examine the frequency of personality disorders in 36 patients with obsessive-compulsive disorder (OCD), and to investigate whether patients with a coexisting personality disorder could be characterized by certain personality traits assessed by means of the Karolinska Scales of Personality (KSP). In total, 27 (75%) of the OCD patients fulfilled the DSM-III-R criteria for a personality disorder, and 13 patients (36%) had an obsessive-compulsive personality disorder. Subjects with a comorbid personality disorder had significantly higher scores on most of the KSP scales, including all anxiety scales, as well as scales measuring indirect aggression, irritability, guilt and detachment, whereas subjects without personality disorders did not differ significantly from healthy controls with regard to personality traits.
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| 19. |
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| 20. |
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| 21. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Diagnostik och terapi utmanar än, trots snabb tillväxt av kunskap [Diagnosis and therapy are still challenging, despite the rapid growth of knowledge]
- 2014
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 111:39, s. 1638-1641
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Forskningsöversikt (refereegranskat)abstract
- Psychiatric diagnoses are not reflections of the aetiology of the disorder, but rather lists of symptoms with considerable overlaps, which hamper research and may cause confusion. The diagnoses of autism spectrum disorder, attention deficit hyperactivity disorder and tic disorder are often comorbid along with a number of other symptomatic syndromes. Individual immune responsivity is possibly involved in pathophysiological mechanisms. Multiple environmental factors may contribute to the clinical phenotypes. Recent research supports to some extent the involvement of dietary and nutritional factors in ADHD. In spite of impressive progress in the molecular biological understanding of the pathophysiology of these disorders, treatment options are still limited and more research is warranted.
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| 22. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers?
- 2009
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Ingår i: Psychopathology. - Basel, Switzerland : S. Karger. - 0254-4962 .- 1423-033X. ; 42:3, s. 170-176
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits.Methods: Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied.Results: There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients.Conclusions: Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD.
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| 23. |
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| 24. |
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| 25. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Evidence-Based Brief Obsessive-Compulsive Scale
- 2017
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Ingår i: Journal of Central Nervous System Disease. - : Sage Publications. - 1179-5735. ; 9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 26. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Fördelar och nackdelar med en legalisering av cannabis i Sverige [Legalization of cannabis - A Swedish perspective]
- 2021
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Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 118
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Tidskriftsartikel (refereegranskat)abstract
- While no European country has legalized recreational use of cannabis, several countries, but not Sweden, have decriminalized it. Although we hitherto have a relatively low prevalence of users compared to other countries, Swedish policy is criticized. Strong voices advocate legalization. It is hypothesized that a legalization would minimize adolescent access, ensure quality control, make consumption safer and raise tax revenue. Furthermore, it is assumed to diminish the illicit drug market and drug related crimes. However, the legalization in the US and Canada has instead made cannabis more available to users by innovative marketing and product development, while the illegal market persists. Meanwhile the price of cannabis decreases and potency, which are related to many of the risks, increases. Cannabis-related harms include e.g. cognitive impairment, psychosis and psychosocial problems. The long-term effects from legalization is yet to be seen.
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| 27. |
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| 28. |
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| 29. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Joint Hypermobility in Paediatric Acute-Onset Neuropsychiatric Syndrome : A Preliminary Case-Control Study
- 2021
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Individuals with generalised joint hypermobility (GJH, present in 10–20% of the general population) are at increased risk of being diagnosed with a range of psychiatric and rheumatological conditions. It is unknown whether Paediatric acute-onset neuropsychiatric syndrome (PANS), characterised by childhood onset obsessive-compulsive disorder or restricted eating and typically associated with several comorbid neuropsychiatric symptoms, is associated with GJH. It is also unknown whether extensive psychiatric comorbidity is associated with GJH.Method: This is a case-control study including 105 participants. We compared three groups: Individuals with PANS, individuals with other mental disorders and healthy controls. Joint mobility was assessed with the Beighton scoring system, psychiatric comorbidity with the M.I.N.I. or MINI-KID interview and symptoms of PANS with the PsychoNeuroInflammatory related Signs and Symptoms Inventory (PNISSI).Results: Hypermobility was similar across groups, and high rates of psychiatric comorbidity was not associated with higher Beighton scores.Conclusion: Although GJH is associated with several psychiatric conditions, such as ADHD and anxiety, this does not seem to be the case for PANS according to this preliminary study.
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| 30. |
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| 31. |
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| 32. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Low prevalence of smoking among patients with obsessive-compulsive disorder
- 1999
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Ingår i: Comprehensive Psychiatry. - Philadelphia, USA : Saunders Elsevier. - 0010-440X .- 1532-8384. ; 40:4, s. 268-272
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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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| 33. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Low prevalence of smoking in patients with autism spectrum disorders
- 2003
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Ingår i: Psychiatry Research. - Claire, Ireland : Elsevier. - 0165-1781 .- 1872-7123. ; 119:1-2, s. 177-182
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Tidskriftsartikel (refereegranskat)abstract
- Psychiatric patients are significantly more often smokers than the general population, the only known exception being obsessive-compulsive disorder (OCD) and catatonic schizophrenia. We have investigated nicotine use in subjects with autism spectrum disorders (ASD). Ninety-five subjects (25 females and 70 males) consecutively diagnosed with any ASD and of normal intelligence were included in the study. Only 12.6% were smokers, compared with 19% in the general population and 47% in a control group of 161 outpatients diagnosed with schizophrenia or a schizophreniform disorder. The results suggest that smoking is rare among subjects with ASD, while the opposite was shown for schizophrenia. If replicated, this finding could suggest biological differences between non-catatonic schizophrenia and ASD, and support the theory of a biological link between ASD and a subtype of OCD, and between ASD and catatonic schizophrenia.
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| 34. |
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| 35. |
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| 36. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Neuromyelitis optica spectrum disorder with increased aquaporin-4 microparticles prior to autoantibodies in cerebrospinal fluid : a case report
- 2019
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Ingår i: Journal of Medical Case Reports. - : BioMed Central (BMC). - 1752-1947. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Neuromyelitis optica spectrum disorders are severe autoimmune inflammatory diseases of the central nervous system associated with the presence of immunoglobulin G antibodies against the water channel protein aquaporin-4. During exacerbation, specific aquaporin-4 immunoglobulin G may be produced intrathecally. We measured extracellular aquaporin-4 microparticles in the cerebrospinal fluid of a patient who later developed the typical symptoms and signs of a neuromyelitis optica spectrum disorder.CASE PRESENTATION: A 17-year-old South American girl developed acute severe motor and vocal tics and difficulties in walking, peripheral numbness, muscle pain, and bilateral headache. At age 22, she had a multitude of motor and psychiatric symptoms. Over the years, she fulfilled the diagnostic criteria for anorexia nervosa, depression, sleep disorder, obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, development coordination disorder, attention-deficit/hyperactivity disorder, hypomania, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, conversion disorder, psychosis, and schizotypal personality syndrome. At age 24, she was found to have elevated titers of aquaporin-4 antibodies in serum, suggestive of probable neuromyelitis optica. She subsequently developed visual impairment, and swollen optic nerves were verified by magnetic resonance imaging. She was thus treated with a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20 (rituximab), and almost all symptoms, including the psychiatric symptoms, rapidly decreased. We found a significant increase of extracellular microparticles of aquaporin-4 in cerebrospinal fluid sampled from our patient when she was 22 years old, 2 years before the full clinical development of neuromyelitis optica.CONCLUSIONS: Microparticles of aquaporin-4 represent subcellular arrangements that may influence the pathogenesis of neuromyelitis optica spectrum disorders and may serve as biomarkers for the underlying cellular disturbances. The increase of aquaporin-4 microparticles in cerebrospinal fluid may be used for early diagnostic purposes; for prevention; and for evaluation of effective treatment, long-term follow-up studies, and elucidating the pathophysiology in neuromyelitis optica spectrum disorders. Further studies of aquaporin-4 microparticles in cerebrospinal fluid of patients with neuromyelitis optica and similar neuropsychiatric disorders are thus called for.
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| 37. |
- Bejerot, Susanne
(författare)
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Obsessive-compulsive disorders : Personality traits and disorders, autistic traits and biochemical findings
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Obsessive-compulsive disorder (OCD) is a common disabling mental disorder.Personality disorders are frequent in OCD. Asperger syndrome and high-functioning autism share similarities with obsessive-compulsive and schizoid personality disorders and may be referred to as "odd" personality traits. Also compulsions are common in autism. The present study aims at investigating personality disorders and dimensions in OCD and their relationship to autistic traits Sixty-four subjects suffering from OCD participated. The Karolinska Scales of Personality (KSP), the Temperament and Character Inventory (TCI), self-report questionnaires for personality disorders and an instrument to identify autistic traits were used. Nicotine use and its relation to personality traits were investigated in 193 subjects with OCD. In addition, we looked for serotonergic response predictors in, therapy with SRIs, by investigating serotonin levels in whole blood repeatedly during treatment with SRIs in 36 patients with OCD. Finally,one patient that needed high dose treatmentwith SRIs is presented.Results: In 61% of the 64 subjects with OCD, personality disorders were identified. More-over, subjects with OCD had significantly higher scores in KSP scales measuring Anxiety, Muscular tension, Psychasthenia, Indirect aggression, Irritability, Suspicion and Guilt, whereas Socialization and Social desirability were lower. The TCI scale measuring Harm avoidance was higher among subjects with OCD and Self-directedness and Cooperativeness were lower. In addition we found obvious autistic traits in 20 % of the subjects. Subjects with autistic traits fulfilled significantly more personality disorder criteria. In addition, subjects with autistic traits scored significantly higher on KSP scales measuring Muscular tension, Psychasthenia and Inhibition of aggression whereas Socialization was lower as compared to OCD subjects without autistic traits. However, subjects with most conspicuous autistic traits lacked insight, and identified less of those traits in themselves. Smoking was rare among subjects with OCD,especially among those with an obsessive-compulsive personality disorder. Smokers with OCD did not differ from the normal population as regard to personality disorders and traits, and none had autistic traits. Autistic traits predicted non-response to SRI treatment. Those subjects who responded to SRI treatmenthad significantly less reduction of whole-blood serotonin after one week as compared to non-responders. Occasionally, high doses of SRIs may be needed.Conclusions: In OCD, autistic traits are common whereas smoking is race. Subjects with OCD and autistic traits may be identical to those OCD subjects often referred to as "odd" or schizotypal. OCD with autistic traits is suggested to constitute a distinct phenotype within the neuropsychiatric spectrum. A possible response predictor in pharmacotherapy of OCD is suggested.
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| 38. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Pediatric autoimmune neuropsychiatric syndrome (PANS), developmental regression and autism
- 2017
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Ingår i: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 41:Suppl., s. S123-S123
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Pediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.Objectives: The aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.Methods: Participants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.Results: Twelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.Conclusions: Very early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.
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| 39. |
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| 40. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive-compulsive disorder
- 1998
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Ingår i: Acta Psychiatrica Scandinavica. - Copenhagen, Denmark : Munksgaard Forlag. - 0001-690X .- 1600-0447. ; 98:3, s. 243-249
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence of personality disorders was investigated in 36 patients with obsessive-compulsive disorder by means of the SCID Screen questionnaire. In addition, the personality dimensions were explored by means of the Temperament and Character Inventory (TCI). In total, 75% of the patients fulfilled the criteria for a personality disorder according to the SCID Screen questionnaire, mostly (55%) within cluster C. Several significant correlations were found between the separate personality disorders (PD) and subscales of the TCI, the most pronounced being between avoidant and obsessive-compulsive PD and novelty-seeking and self-directedness. Strong correlations were also found between self-directedness and paranoid and borderline PD. In multiple regressions where the presence of PD in clusters A, B and C, respectively, were used as dependent variables and where the separate subscales of the TCI were used as independent variables, the multiple R reached 0.68, 0.76 and 0.80 in clusters A, B and C, respectively. Thus 46-64% of the variance in the personality disorder clusters could be explained by the TCI subscales.
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| 41. |
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| 42. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Personality traits and smoking in patients with obsessive-compulsive disorder
- 2000
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Ingår i: European psychiatry. - Paris, France : Elsevier. - 0924-9338 .- 1778-3585. ; 15:7, s. 395-401
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Tidskriftsartikel (refereegranskat)abstract
- As opposed to other psychiatric populations, subjects with obsessive-compulsive disorder (OCD) smoke less than the general population. The present study aims at further investigating the relationship between smoking in OCD subjects and personality traits. Sixty-four subjects with OCD were interviewed concerning their smoking habits. Personality traits were evaluated using the Karolinska Scales of Personality, and specific obsessive-compulsive personality traits were elicited through self-report questionnaires. Non-smokers were more easily fatigued, more inclined to worry, more remorseful, less self-confident, less impulsive and became uneasy more frequently when urged to speed up, than smokers with OCD. Additionally, non-smokers fulfilled significantly more obsessive-compulsive personality disorder criteria as compared to the smokers (P < 0.001). We propose a clinical subtype of OCD related to non-smoking, psychasthenia, anxiety, and pronounced obsessive-compulsive personality disorder traits.
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| 43. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Poor Motor Skills : A Risk Marker for Bully Victimization
- 2013
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Ingår i: Aggressive Behavior. - : Wiley. - 0096-140X .- 1098-2337. ; 39:6, s. 453-461
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Tidskriftsartikel (refereegranskat)abstract
- Children who are clumsy are often bullied. Nevertheless, motor skills have been overlooked in research on bullying victimization. A total of 2,730 Swedish adults (83% females) responded to retrospective questions on bullying, their talents in physical education (i.e., coordination and balls skills) and school academics. Poor talents were used as indicators of poor gross motor skills and poor academic skills. A subset of participants also provided information on educational level in adulthood, childhood obesity, belonging to an ethic minority in school and socioeconomic status relative to schoolmates. A total of 29.4% of adults reported being bullied in school, and 18.4% reported having below average gross motor skills. Of those with below average motor skills, 48.6% were bullied in school. Below average motor skills in childhood were associated with an increased risk (OR 3.01 [95% CI: 1.97-4.60]) of being bullied, even after adjusting for the influence of lower socioeconomic status, poor academic performance, being overweight, and being a bully. Higher odds for bully victimization were also associated with lower socioeconomic status (OR 2.29 [95% CI: 1.45-3.63]), being overweight (OR 1.71 [95% CI: 1.18-2.47]) and being a bully (OR 2.18 [95% CI: 1.53-3.11]). The findings indicate that poor gross motor skills constitute a robust risk-marker for vulnerability for bully victimization. Aggr. Behav. 39:453-461, 2013. (c) 2013 The Authors. Aggressive Behavior Published by Wiley-Blackwell
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| 44. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Poor performance in physical education - a risk factor for bully victimization A case-control study
- 2011
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Ingår i: Acta Paediatrica. - Malden, USA : Wiley. - 0803-5253 .- 1651-2227. ; 100:3, s. 413-419
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Poor social skills are a risk factor for becoming bullied, which could explain why this frequently occurs to children with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). Poor social skills tend to coexist with clumsiness. According to a pilot study, poor performance in physical education (PE) was correlated with bully victimization. Methods: Sixty-nine healthy university students reported performance in PE and bully victimization in childhood. In addition, the participants responded to questionnaires for ADHD and ASDs to assess personality traits related to increased risk for bully victimization. Results: Below average performance in PE was a risk factor of being bullied in school with an odds ratio of 3.6 [95% confidence interval: 1.23-10.5; p = 0.017]. Strong correlations between poor performance in PE and long duration of victimization (p = 0.007) and poor performance in PE and high frequency of victimization (p = 0.008) were found. Autistic traits were related to performance below average in PE. Conclusion: Poor motor skills are a strong risk factor for becoming bullied. Prevention programmes that identify, protect and empower the clumsy children could be an important step to avoid bullying of the most vulnerable children.
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| 45. |
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| 46. |
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| 47. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Response to high doses of citalopram in treatment-resistant obsessive-compulsive disorder
- 1998
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Ingår i: Acta Psychiatrica Scandinavica. - Copenhagen, Denmark : Munksgaard Forlag. - 0001-690X .- 1600-0447. ; 98:5, s. 423-424
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Tidskriftsartikel (refereegranskat)abstract
- We report a severe case of obsessive-compulsive disorder (OCD) that responded to very high doses of citalopram (160 mg/day) after a poor response to clomipramine 250 mg/day for several years, alone or in combination with buspirone 30 mg/day or flupenthixol 4 mg/day. The patient had previously been submitted for capsulotomy which was declined, probably due to the magical content of her obsessions, which resembled delusions.
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| 48. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Rituximab as an adjunctive treatment for schizophrenia spectrum disorder or obsessive-compulsive disorder : Two open-label pilot studies on treatment-resistant patients
- 2023
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Ingår i: Journal of Psychiatric Research. - : Elsevier. - 0022-3956 .- 1879-1379. ; 158, s. 319-329
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Tidskriftsartikel (refereegranskat)abstract
- In this explorative study, we investigated if an adjunctive treatment with one single dose of the monoclonal antibody rituximab would improve symptoms and function in treatment-resistant patients with schizophrenia spectrum disorder (SSD, n = 9) or obsessive-compulsive disorder (OCD, n = 10), based on the inflammatory hypothesis for mental disorders. Patients were followed for one year. Disability was measured with the Personal and Social Performance score (PSP). At baseline, the mean PANSS score in the SSD group was 99 ± 32 and the mean Y-BOCS score in the OCD group was 27.5 ± 7. Mean PSP scores were 32 ± 10.2 and 42.5 ± 9.9 in the SSD and OCD groups, respectively. Seven had Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS) in retrospect, and 3 SSD patients had schizo-obsessive subtype. 4/8 SSD patients showed a ≥40% reduction in PANSS at endpoint I week 20, however, 7/9 were similarly improved already at week 12. Among the OCD patients, 2/10 showed a ≥35% reduction in Y-BOCS at week 20. Disability was significantly improved only in the SSD group. The percentual decrease of PANSS scores in SSD patients was associated with the increase in immunoglobulin levels week 20 (n = 8: IgG r = 0.85, p = .007; IgA r = 0.79, p = .019; IgM r = 0.73, p = .038). Rituximab was generally well tolerated in these patients. Self-rated improvements since baseline were reported for psychic (p = .021), neurological (p = .059), and autonomic (p < .001) side effects (UKU-SERS-Pat side-effect scale). Anxiety was commonly reported by OCD patients, while an initial increase in psychotic symptoms was seen in a few SSD patients. An RCT is underway to evaluate rituximab in SSD.
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| 49. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Schizotypal traits in Swedish speaking psychiatric patients and non-psychiatric controls
- 2020
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 74:5, s. 327-331
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Recently, schizotypal personality traits were measured in a multinational sample recruited from 14 countries, however no Scandinavian cohort was included. The aim of this study was, therefore, to measure schizotypal personality traits in Swedish-speaking populations, with and without psychiatric disorders, and to investigate the psychometric properties of the Swedish version of the Schizotypal Personality Questionnaire-Brief (SPQ-B).Methods: The SPQ-B results from 50 psychiatric patients were compared to controls (n = 202). An additional sample of 25 controls completed the full SPQ twice and we calculated test-retest reliability for SPQ and SPQ-B. We estimated the internal consistency for SPQ-B and SPQ-B factors with omega. We compared the results of SPQ-B (M and SD) in patient and control groups to corresponding results worldwide.Results: We found similarity between our SPQ-B scores and those from other published samples. SPQ-B showed good internal consistency and acceptable test-retest correlations. The results indicate that the Swedish version of the instrument is valid and can differentiate psychiatric cohorts from non-psychiatric controls.Conclusion: The Swedish version of the SPQ-B exhibit good psychometric properties and is useful for assessing schizotypal traits in clinical and non-clinical populations.
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| 50. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Sexuality and gender role in autism spectrum disorder : a case control study
- 2014
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Ingår i: PLOS ONE. - San Francisco, USA : Public Library Science. - 1932-6203. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- The 'extreme male brain theory of autism' describes an extreme male pattern of cognitive traits defined as strong systemising abilities paired with empathising weaknesses in autism spectrum disorder. However, beyond these cognitive traits, clinical observations have suggested an ambiguous gender-typed pattern regarding several sexually dimorphic traits. The aim of the present study was to investigate if patterns of non-cognitive sexually dimorphic traits differed between the autism spectrum disorder and control groups. Fifty adults with autism spectrum disorder and intelligence within the normal range, and 53 neurotypical controls responded to questions on gender role, self-perceived gender typicality and gender identity, as well as sexuality. Measures used were a Swedish modification of the Bem Sex Role Inventory and questions on sexuality and gender designed for the purpose of this study. Our results showed that one common gender role emerged in the autism spectrum disorder group. Masculinity (e.g. assertiveness, leadership and competitiveness) was weaker in the autism spectrum disorder group than in the controls, across men and women. Self-perceived gender typicality did not differ between the groups but tomboyism and bisexuality were overrepresented amongst women with autism spectrum disorder. Lower libido was reported amongst both male and female participants with autism spectrum disorder compared with controls. We conclude that the extreme male patterns of cognitive functions in the autistic brain do not seem to extend to gender role and sexuality. A gender-atypical pattern for these types of characteristics is suggested in autism spectrum disorder.
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