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- Edbom, Tobias
(författare)
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Self-esteem, sense of coherence and attention deficit hyperactivity disorder : a longitudinal study from childhood to adulthood
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behavioural disorders in school-aged children. The prognosis in adulthood can sometimes be problematic in different aspects related to education, employment, socialization, and overall mental health. The functional impairment of ADHD has been related to the development of a low self-esteem. However, there are reports describing children and adolescents with severe ADHD symptoms that do not report problems such as low self-esteem or problems in school or social competencies. Aim: Self-esteem and sense of coherence (SOC) are both seen as important factors for health and therefore, the overall aim of this thesis was to examine the longitudinal and concurrent relationship between low self-esteem, SOC and ADHD from childhood to young adulthood. Method: The data used in all four papers came from the longitudinal Twin study of Child and Adolescent Development (TCHAD). The twins and/or their parents have been contacted in four different waves. Wave 1 was in 1994 (twins were 8-9 years old) and wave 2 was in 1999 (twins were 13-14 years old). In 2001, a clinical study with a sub sample including the twin pairs living in the Stockholm county area (twins were 15-17 years of age) and finally Wave 4 was in 2006 (twins were 20-21 years old). I used DSM III based ADHD criteria in order to study ADHD symptoms in Paper I and II and DSM IV based criteria for ADHD symptoms in Paper III and IV. We used the "I think I am" questionnaire in Paper I, II and III for the purpose to study self-esteem and the SOC scale in Paper IV. Results: There was a long-term relationship between ADHD-symptoms in childhood and a low self-esteem in adolescence. However, the patterns of findings in ADHD discordant MZ and DZ twins could indicate the association is not causal but instead problems caused by a common factor for example personality traits due to a genetic factor. A low self esteem in adolescence was associated with a high score of ADHD symptoms in early adulthood, especially with the development of the inattentive subtype of ADHD compared with the hyperactive/impulsive subtype. Children with high scores of ADHD symptoms often seem to have profiles of self-esteem characterized by low scores in the domains skills and talents and psychological well-being. However, more than a few children with high score ADHD had profiles characterized of good self-esteem. In addition, children with the most persistent high scores of ADHD symptoms had relatively good self-esteem profiles. SOC could be a protective factor for the development and the maintenance of mental and physical health. This hypothesis was supported by the findings of a statistically significant interaction between SOC and ADHD at 16 on the outcome, i.e. ADHD at 21 years. The young persons with high (SOC) at age 16 had a low score of ADHD symptoms at age 21 even if they had a high ADHD score at age 16. Conclusions: There was a longitudinal relationship between low self-esteem and high scores of ADHD symptoms from childhood to early adulthood. A high SOC seems to be a good predictor for a reduction of ADHD symptoms from adolescence to early adulthood.
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- Malmberg, Kerstin, et al.
(författare)
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Psychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers
- 2011
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 100:11, s. 1468-1475
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To study the coexistence of subthreshold diagnoses of both attention deficit hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBD) with other symptoms of child and adolescent psychiatric disorders as well as risk behaviours associated with smoking, alcohol and drug use. Methods: A population-based sample of twins including 177 girls and 135 boys was interviewed using the Swedish version of Kiddie-SADS Present and Lifetime Version (K-SADS-PL). Subthreshold diagnoses were compiled based on the ADHD and DBD criteria, where each criterion was assessed as 'possible' or 'certain' according to K-SADS-PL. The odds ratios (OR) between the subthreshold diagnoses and each of the screening questions in K-SADS-PL were calculated. Results: Subthreshold diagnoses of ADHD and DBD coexisted with the screening questions concerning depression, mania, panic attack, phobias, anorexia nervosa, motor tics and posttraumatic stress disorder (PTSD) in girls. In boys, these subthreshold diagnoses coexisted with symptoms of depression and PTSD. For both boys and girls, smoking and high alcohol consumption contributed to a high OR with regard to ADHD and DBD. Conclusion: Subthreshold diagnoses of ADHD and DBD were risk factors for several other psychiatric symptoms as well as smoking and high alcohol consumption. Thus, a broad clinical assessment is needed for adolescents with such preliminary diagnoses.
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- Owe-Larsson, Björn, et al.
(författare)
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Increased plasma levels of thioredoxin-1 in patients with first episode psychosis and long-term schizophrenia.
- 2011
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Ingår i: Progress in neuro-psychopharmacology & biological psychiatry. - : Elsevier BV. - 1878-4216 .- 0278-5846. ; 35:4, s. 1117-21
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Tidskriftsartikel (refereegranskat)abstract
- Excessive level of radicals and/or dysfunctional antioxidant response, oxidative stress, is implicated in the pathogenesis of schizophrenia. A condition of oxidative stress has been detected in the brain, peripheral tissues and fluids including plasma. Plasma thioredoxin-1 (Trx1) is well characterized and a putative marker for oxidative stress and recently shown to be increased in plasma at the onset of schizophrenia. The present study aimed to explore whether Trx1 can be used as a marker to identify schizophrenic patients at the time-point when patients have their first episode of psychosis as compared to patients with long-term schizophrenia and mentally healthy patients, respectively. Plasma samples obtained from 18 patients at first episode of psychosis, from 49 long-term schizophrenic patients and from 20 mentally healthy controls (admitted with minor physical injury to the general ward) where analyzed by ELISA for Trx1. The patients with first episode of psychosis were diagnosed at least 6months later and shown to constitute various psychotic syndromes, including schizophrenia, or affective disorder. The concentration of Trx1 in the patients with first episode of psychosis was 1.5±1.0ng/ml and 0.8±0.6ng/ml in controls. In the long-term schizophrenic patients the plasma concentration was 1.5±0.7. The differences between the groups of acute psychotic or long-term schizophrenia patients to controls were significant (p<0.016 and p<0.001, respectively). Our data indicate that Trx1 may not be used as an early marker to identify schizophrenic patients in a mixed population of first episode psychotic patients. Further, Trx1 did not discriminate with reliable accuracy patients with psychotic disorder from mentally healthy controls on an individual basis due to overlap in levels of Trx1. However, our observations show that psychotic patients in general are in a significant long-term condition of oxidative stress, with possible implications for the profound morbidity and mortality found in this patient population.
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