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1.
  • von Knorring, L, et al. (författare)
  • Cost-effectiveness in the prevention of suicide.
  • 1999
  • Ingår i: In: Manage or Perish? The challenge of managed mental health in Europe. - : Plenum Press, Geneve 1999.
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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  • Bejerot, Susanne, 1955-, et al. (författare)
  • Comorbidity between obsessive-compulsive disorder (OCD) and personality disorders
  • 1998
  • Ingår i: Acta Psychiatrica Scandinavica. - Copenhagen, Denmark : Munksgaard Forlag. - 0001-690X .- 1600-0447. ; 97:6, s. 398-402
  • 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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  • Bejerot, Susanne, 1955-, et al. (författare)
  • Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive-compulsive disorder
  • 1998
  • Ingår i: Acta Psychiatrica Scandinavica. - Copenhagen, Denmark : Munksgaard Forlag. - 0001-690X .- 1600-0447. ; 98:3, s. 243-249
  • 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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  • Bejerot, Susanne, 1955-, et al. (författare)
  • Personality traits and smoking in patients with obsessive-compulsive disorder
  • 2000
  • Ingår i: European psychiatry. - Paris, France : Elsevier. - 0924-9338 .- 1778-3585. ; 15:7, s. 395-401
  • 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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  • Ekselius, L, et al. (författare)
  • Personaltiy disorders
  • 2000
  • Ingår i: In: M Steiner, KA Yonkers, E Eriksson (eds) Mood disorders in women. - : Martin Dunitz, London. ; , s. 399416-
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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14.
  • Ekselius, L, et al. (författare)
  • SCID II interviews and the SCID Screen questionnaire as diagnostic tools for personality disorders in DSM-III-R.
  • 1994
  • Ingår i: Acta Psychiatrica Scandinavica. - 0001-690X .- 1600-0447. ; 90:2, s. 120-3
  • Tidskriftsartikel (refereegranskat)abstract
    • A modified version of the SCID Screen questionnaire covering 103 criteria by means of 124 questions was compared with SCID II interviews in 69 psychiatric patients. The correlation between the number of criteria fulfilled in the SCID II interviews or the questionnaires was 0.84. In the SCID interviews, 54% of the patients had a personality disorder. When the SCID Screen questionnaire was used, 73% had a personality disorder. When the cut-off level for diagnosis was adjusted, the frequency found by means of the SCID screen questionnaire or the interviews was roughly the same, 58% and 54%, respectively. The overall kappa for agreement between the SCID II interviews and questionnaire with adjusted cut-off was 0.78.
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  • Henningsson, Susanne, 1977, et al. (författare)
  • Sex steroid-related genes and male-to-female transsexualism
  • 2005
  • Ingår i: Psychoneuroendocrinology. - Oxford : Pergamon Press. - 0306-4530 .- 1873-3360. ; 59:5, s. 412-412
  • Tidskriftsartikel (refereegranskat)abstract
    • Transsexualism is characterised by Lifelong discomfort with the assigned sex and a strong identification with the opposite sex. The cause of transsexualism is unknown, but it has been suggested that an aberration in the early sexual differentiation of various brain structures may be involved. Animal experiments have revealed that the sexual differentiation of the brain is mainly due to an influence of testosterone, acting both via androgen receptors (ARs) and-after aromatase-catalyzed conversion to estradiol-via estrogen receptors (ERs). The present study examined the possible importance of three polymorphisms and their pairwise interactions for the development of male-to-female transsexualism: a CAG repeat sequence in the first exon of the AR gene, a tetra nucleotide repeat polymorphism in intron 4 of the aromatase gene, and a CA repeat polymorphism in intron 5 of the ER beta gene. Subjects were 29 Caucasian male-to-female transsexuals and 229 healthy mate controls. Transsexuals differed from controls with respect to the mean Length of the ER repeat polymorphism, but not with respect to the length of the other two studied polymorphisms. However, binary logistic regression analysis revealed significant partial effects for all three polymorphisms, as well as for the interaction between the AR and aromatase gene polymorphisms, on the risk of developing transsexualism. Given the small number of transsexuals in the study, the results should be interpreted with the utmost caution. Further study of the putative role of these and other sex steroid-related genes for the development of transsexualism may, however, be worthwhile.
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  • von Knorring, L, et al. (författare)
  • Somatoforma smärttillstånd
  • 2003
  • Ingår i: In Mads Werner & Peter Strang (Eds)SMärta och smärtbehandling. - : Liber AB, Stockholm. ; , s. 478-
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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  • Åkerblad, AC, et al. (författare)
  • Effects of an educational compliance enhancement programme and therapeutic drug monitoring on treatment adherence in depressed patients managed by general practitioners
  • 2003
  • Ingår i: International Clinical Psychopharmacology. - : Ovid Technologies (Wolters Kluwer Health). - 0268-1315 .- 1473-5857. ; 18:6, s. 347-354
  • Tidskriftsartikel (refereegranskat)abstract
    • Medication non-adherence is a major obstacle in the treatment of affective disorders. The primary objective of this study was to evaluate two different interventions to improve adherence to antidepressant drugs. Secondary objectives included response to treatment, relation between adherence and response, patient satisfaction and tolerability. A randomized controlled design was used to assess the effect of a patient educational compliance enhancing programme (CP) and therapeutic drug monitoring in 1031 major depressed patients treated with sertraline for 24 weeks and managed by their general practitioner. Adherence was measured by questioning, measurable serum levels of sertraline and desmethylsertraline, appointments kept and a composite index including all three methods. Treatment adherence was found in 37-70% of patients, depending on the method used. Neither of the interventions resulted in a significant increase in adherence rate. However, significantly more patients in the CP group had responded at week 24 compared to patients in the control group. Overall, significantly more adherent patients responded to treatment compared to non-adherent patients, regardless of method used to determine adherence. This large study demonstrates that treatment response increases when using an educational compliance programme and that a strong relationship between treatment adherence and response exists. ⌐ 2003 Lippincott Williams & Wilkins.
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  • Andersson, Gerhard, et al. (författare)
  • Delivering cognitive behavioural therapy for mild to moderate depression via the Internet : Predicting outcome at 6-month follow-up
  • 2004
  • Ingår i: Verhaltenstherapie (Basel). - : S. Karger AG. - 1016-6262 .- 1423-0402. ; 14:3, s. 185-189
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Mild to moderate depression has been successfully treated with cognitive-behavioural (CBT) bibliotherapy, including minimal therapist contact. More recently, the Internet has been used to deliver the treatment, with obvious gains in terms of cost reduction and increased accessibility. In the present study we analysed pre-treatment predictors of improvement following Internet-based self-help treatment of mild to moderate depression. Patients and Methods: Included were 71 participants from a randomised trial who completed a 6-month follow-up. Change indexes were calculated from the Beck Depression Inventory (BDI) and the Montgomery Åsberg Depression Rating Scale (MADRS). Results: In line with the literature on depression, the number of previous episodes of depression was negatively associated with improvement after treatment. Follow-up scores on the BDI and MADRS were associated with pre-treatment levels of depression, anxiety and low levels of quality of life. Discussion: As indicated by traditional psychotherapy studies, finding predictors of outcome is a difficult task. Patients with repeated episodes of depression might benefit less from self-help over the Internet, but as the correlation is weak, no firm conclusions can be drawn.
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  • Aspegren Kendall, Sally, 1950-, et al. (författare)
  • Feldenkrais intervention in fibromyalgia patients : A pilot study
  • 2001
  • Ingår i: Journal of Musculoskeletal Pain. - 1058-2452 .- 1540-7012. ; 9:4, s. 25-35
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To evaluate the effect of the Feldenkrais intervention, in fibromyalgia patients. Methods: Twenty fibromyalgia patients started Feldenkrais intervention done as one individual and two group sessions weekly for 15 weeks. Nineteen started a group-based pain education program followed by a pool program. Test and self-report questionnaires were administered at the start, at six month follow up, and at the end of intervention. Results: After the Feldenkrais intervention improvement in balance and trends to better lower extremity muscle function were shown, but the improvements were not maintained. Conclusions: No sustained benefit of the Feldenkrais intervention compared to a pool program was seen. Methodological problems are discussed. ⌐ 2001 by The Haworth Press, Inc. All rights reserved.
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  • Bhandage, Amol K., 1988-, et al. (författare)
  • Depression, GABA, and Age Correlate with Plasma Levels of Inflammatory Markers
  • 2019
  • Ingår i: International Journal of Molecular Sciences. - : MDPI. - 1661-6596 .- 1422-0067. ; 20:24
  • Tidskriftsartikel (refereegranskat)abstract
    • Immunomodulation is increasingly being recognised as a part of mental diseases. Here, we examined whether levels of immunological protein markers changed with depression, age, or the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). An analysis of plasma samples from patients with a major depressive episode and control blood donors (CBD) revealed the expression of 67 inflammatory markers. Thirteen of these markers displayed augmented levels in patients compared to CBD. Twenty-one markers correlated with the age of the patients, whereas 10 markers correlated with the age of CBD. Interestingly, CST5 and CDCP1 showed the strongest correlation with age in the patients and CBD, respectively. IL-18 was the only marker that correlated with the MADRS-S scores of the patients. Neuronal growth factors (NGFs) were significantly enhanced in plasma from the patients, as was the average plasma GABA concentration. GABA modulated the release of seven cytokines in anti-CD3-stimulated peripheral blood mononuclear cells (PBMCs) from the patients. The study reveals significant changes in the plasma composition of small molecules during depression and identifies potential peripheral biomarkers of the disease.
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  • Bingefors, Kerstin, et al. (författare)
  • Antidepressant-treated patients in ambulatory care long-term use of non-psychotropic and psychotropic drugs
  • 1996
  • Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 168:3, s. 292-98
  • Tidskriftsartikel (refereegranskat)abstract
    • AbstractBackground. Despite the problems involved in treating depression and concomitant medical disease, there are virtually no longitudinal studies on drug utilisation among depressed patients.MethodUse of prescription drugs among all first-time users of antidepressants in a defined population five years before and six years after the index (first) treatment was compared to a referent group without antidepressant treatment. The generalised estimating equations (GEE) method was used for analysis.ResultsThe antidepressant-treated group used considerably more non-psychotropic drugs during the whole study period than the referent group. They also used more psychotropic drugs, a use which increased in connection with the initiation of antidepressant treatment, and stayed high for a further five years.ConclusionsThe high use of prescription drugs indicated widespread somatic and psychiatric health problems during the whole study period. Antidepressant-treated patients are at risk for drug interactions and adverse effects, and would benefit from a closer collaboration between psychiatry and medicine.
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31.
  • Bodlund, Owe, et al. (författare)
  • Axis V--Global Assessment of Functioning Scale. Evaluation of a self-report version
  • 1994
  • Ingår i: Acta Psychiatr Scand. - : Wiley. - 0001-690X .- 0001-690X .- 1600-0447. ; 90:5
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study examines a self-report version of the Global Assessment of Functioning Scale according to Axis V (GAF self-report). The sample (n = 73) was a psychiatric outpatient population from a catchment area clinic. Patients with psychotic and organic mental disorders were not included. The diagnostic distribution on Axis I was similar to the findings from previous studies. Axis II disorders were identified among 47%, of whom a majority also had a concomitant Axis I disorder. The mean GAF expert score was 66.5 (range: 48-86). High complexity and severity of disorders and a high number of fulfilled Axis II criteria were significantly associated with low GAF scores. Independent expert ratings on GAF were correlated with the GAF self-report overall at r = 0.62, varying from 0.45 to 0.91 between different diagnostic groups. In general, the patients scored themselves lower (mean: -4.4 units) than expert ratings. Patients with depressive symptoms from an adjustment disorder or mood disorder were most prone to underestimation. Women also tended to score themselves lower than experts did. Conclusively, the GAF self-report turned out to be a valid and reliable unidimensional instrument measuring psychological, social and occupational functioning. The GAF is easy to handle, and with a self-report version as a complement, Axis V could be more frequently used in future clinical practice and research.
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  • Carlbring, P., et al. (författare)
  • Behandling av paniksyndrom via Internet
  • 2000
  • Ingår i: Paper presented at the Läkaresällskapets Riksstämma, Göteborg.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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  • Carlbring, P., Forslin, P., Willebrand, M., Ljungstrand, P., Strandlund, C., Ekselius, L., & Andersson, G (författare)
  • Is the Internet-Administered CIDI-SF Equivalent to a Clinician-Administered SCID-Interview?
  • 2002
  • Ingår i: Cognitive behaviour therapy. ; 31, s. 183-189
  • Tidskriftsartikel (refereegranskat)abstract
    • The procedural validity of the Composite International Diagnostic Interview - short form (CIDI-SF) administered via an Internet web-page was examined and compared with an in-person interview (Structured Clinical Interview for DSM-IV Axis I Disorders, rese
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  • Carlbring, P, et al. (författare)
  • Paniksyndromsbehandling via Internet
  • 2000
  • Ingår i: Paper presented at Beteendeterapeutiska Föreningens årsmöte, Uppsala..
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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39.
  • Cunningham, Janet L., et al. (författare)
  • Agreement between physicians' and patients' ratings on the Montgomery-Asberg Depression Rating Scale
  • 2011
  • Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 135:1-3, s. 148-153
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Self-rating scales developed for monitoring depression severity are potentially informative and cost effective tools. There is an increasing tendency to use the Montgomery-Asberg Depression Rating Scale (MADRS) and the self-rating version (MADRS-S) interchangeably. Methods: 400 patients with major depressive disorder were included. Concordance between patient and physician ratings was measured by means of repeated MADRS and MADRS-S ratings during a six-month drug trial and one-year follow-up. Results: Overall scores from patients and physicians show the same trends and both are sensitive to improvements. Our results, however, show only moderate to good agreement between patient and physician ratings. Intraclass coefficients ranged from 0.47 to 0.75 with highest agreement at week 8. Limitations: Generalizability is restricted to outpatients in general practice with moderate to severe depression. MADRS-S and MADRS scale definitions are similar but not identical concerning language and are scaled differently, 0-6 vs. 0-3, respectively, which may have influenced the results. The exclusion criteria restricted the range of values for the item Suicidal thoughts/Zest for life, which may have reduced the correlations. Conclusions: MADRS-S is a suitable tool for following patients' symptoms on a regular basis over time and may also be used to compensate for bias in physicians' ratings in drug trials.
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40.
  • Cunningham, Janet L., et al. (författare)
  • No regrets : Young adult patients in psychiatry report positive reactions to biobank participation
  • 2017
  • Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Research in vulnerable individuals must insure voluntariness and minimize negative reactions caused by participation. This study aimed to describe consent and completion rate in young psychiatric patients in relation to study components, degree of disability and to compare response to research participation in patients and controls.METHODS: Between 2012 and 2015, 463 patients with psychiatric disorders between the ages of 18-25 from the Dept. of General Psychiatry at Uppsala University Hospital and 105 controls were recruited to donate data and samples to a biobank. Consent and completion in relation to questionnaires, biological sampling of blood, saliva or feces, were monitored. Both groups were also asked about their perceived disability and how research participation affected them.RESULTS: Most patients who participated consented to and completed questionnaires and blood sampling. The majority also consented to saliva sampling, while less than half consented to collect feces. Of those who gave consent to saliva and feces only half completed the sampling. Both patients and controls reported high voluntariness and were positive to research participation. Within the patient group, those with greater perceived disability reported greater distress while participating in research, but there was no difference in consent or completion rates or level of regret.CONCLUSIONS: With the described information procedures, psychiatric patients, regardless of perceived disability, reported high voluntariness and did not regret participation in biobanking. Compared to questionnaires and blood sampling, given consent was reduced for feces and completion was lower for both saliva and feces sampling.
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  • Cunningham, Janet L., et al. (författare)
  • Predicting disagreement between physicians and patients on depression response and remission
  • 2013
  • Ingår i: International Clinical Psychopharmacology. - 0268-1315 .- 1473-5857. ; 28:3, s. 134-140
  • Tidskriftsartikel (refereegranskat)abstract
    • Demographic, personality, and disease-related factors all contribute when patients disagree with physicians on the severity of subjective symptoms. This study aims to create a model, on the basis of patient factors at treatment initiation, for longitudinal prediction of disagreement on treatment response and remission in depressed patients. Four hundred patients with major depressive disorder were studied during a clinical drug trial. Repeated assessments with the Montgomery-Asberg Depression Rating Scale (MADRS) and the self-rating version (MADRS-S) were used to indicate response or remission. Factors at baseline and week 2 were tested for inclusion in a model for the prediction of discordance on remission and response between patients and physicians at week 8. The models were then tested, in the same population, at weeks 12, 16, and 24. Model AUCs ranged from 0.71 to 0.74 for week 8. The models that were validated at weeks 12, 16, and 24 indicated stability in the predictive value of the models. The risk for longitudinal disagreement in the evaluation of depression treatment response and remission in clinical practice and drug trials can be predicted using factors at study initiation and at week 2.
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  • Ekselius, Lisa, et al. (författare)
  • Personality disorders in DSM-III-R as categorical or dimensional.
  • 1993
  • Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 88:3, s. 183-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite the atheoretical approach of the DSM-III-R, the personality disorders have their roots in specific theoretical schools. Due to clinical tradition, analogies with Axis I and the tradition in psychiatry and medicine, the personality disorders are presented as categories although there is more empirical support for a dimensional approach. This study attempted to determine whether the separate personality disorders meet Kendell's criteria for distinct entities, i.e., bimodality with distinct points of rarity. None of the personality disorders met the criteria for a distinct disease entity. Instead, all of the personality disorders presented as continuous, dimensional personality traits present among healthy subjects and more pronounced in patients with mental disorders.
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  • Furmark, Tomas, et al. (författare)
  • Social phobia subtypes in the general population revealed by cluster analysis
  • 2000
  • Ingår i: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 30:6, s. 1335-1344
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Epidemiological data on subtypes of social phobia are scarce and their defining features are debated. Hence, the present study explored the prevalence and descriptive characteristics of empirically derived social phobia subgroups in the general population. Methods. To reveal subtypes, data on social distress, functional impairment, number of social fears and criteria fulfilled for avoidant personality disorder were extracted from a previously published epidemiological study of 188 social phobics and entered into an hierarchical cluster analysis. Criterion validity was evaluated by comparing clusters on the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Finally, profile analyses were performed in which clusters were compared on a set of sociodemographic and descriptive characteristics. Results. Three clusters emerged, consisting of phobics scoring either high (generalized subtype), intermediate (non-generalized subtype) or low (discrete subtype) on all variables. Point prevalence rates were 2.0%, 5.9% and 7.7% respectively. All subtypes were distinguished on both SPS and SIAS. Generalized or severe social phobia tended to be over-represented among individuals with low levels of educational attainment and social support. Overall, public-speaking was the most common fear. Conclusions. Although categorical distinctions may be used, the present data suggest that social phobia subtypes in the general population mainly differ dimensionally along a mild-moderate-severe continuum, and that the number of cases declines with increasing severity.
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  • Furmark, T, et al. (författare)
  • Social phobia subtypes in the general population revealed by cluster analysis
  • 2000
  • Ingår i: PSYCHOLOGICAL MEDICINE. - : CAMBRIDGE UNIV PRESS. - 0033-2917. ; 30:6, s. 1335-1344
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Epidemiological data on subtypes of social phobia are scarce and their defining features are debated. Hence, the present study explored the prevalence and descriptive characteristics of empirically derived social phobia subgroups in the genera
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