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- Harvey, P. D., et al.
(författare)
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Functional Capacity and Functional Disability in Schizophrenia : A Cross-National Study in New York and Sweden
- 2008
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Konferensbidrag (refereegranskat)abstract
- Background: Functional disability is a central feature of schizophrenia and has been reported to occur across different countries and systems of care. Recent advances in the assessment of disability have separeted the measuremet of functional capacity: the ability to perform skills required for everyday functioning from the measurement of real-world functional outcomes. This presentation reports on a cross-national study of the correlation between functional capacity measured with the UCSD Performance-based Skills Assessment, Brief version (UPSA-B), casemanager ratings of patient everyday functioning with the Specific Levels Of Functioning (SLOF), and occurrence of real-world functional milestones, including independent living, employment, and marital status. Patients with schizophrenia who lived in an urban American setting and a generally rural region in Sweden were compared on their functional capacity performance and real-world outcomes. Metods:Samples of schizophrenia patients in Sweden (n=146) and New York (n=244) performed the UPSA-B and a neuropsychological assessment and were rated by their case managers. Information from archival records and case managers was used to determine the occurence of the different real world outcomes, including living independently and having ever experienced a stable romantic relationship.Results: Performance on the UPSA-B was essentially identical in the two patient samples, with a total raw score in the New York sample 13.8 and the score in the Swedish sample 13.8. Scores on the case manager ratings of everyday activities were also strikingly similar (New York:49; Sweden:49). Further, the correlation between UPSA-B scores and ratings of everyday activities were quite similar, New York: r=.36 Sweden: r=.27 as were the correlations between NP performance and UPSA-B scores, New York: r=.58; Sweden: r=.55. Also, the proportion of cases who had never been married or had a close relationship was 59% in New York and 64% in Sweden. In notable contrast, 80% of the Swedish patients and 46% of the New York patients were living independently.Implications: Performance-based measures of functional capacity were very similar across samples of people with schizophrenia in very different living environments. These results are consistent with previous studies showing that performance-based measures of cognition are also quite similar across different countries in people with schizophrenia. While measures of functional ability and case manager estimates of patients' real-world outcomes were very similar in level of impairment and correlational structure, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to very divergent outcomes in individuals who have evidence of the same levels of ability and potential.
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- Harvey, P.D, et al.
(författare)
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Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden
- 2009
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Ingår i: American Journal of Psychiatry. - : American Psychiatric Association Publishing. - 0002-953X .- 1535-7228. ; :166, s. 821-827
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Recent advances in the assessment of disability in schizophrenia have separated the measurement of functional capacity from real-world functional outcomes. The authors examined the similarity of performance-based assessments of everyday functioning, real-world disability, and achievement of milestones in people with schizophrenia in the United States and Sweden. METHOD: The UCSD Performance-Based Skills Assessment-Brief Version (UPSA-B) and a neuropsychological assessment were administered to schizophrenia patients living in rural areas in Sweden (N=146) and in the New York City area (N=244), and patients' functioning was rated by their case managers. Information from records and case managers was used to determine the frequency of living independently, working, and having ever experienced a stable romantic relationship. RESULTS: Performance on the UPSA-B was essentially identical in the two samples (New York, mean score=13.84; Sweden, mean score=13.30), as were scores on the case manager ratings of everyday activities (New York, mean=49.0; Sweden, mean=48.8). The correlations between UPSA-B score, neuropsychological test performance, and case manager ratings did not differ across the two samples. The proportion of patients who had never had a close relationship and the rate of vocational disability were also nearly identical. However, while 80% of the Swedish patients were living independently, only 46% of the New York patients were. CONCLUSIONS: While scores on performance-based measures of everyday living skills were similar in people with schizophrenia across cultures, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to divergent real-world outcomes among individuals who show evidence of the same levels of ability and potential.
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- Helldin, L, et al.
(författare)
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Increase of symptom remission in psychosis : Integrating science and service in the Swedish CLIPS study
- 2009
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Konferensbidrag (refereegranskat)abstract
- The Clinical Long term Investigation of Psychosis in Sweden (CLIPS), is a naturalistic longitudinal study, in which about 300 patients diagnosed with schizophrenia, schizoaffective disorder or delusional disorder are evaluated regularly. Besides being a guideline for treatment, the evaluations are also used for scientific research after informed consent, hence combining regular health service with science in a concrete way. As a likely consequence of the annual structured assessments, the percentage of patients in remission has raised from 35 % to about 50 % in the last three years. Several scientific articles have been published on several psychosis related topics within the frame of the CLIPS study, proving that science can be successfully integrated with clinical practise for better evidence based health care, including a higher percentage of patients in remission
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- Hjärthag, Fredrik, 1973-, et al.
(författare)
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How is family burden correlated to the patients' symptoms, function, quality of life and attitude to medication?
- 2008
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Ingår i: European Neuropsychopharmacology. ; 18:4, s. 468-
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Tidskriftsartikel (refereegranskat)abstract
- Earlier research has concluded that symptom severity is an important factor for explaining family burden related to psychotic illness. Some studies also point out the impaired function of the ill person as a contributing factor to the burden. However, there are few investigations that also considerate the ill persons own view of his/her quality of life and attitude to medication. This study investigates how persons with psychosis symptom severity, functional disability, quality of life and attitude to medication, could be correlated to family burden.
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- Holmström, Mats, et al.
(författare)
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Current perspectives on the treatment of nasal polyposis : a Swedish opinion report
- 2002
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 122:7, s. 736-744
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Tidskriftsartikel (refereegranskat)abstract
- This Swedish study group has examined the current knowledge of nasal polyposis with emphasis on different treatment modalities. Polyposis is a multifactorial disease that exists for decades in the majority of cases. Different types of treatment must be considered, focusing on the underlying disease. However, as we only know the specific origin of polyposis in a minority of cases, treatment is usually symptomatic. When making a thorough evaluation of different treatment strategies, it is obvious that there is a real need for more controlled treatment studies which would make the scientific ground more stable when it comes to suggesting medical, surgical or combined treatments.
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- Malm, Ulf, et al.
(författare)
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Resource group ACT (RACT) - A review of an integrative approach to psychoeducation of individual families involving the patient
- 2015
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Ingår i: International Journal of Mental Health. - : Routledge. - 0020-7411 .- 1557-9328. ; 44:4, s. 269-276
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Tidskriftsartikel (refereegranskat)abstract
- The implementation of evidence-based treatment methods for patients with severe mental illness must be deeply rooted in clinical case management and an ACT service delivery model, where the patient user can be involved in shared-decision making in the cycle of "assess-plan-act-follow up-feedback". In order to prepare and empower the client for the new role as a participating decision maker in the management of his/her own illness, various psychoeducational strategies are employed. The original family unit in the community of the Integrated Mental Health Care program (IC) was developed step-by-step through practice-based evidence and clinical expertise to include significant others as resource persons in a so called Resource Group, and therefore the program was subsequently named as "Resource group ACT" (RACT). The service delivery by community mental health teams involving the patient by way of resource groups as well as the psychoeducational treatment conditions involving both individual patients and family groups may contribute to the understanding of how RACT added clinical effectiveness in functioning and satisfaction. © 2015 Copyright © Taylor & Francis Group, LLC.
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- Norlander, T, et al.
(författare)
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Effects of experimental Mycoplasma pulmonis infection on sensory neuropeptides and airway mucosa in the rat
- 1997
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 10:10, s. 2334-2342
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Tidskriftsartikel (refereegranskat)abstract
- The effect of airway infection on neurogenic inflammation is not known. The present study examines the effect of Mycoplasma pulmonis infection on the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) in the trigeminal ganglion and in the mucosa of the nose and trachea in rats. We compared germ-free (GF), conventionally raised (CV) and specific pathogen-free (SPF) rats. The concentrations of SP and CGRP in the nasal mucosa were assessed with immunohistochemistry, and their prohormonal transcripts in the trigeminal ganglion were assessed with Northern blot. Mucosa was also processed for light microscopy and electron microscopy. SP-like immunoreactivity was greater in the nasal mucosa of infected animals than in uninfected controls. CGRP-like immunoreactivity was greater in the nasal septum, but not in the nasal turbinate, of infected than uninfected animals. In contrast, no change was evident in the expression levels of the prohormonal transcripts in the trigeminal ganglion. Infected nasal and tracheal mucosa was oedematous and locally infiltrated with inflammatory cells. In the nose of uninfected GF rats, subepithelial lymphoid aggregations were scarce and appeared inactive. We conclude that Mycoplasma pulmonis infection results in increased immunoreactivity of substance P, probably within nerves. There was no clear evidence of increased synthesis of the precursors of substance P and calcitonin gene-related peptide.
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- Olsson, A-K, et al.
(författare)
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Psychometric properties of a performance-based measurement of functional capacity
- 2012
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 197:3, s. 290-294
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Tidskriftsartikel (refereegranskat)abstract
- The UCSD Performance-based Skills Assessment - Brief version (UPSA-B) describes the functions of patients without negative influences of environmental factors such as unemployment or shortage in housing. The aim of the present study is to further explore the psychometric properties of the UPSA-B as well as to ensure that the Swedish version can be used in clinical practice and for research purposes. Participants were 211 patients, 135 men and 76 women, diagnosed with schizophrenia, schizoaffective disorder, or delusional disorder. Results indicate that the UPSA-B is a reliable instrument with good psychometric properties regarding validity and reliability. The instrument also had a capacity to reveal differences between various patient groups, both diagnostic groups and groups based on remission status. The conclusion drawn is that the UPSA-B is a valuable instrument that could be used in future cross-national studies to describe the level of functioning for patients with schizophrenia and other psychotic illnesses.
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