| 1. |
- Lenninger, Sofia, et al.
(författare)
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Changes in patterns of alcohol consumption in young psychiatric outpatients : two comparable samples assessed with 10 years apart
- 2023
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 77:8, s. 747-753
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Over the past 20 years, a trend towards non-drinking and less use of alcohol has been reported among young adults. This study aimed to investigate if a similar trend in alcohol consumption can be seen among young adult psychiatric outpatients.METHODS: This was a cross-sectional study based on two comparable samples of young adult (18-25 years) psychiatric outpatients recruited approximately 10 years apart in 2002-2003 (N = 197) and 2012-2016 (N = 380). The Swedish version of the Alcohol Use Disorders Identification Test (AUDIT) was used to assess alcohol consumption. Psychiatric diagnoses were based on diagnostic interviews. Differences between the two samples in alcohol consumption and a number of alcohol-use disorder diagnoses were analysed. Cramer's V was chosen as the effect size measure.RESULTS: Mean AUDIT scores and prevalence of diagnosed alcohol-use disorder in the two samples did not differ significantly. The number of non-drinkers was larger among patients in the mid-2010s (15.8% vs. 8.1%; χ2 = 6.76, p < 0.01, Φ = 0.11), but when non-drinkers were excluded, the alcohol consumption was higher among females in the later sample.CONCLUSION: The mean level of alcohol consumption seems not to have changed to the same extent among young psychiatric patients as in the general population. However, some young psychiatric patients have followed the trend of non-drinking, while others consume more alcohol. Further studies on both non-drinking and high alcohol consumption in psychiatric patients are needed to understand their mechanisms.
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| 2. |
- Ramirez, Adriana, 1968-, et al.
(författare)
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Axis IV - psychosocial and environmental problems - in the DSM-IV
- 2013
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 20:9, s. 768-775
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Tidskriftsartikel (refereegranskat)abstract
- Accessible summaryThe aim of this study was to extensively explore the properties of the revised axis IV of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV).Psychosocial and environmental problems, which are believed to exacerbate current mental disorders, were evaluated by using a questionnaire and through clinical interviews. The reliability between self-assessment and professional assessment was also examined.The results showed that the revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability.These findings could be useful for the upcoming DSM-V revision as well as help clinicians and patients to better identify mental health problems.AbstractThe aim of this study was to further explore the properties of axis IV in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). In a naturalistic cross-sectional design, a group (n = 163) of young (18–25 years old) Swedish psychiatric outpatients was assessed according to DSM-IV. Psychosocial and environmental problems/axis IV were evaluated through structured interviewing by a social worker and by self-assessment on a questionnaire. Reliability between professional assessment and self-assessment of axis IV was examined. Concurrent validity of axis IV was also examined. Reliability between professional and self-assessed axis IV was fair to almost perfect, 0.31–0.83, according to prevalence and bias-adjusted kappa. Categories of psychosocial stress and environmental problems were related to the presence of axis I disorders, co-morbidity, personality disorders and decreasing Global Assessment of Functioning (GAF) values. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability.
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| 3. |
- Ramirez, Adriana, 1968-, et al.
(författare)
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Depression in young adult psychiatric outpatients : delimiting early onset
- 2015
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Ingår i: Early Intervention in Psychiatry. - : Wiley. - 1751-7885 .- 1751-7893. ; 9:2, s. 108-117
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Tidskriftsartikel (refereegranskat)abstract
- AimThe aim of this study was to examine differences in childhood, adolescent and adult onset of depression.MethodsYoung psychiatric outpatients (n = 156) diagnosed with a lifetime depressive episode were divided into three groups according to age of onset of their first depressive episode: childhood (≤12 years, n = 21), adolescent (13–17 years, n = 58) and early adult onset (18–25 years,n = 77). Participants were assessed by diagnostic interviews and by questionnaires measuring previous life events and childhood developmental delays. Clinical characteristics and various risk factors were compared between groups.ResultsThis clinical sample was dominated by women, with onset of their first depressive episode occurring during adolescence. Childhood onset was related to an increased number of depressive episodes, higher prevalence of personality disorders, more current social problems and more reported development delays during childhood regarding literacy learning, social skills and memory. They also reported more separation anxiety symptoms and neglect during childhood and more experiences of teenage pregnancies and abortions.ConclusionsChildhood onset of depression is associated with more severe symptoms, more psychosocial risk factors and childhood developmental delays. Because all onset groups shared many features, the results are inconclusive if there are distinct subgroups according to age of onset.
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| 4. |
- Ramirez, Adriana, 1968-
(författare)
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Young Adults in General Psychiatry
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Mental illness is common, and usually starts early in life. However, the majority of those affected never seek mental health care. The overall aim of this thesis was to increase knowledge about help-seeking young adults with mental illness in order to improve diagnostic procedures in clinical psychiatry. A group of young adult psychiatric out-patients (n=217) were consecutively invited to participate in the study between October 2002 and September 2003. Altogether 200 (92%) agreed to participate. Among them, there were 161 (80%) women and 39 (20%) men. Participants’ mean age was 22.4±1.9 years. All participants were carefully and comprehensively assessed with respect to axes I, II, IV and V in the DSM-IV. Psychiatric disorders and personality disorders were assessed using the Structured Clinical Interview for DSM-IV for axis I disorders and the Structured Clinical Interview for DSM-IV for axis II disorders. Psychosocial and environmental problems (axis IV) were evaluated through structured interviewing by a social worker and by self-assessment with a questionnaire. Professional and patient ratings on the Global Assessment of Functioning scale were compared before and after treatment. Patients also reported on the Swedish universities Scales of Personality, the Child and Adolescent Psychiatric Screening Inventory-Retrospect and the Coddington’s life event scale. Taken together, the young adult, psychiatric outpatients were characterized by an early onset of their mental disorders, by co-morbidity, by being female and by having mood or anxiety disorders. There were no significant differences between self-referred and those referred by medical professionals according to either number of current or lifetime diagnoses. Childhood onset of depression was associated with more severe symptoms, more psychosocial risk factors, and more childhood developmental delays. Axis IV psychosocial stress categories were related to the presence of axis I disorders, personality disorders, co-morbidity, and impaired functioning. Agreement between patients’ and professionals’ ratings on the GAF scale was good before treatment and excellent after treatment. In summary, the findings suggest that direct self-referral to specialized psychiatric care does not seem to be associated with overutilization of such care. Childhood onset of depression is associated with a more complex illness. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability. And finally, the results support the usefulness of the self-report GAF instrument for measuring outcome in psychiatric care.
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| 5. |
- Richter, Miriam, et al.
(författare)
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The clinical relevance of asking young psychiatric patients about childhood ADHD symptoms
- 2020
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Ingår i: Nordic Journal of Psychiatry. - : TAYLOR & FRANCIS LTD. - 0803-9488 .- 1502-4725. ; 74:1, s. 23-29
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to explore the relevance of asking young psychiatric patients about childhood symptoms of attention deficit hyperactivity disorder (ADHD).Method: A total of 180 young adults (18-25 years of age) from a general psychiatric out-patient clinic in Uppsala filled in the Child and Adolescent Psychiatric Screening Inventory-Retrospect (CAPSI-R) as part of the diagnostic procedure. The study population was divided into groups based on number and subtype of reported ADHD symptoms, inattention (IN) or hyperactivity/impulsivity (HI). The clinical characteristics associated with different symptoms of ADHD were explored.Results: The groups with five or more self-reported ADHD childhood symptoms, of either IN or HI, had more psychiatric comorbid conditions, a significantly higher co-occurrence of substance use disorders and personality disorders, and experienced more psychosocial and environmental problems.Conclusion: High level of self-reported ADHD childhood symptoms in young psychiatric patients identified a group more burdened with psychiatric comorbid conditions and more psychosocial problems. This group should be offered a thorough diagnostic assessment of ADHD.
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| 6. |
- Spangenberg, Hanna, et al.
(författare)
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A long-term follow-up study of labor market marginalization in psychiatric patients with and without personality disorder
- 2023
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Ingår i: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 128
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Tidskriftsartikel (refereegranskat)abstract
- Background: Personality disorders (PDs) in adulthood are considered stable over time and are likely to have lasting psychosocial impact on the affected individual, including in areas like vocational functioning. The aim of this study was to study labor market marginalization (LMM) and receipt of social welfare benefits during 13 years from age 18 to 25 years in a sample of former psychiatric patients with and without PD.Methods: This study followed-up 186 former psychiatric patients who were thoroughly assessed in 2002–2004, including for PD, and compared them with controls. Participants were divided into three groups: former patients with PD, without PD, and a matched control group from the general population. Register data on employment, sick leave absence, disability pensioning, education, days of psychiatric care, income, and receipt of social welfare benefits in 2003–2016 were collected.Results: Former patients had more days of unemployment, sick leave absence, and disability pensioning and received more social welfare benefits than controls during the study period. Differences between patients with and without PD were smaller than expected, but significant as regards receipt of social welfare benefits. PD also had an effect on income at age 30 years.Conclusions: Early onset of psychiatric disorders impairs vocational functioning up to 13 years after diagnosis, and most in those with PD.
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| 7. |
- Spangenberg, Hanna, et al.
(författare)
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Correlations between personality traits, personality disorders, and immunometabolic markers
- 2024
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Evidence links immune system alterations to major psychiatric disorders. The few previous studies on personality traits or personality disorders (PDs) indicate that immunometabolic dysregulation may be prevalent in this population. This study aimed to investigate relationships between personality traits, PDs, and immunometabolic markers in peripheral blood. We hypothesized that neuroticism would be correlated with elevated leptin. Participants were recruited as young adults seeking care for general psychiatric disorders. They responded to a personality inventory and were assessed for PDs, and reevaluated again at a 12 years follow-up. Blood samples were collected at the follow-up and analyzed for 29 immunometabolic markers. A positive correlation was found between the personality trait neuroticism and leptin (ρ = 0.31, p = 0.02). An exploratory analysis also revealed a positive correlation between brain-derived neurotrophic factor (ρ = 0.36, p < 0.01) and neuroticism. These findings remained after adjusting for other variables in general linear models. There were no relationships between PDs and any immunometabolic markers. Results both confirm previous findings of correlations between the immunometabolic system and personality traits and suggest directions for future research.
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| 8. |
- Spangenberg, Hanna, 1983-
(författare)
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Deviant personality in the long run : - a follow-up of young adult psychiatric patients
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Personality is constituted by a number of traits, which are more or less pronounced in each individual. When personality traits are extreme, they can cause suffering or loss of function, and are then denoted as personality disorders (PDs). Personality and PDs are of relevance for physical and mental health. The aim of this thesis was to longitudinally study personality traits, PDs, and mental disorders in previously young adult psychiatric patients. For this purpose, a cohort of 200 psychiatric outpatients from a study conducted in 2002-2004 was followed up in 2016. In total, 103 participants filled in self-report instruments, 77 participants underwent psychiatric assessments, and 57 participants donated blood samples. Self-report instruments were analyzed for trajectories of personality traits during the study period. Blood samples were analyzed for correlations between personality traits and PDs with immunometabolic markers. Data from national registries were collected for 186 participants who had undergone PD assessment at baseline. These data were analyzed for psychosocial outcomes in individuals with or without PDs.Results showed that participants personality traits had changed during the study period, with many traits moving towards the norm. In the analysis of blood samples, personality trait neuroticism was found to correlate with elevated levels of metabolic hormone leptin, and trait extraversion was inversely correlated with levels of interleukin-10 in blood. No immunometabolic marker was found to be correlated with PD. In the investigation of registry data, PD was associated with worse outcomes in labour market and relationship domains. The studies in this thesis have expanded the scientific field of personality research in regards to changeability of personality traits, correlations of personality traits to immunometabolic markers, and psychosocial outcomes in PD.
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| 9. |
- Spangenberg, Hanna, et al.
(författare)
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Long-term stability of personality traits in a clinical psychiatric sample
- 2019
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Ingår i: Nordic Journal of Psychiatry. - : TAYLOR & FRANCIS LTD. - 0803-9488 .- 1502-4725. ; 73:6, s. 309-316
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to describe personality traits in psychiatric patients and to investigate whether these traits are stable over 13 years. Methods: A total of 95 individuals who were patients at a psychiatric outpatients' clinic in 2003 completed the Swedish universities Scales of Personality (SSP). Scores from 2003 were compared with SSP scores from 2016. Based on the current score on the comprehensive psychopathological rating scale - self rating for affective disorders (CPRS-S-A), the participants were divided into two groups representing 'good' and 'poor' current mental states, to investigate the effect of current mental state on reports of personality traits. Results: Out of 13 personality traits, 11 showed a significant change in mean T-score over the study interval. The group with lower CPRS-S-A scores showed a significant change in T-score for 10 traits, whereas in the group with higher CPRS-S-A scores only 3 traits showed a significant change. Conclusions: The findings support the theory that personality is changeable over the course of life, also in psychiatric patients. We do not know if persisting psychiatric symptoms halter change or if deviant personality traits cause psychiatric symptoms to continue.
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| 10. |
- Spangenberg, Hanna, et al.
(författare)
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Moving in together, marriage, and motherhood : A follow up study of relationships in psychiatric patients with personality disorders
- 2021
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Ingår i: Personality and Mental Health. - : John Wiley & Sons. - 1932-8621 .- 1932-863X. ; 15:3, s. 186-197
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Tidskriftsartikel (refereegranskat)abstract
- Background Personality disorders (PDs) are related to poor psychosocial function, including fewer relationships with friends and romantic partners. Methods One-hundred eighty-six psychiatric patients were included in a study cohort in 2002-2003. In 2017, data regarding living arrangements and marital status between 2003 and 2016 were collected for these participants and from a matched control group. Data on birth of first child during the study period were collected for women. The former patients were divided into two groups based on occurrence of PD or not. Groups were compared with each other and with the controls. Results The proportion of participants with PD who lived together with someone did not increase at the same rate as in the other groups. PD was associated with a reduced likelihood of getting married during the study period. Women in the PD group had children to a lower extent than females in the other groups. Conclusion Personality disorder was associated with an increased likelihood of living alone and being unmarried. Female participants with PD had a decreased likelihood of having children compared with controls.
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| 11. |
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