| 1. |
- Andersson, Peter, et al.
(författare)
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Changes in Body Mass Index During Mandatory Forensic Psychiatric Care : Findings from a Long-Term (2009-2020) Cohort Study Based on Swedish Registry Data
- 2024
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Ingår i: International Journal of Forensic Mental Health. - : Routledge. - 1499-9013 .- 1932-9903. ; 23:2, s. 106-116
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Tidskriftsartikel (refereegranskat)abstract
- Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009-2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.
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| 2. |
- Helander, Maria, et al.
(författare)
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The Efficacy of Parent Management Training With or Without Involving the Child in the Treatment Among Children with Clinical Levels of Disruptive Behavior : A Meta-analysis
- 2024
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Ingår i: Child Psychiatry and Human Development. - : Springer Nature. - 0009-398X .- 1573-3327. ; 55, s. 164-181
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Tidskriftsartikel (refereegranskat)abstract
- A systematic review and meta-analysis was conducted where we evaluated the effects of Parent Management Training (PMT), Parent–Child Interaction Therapy (PCIT) and PMT combined with child cognitive behavioral therapy (CBT) using data from 25 RCTs on children with clinical levels of disruptive behavior (age range 2–13 years). Results showed that PMT (g = 0.64 [95% CI 0.42, 0.86]) and PCIT (g = 1.22 [95% CI 0.75, 1.69]) were more effective than waiting-list (WL) in reducing parent-rated disruptive behavior, and PMT also in improving parental skills (g = 0.83 [95% CI 0.67, 0.98]) and child social skills (g = 0.49 [95% CI 0.30, 0.68]). PCIT versus WL had larger effects in reducing disruptive behavior than PMT versus WL. In the few studies found, the addition of child CBT to PMT did not yield larger effects than PMT or WL. These results support offering PMT to children with clinical levels of disruptive behavior and highlight the additional benefits of PCIT for younger ages.
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| 3. |
- Wetterborg, Dan, et al.
(författare)
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Borderline personality disorder: Prevalence and psychiatric comorbidity among male offenders on probation in Sweden
- 2015
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Ingår i: Comprehensive Psychiatry. - : W B SAUNDERS CO-ELSEVIER INC. - 0010-440X .- 1532-8384. ; 62, s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Borderline personality disorder (BPD) is a severely disabling condition, associated with substantially increased risk of deliberate self-harm and, particularly in men, also with interpersonal violence and other criminal behavior. Although BPD might be common among prison inmates, little is known about prevalence and psychiatric comorbidity in probationers and parolees. Method: In 2013, a consecutive sample of 109 newly admitted adult male offenders on probation or parole in all three probation offices of Stockholm, Sweden, completed self-report screening questionnaires for BPD and other psychiatric morbidity. Participants scoring over BPD cut-off participated in a psychiatric diagnostic interview. Results: We ascertained a final DSM-5 BPD prevalence rate of 19.8% (95% CI: 12.3-27.3%). The most common current comorbid disorders among subjects with BPD were antisocial personality disorder (91%), major depressive disorder (82%), substance dependence (73%), attention deficit hyperactivity disorder (ADHD) (70%), and alcohol dependence (64%). Individuals diagnosed with BPD had significantly more current psychiatric comorbidity (M = 6.2 disorders) than interviewed participants not fulfilling BPD criteria (M = 3.6). Participants with BPD also reported substantially more symptoms of ADHD, anxiety and depression compared to all subjects without BPD. Conclusions: BPD affected one fifth of probationers and was related to serious mental ill-health known to affect recidivism risk. The findings suggest further study of possible benefits of improved identification and treatment of BPD in offender populations. (C) 2015 Elsevier Inc. All rights reserved.
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| 4. |
- Wetterborg, Dan, et al.
(författare)
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Dialectical Behavior Therapy for Men With Borderline Personality Disorder and Antisocial Behavior : A Clinical Trial
- 2020
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Ingår i: Journal of Personality Disorders. - : GUILFORD PUBLICATIONS INC. - 0885-579X .- 1943-2763. ; 34:1, s. 22-39
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Tidskriftsartikel (refereegranskat)abstract
- In addition to suicidal behaviors, men with borderline personality disorder (BPD) often display antisocial behavior that could impair contacts with mental health services. While research has established effective treatments for women with BPD, this is not yet the case for men. The authors evaluated 12 months of dialectical behavior therapy (DBT) for 30 men with BPD and antisocial behavior, using a within-group design with repeated measurements. The authors found moderate to strong, statistically significant pre-to posttreatment reductions of several dysfunctional behaviors, including self-harm, verbal and physical aggression, and criminal offending (rate ratios 0.17-0.39). Symptoms of BPD and depression were also substantially decreased. The dropout rate was 30%, and completing participants reported high satisfaction with treatment and maintained their improvements at 1-year follow-up. The authors conclude that DBT could be an effective treatment alternative for men with BPD and antisocial behavior, and it merits future studies with more rigorous design.
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| 5. |
- Wetterborg, Dan
(författare)
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Men with borderline personality disorder and antisocial behavior : clinical characteristics, developmental perspectives and interventions
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Borderline personality disorder (BPD) is a mental disorder characterized by a pervasive pattern of emotional instability, impulsivity, relationship problems and identity disturbance. As the disorder has been considered more prevalent in women, research on men with BPD has lagged behind. In addition to the suicidal and self-harming behaviors traditionally associated with BPD, a substantial proportion of men with this disorder also exhibit antisocial behaviors. Aims: • to estimate the prevalence of BPD in a sample of adult male offenders on probation or parole in Stockholm, and examine comorbidity patterns (Study I). • to explore how men with BPD and antisocial behaviors describe their difficulties and their experiences of the health care system (Study II). • to investige the utility of 12 months treatment with Dialectical behavior therapy (DBT) for men with BPD and antisocial behavior (Study III). • to evaluate a new internet-delivered preventive program for parents of adolescents at risk of developing BPD-traits and/or antisocal behavior (Study IV). Methods: We screened 109 probationers for BPD and conducted diagnostic interviews with those scoring above cut-off (Study I). We interviewed 8 men and analyzed the data using qualitative content analysis (Study II). Thirty men received DBT in a study using within-group design with repeated measurements of various dysfunctional behaviors (Study III). We randomized parents to receive the Parent-Web intervention directly (n= 43) or to a waitlist control (n= 32), and compared the groups on adolescent externalizing behavior, family conflicts and warmth (Study IV). Results: 19.8% of male offenders on probation were estimated to have BPD, and the disorder was associated with severe mental ill health. Male psychiatric patients with BPD and antisocial behavior experienced a distressing sense of alienation and had experienced difficulties accessing mental health resources. After DBT, participants had reduced most of the dysfunctional behaviors assessed. Treatment completers (n= 19) reported high satisfaction with treatment, and maintained their improvements one year after the intervention. The Parent-Web was associated with interrupted deterioration of adolescent externalizing behavior and improvements in conflicts and family warmth. Conclusions: BPD may be 10-times more common in male probationers/parolees than in the general population. Although men with BPD and antisocial behavior may have difficulties utilizing mental health services, preliminary evidence suggest that DBT may be a treatment alternative worth considering. A short internet delivered program may reduce risk factors associated with the development of BPD and antisocial behavior in adolescents.
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