| 1. |
- Anckarsäter, Henrik, et al.
(författare)
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The sociocommunicative deficit subgroup in anorexia nervosa: autism spectrum disorders and neurocognition in a community-based, longitudinal study
- 2012
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Ingår i: Psychological Medicine. - 1469-8978 .- 0033-2917. ; 42:9, s. 1957-1967
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A subgroup of persons with anorexia nervosa (AN) have been proposed to have sociocommunicative problems corresponding to autism spectrum disorders [ASDs, i.e. DSM-IV pervasive developmental disorders (PDDs): autistic disorder, Asperger's disorder, PDD not otherwise specified (NOS)]. Here, clinical problems, personality traits, cognitive test results and outcome are compared across 16 subjects (32%) with teenage-onset AN who meet or have met ASD criteria (AN+ASD), 34 ASD-negative AN subjects and matched controls from a longitudinal Swedish study including four waves of independent assessments from the teens to the early thirties.MethodThe fourth wave included the Structured Clinical Interview for DSM-IV (SCID)-I and the SCID-II (cluster C, i.e. 'anxious' PDs) interviews, the Asperger Syndrome Diagnostic Interview, self-assessments by the Autism Spectrum Quotient and the Temperament and Character Inventory, neurocognitive tests by subscales from the Wechsler scales, continuous performance tests, Tower of London, and Happé's cartoons. RESULTS: The ASD assessments had substantial inter-rater reliability over time (Cohen's κ between 0.70 and 0.80 with previous assessments), even if only six subjects had been assigned a diagnosis of an ASD in all four waves of the study, including retrospective assessments of pre-AN neurodevelopmental problems. The AN+ASD group had the highest prevalence of personality disorders and the lowest Morgan-Russell scores. The non-ASD AN group also differed significantly from controls on personality traits related to poor interpersonal functioning and on neurocognitive tests. CONCLUSIONS: A subgroup of subjects with AN meet criteria for ASDs. They may represent the extreme of neurocognitive and personality problems to be found more generally in AN.
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| 2. |
- Andreasson, Helena, et al.
(författare)
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Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence
- 2014
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 37:6, s. 635-642
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Tidskriftsartikel (refereegranskat)abstract
- This study describes the prevalence of adverse events and length of stay in forensic psychiatric patients with and without a restriction order. Detailed clinical and administrative information from medical records and written court decisions was gathered retrospectively from admission until discharge for a Swedish population-based, consecutive cohort of forensic psychiatric patients (n = 125). The median length of stay for the whole cohort was 951 days, but patients with a restriction order stayed in hospital almost five times as long as patients without. Restriction orders were related to convictions for violent crime, but not for any other differences in demographic or clinical variables. The majority of the patients (60%) were involved in adverse events (violence, threats, substance abuse, or absconding) at some time during their treatment. Patients with restriction orders were overrepresented in violent and threat events. Previous contact with child and adolescence psychiatric services, current violent index crime, psychotic disorders, a history of substance, and absconding during treatment predicted longer length of stay. Being a parent, high current Global Assessment of Functioning scores, and mood disorders were all significantly related to earlier discharge. In a stepwise Cox regression analysis current violent index crime and absconding remained risk factors for a longer hospital stay, while a diagnosis of mood disorder was significantly related to a shorter length of stay.
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| 3. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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The Brief Obsessive-Compulsive Scale (BOCS) : a self-report scale for OCD and obsessive-compulsive related disorders
- 2014
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Ingår i: Nordic Journal of Psychiatry. - : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 68:8, s. 549-559
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive-compulsive symptoms and diagnosis of obsessive-compulsive disorder (OCD). It is widely used throughout child, adolescent and adult psychiatry settings in Sweden but has not been validated up to date.Aim: The aim of the current study was to examine the psychometric properties of the BOCS amongst a psychiatric outpatient population.Method: The BOCS consists of a 15-item Symptom Checklist including three items (hoarding, dysmorphophobia and self-harm) related to the DSM-5 category "Obsessive-compulsive related disorders", accompanied by a single six-item Severity Scale for obsessions and compulsions combined. It encompasses the revisions made in the Y-BOCS-II severity scale by including obsessive-compulsive free intervals, extent of avoidance and excluding the resistance item. 402 adult psychiatric outpatients with OCD, attention-deficit/hyperactivity disorder, autism spectrum disorder and other psychiatric disorders completed the BOCS.Results: Principal component factor analysis produced five subscales titled "Symmetry", "Forbidden thoughts", "Contamination", "Magical thoughts" and "Dysmorphic thoughts". The OCD group scored higher than the other diagnostic groups in all subscales (P < 0.001). Sensitivities, specificities and internal consistency for both the Symptom Checklist and the Severity Scale emerged high (Symptom Checklist: sensitivity = 85%, specificities = 62-70% Cronbach's alpha = 0.81; Severity Scale: sensitivity = 72%, specificities = 75-84%, Cronbach's alpha = 0.94).Conclusions: The BOCS has the ability to discriminate OCD from other non-OCD related psychiatric disorders. The current study provides strong support for the utility of the BOCS in the assessment of obsessive-compulsive symptoms in clinical psychiatry.
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| 4. |
- Degl'Innocenti, Alessio, 1961, et al.
(författare)
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First report from the Swedish National Forensic Psychiatric Register (SNFPR)
- 2014
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 37:3, s. 231-237
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Tidskriftsartikel (refereegranskat)abstract
- To the best of our knowledge, the present register is the only nationwide forensic psychiatric patient register in the world. The aim of this article is to describe the content of the Swedish National Forensic Psychiatric Register (SNFPR) for Swedish forensic patients for the year 2010. The subjects are individuals who, in connection with prosecution due to criminal acts, have been sentenced to compulsory forensic psychiatric treatment in Sweden. The results show that in 2010, 1476 Swedish forensic patients were assessed in the SNFPR; 1251 (85%) were males and 225 (15%) were females. Almost 60% of the patients had a diagnosis of schizophrenia, with a significantly higher frequency among males than females. As many as 70% of the patients had a previous history of outpatient psychiatric treatment before becoming a forensic psychiatric patient, with a mean age at first contact with psychiatric care of about 20 years old for both sexes. More than 63% of the patients had a history of addiction, with a higher proportion of males than females. Furthermore, as many as 38% of all patients committed crimes while under the influence of alcohol and/or illicit drugs. This was more often the case for men than for women. Both male and female patients were primarily sentenced for crimes related to life and death (e.g., murder, assault). However, there were more females than males in treatment for general dangerous crimes (e.g., arson), whereas men were more often prosecuted for crimes related to sex. In 2010, as many as 70% of all forensic patients in Sweden had a prior sentence for a criminal act, and males were prosecuted significantly more often than females. The most commonly prescribed pharmaceuticals for both genders were antipsychotics, although more women than men were prescribed other pharmaceuticals, such as antidepressants, antiepileptics, and anxiolytics. The result from the present study might give clinicians an opportunity to reflect upon and challenge their traditional treatment methods. (C) 2013 Elsevier Ltd. All rights reserved.
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| 5. |
- Hofvander, Björn, et al.
(författare)
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Life History of Aggression scores are predicted by childhood hyperactivity, conduct disorder, adult substance abuse, and low cooperativeness in adult psychiatric patients.
- 2011
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123. ; 185:1-2, s. 280-285
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Tidskriftsartikel (refereegranskat)abstract
- The prevention of aggressive behaviours is a core priority for psychiatric clinical work, but the association between the diagnostic concepts used in psychiatry and aggression remains largely unknown. Outpatients referred for psychiatric evaluations of childhood-onset neuropsychiatric disorders (n = 178) and perpetrators of violent crimes referred to pre-trial forensic psychiatric investigations (n = 92) had comprehensive, instrument-based, psychiatric assessments, including the Life History of Aggression (LHA) scales. Total and subscale LHA scores were compared to the categorical and dimensional diagnoses of childhood and adult DSM-IV axis I and II mental disorders, general intelligence (IQ), Global Assessment of Functioning (GAF), and personality traits according to the Temperament and Character Inventory (TCI). Overall, the two groups had similar LHA scores, but the offender group scored higher on the Antisocial subscale. Higher total LHA scores were independently associated with the hyperactivity facet of attention-deficit/hyperactivity disorder (AD/HD), childhood conduct disorder, substance-related disorders, and low scores on the Cooperativeness character dimension according to the TCI. IQ and GAF-scores were negatively correlated with the LHA subscale Self-directed aggression. Autistic traits were inversely correlated with aggression among outpatients, while the opposite pattern was noted in the forensic group. The findings call for assessments of aggression-related behaviours in all psychiatric settings.
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| 6. |
- Johnsson, Malte, et al.
(författare)
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Blame attribution and guilt feelings in violent offenders
- 2014
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Ingår i: Journal of Forensic Psychiatry & Psychology. - : Informa UK Limited. - 1478-9957 .- 1478-9949. ; 25:2, s. 212-223
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Tidskriftsartikel (refereegranskat)abstract
- Offenders with high psychopathic traits and/or antisocial personality disorder (ASPD) are hypothesised to experience less guilt and less responsibility for their actions than offenders without these problems. These hypotheses were tested and partly substantiated. The study investigates blame attributions and guilt feeling using Gudjonsson Blame Attribution Inventory-Revised (GBAI-R) for 177 young male violent offenders. GBAI scores were compared to ASPD and psychopathy according to the Psychopathy Checklist-Revised. Results showed that individuals with ASPD and those with higher degrees of psychopathy tended to report significantly less guilt and higher degree of mental control than other subjects. Another finding was a weak relationship between ASPD, high scores on psychopathic traits and external attribution. We suggest these results might be explained by admitting poor mental control may be extra difficult for individuals belonging to either of these groups and that the external attribution items do not separate causal from moral responsibility.
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| 7. |
- Lund, Christina, et al.
(författare)
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Violent criminal recidivism in mentally disordered offenders: A follow-up study of 13-20 years through different sanctions
- 2013
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 36:3-4, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe criminal recidivism, especially violent recidivism, in a long-term follow-up of mentally disordered offenders sentenced to different types of sanctions. Subjects and methods: A population-based Swedish cohort of male offenders referred to pre-trial psychiatric investigations between 1988 and 1995, was sentenced to forensic psychiatric treatment (n = 163), prison (n = 120), or noncustodial sanctions (n = 52). They were followed from the beginning of their sanctions until the end of June, 2008, through official health and crime registers. Survival analyses were used to compare time until violent recidivism across different sanctions and mental disorders, and predictors of violent recidivism were investigated using univariate comparisons, a multivariate Cox regression analysis and Receiver Operating Characteristic (ROC) curves. Finally, all criminal reconvictions until the end of follow-up were assessed (a total time period of 13 to 20 years). Results: Forty-seven percent of all subjects were reconvicted for violent crimes during follow-up. There were no significant differences between sanction groups. By contrast, diagnostic groups that included substance abuse had significant effects, and stood out as the strongest predictor of violent reconvictions together with the number of previous violent crimes, and age at the first registered criminal offence. Variables identified in the multivariate model together predicted violent recidivism with an area under the ROC curve of 0.72, while the corresponding figure for the age at onset of criminality as the sole predictor was 0.71. Among the different sanction forms for different time periods, time in hospital and prison were significantly less associated with violent recidivism compared to time in conditional release/probation.
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| 8. |
- Wallinius, Märta, 1981, et al.
(författare)
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Facets of psychopathy among mentally disordered offenders: Clinical comorbidity patterns and prediction of violent and criminal behavior
- 2012
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123. ; 198:2, s. 279-284
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Tidskriftsartikel (refereegranskat)abstract
- The complexity and consequences of psychopathy are still debated, and its relation to other mental disorders, pathological personality traits, and criminality needs to be further investigated by clinical, longitudinal studies using structured diagnostic instruments. The present study used two groups of mentally disordered offenders (N=153) investigated with in-depth clinical assessments and prospective long-term follow-up to identify the convergence between 1) the four facets of psychopathy defined by the Psychopathy Checklist-Revised (PCL-R; Interpersonal, Affective, Lifestyle, and Antisocial), 2) mental disorders according to SOD I and II interviews. 3) personality traits as measured by the Karolinska Scales of Personality, and 4) criminal recidivism. The Interpersonal facet differed substantially from the other three facets by not being significantly associated with substance use disorders, antisocial personality disorder (the other facets at P <= 0.001 level), or personality traits involving impulsive and aggressive antisocial behaviors (the other facets at P<0.01 level). Furthermore, the interpersonal facet could not predict violent recidivism better than random. The Antisocial facet outperformed not only the other facets but also the total PCL-R score in the prediction of violent recidivism, P<0.001. The findings confirm psychopathy as a heterogeneous phenomenon and have clinical implications for assessments of psychopathy and violence risk assessments in clinical and forensic contexts. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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