| 11. |
- Buli, Benti Geleta, et al.
(författare)
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Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors
- 2024
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Ingår i: BMC Public Health. - 1471-2458. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Background Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.Methods The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.Results There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).Conclusions The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.
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| 12. |
- Checknita, Dave, et al.
(författare)
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Associations of Age, Sex, Sexual Abuse, and Genotype with Monoamine Oxidase A Gene Methylation
- 2021
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Ingår i: Journal of neural transmission. - : Springer Nature. - 0300-9564 .- 1435-1463. ; 128:11, s. 1721-1739
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Tidskriftsartikel (refereegranskat)abstract
- Epigenome-wide studies report higher methylation among women than men with decreasing levels with age. Little is known about associations of sex and age with methylation of monoamine oxidase A (MAOA). Methylation of the first exonic and partial first intronic region of MAOA has been shown to strengthen associations of interactions of MAOA-uVNTR genotypes and adversity with aggression and substance misuse. Our study examined associations of sex and age with MAOA first exon and intron methylation levels in 252 women and 157 men aged 14–73 years. Participants included adolescents recruited at a substance misuse clinic, their siblings and parents, and healthy women. Women showed ~ 50% higher levels of exonic, and ~ 15% higher intronic, methylation than men. Methylation levels were similar between younger (M = 22.7 years) and older (M = 46.1 years) participants, and stable across age. Age modified few associations of methylation levels with sex. MAOA genotypes modified few associations of methylation with sex and age. Higher methylation levels among women were not explained by genotype, nor interaction of genotype and sexual abuse. Findings were similar after adjusting for lifetime diagnoses of substance dependence (women = 24.3%; men = 34.2%). Methylation levels were higher among women who experienced sexual abuse than women who did not. Results extend on prior studies by showing that women display higher levels of methylation than men within first intronic/exonic regions of MAOA, which did not decrease with age in either sex. Findings were not conditioned by genotype nor interactions of genotype and trauma, and indicate X-chromosome inactivation.
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| 13. |
- Checknita, Dave, et al.
(författare)
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Monoamine oxidase A genotype and methylation moderate the association of maltreatment and aggressive behaviour
- 2020
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Ingår i: Behavioural Brain Research. - : ELSEVIER. - 0166-4328 .- 1872-7549. ; 382
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Tidskriftsartikel (refereegranskat)abstract
- Background: The association between childhood maltreatment and subsequent aggressive behaviour is modified by monoamine oxidase A (MAOA) functional polymorphism (MAOA-uVNTR) genotype, MAOA-Long (MAOA-L) in females, MAOA-Short (MAOA-S) in males. Childhood maltreatment is associated with differential DNA methylation in several genes. Consistent with recent proposals, we hypothesized that the association of the interaction of MAOA genotype and maltreatment with aggressive behaviour is further moderated by methylation of a region of interest (ROI) spanning the first exon and partial first intron of MAOA.Method: The sample included 117 women and 77 men who completed interviews and questionnaires to report maltreatment and aggressive behaviour towards others and provided saliva samples for DNA extraction. The MAOA-uVNTR polymorphism was genotyped, and methylation of the MAOA ROI was assessed.Results: Following adjustment for substance misuse, psychoactive medication use, and in males tobacco use, the highest levels of aggressive behaviour were found among maltreated male carriers of MAOA-S with high levels of exonic methylation.Conclusion: Methylation levels within the MAOA ROI further contributed to the interaction of MAOA risk genotypes and maltreatment on aggressive behaviours among men.
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| 14. |
- Checknita, David, 1983-
(författare)
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The Monoamine Oxidase A Gene and Antisocial Outcomes : An Examination of Genetic, Epigenetic, and Environmental Factors
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background. Antisocial behaviour involves violation of the basic rights of others or social norms or rules. Such behaviours are indexed in diagnoses such as conduct disorder (CD) in adolescence and antisocial personality disorder (ASPD) in adulthood, which are typified by comorbidity with mood, anxiety, and substance misuse disorders. Alcohol misuse is strongly associated with antisocial behaviour and persistent aggressive behaviours. How environmental and biological factors interface to modulate risk for these outcomes is not yet understood, however, the interaction of adversity with a variable number tandem repeat (uVNTR) polymorphism of the monoamine oxidase gene A (MAOA) gene associates with antisocial behaviour and mental disorders. Further, DNA methylation in a region of interest (ROI) spanning MAOA’s first exonic/intronic junction associates with ASPD in men as well as other mood, anxiety, and substance misuse disorders. Aim and Methods. We characterized methylation of the MAOA ROI by sex and age and examined how negative and positive environmental factors interact with MAOA genotype and methylation on antisocial phenotypes and mental disorders. Participants included men and women from a clinical population of young adults recruited in adolescence at a substance misuse clinic and a community sample of adolescents. Findings. (1) Sex but not age was associated with methylation levels such that high methylation levels among women likely represent X-chromosome inactivation, and sexual abuse was associated with hypermethylation of the MAOA first exon, (2) high methylation levels mediated associations between sexual abuse and current depression diagnosis in women, (3) the highest levels of aggressive behaviour were found among maltreat male carriers of the low-expressing MAOA-uVNTR allele and displayed high levels of exonic methylation, while no interactions were shown in women, and (4) among adolescent girls, but not boys, positive parent-child relationship attenuated the interaction of maltreatment and the high-expressing MAOA-uVNTR allele on alcohol consumption, though the interactions were not robust to adjustments for tobacco use, substance misuse, and delinquent behaviours.Conclusion. The findings presented here advance our understanding of how maltreatment interfaces with genotypic and epigenetic factors, in a sex-dependent manner, to promote aggressive behaviour and mental disorders among susceptible individuals.
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| 15. |
- Giannotta, Fabrizia, et al.
(författare)
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Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older?
- 2022
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Ingår i: BMC Psychiatry. - : NLM (Medline). - 1471-244X. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS: One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS: Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS: The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
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| 16. |
- Giannotta, Fabrizia, 1978-, et al.
(författare)
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Frequency of vigorous physical activity and depressive symptoms across adolescence : Disentangling the reciprocal associations between different groups and subtypes of symptoms
- 2023
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Ingår i: Mental Health and Physical Activity. - : Elsevier BV. - 1755-2966 .- 1878-0199. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity has a demonstrated positive effect on youth depressive symptoms. However, very few studies have explored the bi-directionality of the links between physical activity and depression. The present study aims at filling this gap and tests whether any associations are moderated by sex. Moreover, the role of subtype of depressive symptoms, vegetative (i.e., lack of energy, poor sleep) or non-vegetative (i.e., mood-related), is explored. Participants were 910 12-13 year-old Swedish adolescents (56% girls) who answered a three-wave survey at ages 12-13 (T1), 15-16 (T2), and 18-19 (T3). Using a cross-lagged structural model, depression predicted decreased frequency of vigorous physical activity (VPA) from T1 to T2 (& beta; = -0.09, p < .05) and from T2 to T3 (& beta; = -0.10, p < .01), while frequency of VPA at T2 decreased depression at T3 (& beta; = -0.12, p < .05). Associations did not differ between boys and girls. Non-vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (& beta; = -0.10, p < .05), while frequency of VPA at T2 predicted decreased non-vegetative symptoms at T3 (& beta; = -0.15, p < .05). Vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (& beta; = -0.09, p < .05), while have a reciprocal influence with VPA from T2 to T3. Overall, our results highlight an association across adolescence between VPA and depression. The association becomes stronger and reciprocal in middle adolescence, which suggests this period as an effective developmental time to plan physical-activity-based interventions to decrease youth depressive symptoms.
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| 17. |
- Haraldson, Philip, et al.
(författare)
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Botulinum Toxin A as a Treatment for Provoked Vestibulodynia A Randomized Controlled Trial
- 2020
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Ingår i: Obstetrics and Gynecology. - : LIPPINCOTT WILLIAMS & WILKINS. - 0029-7844 .- 1873-233X. ; 136:3, s. 524-532
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate pain reduction after two injections of 50 units botulinum toxin A compared with placebo for provoked vestibulodynia. METHODS: We conducted a double-blinded, placebo-controlled randomized trial of 50 units botulinum toxin A or placebo injected in the bulbocavernosus muscles twice, 3 months apart, in women with provoked vestibulodynia. Primary outcome was self-reported dyspareunia or pain at tampon use on a visual analog scale (VAS, 0-100). Secondary outcomes were pain at weekly tampon insertion (VAS score), reduction of pelvic floor hypertonicity (measured with a vaginal manometer), adverse events, and sexual function and distress. A sample size of 38 participants for each group was calculated to achieve a statistical power of 80% based on an effect size of 20 VAS units (0-100) (mean score range 56-76 +/- 31 SD). RESULTS: Between May 2016 and June 2018, 124 women with provoked vestibulodynia were assessed, and 88 were randomized to botulinum toxin A (BTA group, n=44) or placebo (placebo group, n=44). Primary outcome showed a lower but statistically nonsignificant pain rating by 7 VAS units (95% CI -15.0 to 0.4) in the BTA group compared with the placebo group. Secondary results showed a significant decrease in pain at weekly tampon insertion by 11 VAS units (95% CI -16.6 to 6.0) with botulinum toxin A injection. The vaginal manometer measured lower maximum contraction strength by 7 mm Hg (95% CI -12.7 to -2.4) and lower 10-second endurance strength by 4 mm Hg (95% CI -7.72 to -1.16) in the BTA group compared with the placebo group. No changes were observed for sexual function and distress, but there was a significant increase in women attempting vaginal intercourse in the BTA group (0.27, 95% CI 0.06-0.48). No severe adverse events were reported. CONCLUSION: Twice-repeated injections of 50 units of botulinum toxin A in women with provoked vestibulodynia did not reduce dyspareunia or pain at tampon use, but secondary outcomes suggested positive effects of the treatment.
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| 18. |
- Haraldson, Philip, et al.
(författare)
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Botulinum Toxin A for Provoked Vestibulodynia : 12 Months’ Follow-up of a Randomized Controlled Trial
- 2022
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Ingår i: Journal of Sexual Medicine. - : Elsevier B.V.. - 1743-6095 .- 1743-6109. ; 19:11, s. 1670-1679
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Tidskriftsartikel (refereegranskat)abstract
- Background: Provoked vestibulodynia (PVD) is a common pain disorder afflicting primarily young women, and botulinum toxin A (BTA) has been to a limited extent tested as a treatment. Aim: Evaluate outcome 12 months after injection with BTA as a treatment for PVD. Methods: We conducted a double-blinded, placebo-controlled trial of twice repeated injections of 50 units of BTA or placebo in the bulbocavernosus muscles, 3 months apart, in women with PVD. Treatment outcome after six months’, failed to show any significant difference in pain reduction between the groups, as previously reported. Here, we report treatment outcomes 12 months after the first injections. In addition to injections, participants where instructed to perform pelvic floor exercises during month 6-12. 38 participants/group was calculated to achieve a statistical power of 80% based on an effect size of 20 VAS units (mean score range 56-76±31 SD). Outcomes: Primary outcome was self-reported dyspareunia or pain at tampon use, using a visual analogue scale (VAS) 0-100. Secondary outcomes were vaginal pressure measurements, psychological health, sexual function and distress. Results: From the initial 88 randomized women with PVD, 75 remained at 12 months; 38 in the BTA and 37 in the placebo group. There was no significant difference in primary outcome between the groups. Vaginal pressure in the BTA group had been restored to pre-treatment levels, with no differences between the groups at 12 months. There was an increase in sexual function in the BTA group, with a Female Sexual Function Index of 22.8 (±4.8) compared to the placebo group to 19.7 (±5.0), P=.048. No differences were observed in sexual distress, stress and anxiety. There was an increase in number of women attempting intercourse in the BTA group (74%) compared with placebo (43%), P=.005. Too few patients performed the pelvic floor exercises for this intervention to be analyzed. Clinical Implications: This study highlights BTA as a safe treatment option for patients with PVD. Strengths and limitations: The randomized, double-blinded design and repeated treatments are the major strengths of this study and it is the first study to objectively evaluate muscular effect after BTA injections. The major shortcoming is that few participants performed the pelvic floor exercises, preventing analyses. Conclusion: At 12 months’ follow up, no significant difference in reduction of dyspareunia or pain at tampon use was observed. Women receiving BTA attempted intercourse more often and improved their sexual function compared with women receiving placebo. Haraldson P, Mühlrad H, Heddini U, et al. Botulinum Toxin A for Provoked Vestibulodynia: 12 Months’ Follow-up of a Randomized Controlled Trial. J Sex Med 2022;19:1670–1679.
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| 19. |
- Hjalmarsson, Anna, 1976-, et al.
(författare)
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Characteristic patterns of emergency ambulance assignments for older adults compared with adults requiring emergency care at home in Sweden : a total population study
- 2020
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Ingår i: BMC Emergency Medicine. - : BioMed Central. - 1471-227X .- 1471-227X. ; 20, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18– 69 years requiring emergency care at home in Sweden.Methods: A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns.Results: Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00– 11:59 interval (p < 0.001, χ2 = 1224.08).Conclusion: The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice.
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| 20. |
- Hultman, Cathrine, et al.
(författare)
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Autonomic responses during Gambling : the Effect of Outcome Type and Sex in a large community sample of young adults
- 2023
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Ingår i: Journal of Gambling Studies. - : Springer Nature. - 1050-5350 .- 1573-3602. ; 39:1, s. 159-182
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Tidskriftsartikel (refereegranskat)abstract
- Psychological theories consider autonomic arousal to be a reinforcer for problem gambling. Structural characteristics such as near-misses, which are non-win events that come close to a real win, have been shown to elicit win-like responses while increasing motivation and gambling persistence. This study investigated the autonomic and subjective responses of young adults to different gambling outcomes. This study also investigated sex differences in autonomic and subjective responses to different gambling outcomes. Participants from Sweden (n = 270) performed a computerized slot machine task that produced wins, near-misses (before and after payline) and full-misses. Phasic measurements of heart rate (HR) and skin conductance responses (SCR) were recorded during gambling performance and ratings of perceived chance of winning, pleasure and motivation to play were collected following each gambling outcome. Autonomic responses differed across slot machine outcomes as indicated by HR and SCR. Compared with other gambling outcomes, near-misses elicited the largest HR accelerations, and they also elicited larger HR decelerations and SCRs relative to full-misses. Near-misses before and after payline elicited differential psychophysiological responses and subjective reports, suggesting different emotional processing of near-miss subtypes. Females showed increased SCRs and motivation following win outcomes compared with males. In conclusion, wins, near-misses and full-misses generate differential physiological and subjective responses among young adults. Autonomic responses to wins differed between male and female players, emphasizing the need to consider sex differences when investigating the role of autonomic arousal in gambling.
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