| 1. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Hyperacusi - ett outforskat område. Kognitiv beteendeterapi kan lindra besvären vid ljudöverkänslighet, ett tillstånd med många frågetecken
- 2005
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 44, s. 3210-3212
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Tidskriftsartikel (refereegranskat)abstract
- Hyperacusis innebär extrem känslighet för vardagens ljud är ett problem som drabbar cirka 8% av befolkningen. I svåra fall uppstår undvikande av många situationer samt en vana att skydda öronen med hörselskydd även i situationer där det inte behövs. Orsakerna till hyperacusis är till viss del kända, men många frågetecken kvarstår. För hyperacusis finns ingen dokumenterat botande behandling, men kognitiv beteendeterapi, samt eventuellt även tinnitus retraining therapy med brusgenerator, kan minska besvären,. Gott omhändertagande och en multidisciplinär utredning är att rekommendera i svåra fall. En av de viktigaste uppgifterna för framtida forskning är att kartlägga naturalförloppet vad gäller hyperacusis, då detta är i stort okänt. Det finns även ett stort behov av kontrollerade behandlingsstudier.
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| 2. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Internet-based self-help for depression : randomised controlled trial
- 2005
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 187, s. 456-461
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Major depression can be treated by means of cognitive-behavioural therapy, but as skilled therapists are in short supply there is a need for self-help approaches. Many individuals with depression use the internet for discussion of symptoms and to share their experience.AIMS:To investigate the effects of an internet-administered self-help programme including participation in a monitored, web-based discussion group, compared with participation in web-based discussion group only.METHOD:A randomised controlled trial was conducted to compare the effects of internet-based cognitive-behavioural therapy with minimal therapist contact (plus participation in a discussion group) with the effects of participation in a discussion group only.RESULTS:Internet-based therapy with minimal therapist contact, combined with activity in a discussion group, resulted in greater reductions of depressive symptoms compared with activity in a discussion group only (waiting-list control group). At 6 months' follow-up, improvement was maintained to a large extent.CONCLUSIONS:Internet-delivered cognitive cognitive-behavioural therapy should be pursued further as a complement or treatment alternative for mild-to-moderate depression.
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| 3. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Internet-based self-help with therapist feedback and in vivo group exposure for social phobia : A randomized controlled trial
- 2006
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Ingår i: Journal of Consulting and Clinical Psychology. - 0022-006X .- 1939-2117. ; 74:4, s. 677-686
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Tidskriftsartikel (refereegranskat)abstract
- Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail. Results were analyzed on an intention-to-treat basis, including all randomized participants. From pre- to posttest, treated participants in contrast to controls showed significant improvement on most measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). The overall within- and between-groups effect sizes were Cohen's d = 0.87 and 0.70, respectively. Treatment gains were maintained at 1-year follow-up. The results from this study support the continued use and development of Internet-distributed, self-help programs for people diagnosed with social phobia.
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| 4. |
- Borgström, Anna, et al.
(författare)
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Adverse mood effects of combined oral contraceptives in relation to personality traits
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 141:2, s. 127-130
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Mood symptoms, such as depressed mood, anxiety and increased irritability, remain one of the major reasons for discontinuation of combined oral contraceptive (COC) pills. The aim of this study was to compare personality traits in women with ongoing or previous use of COCs and different experiences from these compounds with respect to adverse mood symptoms. STUDY DESIGN: Thirty women currently on COCs with no reports of adverse mood symptoms, 28 women currently on COCs and experiencing mood-related side effects, 27 women who had discontinued COC use for reasons other than adverse mood symptoms and 33 women who had discontinued COC use due to adverse mood effects were included. All participants were asked to fill out the Swedish universities Scales of Personality (SSP) to assess different personality traits. RESULTS: The women who were experiencing mood-related side effects on their current COC use exhibited higher scores on the somatic anxiety and stress susceptibility traits as compared to the women who did not experience any mood-related side effects from their current COCs. Women who had discontinued COC treatment because of adverse mood effects had higher scores of detachment and mistrust compared to women who had discontinued COC for reasons unrelated to mood effects. CONCLUSION: Higher scores on specific personality traits such as somatic anxiety and stress susceptibility are found in women with ongoing experience of adverse mood symptoms from COC. Higher scores of mistrust and detachment are more common among women who have discontinued COC treatment due to adverse mood effects.
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| 5. |
- Carlbring, Per, 1972-, et al.
(författare)
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An open study of Internet-based bibliotherapy with minimal therapist contact via e-mail for social phobia
- 2006
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Ingår i: Clinical Psychologist. - 1328-4207 .- 1742-9552. ; 10, s. 30-38
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated a nine-week Internet-based self-help program for people suffering from social phobia. After confirming the diagnosis with a structured clinical interview for the DSM-IV (SCID) by telephone, 26 participants were treated with a multimodal treatment package based on cognitive behavioral therapy plus weekly therapist contact via e-mail. Results were analyzed on a basis of intention-to-treat. There were no differences between the two pre-treatment assessment points. However, from pre- to post-test, treated participants improved signi?cantly on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). The overall within-group effect size measured with Cohen-s d was d=0.88. Treatment gains were maintained or improved at the 6-month follow-up (Cohen-s d=1.31). The results of this study support the continued use and development of Internet-distributed self-help programs for people diagnosed with social phobia.
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| 6. |
- Carlbring, Per, 1972-, et al.
(författare)
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Internet treatment for social phobia
- 2005
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Ingår i: 5th international congress of cognitive psychotherapy,2005. ; , s. 56-
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Konferensbidrag (refereegranskat)
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| 7. |
- Carlbring, Per, 1972-, et al.
(författare)
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Remote treatment of panic disorder : A randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls
- 2006
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Ingår i: American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 163:12, s. 2119-2125
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study evaluated a 10-week Internet-based bibliotherapy self-help program with short weekly telephone calls for people suffering from panic disorder with or without agoraphobia. Method: After the authors confirmed the diagnosis by administering the Structured Clinical Interview for DSM-IV by telephone, 60 participants were randomly assigned to either a wait-listed control group or a multimodal treatment package based on cognitive behavior therapy plus minimal therapist contact via e-mail. A 10-minute telephone call was made each week to support each participant. Total mean time spent on each participant during the 10 weeks was 3.9 hours. The participants were required to send in homework assignments before receiving the next treatment module. Results: Analyses were conducted on an intention-to-treat basis, which included all randomly assigned participants. From pretreatment to posttreatment, all treated participants improved significantly on all measured dimensions (bodily interpretations, maladaptive cognitions, avoidance, general anxiety and depression levels, and quality of life). Treatment gains on self-report measures were maintained at the 9-month follow-up. A blind telephone interview after the end of treatment revealed that 77% of the treated patients no longer fulfilled the criteria for panic disorder, whereas all of the wait-listed subjects still suffered from it. Conclusions: This study provides evidence to support the use of treatment distributed via the Internet with the addition of short weekly telephone calls to treat panic disorder. Replication should be made to compare self-help and telephone treatment based on cognitive behavior methods with nonspecific interventions.
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| 8. |
- Carlbring, Per, 1972-, et al.
(författare)
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Treatment of Panic Disorder : Live Therapy vs. Self-Help via Internet
- 2005
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 43:10, s. 1321-1333
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Tidskriftsartikel (refereegranskat)abstract
- A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.
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| 9. |
- Carlbring, Per, et al.
(författare)
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Treatment of social phobia : Randomised trial of internet-delivered cognitive-behavioural therapy with telephone support
- 2007
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 190, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although effective therapies for social phobia exist, many individuals refrain from seeking treatment owing to the embarrassment associated with help-seeking. Internet-based cognitive-behavioural self-help can be an alternative, but adherence is a problem. Aims: To evaluate a 9-week programme of internet-based therapy designed to increase treatment adherence by the addition of short weekly telephone calls, nine in all, with a total duration of 95 min. Method: In a randomised controlled trial the effects of internet-based cognitive-behavioural therapy in the treatment group (n=29) were compared with a waiting-list control group (n=28). Results: Compared with the control group the treated participants experienced greater reductions on measures of general and social anxiety, avoidance and depression. Adherence to treatment was high, with 93% finishing the complete treatment package. One year later all improvements were maintained. Conclusions: This study provides evidence to support the use of internet-based treatment supplemented by short, weekly telephone calls.
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| 10. |
- Dyster-Aas, Johan, et al.
(författare)
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Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity
- 2008
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Ingår i: Journal of Trauma - Injury, Infection and Critical Care. - 0022-5282. ; 64:5, s. 1349-1356
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Psychiatric history has been suggested to have an impact on long-term adjustment in burn survivors. A rigorous, prospective, longitudinal approach was used to study psychiatric history in a population-based burn sample and its impact on symptomatology of depression and posttraumatic stress disorder (PTSD) at a 12-month follow-up. METHODS: Seventy-three consecutive patients admitted to the Uppsala Burn Unit were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for psychiatric disorders, of whom 64 were also assessed after 12 months. RESULTS: Forty-eight patients (66%) presented with at least one lifetime psychiatric diagnosis; major depression (41%), alcohol abuse or dependence (32%), simple phobia (16%), and panic disorder (16%) were most prevalent. At 12-months postburn, 10 patients (16%) met criteria for major depression, 6 (9%) for PTSD, and 11 (17%) for subsyndromal PTSD. Patients with lifetime anxiety disorder and with lifetime psychiatric comorbidity were more likely to be depressed at 12 months, whereas those with lifetime affective disorder, substance use disorder and psychiatric comorbidity were more likely to have symptoms of PTSD. CONCLUSIONS: Two-thirds of burn survivors exhibit a history of lifetime psychiatric disorders. Those with a psychiatric history have a higher risk of postburn psychiatric problems.
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| 11. |
- Dyster-Aas, Johan, 1958-
(författare)
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Psychiatric History and Adaptation in Burn Injured Patients
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The intertwined relationship between physical and psychological problems is a topic of much interest in the rehabilitation of severely injured patients, e.g. after a burn. The present study aims at gaining further knowledge concerning the impact of psychological factors and psychiatric morbidity on short and long-term adaptation after burn injury. Outcome was assessed for three main areas: pruritus, return to work and psychiatric health. Three separate samples of previous or current adult patients treated at the Uppsala Burn Unit during different time periods: 1980-1995 (n=248), 1996-2000 (n=86), and 2000-2005 (n=73), were assessed. Chronic burn-related pruritus is more common than previously reported and psychological factors such as anxiety-related personality traits and coping are significantly associated with its presence. Only a small group of former patients with work-related accidents were not working an average of nine years after injury. The unemployed reported more pain and worse perceived health, particularly in psychosocial domains. Returning to work was explained by both injury severity and personality characteristics. Those who were not working had lower health-related quality of life and poorer traumarelated physical and psychological health, and more pain. Preburn psychiatric morbidity is high in a lifetime perspective. Two thirds of the sample had at least one disorder according to the Structured Clinical Interview for DSM-IV Axis I disorders. Affective disorders were especially highly represented. A logistic regression showed that having a history of preburn disorders was associated with a higher risk of both PTSD and depression one year after the injury. In this material it was actually uncommon for a patient without a preburn psychiatric history to develop postburn psychiatric symptomatology. The results have strengthened the overall model for adaptation after burn injury by showing that psychological factors and psychiatric history are important moderators of the adaptation process after the injury.
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| 12. |
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| 13. |
- Furmark, Tomas, et al.
(författare)
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Guided and unguided self-help for social anxiety disorder : randomised controlled trial
- 2009
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 195:5, s. 440-447
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Tidskriftsartikel (refereegranskat)abstract
- Background Internet-delivered self-help programmes with added guidance have shown efficacy in social anxiety disorder, unguided self-help has been insufficiently studied. Aims To evaluate the efficacy of guided and unguided self-help social anxiety disorder. Method Participants followed a cognitive-behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n=235) were randomised to one of three conditions in the first trial, or one of four conditions in the second. Results Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later. Conclusions Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.
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| 14. |
- Hedlund, Mathilde, 1968-
(författare)
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Coping, Psychiatric Morbidity and Perceived Care in Patients with Aneurysmal Subarachnoid Haemorrhage
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many patients with an aneurysmal subarachnoid haemorrhage (SAH) exhibit difficulties in rehabilitation, even in cases of a good prognosis. The present project investigates this using qualitative methods and standardised outcome measures. Patients with SAH treated at Uppsala University Hospital between 2002 and 2005 with an expected good prognosis were consecutively included. In addition, nurses working with such patients were interviewed. Outcome was assessed in terms of perception of care, psychiatric health, coping and health related quality of life (HRQoL). Qualitative content analyses revealed eight categories, which were divided into two patterns, Confident or Pessimistic perception of recovery, largely on the basis of the presence or absence of depression. Eighty-three patients were assessed by The Structured Clinical Interview for DSM-IV, Axis I (SCID-I). Forty-one percent fulfilled criteria for any psychiatric disorder seven months after SAH and 45 % presented with a history of lifetime psychiatric morbidity. Logistic regressions indicated that a psychiatric history was related to a higher risk of psychiatric problems seven months after SAH, as well as a lower return to work. SAH patients had lower HRQoL than the general Swedish population; almost entirely in the subgroup with a psychiatric history prior to the SAH. Those with a psychiatric history used more evasive, fatalistic, emotive and palliative coping strategies associated with inability to handle illness. Multiple regressions revealed that a psychiatric history and use of coping were independently associated with HRQoL, albeit more in the mental than the physical domains. Qualitative content analyses revealed that nurses viewed patients’ support needs as a process ranging from technological to emotional care. Shortcomings in the communication between nurses in acute and rehabilitation settings on the subject of support were acknowledged. The results underline the importance of early diagnosis of coexisting psychiatric illness and the need for an intact health care chain.
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| 15. |
- Hedlund, Mathilde, et al.
(författare)
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Diagnostic agreement between a doctor and a nurse for psychiatric disorders: A pilot study
- 2005
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Ingår i: Nord J Psychiatry. - : Informa UK Limited. ; 59, s. 339-342
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Tidskriftsartikel (refereegranskat)abstract
- The aim with the present paper is to illustrate the use of multivariate strategies (i.e. integration of different multivariate methods) with five examples, four from the pharmaceutical industry and one from environmental research.In the first part, two examples wherein hierarchical models are applied to quality control (QC) and process control are discussed. In the second part a more complex problem and a strategy for material discovery/development are presented wherein a combination of multivariate calibration, multivariate analysis and multivariate design is needed. In the third part, a process analytical/optimization problem is illustrated with a two-step process, demanding that different multivariate tools are combined in a sequential way so that a useful model can be established and the process can be understood. In the final part the usefulness of principal component analysis followed by soft independent modelling of class analogy is illustrated with an example from environmental process monitoring. The five examples from quite different areas show that the chemometric tools are even more powerful if used integrated. However, different strategies and combinations of the tools have to be applied, depending on the problem and the aim.
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| 16. |
- Hedlund, Mathilde, et al.
(författare)
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From monitoring physiological functions to using psychological strategies : Nurses' view of caring for the aneurysmal subarachnoid haemorrhage patient
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:3, s. 403-411
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The aims of this study were: (1) to describe nurses' views of the physical and supportive needs of patients who have suffered a subarachnoid haemorrhage (SAH), (2) to describe nurses' views of changes in social circumstances and (3) changes in the mental condition of patients after SAH. BACKGROUND: As patients with SAH are generally younger and predominantly female compared with other stroke groups they may have different needs of nursing support to facilitate adaptation. Caring for persons surviving stroke involves advanced nursing skills such as monitoring neurological functions in neurointensive care and providing physical care during rehabilitation. DESIGN: Explorative descriptive design. METHOD: Semi-structured interviews were performed with 18 nurses in neurointensive and rehabilitation care. A qualitative latent content analysis was conducted. RESULTS: Nurses viewed patients' need for support as a process ranging from highly advanced technological care to 'softer' more emotional care. However, shortages in the communication between neurointesive and rehabilitation nurses regarding this support were acknowledged. Changes in social circumstances and mental conditions were viewed both as obstacles and advantages regarding return to everyday life. Nurses also viewed that the characteristics of the group with SAH was not particularly different from the group with other types of stroke. CONCLUSIONS: Support to patients with SAH is viewed as a process carried out by nurses at neurointensive care units and rehabilitation units. Shortages in communication, regarding this support, were acknowledged. Obstacles and advantages with respect to returning to everyday life could apply to any stroke group, which could make it more difficult for nurses to detect the specific needs of patients with SAH. RELEVANCE TO CLINICAL PRACTICE: The communication between neurointensive nurses and rehabilitation nurses regarding support to patients with SAH is not satisfactory. Occasionally the specific needs of patients with SAH are not recognized.
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| 17. |
- Herlofson, Jörgen, et al.
(författare)
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Inledning
- 2009
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Ingår i: Psykiatri. - Lund : Studentlitteratur. - 9789144040264 ; , s. 27-29
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
- Herlofson, Jörgen, et al.
(författare)
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Personlighetsstörningar
- 2009
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Ingår i: Psykiatri. - Lund : Studentlitteratur. - 9789144040264
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 19. |
- Kildal, Morten, et al.
(författare)
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Coping strategies, injury characteristics and long term outcome after burn injury
- 2005
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Ingår i: Injury. - : Elsevier BV. - 0020-1383 .- 1879-0267. ; 36:4, s. 511-518
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Tidskriftsartikel (refereegranskat)abstract
- Coping consists of cognitive and behavioural strategies aimed at enhancing adaptation, and the use of certain coping strategies is proposed to be beneficial for health. The relationship between coping strategies and burn injury characteristics, sociodemographics and long-term outcome was evaluated in 161 previous victims of severe burn injury. Functional and psychosocial restrictions were measured with the burn specific health scale-brief (BSHS-B) and related to coping strategies measured by the coping with burns questionnaire (CBQ). Patients were on average 47.7 years at measurement of health status and they were assessed 9.2 (S.D. = 4.8) years after injury. The mean area burned was 24.0 and 7.2% was full thickness injury.There was no relation between coping strategies and injury characteristics except in individuals with a full thickness burn exceeding 10%, who exhibited more Revaluation/adjustment. An Avoidant coping strategy was related to work status, marital status and living conditions, and this was the strategy most clearly related to--Bad outcome-- in all scales of the BSHS-B. Emotional support was the most beneficial strategy and was mainly associated with the psychosocial scales of the BSHS-B.
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| 20. |
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| 21. |
- Low, Aili Janina, et al.
(författare)
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The presence of nightmares as a screening tool for symptoms of posttraumatic stress disorder in burn survivors
- 2006
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Ingår i: Journal of Burn Care and Research. - 1559-047X. ; 27:5, s. 727-733
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Tidskriftsartikel (refereegranskat)abstract
- Recurrent nightmares can be a symptom of posttraumatic stress disorder (PTSD). This study evaluated the method of asking burn survivors about nightmares as a screening tool for the presence of PTSD symptomatology. The presence of nightmares in 85 individuals treated at the Burn Center in Uppsala, Sweden, between 1996 and 2000 (23 women, 62 men, average age 47 years, average burn size 17% TBSA, average time after burn 3.6 years) was evaluated by one question from the Burn Specific Health Scale (BSHS) and by using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for nightmares. PTSD symptomatology was assessed with the Impact of Event Scale-Revised. Sensitivity, Specificity, Discriminant Ability, and Likelihood Ratios for a positive and a negative result were calculated to evaluate the screening questions. As many as 46% of the burn survivors reported nightmares of some frequency in the BSHS and as many as 28% when using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Both approaches were useful tools for detecting or ruling out PTSD symptoms. The best Discriminant Ability was achieved with a screening test using the BSHS item "I have nightmares." Screening questions for presence of nightmares after burns can be useful in detecting PTSD symptomatology.
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| 22. |
- Low, Janina Francisca Aili, 1966-
(författare)
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It’s Not Just a Burn : Physical and Psychological Problems after Burns
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Survival after severe burns has improved in recent decades, but there is limited information on the course of recovery after surviving a burn and on factors that can affect recovery. The aims of this thesis were to investigate the occurrence of physical and psychological problems after burns, and to examine the consequences of psychological problems for the clinical management of burn patients. Three groups of consecutive patients who were treated at the Burn Unit at Uppsala University Hospital between 1980 and 2005 were included in the studies. The Burn Specific Health Scale (BSHS) was used for self-report of burn-specific aspects of health. Personality traits and coping strategies as psychological factors during recovery were examined with the Swedish universities Scales of Personality (SSP) and the Coping with Burns Questionnaire (CBQ). Presence of symptoms of posttraumatic stress were assessed with the Impact of Event Scale-Revised (IES-R), and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to determine the concurrent validity of the IES-R as a measure of Posttraumatic Stress Disorder (PTSD). Furthermore, the effect of pre-injury psychiatric morbidity on perceived health one year after injury was assessed. Both pruritus and nightmares were common problems after burns; 59% of the individuals in the study reported pruritus and 43% reported nightmares. Neuroticism-related personality traits and avoidant coping strategies were associated with an increased risk of having pruritus or nightmares. The presence of nightmares could be used as a screening tool for high scores in the IES-R. The IES-R was in turn shown to be a good, although overly inclusive, test for the diagnosis of PTSD. Pre-injury psychiatric morbidity predicted perceived outcome in six out of nine burn-specific health domains. These studies show that psychological factors and psychiatric morbidity affect outcome after burns.
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| 23. |
- McKibben, Jodi B. A., et al.
(författare)
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Epidemiology of burn injuries II : Psychiatric and behavioral perspectives
- 2009
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Ingår i: International Review of Psychiatry. - : Informa UK Limited. - 0954-0261 .- 1369-1627. ; 21:6, s. 512-521
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Tidskriftsartikel (refereegranskat)abstract
- Modern technological advances have decreased the incidence and severity of burn injuries, and medical care improvements of burn injuries have significantly increased survival rates, particularly in developed countries. Still, fire-related burn injuries are responsible for 300,000 deaths and 10 million disability-adjusted life years lost annually worldwide. The extent to which psychiatric and behavioural factors contribute to the incidence and outcomes of these tragedies has not been systematically documented, and the available data is often insufficient to reach definitive conclusions. Accordingly, this article reviews the evidence of psychiatric and behavioural risk factors and prevention opportunities for burn injuries worldwide. Psychiatric prevalence rates and risk factors for burn injuries, prevalence and risks associated with 'intentional' burn injuries (self-immolation, assault, and child maltreatment), and prevention activities targeting the general population and those with known psychiatric and behavioural risk factors are discussed. These issues are substantially interwoven with many co-occurring risk factors. While success in teasing apart the roles and contributions of these factors rests upon improving the methodology employed in future research, the nature of this entanglement increases the likelihood that successful interventions in one problem area will reap benefits in others.
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| 24. |
- Mårtensson, Björn, et al.
(författare)
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Behandling av depression med ljusterapi : En systematisk litteraturöversikt. SBU:s sammanfattning och slutsatser
- 2008
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:28-29, s. 2024-2025
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Tidskriftsartikel (refereegranskat)abstract
- Over the last 20 years light therapy has been increasingly used for the treatment of Seasonal Affective Disorder (SAD). A systematic review of randomized controlled trials (RCTs) was conducted by the Swedish Council on Technology Assessment in Health Care (SBU) to assess the scientific basis for that treatment. Papers assessed were published between 1984 and November 2006, indexed in the PubMed database and included adult patients (>18 years) with SAD or major depression (MD). The search generated 11 RCTs that fulfilled set criteria. The efficacy of light therapy in SAD was assessed with meta-analysis. There was no difference in response rate between those given active treatment and those given placebo in any of the studies on light therapy for SAD. The effect on remission rate differed between studies. The meta-analysis showed a weak and only transient effect (effect size 0.4) which was noticeable after two and three weeks of treatment, but not later. Studies on light therapy for non-seasonal depression were few and heterogeneous with respect to type of depression and patient population. No conclusions on efficacy of light therapy could be drawn.
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| 25. |
- Nilsson, Björn M, et al.
(författare)
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Acute and maintenance electroconvulsive therapy for treatment of severely disabling obsessive-compulsive symptoms in a patient with Asperger syndrome
- 2009
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Ingår i: Journal of ECT. - 1095-0680 .- 1533-4112. ; 25:3, s. 205-207
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Tidskriftsartikel (refereegranskat)abstract
- We report successful treatment with electroconvulsivetherapy of a comorbid condition including severe obsessive-compulsivesymptoms and hypochondriacal delusions in a 38-year-old man withAsperger syndrome. His condition deteriorated into a severely disabledchronic state that was refractory to different pharmacological andpsychological treatments but was completely reversed after electroconvulsivetherapy. Although typical obsessive-compulsive symptoms werepredominant, the case also exhibits differences compared with regularobsessive-compulsive disorder regarding onset and course that arediscussed in the report.
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