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| 3. |
- Bejerot, Eva, et al.
(författare)
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Svenska läkares arbetsmiljö 1992 och 2010 – en profession i fritt fall? : Programnummer AR28, 2/12 2011
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- En jämförelse av två enkätstudier med läkare från 1992 och 2010 visar att det har skett avsevärda försämringar över tid, särskilt avseende känslan av att ha ett verksamhetsansvar och i upplevelsen av stöd från närmaste chef. Indikationer på att läkares villkor är problematiska har funnits i Arbetsmiljöverkets och SCBs återkommande arbetsmiljöundersökningar under 2000-talet. Läkare har här identifierats som ett yrke där man rapporterar hög arbetstakt samt brist på stöd och uppmuntran från chefer. För att analysera om det skett förändringar i läkares arbetsvillkor gjordes en enkätstudie under 2010/2011 där det ingick ett antal frågor om arbetsmiljö som också ställts i en enkät år 1992. Utifrån detta material har jämförelser gjorts av läkares position i verksamheten, krav, kontroll och stöd i arbetet, samt frågor som belyser tid för fortbildning, press att följa med i kunskapsutvecklingen och arbetstillfredsställelse. Båda studierna är baserade på ett slumpmässigt urval ur Sveriges läkarförbunds medlemsregister. Antal respondenter år 1992 (n=362) och år 2010 (n=1955), svarsfrekvensen var 70 respektive 68 procent. Andelen läkare som upplever sig ha något verksamhetsansvar har minskat med 45 procentandelar över tid, från 76 procent år 1992 till 31 procent år 2010. Läkarnas inflytande över det egna arbetet har minskat något över tid, framför allt har inflytande över beslut på avdelningen minskat över tid. I frågor som avhandlar krav i arbetet rapporterades försämringar avseende mängden arbetsuppgifter, medan tidspress och nödvändig avskildhet för vissa arbetsuppgifter var oförändrad över tid. Resultaten visar också på försämringar avseende arbetsklimat, och att den tid som läggs på forskning och fortbildning har minskat. I området stöd och återkoppling från närmaste chef är förändringarna snudd på dramatiska, exempelvis instämde 45 procent av respondenterna helt i att de hade möjlighet att diskutera svårigheter i arbetet med närmaste chef 1992, jämfört med 14 procent 2010.
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| 4. |
- Andersen, Lisa M. J., et al.
(författare)
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The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R) : A Validation Study of a Rating Scale for Adults
- 2011
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Ingår i: Journal of autism and developmental disorders. - New, York, USA : Springer. - 0162-3257 .- 1573-3432. ; 41:12, s. 1635-1645
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Tidskriftsartikel (refereegranskat)abstract
- There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75 adults with ASD and 197 comparison cases. Also, a subset completed the Autism Spectrum Quotient (AQ). Three out of four subscales had high internal consistency. Sensitivity was 91% and specificity was 93%. The ASD subjects had significantly higher mean scores on all subscales. ASD females had higher scores than ASD males on the sensory motor subscale, a dimension not included in the AQ. RAADS-R showed promising test re-test reliability.
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| 5. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Autismspektrumsyndrom ersätter Aspergers syndrome och autism : [Autism spectrum syndrome replaces Asperger syndrome and autism]
- 2014
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidingen Förlag AB. - 0023-7205 .- 1652-7518. ; 111:39, s. 1660-1663
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Tidskriftsartikel (refereegranskat)abstract
- Autism spectrum disorder describes a behaviourally defined impairment in social interaction and communication, along with the presence of restricted interests and repetitive behaviours. Although the etiology is mostly unknown, it is evident that biological factors affect the brain and result in the autistic clinical presentation. Assessment for diagnosing autism spectrum disorder should be comprehensive in order to cover all sorts of problems related to the disorder. Knowledge and experience from working with neurological and psychiatric disorders are a prerequisite for quality in the examination. Up to now, there is no cure for autism spectrum disorder, but support and adaptations in education are nevertheless important for obtaining sufficient life quality for the patients and the family.
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| 6. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Childhood clumsiness and peer victimization : a case-control study of psychiatric patients
- 2013
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Ingår i: BMC Psychiatry. - London, United Kingdom : BioMed Central. - 1471-244X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Poor motor and social skills as well as peer victimization are commonly reported in both ADHD and autism spectrum disorder. Positive relationships between poor motor and poor social skills, and between poor social skills and peer victimization, are well documented, but the relationship between poor motor skills and peer victimization has not been studied in psychiatric populations.Method: 277 patients (133 males, 144 females), mean age 31 years, investigated for ADHD or autism spectrum disorder in adulthood and with normal intelligence, were interviewed about childhood peer victimization and examined for gross motor skills. The parents completed a comprehensive questionnaire on childhood problems, the Five to Fifteen. The Five to Fifteen is a validated questionnaire with 181 statements that covers various symptoms in childhood across eight different domains, one of them targeting motor skills. Regression models were used to evaluate the relationship between motor skills and the risk and duration of peer victimization, adjusted for sex and diagnosis.Results: Victims were described as more clumsy in childhood than their non-victimized counterparts. A significant independent association was found between reportedly poor childhood gross motor skills and peer victimization (adjusted odds ratio: 2.97 [95% confidence interval: 1.46-6.07], n = 235, p = 0.003). In adulthood, the victimized group performed worse on vertical jumps, a gross motor task, and were lonelier. Other factors that were expected to be associated with peer victimization were not found in this highly selected group.Conclusion: Poor gross motor skills constitute a strong and independent risk factor for peer victimization in childhood, regardless of sex, childhood psychiatric care and diagnosis.
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| 7. |
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| 8. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Diagnostik och terapi utmanar än, trots snabb tillväxt av kunskap [Diagnosis and therapy are still challenging, despite the rapid growth of knowledge]
- 2014
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 111:39, s. 1638-1641
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Forskningsöversikt (refereegranskat)abstract
- Psychiatric diagnoses are not reflections of the aetiology of the disorder, but rather lists of symptoms with considerable overlaps, which hamper research and may cause confusion. The diagnoses of autism spectrum disorder, attention deficit hyperactivity disorder and tic disorder are often comorbid along with a number of other symptomatic syndromes. Individual immune responsivity is possibly involved in pathophysiological mechanisms. Multiple environmental factors may contribute to the clinical phenotypes. Recent research supports to some extent the involvement of dietary and nutritional factors in ADHD. In spite of impressive progress in the molecular biological understanding of the pathophysiology of these disorders, treatment options are still limited and more research is warranted.
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| 9. |
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| 10. |
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| 11. |
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| 12. |
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| 13. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Poor Motor Skills : A Risk Marker for Bully Victimization
- 2013
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Ingår i: Aggressive Behavior. - : Wiley. - 0096-140X .- 1098-2337. ; 39:6, s. 453-461
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Tidskriftsartikel (refereegranskat)abstract
- Children who are clumsy are often bullied. Nevertheless, motor skills have been overlooked in research on bullying victimization. A total of 2,730 Swedish adults (83% females) responded to retrospective questions on bullying, their talents in physical education (i.e., coordination and balls skills) and school academics. Poor talents were used as indicators of poor gross motor skills and poor academic skills. A subset of participants also provided information on educational level in adulthood, childhood obesity, belonging to an ethic minority in school and socioeconomic status relative to schoolmates. A total of 29.4% of adults reported being bullied in school, and 18.4% reported having below average gross motor skills. Of those with below average motor skills, 48.6% were bullied in school. Below average motor skills in childhood were associated with an increased risk (OR 3.01 [95% CI: 1.97-4.60]) of being bullied, even after adjusting for the influence of lower socioeconomic status, poor academic performance, being overweight, and being a bully. Higher odds for bully victimization were also associated with lower socioeconomic status (OR 2.29 [95% CI: 1.45-3.63]), being overweight (OR 1.71 [95% CI: 1.18-2.47]) and being a bully (OR 2.18 [95% CI: 1.53-3.11]). The findings indicate that poor gross motor skills constitute a robust risk-marker for vulnerability for bully victimization. Aggr. Behav. 39:453-461, 2013. (c) 2013 The Authors. Aggressive Behavior Published by Wiley-Blackwell
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| 14. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Poor performance in physical education - a risk factor for bully victimization A case-control study
- 2011
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Ingår i: Acta Paediatrica. - Malden, USA : Wiley. - 0803-5253 .- 1651-2227. ; 100:3, s. 413-419
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Poor social skills are a risk factor for becoming bullied, which could explain why this frequently occurs to children with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). Poor social skills tend to coexist with clumsiness. According to a pilot study, poor performance in physical education (PE) was correlated with bully victimization. Methods: Sixty-nine healthy university students reported performance in PE and bully victimization in childhood. In addition, the participants responded to questionnaires for ADHD and ASDs to assess personality traits related to increased risk for bully victimization. Results: Below average performance in PE was a risk factor of being bullied in school with an odds ratio of 3.6 [95% confidence interval: 1.23-10.5; p = 0.017]. Strong correlations between poor performance in PE and long duration of victimization (p = 0.007) and poor performance in PE and high frequency of victimization (p = 0.008) were found. Autistic traits were related to performance below average in PE. Conclusion: Poor motor skills are a strong risk factor for becoming bullied. Prevention programmes that identify, protect and empower the clumsy children could be an important step to avoid bullying of the most vulnerable children.
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| 15. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Sexuality and gender role in autism spectrum disorder : a case control study
- 2014
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Ingår i: PLOS ONE. - San Francisco, USA : Public Library Science. - 1932-6203. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- The 'extreme male brain theory of autism' describes an extreme male pattern of cognitive traits defined as strong systemising abilities paired with empathising weaknesses in autism spectrum disorder. However, beyond these cognitive traits, clinical observations have suggested an ambiguous gender-typed pattern regarding several sexually dimorphic traits. The aim of the present study was to investigate if patterns of non-cognitive sexually dimorphic traits differed between the autism spectrum disorder and control groups. Fifty adults with autism spectrum disorder and intelligence within the normal range, and 53 neurotypical controls responded to questions on gender role, self-perceived gender typicality and gender identity, as well as sexuality. Measures used were a Swedish modification of the Bem Sex Role Inventory and questions on sexuality and gender designed for the purpose of this study. Our results showed that one common gender role emerged in the autism spectrum disorder group. Masculinity (e.g. assertiveness, leadership and competitiveness) was weaker in the autism spectrum disorder group than in the controls, across men and women. Self-perceived gender typicality did not differ between the groups but tomboyism and bisexuality were overrepresented amongst women with autism spectrum disorder. Lower libido was reported amongst both male and female participants with autism spectrum disorder compared with controls. We conclude that the extreme male patterns of cognitive functions in the autistic brain do not seem to extend to gender role and sexuality. A gender-atypical pattern for these types of characteristics is suggested in autism spectrum disorder.
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| 16. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Social anxiety in adult autism spectrum disorder
- 2014
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Ingår i: Psychiatry Research. - London : Elsevier. - 0165-1781 .- 1872-7123. ; 220:1-2, s. 705-707
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Tidskriftsartikel (refereegranskat)abstract
- A link has been suggested between Autism Spectrum Disorder (ASD) and anxiety disorders. The aim of the study was to examine the severity of social anxiety measured by the Liebowitz Social Anxiety Scale Self-Report and prevalence of Social Anxiety Disorder (SAD) in adults with ASD, with SAD and a non-ASD comparison group. Individuals with ASD showed significantly higher scores of social anxiety and social avoidance relative to the comparison group, but significantly lower scores relative to the SAD sample.
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| 17. |
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| 18. |
- 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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| 19. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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The extreme male brain revisited: gender coherence in adults with autism spectrum disorder
- 2012
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Ingår i: British Journal of Psychiatry. - London, United Kingdom : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 201:2, s. 116-123
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Tidskriftsartikel (refereegranskat)abstract
- Background The 'extreme male brain' theory suggests that autism spectrum disorder (ASD) is an extreme variant of male intelligence. However, somewhat paradoxically, many individuals with ASD display androgynous physical features regardless of gender. Aims To assess physical measures, supposedly related to androgen influence, in adults with and without ASD. Method Serum hormone levels, anthropometry, the ratio of 2nd to 4th digit length (2D:4D) and psychiatric symptomatology were measured in 50 adults with high-functioning ASD and age- and gender-matched neurotypical controls. Photographs of face and body, as well as voice recordings, were obtained and assessed with respect to gender coherence, blindly and independently, by eight assessors. Results Women with ASD had higher total and bioactive testosterone levels, less feminine facial features and a larger head circumference than female controls. Men in the ASD group were assessed as having less masculine body characteristics and voice quality, and displayed higher (i.e. less masculine) 2D:4D ratios, but similar testosterone levels to controls. Androgynous facial features correlated strongly and positively with autistic traits measured with the Autism-Spectrum Quotient in the total sample. In males and females with ASD dehydroepiandrosterone sulfate did not decrease with age, in contrast to the control group. Conclusions Women with ASD had elevated testosterone levels and several masculinised characteristics compared with controls, whereas men with ASD displayed several feminised characteristics. Our findings suggest that ASD, rather than being characterised by masculinisation in both genders, may constitute a gender defiant disorder.
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| 20. |
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| 21. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Two-year outcome of treatment with central stimulant medication in adult attention-deficit/hyperactivity disorder : a prospective study
- 2010
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Ingår i: Journal of Clinical Psychiatry. - Memphis, USA : Physicians Postgraduate Press, Inc.. - 0160-6689 .- 1555-2101. ; 71:12, s. 1590-1597
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Tidskriftsartikel (refereegranskat)abstract
- Background: Given that adults with ADHD continue to use stimulants for extended periods of time, studies on the long-term effectiveness and adverse events are warranted. The aims of this study were to investigate factors associated with persistence in treatment in an exploratory manner and to document side effects and reasons for discontinuation.Method: The current study describes the systematic follow-up of 133 psychiatric patients with DSM-IV-diagnosed ADHD treated with central stimulants at a specialized outpatient unit between January 1, 2001, and August 31, 2006. A standardized questionnaire, derived from the Targeted Attention-deficit Disorder Symptoms Rating Scale, was used in order to measure improvement of the following target symptoms: hyperactivity, impulsivity, irritability, distractibility, structure/organization problems, inattention, and restlessness.Results: Eighty percent of the patients were successfully treated with stimulants at the 6- to 9-month follow-up. Fifty percent remained in treatment after 2 years or more. Forty-five percent were treated for comorbid anxiety and/or depression during the study period. Only 15% dropped out because of lack of efficacy. The amount of clinical response over the first 6 to 9 months (but not at 6 weeks) predicted adherence to treatment at 2 years. The patients' heart rate increased from a least squares mean ± SE of 70 ± 2.2 to 80 ± 2.1 bpm (P = .00003) while blood pressure remained unchanged at the ≥ 2-year follow-up. Severe side effects or drug abuse were not detected in this cohort.Conclusions: The long-term treatment outcome shows that stimulants are effective in adult ADHD and side effects tend to be mild.
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| 22. |
- Blomqvist, My, et al.
(författare)
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Experiences of dental care and dental anxiety in adults with autism spectrum disorder
- 2014
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Ingår i: Autism Research and Treatment. - New York, USA : Hindawi Publishing Corporation. - 2090-1925 .- 2090-1933. ; 2014
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Tidskriftsartikel (refereegranskat)abstract
- Dental anxiety is associated with previous distressing dental experiences, such as lack of understanding of the dentist intentions, perceptions of uncontrollability and experiences of pain during dental treatment. People with autism spectrum disorder (ASD) are impaired in building flexible predictions and expectations, which is very much needed during a dental visit. The aims of the study were to investigate if people with ASD have more negative dental experiences and a higher level of dental anxiety compared to a matched control group. Forty-seven adults with ASD and of normal intellectual performance, and 69 age- and sex-matched typically developing controls completed questionnaires on previous dental experiences and dental anxiety, the Dental Anxiety Scale, and the Dental Beliefs Survey. The ASD group experienced pain during dental treatments more often than the controls and 22% had repeatedly experienced being forced to dental treatment they were not prepared for, compared to 3% of the controls. A higher level of dental anxiety was reported by the ASD group. Dental treatment and methods for supporting the communication with patients with ASD need to be developed, in order to reduce the negative dental experiences and dental anxiety in people with ASD.
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| 23. |
- Eriksson, Jonna M., et al.
(författare)
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RAADS-14 Screen : validity of a screening tool for autism spectrum disorder in an adult psychiatric population
- 2013
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Ingår i: Molecular Autism. - London, United Kingdom : BioMed Central. - 2040-2392. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Autism spectrum disorder (ASD) can be difficult to distinguish from other psychiatric disorders. The clinical assessment of ASD is lengthy, and has to be performed by a specialized clinician. Therefore, a screening instrument to aid in the identification of patients who may have undiagnosed ASD should be useful. The purpose of this study was to develop such a screening instrument.Methods: Based on the 80 item Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), we developed a 14 item self-evaluation questionnaire, the RAADS-14 Screen. In total, 135 adults with ASD and 508 psychiatric controls completed the abridged version of the RAADS-R.Results The RAADS-14 Screen score was significantly higher in the ASD group than in the control samples, with a median score of 32 for ASD, 15 for attention deficit hyperactivity disorder, and 11 for other psychiatric disorders (P < 0.001). A cut-off score of 14 or above reached a sensitivity of 97% and a specificity of 46 to 64%. A factor analysis identified three factors consistent with mentalizing deficits, social anxiety, and sensory reactivity relevant for the diagnosis of ASD. The psychometric properties of RAADS-14 Screen were shown to be satisfactory.Conclusions: The results of this study indicate that RAADS-14 Screen is a promising measure in screening for ASD in adult psychiatric outpatients.
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| 24. |
- Hesselmark, Eva, et al.
(författare)
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Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders : a preliminary randomized controlled trial
- 2014
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Ingår i: Autism. - London, United Kingdom : Sage Publications. - 1362-3613 .- 1461-7005. ; 18:6, s. 672-683
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Tidskriftsartikel (refereegranskat)abstract
- Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This preliminary randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive behavioural therapy and recreational activity. Both interventions comprised 36 weekly 3-h sessions led by two therapists in groups of 6-8 patients. A total of 68 psychiatric patients with autism spectrum disorders participated in the study. Outcome measures were Quality of Life Inventory, Sense of Coherence Scale, Rosenberg Self-Esteem Scale and an exploratory analysis on measures of psychiatric health. Participants in both treatment conditions reported an increased quality of life at post-treatment (d = 0.39, p < 0.001), with no difference between interventions. No amelioration of psychiatric symptoms was observed. The dropout rate was lower with cognitive behavioural therapy than with recreational activity, and participants in cognitive behavioural therapy rated themselves as more generally improved, as well as more improved regarding expression of needs and understanding of difficulties. Both interventions appear to be promising treatment options for adults with autism spectrum disorder. The interventions' similar efficacy may be due to the common elements, structure and group setting. Cognitive behavioural therapy may be additionally beneficial in terms of increasing specific skills and minimizing dropout.
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| 25. |
- Humble, Mats B., 1952-, et al.
(författare)
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Low serum levels of 25-hydroxyvitamin D (25-OHD) among psychiatric out-patients in Sweden : Relations with season, age, ethnic origin and psychiatric diagnosis
- 2010
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Ingår i: Journal of Steroid Biochemistry and Molecular Biology. - Oxford, United Kingdom : Elsevier BV. - 0960-0760 .- 1879-1220. ; 121:1-2, s. 467-470
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Tidskriftsartikel (refereegranskat)abstract
- In a chart review at a psychiatric out-patient department, latitude 59.3 degrees N, a sample of patients with tests of serum 25-hydroxy-vitamin D (25-OHD) and plasma intact parathyroid hormone (iPTH) was collected, together with demographic data and psychiatric diagnoses. During 19 months, 117 patients were included. Their median 25-0HD was 45 nmol/l; considerably lower than published reports on Swedish healthy populations. Only 14.5% had recommended levels (over 75). In 56.4%, 25-OHD was under 50 nmol/l, which is related to several unfavourable health outcomes. Seasonal variation of 25-OHD was blunted. Patients with ADHD had unexpectedly low iPTH levels. Middle East, South-East Asian or African ethnic origin, being a young male and having a diagnosis of autism spectrum disorder or schizophrenia predicted low 25-OHD levels. Hence, the diagnoses that have been hypothetically linked to developmental (prenatal) vitamin D deficiency, schizophrenia and autism, had the lowest 25-OHD levels in this adult sample, supporting the notion that vitamin D deficiency may not only be a predisposing developmental factor but also relate to the adult patients' psychiatric state. This is further supported by the considerable psychiatric improvement that coincided with vitamin D treatment in some of the patients whose deficiency was treated.
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| 26. |
- Humble, Mats B., 1952-, et al.
(författare)
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Plasma oxytocin changes and anti-obsessive response during serotonin reuptake inhibitor treatment : a placebo controlled study
- 2013
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Ingår i: BMC Psychiatry. - 1471-244X. ; 13, s. 344-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The drug treatments of choice for obsessive-compulsive disorder (OCD) are serotonin reuptake inhibitors (SRIs). However, a correlation between the neuropeptide oxytocin in cerebrospinal fluid and the severity of OCD has previously been shown, and oxytocin and serotonin are interconnected within the brain. Few studies have investigated whether SRIs have any effect on oxytocin; thus, our aim was to explore the possibility that oxytocinergic mechanisms contribute to the anti-obsessive effect of SRIs.Method: In a randomized, double-blind trial, comparing SRIs (clomipramine and paroxetine) with placebo in 36 adults with OCD (characterized for subtypes), plasma oxytocin was measured with radioimmunoassay after plasma extraction, at baseline, after 1 week, and after 4 weeks of treatment, and related to baseline severity and clinical response after 12 weeks, as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).Results: Baseline oxytocin levels correlated positively with baseline Y-BOCS ratings, but only among the future SRI responders. Patients with early onset of OCD had higher baseline oxytocin. During treatment, plasma oxytocin did not differ between SRI and placebo treatment. In SRI responders, plasma oxytocin first decreased and then increased; in non-responders (to SRI as well as to placebo), the reverse was the case. After 4 weeks, treatment responders had attained higher oxytocin levels compared to non-responders. The intra-individual range (i.e. the variability) of plasma oxytocin between measurements was the measure that best differentiated responders from non-responders. This range was higher in responders than non-responders, and lower in patients with autistic traits.Conclusions: SRIs have highly variable effects on plasma oxytocin between individuals. The associations between baseline oxytocin and OCD severity and between oxytocin changes and treatment response support the notions that oxytocin is involved in OCD pathophysiology, and that the anti-obsessive effects of SRIs are partly exerted through oxytocinergic mechanisms.
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| 27. |
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| 28. |
- Kooij, Sandra J. J., et al.
(författare)
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European consensus statement on diagnosis and treatment of adult ADHD : The European Network Adult ADHD
- 2010
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Ingår i: BMC Psychiatry. - London, United Kingdom : BioMed Central. - 1471-244X. ; 10
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Forskningsöversikt (refereegranskat)abstract
- Background: Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe.Methods: The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated.Results: Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated?Conclusions: ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group.
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| 29. |
- Manouilenko, Irina, et al.
(författare)
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Autistic traits, ADHD symptoms, neurological soft signs and regional cerebral blood flow in adults with autism spectrum disorders
- 2013
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Ingår i: Research in Autism Spectrum Disorders. - Oxon, United Kingdom : Elsevier. - 1750-9467 .- 1878-0237. ; 7, s. 566-578
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Tidskriftsartikel (refereegranskat)abstract
- The resting regional cerebral blood flow (rCBF) patterns related to co-occurring symptoms such as inattention, hyperactivity, neurological soft signs and motor problems have not yet been disclosed in autism spectrum disorders (ASD). In this study thirteen adults with ASD and ten matched neurotypical controls underwent PET. The scores of rating scales for autistic traits, attention deficit hyperactivity disorder (ADHD) and neurological soft signs were included in a factorial analysis and correlated with rCBF. Factors corresponding to “autistic/ADHD traits”, “sensory-motor integration” and “intelligence/motor sequencing” were identified. In the ASD group, positive correlations with CBF were found for “autistic/ADHD traits” in caudate bilaterally and the inferior parietal lobule, for “sensory-motor integration” in parieto-occipital cortex and for “intelligence/motor sequencing” in the right temporal cortex. Notably, CBF in the left thalamus correlated negatively with all three factors. Autistic traits and ADHD symptoms were associated with shared neural substrates. The correlation between “autistic/ADHD traits” and rCBF in the caudate is possibly associated with the executive impairments and ritualistic/stereotyped behaviors apparent in ASD. Furthermore, sensory-motor deficits were correlated with rCBF in the occipital visual cortex, involved in atypical visual perception in ASD. Various behavioral and neurological symptoms are suggested to converge into the ASD phenotype.
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| 30. |
- Manouilenko, Irina, et al.
(författare)
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Minor physical anomalies in adults with autism spectrum disorder and healthy controls
- 2014
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Ingår i: Autism Research and Treatment. - New York, USA : Hindawi Publishing Corporation. - 2090-1925 .- 2090-1933.
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Tidskriftsartikel (refereegranskat)abstract
- Minor Physical Anomalies (MPAs) are subtle abnormalities of the head, face, and limbs, without significant cosmetic or functional impact to the individual. They are assumed to represent external markers of developmental deviations during foetal life. MPAs have been suggested to indicate severity in mental illness and constitute external markers for atypical brain development. Higher frequencies of MPAs can be found in children with autism. The aims of the present study were to examine the prevalence and patterns of MPAs in adults with autism spectrum disorder (ASD) and to investigate whether MPAs are associated with symptom severity and overall functioning. Fifty adults with ASD and intelligence within the normal range and 53 healthy controls were examined with the Waldrop scale, an instrument for assessing MPAs. Face and feet were photographed enabling blinded assessment. Significant differences between the ASD and the control group were found on the MPA total scores, and also in the craniofacial region scores. Moreover, the shape of the ears was associated with autistic traits, in the ASD group. High MPA total scores were associated with poorer functioning. The findings suggest a link between MPAs, autistic traits, and level of functioning. Assessment of MPAs may assist in the diagnostic procedure of psychiatric disorders.
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| 31. |
- McPhillips, Martin, et al.
(författare)
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Motor deficits in children with autism spectrum disorder : a cross-syndrome study
- 2014
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Ingår i: Autism Research. - Hoboken, USA : Wiley-Blackwell. - 1939-3792 .- 1939-3806. ; 7:6, s. 664-676
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Tidskriftsartikel (refereegranskat)abstract
- Recent research suggests that children with autism spectrum disorder (ASD) experience some level of motor difficulty, and that this may be associated with social communication skills. However, other studies show that children with language impairments, but without the social communication problems, are at risk of motor difficulties as well. The aim of the present study was to determine if children with ASD have syndrome-specific motor deficits in comparison to children with specific language impairment (SLI). We used an independent groups design with three groups of children (8-10 years old) matched on age and nonverbal IQ: an ASD group, an SLI group, and a typically developing (TD) group. All of the children completed an individually administered, standardized motor assessment battery. We found that the TD group demonstrated significantly better motor skills than either the ASD or SLI groups. Detailed analyses of the motor subtests revealed that the ASD and SLI groups had very similar motor profiles across a range of fine and gross motor skills, with one exception. We conclude that children with ASD, and SLI, are at risk of clinically significant motor deficits. However, future behavioral and neurological studies of motor skills in children with ASD should include an SLI comparison group in order to identify possible autism-specific deficits.
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| 32. |
- Mörtberg, Ewa, et al.
(författare)
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Intensive group cognitive therapy and individual cognitive therapy for social phobia : Sustained improvement at 5-year follow-up
- 2011
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Ingår i: Journal of Anxiety Disorders. - Oxford, United Kingdom : Elsevier. - 0887-6185 .- 1873-7897. ; 25:8, s. 994-1000
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the long-term outcome of treatments for social phobia. At 5 years post-treatment we contacted the 67 patients who had been treated with intensive group cognitive therapy (IGCT) or individual cognitive therapy (ICT) in a randomized controlled trial (Mörtberg, Clark, Sundin, & Åberg Wistedt, 2007) that originally compared IGCT, ICT, and treatment as usual (n = 100 for the full trial). Seventy-two percent (48 patients) who received IGCT or ICT agreed to participate in the follow-up assessment. All re-completed the original self-report measures of symptoms and disability and a quality of life measure. A subset was also interviewed. Seventy-five percent (36 patients) had sought no further treatment for social phobia. Comparisons between post-treatment and 5-year follow-up indicated that patients who had received either treatment showed further improvement in social phobia symptoms and disability during the follow-up period. These improvements were present in patients who had no additional treatment, as well as in the total sample. In conclusion, it appears that the effects of IGCT and ICT are maintained and improved upon at 5 years post-treatment.
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| 33. |
- Mörtberg, Ewa, et al.
(författare)
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Screening for ADHD in an Adult Social Phobia Sample
- 2012
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Ingår i: Journal of Attention Disorders. - Thousand Oaks, USA : SAGE Publications. - 1087-0547 .- 1557-1246. ; 16:8, s. 645-649
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult ADHD Self-Report Scale). Results: Childhood symptoms of ADHD were reported by 7.8% of the social phobia participants, and 5.1% scored within the range of adult ADHD. The social phobia group reported significantly fewer ADHD symptoms than both of the comparison groups, who frequently reported social anxiety. Conclusion: Participants with social phobia recruited from the general population are less likely to suffer from ADHD. In contrast, patients with ADHD and patients with other psychiatric disorders appear to be likely to suffer from social anxiety.
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| 34. |
- Pagani, Marco, et al.
(författare)
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Brief Report : alterations in cerebral blood flow as assessed by PET/CT in adults with autism spectrum disorder with normal IQ
- 2012
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Ingår i: Journal of autism and developmental disorders. - New York, USA : Springer. - 0162-3257 .- 1573-3432. ; 42:2, s. 313-318
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Tidskriftsartikel (refereegranskat)abstract
- Specific biological markers for autism spectrum disorder (ASD) have not yet been established. Functional studies have shown abnormalities in the anatomo-functional connectivity of the limbic-striatal "social" brain. This study aimed to investigate regional cerebral blood flow (rCBF) at rest. Thirteen patients with ASD of normal intelligence and ten IQ-, sex- and age-matched healthy controls (HC) underwent PET/CT using [1-(11)C]butanol, a perfusion tracer. As compared to HC, ASD showed significant CBF increases in the right parahippocampal, posterior cingulate, primary visual and temporal cortex, putamen, caudatus, substantia nigra and cerebellum. No statistically significant correlation between CBF and IQ was found. The limbic, posterior associative and cerebellar cortices showed increased blood flow in ASD, confirming previous findings about the neurobiology of ASD.
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| 35. |
- Pertusa, Alberto, et al.
(författare)
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Do patients with hoarding disorder have autistic traits?
- 2012
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Ingår i: Depression and anxiety (Print). - Malden, USA : Wiley-Blackwell. - 1091-4269 .- 1520-6394. ; 29:3, s. 210-218
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hoarding symptoms have been described in individuals with autism spectrum disorders (ASD). Furthermore, individuals with hoarding disorder (HD) may display some ASD-like features. In order to further refine the diagnostic boundaries of HD, we examined the presence of autistic traits and theory of mind deficits in individuals with HD and of hoarding behavior in patients with ASD.Methods: Two hundred and twenty-one participants in five groups (HD, ASD, obsessive-compulsive disorder (OCD), anxiety disorders (AD), and healthy controls (HC)) were administered measures of autistic traits (Autism-Spectrum Quotient), theory of mind (eyes test-revised), and hoarding severity (saving inventory-revised; SI-R (add acronym)).Results: Hoarders displayed more autistic traits compared to healthy individuals but not to psychiatric controls. Participants with ASD had significantly higher scores on the SI-R than both psychiatric (OCD or AD) and HC groups, indicating more severe hoarding behavior, but had lower scores than participants with HD. The presence of autistic traits in individuals with HD was related to the presence of comorbid OCD, but the presence of hoarding symptoms in individuals with ASD was unrelated to comorbid OCD.Conclusions We conclude that individuals with HD do not display more autistic traits than psychiatric controls, thus supporting its status as an independent diagnostic entity. More research is needed to further understand the phenomenology and clinical relevance of hoarding symptoms in ASD.
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| 36. |
- Plenty, Stephanie, et al.
(författare)
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Applying an ESSENCE framework to understanding adult autism spectrum disorder and ADHD : retrospective parent reports of childhood problems
- 2013
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Ingår i: Scientific World Journal. - New York, USA : Hindawi Publishing Corporation. - 1537-744X. ; 2013
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Tidskriftsartikel (refereegranskat)abstract
- Diagnoses of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are increasingly being made in adulthood. However, assessments can fail to address the diverse range of problems that patients have experienced. The current study applied an early symptomatic syndromes eliciting neurodevelopmental clinical examinations (ESSENCE) framework to explore retrospectively reported childhood developmental and behavioral problems. It examined if adult ASD and ADHD patients would show problems outside those reflected in the respective diagnostic criteria, and also if these patient groups would show more extensive childhood problems than other psychiatric patients. Parents of adults with ADHD (n = 130), ASD (n = 57), coexisting ADHD and ASD (n = 38), and other psychiatric disorders (n = 56) reported on a range of childhood problems. Descriptions of the ADHD, ASD, and ADHD+ASD groups reflected greater impairment than descriptions for patients with other psychiatric disorders in most problem areas. Although differences were observed between ADHD and ASD patients in the core diagnostic areas, these syndromes also shared a number of childhood difficulties. The ESSENCE approach can assist in understanding the symptom history of adult ADHD and ASD patients and can be helpful to distinguish their childhood experiences from other psychiatric patients' experiences.
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| 37. |
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| 38. |
- Tedroff, K., et al.
(författare)
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What has feet to do with it? Pes planus and medial arch height in adults with and without autism spectrum disorder.
- 2013
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Ingår i: Research in Autism Spectrum Disorders. - Oxford, United Kingdom : Elsevier. - 1750-9467 .- 1878-0237. ; 7:1, s. 187-192
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Tidskriftsartikel (refereegranskat)abstract
- Individuals with autism have higher rates of minor physical anomalies (MPAs) than neurotypical persons. Minor physical anomalies are slight morphological deviations typically harmless and without cosmetic or medical importance to the individual but indicative of an underlying neurodevelopmental disorder. In genetic autism research the utilization of MPAs has been recommended. In the present study the prevalence of pes planus or flatfoot in adults with ASD compared to age and sex matched neurotypical adults was investigated with two different methods. A photograph of the feet was obtained from underneath while the subjects were standing on a glass table. From this imprint calculations were made. In addition the medial longitudinal foot arch was measured with a Verniper caliper. The ultimate purpose of this study was to evaluate if flatfoot deformity could be utilized as an MPA in ASD. In this cohort of nearly one hundred adults no one fulfilled the predefined criteria of a flatfoot diagnosis but a lower foot arch height was shown in individuals with ASD compared to controls, confirming the clinical impression.
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