| 1. |
- Kaiser, Niclas, et al.
(author)
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Depression and anxiety in the reindeer-herding Sami population of Sweden
- 2010
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In: International Journal of Circumpolar Health. - : Informa UK Limited. - 1239-9736 .- 2242-3982. ; 69:4, s. 383-393
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Journal article (peer-reviewed)abstract
- Objectives. The objective of this study was to investigate symptoms and predicting factors of depression and anxiety among reindeer-herding Sami in Sweden. Study design. A total of 319 reindeer-herding Sami (168 men, 151 women) were compared with urban and rural reference populations comprising 1,393 persons (662 men, 731 women). Methods. A cross-sectional questionnaire study on mental health, which included the Hospital Anxiety and Depression Scale (HADS). Data were analysed with regard to population, gender, age group, education and work-related stress. Results. The Sami population disclosed higher mean values for both depression and anxiety than the reference groups, with Sami men reporting the highest rates. Work-related stress was associated with anxiety and depression in the Sami group. Conclusions. By comparing Sami men and women with reference groups of men and women living in urban and rural areas in northern Sweden, this study identified that reindeer-herding Sami men require special attention with regard to mental health problems.
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| 2. |
- Kaiser, Niclas, 1973-, et al.
(author)
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Depression and anxiety in the reindeer-herding Sami population of Sweden
- 2010
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In: International Journal of Circumpolar Health. - Oulu : International Association of Circumpolar Health Publishers. - 1239-9736 .- 2242-3982. ; 69:4, s. 383-393
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Journal article (peer-reviewed)abstract
- Objectives. The objective of this study was to investigate symptoms and predicting factors of depression and anxiety among reindeer-herding Sami in Sweden. Study design. A total of 319 reindeer-herding Sami (168 men, 151 women) were compared with urban and rural reference populations comprising 1,393 persons (662 men, 731 women). Methods. A cross-sectional questionnaire study on mental health, which included the Hospital Anxiety and Depression Scale (HADS). Data were analysed with regard to population, gender, age group, education and work-related stress. Results. The Sami population disclosed higher mean values for both depression and anxiety than the reference groups, with Sami men reporting the highest rates. Work-related stress was associated with anxiety and depression in the Sami group. Conclusions. By comparing Sami men and women with reference groups of men and women living in urban and rural areas in northern Sweden, this study identified that reindeer-herding Sami men require special attention with regard to mental health problems.
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| 3. |
- Kaiser, Niclas, et al.
(author)
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Experiences of being a young male Sami reindeer herder : a qualitative study in perspective of mental health
- 2013
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In: International Journal of Circumpolar Health. - : CoAction Publishing. - 1239-9736 .- 2242-3982. ; 72:20926
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Journal article (peer-reviewed)abstract
- Objectives. To explore experiences of what it is to be a young male Sami reindeer herder in Sweden, a group with previously known stigma and specific health issues, and to understand experiences in perspective of mental health.Methods. A qualitative content analysis was employed. Data were collected by in-depth interviews with 15 strategically selected reindeer herders aged 18–35 years old.Results. The analysis resulted in 5 sub-themes: (a) being “inside” or “outside” is a question of identity; (b) a paradox between being free/bound; (c) an experience of various threats and a feeling of powerlessness; (d) specific norms for how a “real” reindeer herder should be; and (e) the different impacts and meanings of relations. The overarching theme is summarized thus: being a young reindeer herder means so many (impossible) dreams and conditions. Overall, the experience of the informants was that being a reindeer herder is a privileged position that also implies many impossibilities and unjust adversities they have no control over, and that there is nothing they can do but “bite the bullet or be a failure.”Conclusions. Knowledge about this group's experiences can be used to understand difficulties faced by young reindeer herders and its consequences regarding mental health problems. This also implies a need for a broader perspective when discussing future interventions aimed at preventing mental health problems in this group.
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| 4. |
- Kaiser, Niclas, et al.
(author)
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Hazardous drinking and drinking patterns among the reindeer-herding Sami population in Sweden
- 2011
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In: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 46:10, s. 1318-1327
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Journal article (peer-reviewed)abstract
- The objective of this study was to investigate hazardous drinking among reindeer-herding Sami in Sweden. A cross-sectional questionnaire study was conducted in 2007, which included the Alcohol Use Disorder Identification Test. A total of 319 reindeer-herding Sami were compared with urban and rural reference populations of 1,393 persons. Data were analyzed with regard to population, gender, age group, education, anxiety, depression, and work-related stress. The Sami population did not report a higher prevalence of hazardous drinking compared with the reference groups; however, subgroups of Sami men with symptoms of depression were revealed as at risk, in contrast to Sami women who were not found to be at risk at all. Limitations of the study are discussed.
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| 5. |
- Kaiser, Niclas, 1973-
(author)
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Mental health problems among the Swedish reindeer-herding Sami population : in perspective of intersectionality, organisational culture and acculturation
- 2011
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Doctoral thesis (other academic/artistic)abstract
- The overall objective of the thesis was to investigate aspects of mental health among Swedish Sami reindeer herders and to deepen the understanding of the experience of the living conditions of young Sami reindeer-herding men. Theories of intersectionality, organisational culture and acculturation were used. Methods A questionnaire covering different aspects of mental health was distributed to the Sami population, including the Hospital Anxiety and Depression Scale (HADS), the Alcohol Use Disorder Identification Test, selected parts of the Attitudes Towards Suicide questionnaire (ATTS) and the Job Control Questionnaire (JCQ). 15 interviews with young male reindeer-herders were conducted and analysed according to qualitative content analysis. Results A higher load of anxiety and depression was found in the Sami population, most evident regarding anxiety and among middle aged reindeer-herding men. Regarding alcohol risk consumption reindeer-herding Sami do not in general drink more than a geographically matched reference population, but reindeer-herding men reported a higher proportion of hazardous drinkers, and of teetotallers and periodic drinkers. The reindeer-herding population reported significantly higher exposure to suicide and suicidal behaviour among significant others. Reindeer-herds also reported higher prevalence of different types of suicidal problems. The main theme that emerged in qualitative analysis was ‘Being a young reindeer herder means so many (impossible) dreams and conditions’, and the five subthemes were ‘Being inside or outside is a question of identity’, ‘There is a paradox between being free/unfree’, ‘An experience of different threats and a feeling of powerlessness’, ‘Specific norms for how a ‘real’ reindeer-herder should be’ and ‘The different impacts and meanings of relations’. Conclusions The thesis hypothesizes that the reindeer-herding right as an including, excluding and enclosing historically induced border plays an important part when trying to understand the mental health problems in the group. At present, the situation within reindeer-herding is strained because of practical obstacles and feelings of unfairness and uninfluencability. Furthermore, lack of social support, except from the closest part of the family, and experiences of multi-layered conflicts. This – together with norms of reindeer-herding and reindeer-herders that e.g. say that the reindeer herder is a man who doesn’t show weakness – plays a role in the present mental health problems of the Swedish reindeer-herding population. This applies especially to young and middle-aged reindeer-herding men.
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| 6. |
- Kaiser, Niclas, et al.
(author)
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Suicidal expressions among the Swedish reindeer-herding Sami population
- 2012
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In: Suicidology Online. - 2078-5488. ; :3, s. 102-113
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Journal article (peer-reviewed)abstract
- The objective of this study was to investigate suicidal expressions among reindeer-herding Sami in Sweden. Subjects: A total of 315 reindeer-herding Sami (167 men, 148 women) were compared with geographically matched reference populations comprising 1354 persons (652 men, 702 women). Methods: A questionnaire measuring different aspects of suicidal behaviour, such as exposure to suicide and suicidal ideation in significant others, own suicidal problems and attitudes towards suicide, was distributed to members of Sami villages through community leaders and to the reference group by post. Data were analysed with regard to population, gender, age group, mental health, alcohol use, work strain and formal education. Results: Comparison between groups did not reveal any differences in attitudes towards suicide; however, it did show significantly higher exposure to both suicide and suicidal behaviour in significant others in the Sami group. Compared to the reference group, both Sami women and especially Sami men reported a higher prevalence of various types of suicidal problems, particularly suicidal ideation. In addition, anxiety and alcohol use were associated with suicidal expressions in the Sami group. Conclusion: The study identifies reindeer-herding Sami men and women to be at particular risk for suicidal expressions. Specific attention should be paid to young and middle-aged Sami men with hazardous alcohol consumption and anxiety.
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| 7. |
- Lipsicas, Cendrine Bursztein, et al.
(author)
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Attempted suicide among immigrants in European countries : an international perspective
- 2012
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In: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 47:2, s. 241-251
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Journal article (peer-reviewed)abstract
- This study compares the frequencies of attempted suicide among immigrants and their hosts, between different immigrant groups, and between immigrants and their countries of origin. The material, 27,048 persons, including 4,160 immigrants, was obtained from the WHO/EURO Multicentre Study on Suicidal Behaviour, the largest available European database, and was collected in a standardised manner from 11 European centres in 1989-2003. Person-based suicide-attempt rates (SARs) were calculated for each group. The larger immigrant groups were studied at each centre and compared across centres. Completed-suicide rates of their countries of origin were compared to the SARs of the immigrant groups using rank correlations. 27 of 56 immigrant groups studied showed significantly higher, and only four groups significantly lower SARs than their hosts. Immigrant groups tended to have similar rates across different centres. Moreover, positive correlation between the immigrant SAR and the country-of-origin suicide rate was found. However, Chileans, Iranians, Moroccans, and Turks displayed high SARs as immigrants despite low suicide rates in the home countries. The similarity of most immigrant groups' SARs across centres, and the correlation with suicidality in the countries of origin suggest a strong continuity that can be interpreted in either cultural or genetic terms. However, the generally higher rates among immigrants compared to host populations and the similarity of the rates of foreign-born and those immigrants who retained the citizenship of their country of origin point to difficulties in the acculturation and integration process. The positive correlation found between attempted and completed suicide rates suggests that the two are related, a fact with strong implications for suicide prevention.
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| 8. |
- Lipsicas, Cendrine Bursztein, et al.
(author)
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Immigration and recommended care after a suicide attempt in Europe : equity or bias?
- 2014
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 24:1, s. 63-65
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Journal article (peer-reviewed)abstract
- This report describes the investigation of care recommendations in the medical system across European countries to immigrants who attempted suicide. Data from seven European countries with 8865 local and 2921 immigrant person-cases were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour and ensuing MONSUE (Monitoring Suicidal Behaviour in Europe) project. The relationship between immigrant status and type of aftercare recommended was analysed with binary logistic regression, adjusting for gender, age, method of attempt and the Centre collecting the data. Clear disparities were identified in the care recommendation practices toward immigrants, compared with hosts, over and above differing policies by the European Centres.
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| 9. |
- Lipsicas, Cendrine Bursztein, et al.
(author)
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Repetition of attempted suicide among immigrants in Europe
- 2014
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In: Canadian journal of psychiatry. - : SAGE Publications. - 0706-7437 .- 1497-0015. ; 59:10, s. 539-547
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups.METHOD: Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare.RESULTS: Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results.CONCLUSIONS: The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations.
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| 10. |
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| 11. |
- Music, Emina, et al.
(author)
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Suicide in Bosnia and Herzegovina and the City of Sarajevo With Special Reference to Ethnicity
- 2014
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In: Crisis. - : Hogrefe & Huber Publishers. - 0227-5910 .- 2151-2396. ; 35:1, s. 42-50
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Journal article (peer-reviewed)abstract
- Background: Besides the war experience (1992-1995), Bosnia and Herzegovina (BiH) constitutes an interesting area for studies on suicidal behavior from an ethnic and religious perspective with its mixed ethnic population of Bosniaks, Serbs, and Croats. Aims: The study investigates suicide in BiH and the capital city of Sarajevo before (1985-1991) and after the war (1998-2006), with special reference to gender and ethnicity. Method: Official suicide data were gathered for the two periods with regard to gender, ethnicity, and suicide methods used. Results: No differences in suicide rates were found in BiH and Sarajevo before and after the war. The male-to-female suicide rate ratio in BiH was significantly higher after the war than before the war, with an opposite tendency seen in Sarajevo. Before and after the war, the highest and stable suicide rates were among Serbs in BiH. In Sarajevo the highest suicide rates were found among Croats after the war. Hanging was the most common suicide method used, both before and after the war, while firearms were more commonly used after the war. Poisoning was a rarely used method in both periods. Conclusion: The stable suicide rates in BiH over the pre- and postwar periods indicate no evident influence of the Bosnian war on the postwar level of suicide rates, except for women in Sarajevo. Beside this exception, the findings indicate a long-established underlying pattern in suicide rates that was not immediately changed, even by war. The study supports earlier findings that the accessibility of means influences the choice of suicide method used.
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| 12. |
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| 13. |
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| 14. |
- Skruibis, Paulius, et al.
(author)
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Attitudes towards suicide among regional politicians in Lithuania, Austria, Hungary, Norway and Sweden
- 2010
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In: Suicidology Online. - 2078-5488. ; 1, s. 79-87
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Journal article (peer-reviewed)abstract
- The aim of this study was to compare attitudes towards suicide among regional politicians in five European countries, namely Austria, Hungary, Lithuania, Norway and Sweden. Attitudes of politicians are important as they are key persons in a suicide prevention context. All these countries differ significantly with respect to suicide rates and suicide prevention strategies. Previous research has shown that more permissive attitudes towards suicide are prevalent in countries with higher rates of suicide. Thus, we would expect that regional politicians in these countries would hold rather different attitudes towards suicide. The Attitudes Towards Suicide questionnaire (ATTS) was employed in the study. The results indicated that the acceptance of suicide was higher among Lithuanian, Hungarian and Austrian politicians (high suicide rate, no national prevention strategies), than among Norwegian and Swedish politicians (relatively low suicide rates, national prevention strategies). The same split in attitudes between low and high suicide rate areas was found concerning preparedness to help a person in a suicidal crisis. The only significant difference between male and female politicians was found with respect to perceived preventability of suicide, with male politicians being slightly more optimistic than female politicians. Overall, the results of our study show that differences among countries in suicide rates and suicide prevention policies are reflected in attitudes of politicians.
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| 15. |
- Strömbäck, Maria, 1965-
(author)
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Skapa rum. Ung femininitet, kroppslighet och psykisk ohälsa : genusmedveten hälsofrämjande intervention.
- 2014
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Doctoral thesis (other academic/artistic)abstract
- Mental health problems among young people, girls and young women in particular, are a serious public health problem. Gendered patterns of mental illness are seen in conjunction with stress-related problems such as anxiety, depression, and psychosomatic complaints. Intervention models tailored to the health care situation are therefore in need of development and evaluation. The overall aim of this thesis is to develop knowledge and understanding for young women’s mental health, stress-related, and bodily problems from a psychosomatic and gender theory perspective, and to evaluate a gender sensitive physiotherapeutic intervention model consisting of a stress management course for young women with stress-related problems.The thesis consists of four studies. The overall research design combines qualitative and quantitative methods in which questionnaires and interviews were used to explore participant experiences and symptoms linked to perceived stress before and after the intervention. Data consisted of a cumulative sample of 65 young women, 16 to 25 years of age, who attended the youth-friendly health center because of stress-related problems. In paper I, multiple symptom areas of mental health and somatic problems, self-image and aspects of body perception were measured before the course. Participants were 47 of the young women. The results were compared with published normative and clinical reference groups. In paper II, the young women’s experiences of living stressful femininity were analysed with a qualitative content analysis using gender theoretical and phenomenological perspectives as an interpretative frame. The study was based on interviews with 25 of the women. In paper III, follow-up interviews were done with 32 of the women after completion of the course. Data was using qualitative content analysis to illuminate experiences of participating in the course. In paper IV, the course was evaluated by measuring changes in multiple symptom areas using the Adult Self Report (ASR), Social Analysis of Social Behaviour (SASB), and Body Perception Questionnaire (BPQ). Participants were 54 of the women who completed measurements finishing the course.Young women present complex symptomatology of stress-related problems. The total burden of symptoms plus the narrated experiences highlight how renegotiations of gender constructions and handling of normative and stressful femininity constrain access to bodily resources. After the stress management course, their measured and narrated experiences show positive changes and release of mental health and stress problems, including a more positive self-image and sense of enhanced confidence in their bodies. Experiences of the course as a safe and explorative space for gendered collective understanding and embodied empowerment indicate the need to develop gender-sensitive interventions. The thesis contributes to youth and gender theoretical perspectives with integration of psychosomatic and psychiatric physiotherapy. A broader awareness of how gender constructions and sociocultural aspects are significant in the understanding of psychosomatic expressions of mental ill health and young femininity is valuable in development of theory and interventions in physiotherapy, as well as into other fields.
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| 16. |
- Werneke, Ursula, et al.
(author)
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A decision analysis of long-term lithium treatment and the risk of renal failure
- 2012
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In: Acta Psychiatrica Scandinavica. - : Wiley-Blackwell. - 0001-690X .- 1600-0447. ; 126:3, s. 186-197
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Journal article (peer-reviewed)abstract
- Objective: To establish whether lithium or anticonvulsant should be used for maintenance treatment for bipolar affective disorder (BPAD) if the risks of suicide and relapse were traded off against the risk of end-stage renal disease (ESRD).Method: Decision analysis based on a systematic literature review with two main decisions: (1) use of lithium or at treatment initiation and (2) the potential discontinuation of lithium in patients with chronic kidney disease (CKD) after 20 years of lithium treatment. The final endpoint was 30 years of treatment with five outcomes to consider: death from suicide, alive with stable or unstable BPAD, alive with or without ESRD.Results: At the start of treatment, the model identified lithium as the treatment of choice. The risks of developing CKD or ESRD were not relevant at the starting point. Twenty years into treatment, lithium still remained treatment of choice. If CKD had occurred at this point, stopping lithium would only be an option if the likelihood of progression to ESRD exceeded 41.3% or if anticonvulsants always outperformed lithium regarding relapse prevention.Conclusion: At the current state of knowledge, lithium initiation and continuation even in the presence of long-term adverse renal effects should be recommended in most cases.
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| 17. |
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