| 1. |
- Amin, Leila, et al.
(författare)
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Swedish national population-based study shows an increased risk of depression among patients with Hirschsprung disease.
- 2019
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 108:10, s. 1867-1870
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Hirschsprung disease is usually treated during infancy. The long-term impact on mental health has not been well studied. The aim of this study was to assess the risk for depressive disorders in individuals with Hirschsprung disease.METHODS: This was a nationwide, population-based cohort study. The study exposure was Hirschsprung disease and the study outcome was depression. The exposed cohort included all individuals with Hirschsprung disease, registered in the Swedish National Patient Register between 1964 and 2013 and the unexposed cohort included ten age- and sex-matched controls per patient. The diagnosis of depression was confirmed by diagnosis in the Swedish National Patient Register.RESULTS: The cohort included 739 (76.5% males) individuals with Hirschsprung disease and 7390 (76.5% males) controls. Among the patients with Hirschsprung disease, 35 (4.7%) of the patients had had a depressive disorder and 187 (2.5%) of controls, hazard ratio 1.98, 95% confidence interval 1.38-2.84. The mean age at diagnosis of first depression was 21.9 years (SD ± 7) in Hirschsprung disease patients and 23.4 years (SD ± 7), p = 0.236 in the unexposed group. There were no significant gender differences.CONCLUSION: We found an increased risk of having depressive disorders among individuals with Hirschsprung disease compared to controls.
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| 2. |
- Bengtsson, Kenneth, et al.
(författare)
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Så kan Sverige bli ledande nation i resurseffektivitet
- 2016
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Ingår i: Dagens Nyheter. - 1101-2447. ; :2016-04-30
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Ny rapport. Det svenska näringslivet kan bli mer hållbart, resurssmart och därmed internationellt konkurrenskraftigt. Men för det behövs en tydlig politisk avsiktsförklaring och riktlinjer. Vi har listat sex områden där policyutveckling brådskar, skriver företrädare för näringsliv, forskning och myndigheter i en gemensam uppmaning.
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| 3. |
- Granström, Anna Löf, et al.
(författare)
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No increased risk of attention deficit hyperactivity disorders in patients with Hirschsprung disease.
- 2019
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Ingår i: Journal of Pediatric Surgery. - : Elsevier BV. - 0022-3468 .- 1531-5037. ; 54:10, s. 2024-2027
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Hirschsprung disease (HSCR) has previously been associated with increased need of special education services despite normal intelligence. The aim of this study was to assess the risk of attention deficit hyperactivity disorders (ADHD) in individuals with HSCR in a population-based cohort.METHODS: This was a nationwide, population-based cohort study. The study exposure was HSCR and the study outcome was ADHD. The cohort included all individuals with HSCR registered in the Swedish National Patient Register between 1964 and 2013 and ten age- and sex-matched controls per patient, randomly selected from the Population Register.RESULTS: The cohort comprised 739 individuals with HSCR and 7390 controls. Twenty-six of the 739 individuals with HSCR and 202 of the 7390 controls were diagnosed with ADHD, Odds ratio (OR) 1.30, Confidence interval (CI) 95% 0.84-1.93, indicating no difference in risk for ADHD. The mean age at diagnosis of ADHD was not different between the groups; 18.1 years (SD 8.4) vs 16.7 years (SD 7.8), p = 0.39. Down syndrome did not affect the risk for ADHD, OR 2.26 (CI 95% 0.68-5.53). Female gender decreased the risk for ADHD, OR 0.58 (CI 95% 0.40-0.83).CONCLUSIONS: There is no increased risk of ADHD in patients with Hirschsprung disease.LEVEL OF EVIDENCE: Prognosis study, level of evidence: Level I.
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| 4. |
- Granström, Anna Löf, et al.
(författare)
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Selective serotonin reuptake inhibitors during pregnancy Do not increase the risk of Hirschsprung disease.
- 2019
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Ingår i: Journal of Pediatric Surgery. - : Elsevier BV. - 0022-3468 .- 1531-5037. ; 54:11, s. 2398-2401
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Hirschsprung disease (HSCR) is a multifactorial disease. Maternal intake of selective serotonin reuptake inhibitors (SSRI) during early pregnancy has previously been associated with increased risk for HSCR. The aim of this study was to assess the risk for HSCR in newborns after maternal intake of SSRI in a population-based Swedish cohort.METHODS: This was a Swedish nationwide, population-based, case-control cohort study containing all children born in Sweden between 1/12006 and 31/122012. The cases were identified in the Swedish National Patient Register and the controls (five age- and sex-matched controls per case) were randomly selected among children without HSCR in the cohort. Data on maternal SSRI use during pregnancy were collected from the Swedish Prescribed Drug Register.RESULTS: Out of 775,024 born children during the study period, 150 cases of HSCR (112 males) and 750 controls (560 males) were included. Five (3.3%) mothers of newborns with HSCR had used SSRI during pregnancy compared to 16 (2.1%) mothers of the controls (p = 0.372). The mean age was similar in mothers who had used SSRI compared to those who had not (30.9 (SD +/- 5.1) versus 30.6 (SD +/- 5.0), p = 0.81).CONCLUSIONS: There was no increased risk of HSCR owing to maternal intake of SSRI in this cohort.LEVEL OF EVIDENCE: Level I.
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| 5. |
- Larsson, Helena, et al.
(författare)
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Content Validity Index and Intra- and Inter-Rater Reliability of a New Muscle Strength/Endurance Test Battery for Swedish Soldiers
- 2015
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Ingår i: PLOS ONE. - : Public library science. - 1932-6203. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to examine the content validity of commonly used muscle performance tests in military personnel and to investigate the reliability of a proposed test battery. For the content validity investigation, thirty selected tests were those described in the literature and/or commonly used in the Nordic and North Atlantic Treaty Organization (NATO) countries. Nine selected experts rated, on a four-point Likert scale, the relevance of these tests in relation to five different work tasks: lifting, carrying equipment on the body or in the hands, climbing, and digging. Thereafter, a content validity index (CVI) was calculated for each work task. The result showed excellent CVI (>= 0.78) for sixteen tests, which comprised of one or more of the military work tasks. Three of the tests; the functional lower-limb loading test (the Ranger test), dead-lift with kettlebells, and back extension, showed excellent content validity for four of the work tasks. For the development of a new muscle strength/endurance test battery, these three tests were further supplemented with two other tests, namely, the chins and side-bridge test. The inter-rater reliability was high (intraclass correlation coefficient, ICC2,1 0.99) for all five tests. The intra-rater reliability was good to high (ICC3,1 0.82-0.96) with an acceptable standard error of mean (SEM), except for the side-bridge test (SEM%>15). Thus, the final suggested test battery for a valid and reliable evaluation of soldiers' muscle performance comprised the following four tests; the Ranger test, dead-lift with kettlebells, chins, and back extension test. The criterion-related validity of the test battery should be further evaluated for soldiers exposed to varying physical workload.
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| 6. |
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| 7. |
- Skoglund, Charlotte, et al.
(författare)
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Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden
- 2019
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Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 2:10
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) is associated with a plethora of adverse health outcomes throughout life. While Swedish specialized youth clinics have carefully and successfully targeted risk of unplanned pregnancies in adolescents, important risk groups, such as women and girls with ADHD, might not be identified or appropriately assisted by these interventions. OBJECTIVES To determine whether women and girls with ADHD are associated with increased risk of teenage birth compared with their unaffected peers and to examine the association of ADHD with risk factors for adverse obstetric and perinatal outcomes, such as smoking, underweight or overweight, and substance use disorder. DESIGN, SETTING, AND PARTICIPANTS This nationwide cohort study included data from 6 national longitudinal population-based registries in Sweden. All nulliparous women and girls who gave birth in Sweden between January 1, 2007, and December 31, 2014, were included. Data analyses were conducted from October 7, 2018, to February 8, 2019. EXPOSURES Women and girls treated with stimulant or nonstimulant medication for ADHD (Anatomic Therapeutic Chemical classification code N06BA) in the Swedish Prescribed Drug Register between July 1, 2005, and December 31, 2014. MAIN OUTCOMES AND MEASURES Maternal age at birth. Secondary outcome measures were body mass index, smoking habits, and psychiatric comorbidities. RESULTS Among 384 103 nulliparous women and girls aged 12 to 50 years who gave birth between 2007 and 2014 included in the study, 6410 (1.7%) (mean [SD] age, 25.0 [5.5] years) were identified as having ADHD. The remaining 377 693 women and girls without ADHD (mean [SD] age, 28.5 [5.1] years) served as the control group. Teenage deliveries were more common among women and girls with ADHD than among women and girls without ADHD (15.3% vs 2.8%; odds ratio [OR], 6.23 [95% CI, 5.80-6.68]). Compared with women and girls without ADHD, those with ADHD were more likely to present with risk factors for adverse obstetric and perinatal outcomes, including smoking during the third trimester (OR, 6.88 [95% CI, 6.45-7.34]), body mass index less than 18.50 (OR, 1.29 [95% CI, 1.12-1.49]), body mass index more than 40.00 (OR, 2.01 [95% CI, 1.60-2.52]), and alcohol and substance use disorder (OR, 20.25 [95% CI, 18.74-21.88]). CONCLUSIONS AND RELEVANCE This study found that women and girls with ADHD were associated with an increased risk of giving birth as teenagers compared with their unaffected peers. The results suggest that standard of care for women and girls with ADHD should include active efforts to prevent teenage pregnancies.
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| 8. |
- Skoglund, Charlotte, et al.
(författare)
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Attention-deficit/hyperactivity disorder and risk for substance use disorders in relatives.
- 2015
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Ingår i: Biological Psychiatry. - Philadelphia, USA : Elsevier BV. - 0006-3223 .- 1873-2402. ; 77:10, s. 880-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous research indicates that attention-deficit/hyperactivity disorder (ADHD) is highly associated with substance use disorders (SUD). However, these studies have failed to clarify the nature of the overlap. The main aim of this study was to explore whether the overlap between ADHD and SUD could be explained by shared genetic and environmental factors or by harmful effects of ADHD medication.METHODS: We employed a matched cohort design across different levels of family relatedness recorded from 1973-2009. By linking longitudinal Swedish national registers, 62,015 ADHD probands and first-degree and second-degree relatives were identified and matched 1:10 with control subjects without ADHD and their corresponding relatives. Any record of SUD was defined by discharge diagnoses of the International Classification of Diseases or a purchase of any drug used in the treatment of SUD.RESULTS: First-degree relatives of ADHD probands were at elevated risk for SUD (odds ratios 2.2 and 1.8) compared with relatives of control subjects. The corresponding relative risk in second-degree relatives was substantially lower (odd ratios 1.4 and 1.4). The familial aggregation patterns remained similar for first-degree and second-degree relatives after excluding individuals with coexisting disorders such as schizophrenia, bipolar disorder, depression, and conduct disorder.CONCLUSIONS: Our findings suggest that the co-occurrence of ADHD and SUD is due to genetic factors shared between the two disorders, rather than to a general propensity for psychiatric disorders or harmful effects of ADHD medication.
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| 9. |
- Skoglund, Charlotte, et al.
(författare)
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Clinical trial of a new technique for drugs of abuse testing : a new possible sampling technique.
- 2015
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Ingår i: Journal of Substance Abuse Treatment. - : Elsevier BV. - 0740-5472 .- 1873-6483. ; 48:1, s. 132-6
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Tidskriftsartikel (refereegranskat)abstract
- Exhaled breath has recently been proposed as a matrix for drug testing. This study aims to further explore, develop and validate exhaled breath as a safe and effective non-invasive method for drug testing in a clinical setting. Self-reported drug use was recorded and drug testing was performed by mass spectrometry and immunochemical methods using breath, plasma and urine samples from 45 individuals voluntarily seeking treatment for recreational drug use. Cannabis was the most prevalent drug detected by any method. Urine sampling detected most cases. The exhaled breath technique was less sensitive (73%) than plasma analysis for detection of cannabis uses but captures a more recent drug intake than both plasma and urine. Exhaled breath was the preferred specimen to donate according to interview data of the participants. Testing illicit drugs with the exhaled breath sampling technique is a sufficient, non-invasive and safe alternative and complement to plasma and/or urine sampling.
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| 10. |
- Skoglund, Charlotte, et al.
(författare)
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Factors Associated With Adherence to Methylphenidate Treatment in Adult Patients With Attention-Deficit/Hyperactivity Disorder and Substance Use Disorders
- 2016
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Ingår i: Journal of Clinical Psychopharmacology. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0271-0749 .- 1533-712X. ; 36:3, s. 222-228
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Tidskriftsartikel (refereegranskat)abstract
- Adherence to treatment is one of the most consistent factors associated with a favorable addiction treatment outcome. Little is known about factors associated with treatment adherence in individuals affected with comorbid attention-deficit/hyperactivity disorder and substance use disorders (SUD). This study aimed to explore whether treatment-associated factors, such as the prescribing physician's (sub)specialty and methylphenidate (MPH) dose, or patient-related factors, such as sex, age, SUD subtype, and psychiatric comorbidity, were associated with adherence to MPH treatment. Swedish national registers were used to identify adult individuals with prescriptions of MPH and medications specifically used in the treatment of SUD or a diagnosis of SUD and/or coexisting psychiatric diagnoses. Primary outcome measure was days in active MPH treatment in stratified dose groups (≤36 mg, ≥37 mg to ≤54 mg, ≥55 mg to ≤72 mg, ≥73 mg to ≤90 mg, ≥91 mg to ≤108 mg, and ≥109 mg). Lower MPH doses (ie, ≤36 mg day 100) were associated with treatment discontinuation between days 101 and 830 (HR≤36 mg, 1.67; HR37-54mg, 1.37; HR55-72mg, 1.36; HR73-90mg, 1.19; HR≥108mg, 1.09). The results showed a linear trend (P < 0.0001) toward decreased risk of treatment discontinuation along with increase of MPH doses. In conclusion, this study shows that higher MPH doses were associated with long-term treatment adherence in individuals with attention-deficit/hyperactivity disorder and SUD.
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| 11. |
- Skoglund, Charlotte, et al.
(författare)
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Methylphenidate doses in Attention Deficit/Hyperactivity Disorder and comorbid substance use disorders.
- 2017
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Ingår i: European Neuropsychopharmacology. - : Elsevier BV. - 0924-977X .- 1873-7862. ; 27:11, s. 1144-1152
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Tidskriftsartikel (refereegranskat)abstract
- Patients with Attention Deficit/Hyperactivity Disorder (ADHD) and comorbid Substance Use Disorders (SUD) are increasingly being treated with central stimulant medication despite limited evidence for its effectiveness. Lack of longitudinal follow-up studies of dosing and adverse effects has resulted in conflicting treatment guidelines. This study aims to explore whether individuals with ADHD and comorbid SUD are treated with higher stimulant doses than individuals with ADHD only, and whether doses increase over time as a sign of tolerance, a core symptom of addiction. Information on methylphenidate doses for 14 314 Swedish adults, including 4870 individuals with comorbid SUD was obtained through linkages of Swedish national registers between 2006 and 2009. Differences in doses between patients with and without SUD were estimated using logistic regression while a linear regression model calculated time trends in mean doses. Individuals with SUD were prescribed higher methylphenidate doses than those without (ORday365; 2.12, 95% CI 1.81-2.47: ORday730 2.65, 95% CI 2.13-3.30). Patients with SUD were, two years after initiating stimulant treatment, prescribed approximately 40% higher doses compared to individuals with ADHD only. The results may suggest a need for increased doses in this population to achieve optimal ADHD symptom control. A tendency towards increasing doses during the first years of treatment, more pronounced in individuals with comorbid SUD, may reflect a reluctance to prescribe adequate doses due to lack of clinical guidelines. Mean doses stabilized after about two years in both groups, which does not lend support to continuously increasing tolerance over time.
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| 12. |
- Skoglund, Charlotte, et al.
(författare)
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Public opinion on alcohol consumption and intoxication at Swedish professional football events.
- 2017
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Ingår i: Substance Abuse Treatment, Prevention, and Policy. - : Springer Science and Business Media LLC. - 1747-597X. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Alcohol-related problems at professional sporting events are of increasing concern and alarming reports are often reported in international media. Although alcohol consumption increases the risk for interpersonal violence, it is viewed as a focal element of large football events. Sweden has a long tradition of high public support for strict alcohol-control policies. However, little is known about public opinions on alcohol intoxication and the support for interventions to decrease intoxication at football events. The current study explored the public opinion towards alcohol use, intoxication and alcohol policies at professional football matches in Sweden.METHODS: A cross-sectional design was utilized and a random general population sample of 3503 adult Swedish residents was asked to participate in a web survey during 2016 (response rate 68%).RESULTS: In total, 26% of the respondents supported alcohol sales at football events. Over 90% reported that obviously intoxicated spectators should be denied entrance or evicted from arenas. The support for regulations limiting alcohol availability varied with background factors such as gender, alcohol use and frequency of football event attendance.CONCLUSIONS: There is a strong public consensus for strategies and policies to reduce alcohol sales and intoxication levels at football matches. This public support has implications for our preventive efforts and will facilitate the implementation of strategies and policy changes.
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| 13. |
- Skoglund, Charlotte
(författare)
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When ADHD and substance use disorders coexist : etiology and pharmacological treatment
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Individuals with attention-deficit hyperactivity disorder (ADHD) and comorbid substance use disorder (SUD) comprise a significant group of patients displaying various degrees of personal suffering, entailing a substantial economical burden on society and presenting with challenges in treatment. The overlap between the two disorders is well established, but the underlying genetic and environmental mechanisms of their coexistence, are poorly understood. Furthermore, little is known about the effectiveness and safety of stimulant medication when ADHD and SUD coexist. This thesis aimed to investigate the etiological relationship between ADHD and substance use problems (Studies I and II) and to explore doses of, and adherence to, pharmacological treatment for ADHD in the presence of SUD (Studies III and IV). Quasi-experimental methods (Study I) were used to investigate whether smoking during pregnancy (SDP) is causally associated with ADHD in offspring. A family design (Study II) was applied to explore whether the overlap between ADHD and SUD arises from shared familial factors or is better explained by harmful effects of ADHD medication. Nationwide population-based cohort designs (Study III) were used to explore differences in and development of methylphenidate (MPH) doses in ADHD patients with and without SUD, and the impact of MPH doses on adherence to treatment in individuals with SUD (Study IV). The results show that the increased risk for ADHD in individuals exposed to SDP was attenuated when familial factors were accounted for, suggesting that genetically transmitted factors explain the association. Furthermore, genetic relatedness to an ADHD proband predicts SUD in ADHD-free relatives suggesting that the co-occurrence of ADHD and SUD may be due to common genetic factors shared between the two disorders. The studies focusing on stimulant treatment show that patients with comorbid SUD are prescribed higher MPH doses and have higher adherence to MPH treatment compared to patients with ADHD only. In both groups MPH doses stabilized within two years of treatment. Higher doses of MPH were associated with increased adherence to treatment. In conclusion, the collective findings from this thesis suggest that ADHD and SUD share common genetic underpinnings, that individuals with comorbid SUD receive higher stimulant doses than individuals with ADHD only, without signs of tolerance, and that stimulant doses predict adherence to pharmacological treatment in individuals with comorbid SUD.
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