| 51. |
- Nordenskjöld, Axel, et al.
(författare)
-
Rehospitalization rate after continued electroconvulsive therapy : a retrospective chart review of patients with severe depression
- 2011
-
Ingår i: Nordic Journal of Psychiatry. - : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 65:1, s. 26-31
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Electroconvulsive therapy, ECT, is an effective acute treatment for severe depression. Today ECT is usually discontinued when the patient’s depressive symptoms abate, although relapse is common. Some studies suggest that continuation ECT (cECT) may prevent relapse of depression, but there are few studies available.Aims: The aim of this study was to describe the need for inpatient care before, during and after cECT. Methods: A retrospective chart. review was conducted of all patients (n=27) treated with cECT between 2005 and 2007 at Orebro University Hospital, Sweden. All patients were severely depressed at the initiation of index ECT. The DSM-IV diagnoses were major depression (n=19), bipolar depression (n=5) or schizoaffective depression (n=3).Results: The hospital day quotient was lower (HDQ=15) during cECT (mean duration+/-standard deviation=104+/-74 days) than during the 3 years prior to cECT (HDQ=26). The rehospitalization rate was 43% within 6 months and 58% within 2 years after the initiation of cECT. Seven patients were rehospitalized while on cECT.Conclusion: The need for inpatient care was reduced during cECT. However, rehospitalization was common. At the initiation of the cECT, the patients were improved by the index ECT. Also cECT was often terminated after rehospitalization, which contributed to the lowered hospital day quotient during cECT. Randomized clinical trials are needed to establish the efficacy of cECT. Clinical implications: Relapses and recurrences in depressed patients are common after ECT treatment. The results indicate that continuation ECT combined with pharmacotherapy might be an alternative treatment strategy.
|
|
| 52. |
- Nordstrom, Tanja, et al.
(författare)
-
Comorbidity of disruptive behavioral disorders and attention-deficit hyperactivity disorder-Indicator of severity in problematic behavior?
- 2013
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 67:4, s. 240-248
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Disruptive behavioral disorders (DBD) and attention-deficit hyperactivity disorder (ADHD) are both characterized by certain patterns of misbehavior among adolescents. Aims: The aim of this study was to examine how the comorbidity of DBD and ADHD affects in misbehavior among adolescents. Methods: A total of 158 adolescents aged 16-18 years, from a subsample of the Northern Finland Birth Cohort 1986 (NFBC 1986), were interviewed with the Finnish translation of the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) in order to obtain DBD, including conduct disorder (CD) and oppositional defiant disorder (ODD), and ADHD diagnoses. The structure of the CD symptoms, obtained from the K-SADS-PL, was compared with the previously formed model about the development of the problematic behavior. The severity of the CD symptoms was compared with adolescents diagnosed with only DBD, only ADHD and with both DBD and ADHD. Also, the associations with other psychiatric disorders diagnosed at age 16 were evaluated. Results: The boys in the study sample were diagnosed with ADHD or with comorbid DBD and ADHD more often than girls. The severity of CD symptoms was statistically significantly associated with the comorbid DBD and ADHD group. The adolescents diagnosed with comorbid DBD and ADHD had an increased risk for anxiety disorders, depressive disorders and substance abuse disorders. Conclusions: The comorbidity of DBD and ADHD seems to indicate the severity of CD symptoms. Clinical implications: The comorbidity between DBD and ADHD should be considered in clinical practice because it could indicate more serious problematic behavior than pure disorders alone.
|
|
| 53. |
- Nylander, Lena, et al.
(författare)
-
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in adult psychiatry. A 20-year register study.
- 2013
-
Ingår i: Nordic journal of psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 67:5, s. 344-350
-
Tidskriftsartikel (refereegranskat)abstract
- Nylander L, Holmqvist M, Gustafson L, Gillberg C. Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in adult psychiatry. A 20-year register study. Nord J Psychiatry 2012;Early Online:1-7 Objective: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are increasingly recognized in adults. This study aimed to assess trends in diagnostic practice, diagnostic delay and comorbidity regarding ADHD and ASD in adult psychiatric patients. Methods: Individuals with diagnosed ADHD or ASD were identified in an adult psychiatry register comprising 56,462 patients. Results: ADHD was diagnosed in up to 2.7% and ASD in 1.3% of the patients. Most cases were diagnosed within 2 years of first contact with adult psychiatry, but some patients were treated for 10 years or more before being diagnosed with ADHD or ASD. Seventy per cent of ADHD and 56% of ASD patients were treated as outpatients only. Other psychiatric diagnoses were registered in about 60%. Affective disorders were common in patients with ADHD. Psychoses and intellectual disability were more common in ASD patients. Psychoactive substance use-related disorders were considerably more common in those with ADHD. Concomitant ADHD and ASD were seldom diagnosed in this clinical material. Conclusion: ADHD and ASD were probably much underdiagnosed in the studied group of psychiatric patients. Other psychiatric diagnoses were common, but not ADHD with concomitant ASD.
|
|
| 54. |
- Odelius, Charlotta Benezeder, et al.
(författare)
-
Clinical utility of proposed non-suicidal self-injury diagnosis - A pilot study
- 2014
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 68:1, s. 66-71
-
Tidskriftsartikel (refereegranskat)abstract
- In the forthcoming fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a new diagnosis is proposed: non-suicidal self-injury (NSSI). To test its clinical utility in a pilot study, NSSI criteria were assessed in 39 young psychiatric outpatients with self-harm behavior. There were no differences between the NSSI (n = 18) and the non-NSSI (n = 21) groups concerning other diagnoses, including borderline personality disorder (BPD) (22% vs. 24%). However, NSSI patients had more suicidal behavior than non-NSSI patients. This pilot study indicates that the NSSI diagnosis is different from BPD, but it does not delimit suicidal behavior.
|
|
| 55. |
- Olofsson, Malin Elisabeth, 1981-, et al.
(författare)
-
A psychometric evaluation of the Swedish version of the Responses to Positive Affect questionnaire
- 2014
-
Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 68:8, s. 588-593
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research mainly focused on responses to negative affect in relation to depression, and less on responses to positive affect. Cognitive responses to positive affect are interesting in the context of emotion regulation and emotion disorders: positive rumination is associated to hypomania risk and bipolar disorder. There is to date no questionnaire in Swedish that captures the phenomena of cognitive response styles.Aims: The aim of this study was to investigate the replicability of the Responses to Positive Affect questionnaire (RPA) in a newly translated Swedish versionand to test its psychometric properties.Methods: Swedish undergraduates (n 111) completed a set of self-report questionnaires in a fixed order.Results: The hypothesized three-factor model was largely replicated in the subscales Self-focused positive rumination, Emotion-focused positive rumination and Dampening. The two positive rumination subscales were strongly associated with each other and current positive affect. The subscales showed acceptable convergent and incremental validity with concurrent measures of depression, hypomania, anxiety, repetitive negative thinking, and positive and negative affect. The model explained 25% of the variance in hypomania, but fell short in the explanation of depression.Conclusions: The Swedish version of the RPA shows satisfactory reliability and initial fi ndings from a student sample indicate that it is a valid measure comparable with the original RPA questionnaire. Results give emphasis to the importance of further exploration of cognitive response styles in relation to psychopathology.
|
|
| 56. |
|
|
| 57. |
|
|
| 58. |
- Paulson Karlsson, Gunilla, et al.
(författare)
-
Prediction of weight increase in anorexia nervosa
- 2013
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 67:6, s. 424-432
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Anorexia nervosa (AN) is a serious psychiatric disorder with high mortality rates a poor outcome and no empirically supported treatment of choice for adults. Weight increase is essential for recovery from AN why research exploring important contributors is crucial.Aims: The current study examined the importance of motivation to change eating behaviour, treatment expectations and experiences, eating disorder symptomatology, self-image and treatment alliance for predicting weight increase. Methods: Female patients (n = 89) between 18 and 46 years of age with Lambda N were assessed pre-treatment and at 6- and 36-month follow-ups with interviews and self-report questionnaires. At the 6-month follow-up the response rates differed from n = 58 (65%) to 66 (74%), and at the 36-month follow-up the response rates differed from n = 71 (80%) to 82 (92%).Results: At treatment start, expressed motivation to change eating habits, social insecurity and self-neglect were predictors of weight increase from 0 to 6 months, while duration, the time from onset to entering treatment, body dissatisfaction and interoceptive awareness were predictors of weight increase from 0 to 36 months.Conclusions: In designing treatment for adult patients with AN, it is essential to include multifaceted interventions addressed to patients' motivation to change, social relations, negative self-image and body dissatisfaction in order to achieve weight increase. Early detection and thereby short duration is an additional important factor that contributes to weight increase.
|
|
| 59. |
- Petersson, Suzanne, et al.
(författare)
-
Perfectionism and sense of coherence among patients with eating disorders
- 2014
-
Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis Group. - 0803-9488 .- 1502-4725. ; 68:6, s. 409-415
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is a substantial body of research on eating disorders and perfectionism. Also there are several studies on eating disorders and sense of coherence (SOC), but studies regarding all three subjects are sparse. Perfectionism and the degree of SOC are considered central and aggravating aspects of psychiatric conditions, not least in relation to eating disorders. Aims: The present study aimed to describe the relationship between perfectionism as operationalized by Garner in the Eating Disorder Inventory-2 and SOC as defined by Antonovsky in the SOC-29 scale. The hypothesis was that SOC should be negatively associated with perfectionism. Methods: Data from the two self-measuring instruments collected from 95 consecutively recruited eating disorder outpatients were analysed with descriptive and inferential statistics. Results: The patients in the present study scored consistently with other Swedish eating disorder samples on the Perfectionism subscale in the Eating Disorder Inventory-2 (EDI-P) and on the SOC-29, indicating a higher degree of perfectionism and weaker SOC than normal population groups. Perfectionism was significantly correlated to SOC. The correlation was negative, confirming the study hypothesis. The hypothesis was further confirmed in a subgroup analysis comparing patients with different degrees of SOC related to their EDI-P scores. Conclusions: Perfectionism is associated with SOC in patients with eating disorders. Clinical implications: The clinical implications derived from the study could be a recommendation to focus on the SOC in patients with an eating disorder with the hope of lowering the patients’ perfectionism as well.
|
|
| 60. |
- Priebe, Gisela, et al.
(författare)
-
Sexual abuse and associations with psychosocial aspects of health : A population-based study with Swedish adolescents
- 2010
-
Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 64:1, s. 40-48
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Few population-based Nordic studies with adolescents investigate the associations between sexual abuse (SA) and psychosocial health. Aim: Associations between adolescents' self-reported experiences of SA different severity and aspects of psychosocial health such as emotional and behavioral problems, sense of coherence and self-esteem were investigated. Methods: A school-based study with 1107 Swedish high school seniors was conducted. The students completed the Strengths and Difficulties Questionnaire (SDQ), the Sense of Coherence Scale (SOC), I think I am and a self-report survey that included questions about SA, socio-demographic variables and family variables. Results: SA was related to more emotional and behavioral problems, weaker SOC and lower self- esteem when compared with non-abuse. There was also a dose-response effect insofar as more severe abuse was related to poorer psychosocial health. When adjusted for socio-demographic and family-related variables, the associations between penetrating SA and most of the health variables weakened or disappeared. SOC was associated with penetrating SA even after adjustment. Conclusions: This population-based study suggests that SA should not be regarded as an isolated factor in relation to psychosocial health as the associations at a group level may be smaller than expected. Among a number of covariates, family variables such as parental bonding showed to be especially important. Sense of Coherence may be of special interest in further research and clinical treatment.
|
|
