| 1. |
- 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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| 2. |
- Dalteg, Arne, et al.
(författare)
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Psychosis in adulthood is associated with high rates of ADHD and CD problems during childhood
- 2014
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 68:8, s. 560-566
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients diagnosed with schizophrenia display poor premorbid adjustment (PPA) in half of the cases. Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common child psychiatric disorders. These two facts have not previously been linked in the literature. Aims: To determine the prevalence of ADHD/CD problems retrospectively among patients with psychoses, and whether and to what extent the high frequency of substance abuse problems among such patients may be linked to ADHD/CD problems. Method: ADHD and CD problems/diagnoses were retrospectively recorded in one forensic (n = 149) and two non-forensic samples (n = 98 and n = 231) of patients with a psychotic illness: schizophrenia, bipolar or other, excluding drug-induced psychoses. Results: ADHD and CD were much more common among the patients than in the general population-the odds ratio was estimated to be greater than 5. There was no significant difference in this respect between forensic and non-forensic patients. Substance abuse was common, but substantially more common among patients with premorbid ADHD/CD problems. Conclusions: Previous views regarding PPA among patients with a psychotic illness may reflect an association between childhood ADHD/CD and later psychosis. The nature of this association remains uncertain: two disorders sharing some generative mechanisms or one disorder with two main clinical manifestations. Childhood ADHD and particularly CD problems contribute to the high frequency of substance abuse in such groups.
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| 3. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Flunitrazepam intake in male offenders
- 2012
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Ingår i: Nordic Journal of Psychiatry. - : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 66:2, s. 131-140
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Tidskriftsartikel (refereegranskat)abstract
- The abuse of flunitrazepam (FZ) compounds is worldwide, and several studies have reflected on the consequences with regard to violence, aggression and criminal lifestyle of FZ users. Criminals take high doses of FZ or some other benzodiazepines to "calm down" before the planned crime. There is support from earlier studies that most likely, all benzodiazepines may increase aggression in vulnerable males. Chronic intake of high doses of FZ increases aggression in male rats. Because psychopathy involves aggression, we have examined whether psychopathy as well as any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle and Antisocial) are related to different substance use disorders, with the focus on FZ. We have also examined the relationship between each PCL-R item and FZ use. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Substance use, including FZ, was not more common in those who scored high in psychopathy. Use of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% CI 1.86-9.94). Only one of the PCL-R items, "Criminal versatility", was significantly associated with FZ use (odds ratio = 3.7). It may be concluded that intake of FZ has a specific relationship to only one of the facets and not to psychopathy per se. ; The findings have also important theoretical implications because Facet 4 is not a key factor of the construct of psychopathy. Clinical implications of the article: We have used the new two-factor and four-facet theoretical model of psychopathy in the young offender population, many of them with one or more substance use disorders. The present results suggest that antisocial behavior defined by Facet 4 (poor behavioral control, early behavior problems, juvenile delinquency, revocation of conditional release and criminal versatility) in the studied subjects is more typical for FZ users than it is for non-FZ users. This may have implications for assessment and treatment. Clinicians should be aware that criminals with high scores on Facet 4 have a more than fourfold odds of being a FZ user. This conclusion has an important clinical implication because FZ abuse is very common and is not always the focus of a forensic psychiatric assessment. ;
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| 4. |
- Eklund, Mona, et al.
(författare)
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Psychometric properties and factor structure of the Swedish version of the Perceived Stress Scale.
- 2014
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 68:7, s. 494-499
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Tidskriftsartikel (refereegranskat)abstract
- The Perceived Stress Scale (PSS) measures general stress and the Swedish version, although used in several studies, has not been extensively evaluated for psychometric properties. Aims: This study aimed to investigate psychometric properties and the factor solution of the Swedish 14-item version when used with two samples, namely a mixed Internet sample of women and men (n = 171) and another of women with stress-related disorders (n = 84). Classical test theory, including confirmatory factor analysis, was employed. Results: The factor structure supported a two-factor model for the PSS and confirmed other language versions of the PSS, although one items showed a low item-total correlation. The PSS showed to be feasible with the investigated samples and the results indicated no ceiling or floor effects and good internal consistency of the PSS. Several aspects of construct validity were shown. An association of − 0.66 between the PSS and a measure of coping indicated good concurrent validity. Criterion validity was demonstrated through a statistically significant difference (P < 0.001) between the women with stress-related disorders and the Internet sample. Predictive validity of the PSS could be demonstrated in a short-term perspective. Based on the sample with stress-related disorders, sensitivity to change was shown through a statistically significant stress reduction (P < 0.001) from entering work rehabilitation to discharge. Conclusions: The Swedish version of the PSS showed satisfactory psychometric properties and may be recommended for use with people with and without known stress-related disorders.
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| 5. |
- Eklund, Mona, et al.
(författare)
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Psychometric properties of a Swedish version of the Pearlin Mastery Scale in people with mental illness and healthy people
- 2012
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Ingår i: Nordic Journal of Psychiatry. - Abingdon : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 66:6, s. 380-388
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mastery refers to the degree to which people perceive that they can control factors that influence their life situation, and has been found important for people's quality of life and well-being. It is thus essential to be able to measure mastery in a valid and reliable way. Aim: This study aimed at using the Rasch measurement model to investigate the psychometric properties of a Swedish version of the Pearlin Mastery Scale (Mastery-S). Methods: A sample of 300 healthy individuals and 278 persons with mental illness responded to the Mastery-S. Item responses were Rasch analysed regarding model fit, response category functioning, differential item functioning (DIF) and targeting, using the partial credit model. Results: The Mastery-S items represented a logical continuum of the measured construct but one item displayed misfit. Reliability (Person Separation Index) was 0.7. The response categories did not work as expected in three items, which could be corrected for by collapsing categories. Three items displayed DIF between the two subsamples, which caused a bias when comparing mastery levels between subsamples, suggesting the Mastery-S is not truly generic. Conclusions: The Mastery-S may be used to obtain valid and reliable data, but some precautions should be made. If used to compare groups, new analyses of DIF should first be made. Users of the scale should also consider exempting item 6 from the scale and analyse it as a separate item. Finally, rewording of response categories should be considered in order to make them more distinct and thereby improve score reliability.
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| 6. |
- Gothefors, Dan, et al.
(författare)
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Swedish clinical guidelines-Prevention and management of metabolic risk in patients with severe psychiatric disorders
- 2010
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 64:5, s. 294-302
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Tidskriftsartikel (refereegranskat)abstract
- Individuals with severe psychiatric disorders are more likely than the population at large to develop metabolic derangements such as overweight and diabetes. Cardiovascular disease is also more frequently seen in this group. Contributing factors may include inappropriate diet or lack of physical activity, but antipsychotic medication may also play a role. Seven Swedish specialist medical societies have collaborated in formulating a set of concise clinically applicable guidelines-reproduced here in modified form-for the prevention and management of metabolic risk in this patient group. The importance of implementation is emphasized.
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| 7. |
- Hansson, Helena, et al.
(författare)
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Intervention with feedback using Outcome Questionnaire 45 (OQ-45) in a Swedish psychiatric outpatient population. A randomized controlled trial.
- 2013
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 67:4, s. 274-281
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The objective of the study was to evaluate the efficacy of the Outcome Questionnaire 45 (OQ-45) with feedback in a Swedish psychiatric outpatient population using a randomized controlled design. Method: In all 1720 patients made at least one regular visit to the clinics in the period 12 February 2007 to 10 February 2008 and received information about the study. Of these, 374 patients (22%) agreed to participate. After written consent, 188 patients were randomized to the feedback group and 186 patients to the control group. Those constituted the intention-to-treat (ITT) group. Two hundred and sixty-two patients (70%) completed the OQ-45 questionnaire at least twice, and they were included in the per-protocol analysis. Those who improved less than expected and were at risk for treatment failure were called alerted patients. Results: There was a tendency that patients who received feedback improved more than the controls in OQ-45 total score. In the ITT analysis, the P-value was 0.061 and the effect size g = 0.21. In the per-protocol analysis the P-value was 0.076 and the effect size g = 0.24. In the intervention group, 27% of the patients were alerted because of risk of treatment failure vs. 28% in the control group (reaching level of alertness). The OQ-45 differences between the intervention and control groups did not significantly differ for patients who were alerted/reaching level of alertness and for non-alerted patients (g = 0.17 and g = 0.28, respectively). Conclusions: The feedback group had a tendency to improve more than the control group, possibly indicating that the method is effective, and the result (basically) supports previous findings.
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| 8. |
- Hansson, Lars, et al.
(författare)
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Perceived and anticipated discrimination in people with mental illness-An interview study.
- 2013
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488.
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Tidskriftsartikel (refereegranskat)abstract
- Background. Studies on perceived discrimination of people with mental illness are largely lacking. The purpose of the study was to investigate perceived discrimination in a sample of users in contact with mental health services in Sweden. Methods. Interviews were conducted with 156 users, asking for perceived and anticipated discrimination during the last 2 years. Background characteristics were also collected. Results. Perceived discrimination was common. Highest frequencies were reported regarding family (54%), avoidance by people who knew about the mental illness (53%) and in making or keeping friends (50%). A majority of those anticipating discrimination regarding job or education seeking, or starting a close relationship did not report having been discriminated in these areas. Previous hospitalizations were associated with discrimination, and age with anticipated discrimination. Conclusions. Public stigma and self-stigma have been reported to have a number of negative consequences for people with mental illness. Discrimination is part of this complex situation and this study showed that this largely affects a number of individual life areas posing an obstacle for social integration. Anticipated discrimination or self-stigma was also prevalent and it is pointed out that this to a great extent is an obstacle on its own without being promoted by actual experiences of discrimination.
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| 9. |
- Hansson, Sara Lina, et al.
(författare)
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The Autism--Tics, AD/HD and other Comorbidities (A-TAC) telephone interview: convergence with the Child Behavior Checklist (CBCL).
- 2010
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 64:3, s. 218-224
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare telephone interview screening for child psychiatric/neuropsychiatric disorders using the inventory of Autism-Tics, Attention deficit/hyperactivity disorder (AD/HD) and other Comorbidities (A-TAC) with results from the Child Behavior Checklist (CBCL). Background: The A-TAC is a parent telephone interview focusing on autism spectrum disorders (ASDs) and co-existing problems, developed for lay interviewers. Subjects and methods: A-TAC telephone interviews and CBCL questionnaires were obtained from parents of 106 Swedish twin pairs aged 9 and 12 years. Results: Correlations between A-TAC modules and CBCL scales aimed at measuring similar concepts were generally significant albeit modest, with correlation coefficients ranging from 0.30 through 0.55. Conclusion: The A-TAC has convergent validity with the CBCL in several problem areas, but the A-TAC also provides more detailed and specific assessments of ASD symptoms and related neuropsychiatric problems.
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| 10. |
- Larsen, John Teilmann, et al.
(författare)
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Metabolic syndrome and psychiatrists' choice of follow-up interventions in patients treated with atypical antipsychotics in Denmark and Sweden
- 2011
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 65:1, s. 40-46
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of the present study was to obtain point prevalence estimates of the metabolic syndrome according to the NCEP III criteria in a sample of patients with schizophrenia spectrum disorders treated with atypical antipsychotic drugs in Denmark and Sweden, and to assess the psychiatrists' choice of recommendations for follow-up interventions based on the patients' laboratory results. Method: This was a cross-sectional, observational multi-center study in Denmark and Sweden, in consecutively screened in- and outpatients with schizophrenia spectrum disorders and continuously treated for at least 3 months with atypical antipsychotic drugs. Results: The metabolic syndrome as per medical history was present in 1% of 582 evaluable patients at baseline. After performing laboratory measurements and applying the NCEP III criteria, metabolic syndrome was confirmed in 43% of subjects. The high rate of metabolic syndrome did not elicit much decisive action on the part of the treating psychiatrists; the most frequent action taken was dietary and exercise advice (in 75% of subjects), while in 54% and 19% of subjects a laboratory follow-up and blood pressure follow-up were advised respectively. Change of antipsychotic medication was recommended in only 10% of patients, and in further 11% of patients, no action was taken. Conclusion: Observed metabolic syndrome prevalence rates were at least twice the rates observed in a normal, non-diabetic population. It appears that in this vulnerable population of patients with schizophrenia spectrum disorders, metabolic syndrome remains underdiagnosed and undertreated.
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