| 1. |
- Schön, Ulla-Karin, 1970-, et al.
(författare)
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Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context
- 2015
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Ingår i: Nordic Journal of Psychiatry. - London : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 69:4, s. 275-281
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recovery is understood to be an individual process that cannot be controlled, but can be supported and facilitated at the individual, organizational and system levels. Standardized measures of recovery may play a critical role in contributing to the development of a recovery-oriented system. The INSPIRE measure is a 28-item service user-rated measure of recovery support. INSPIRE assesses both the individual preferences of the user in the recovery process and their experience of support from staff. Aim: The aim of this study was to evaluate the psychometric properties of the Swedish version of the INSPIRE measure, for potential use in Swedish mental health services and in order to promote recovery in mental illness. Method: The sample consisted of 85 participants from six community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. For the test-retest evaluation, 78 participants completed the questionnaire 2 weeks later. Results: The results in the present study indicate that the Swedish version of the INSPIRE measure had good face and content validity, satisfactory internal consistency and some level of instability in test-retest reliability. Conclusions: While further studies that test the instrument in a larger and more diverse clinical context are needed, INSPIRE can be considered a relevant and feasible instrument to utilize in supporting the development of a recovery-oriented system in Sweden. © 2014 Informa Healthcare.
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| 2. |
- Bent-Ennakhil, Nawal, et al.
(författare)
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Incidence of cardiovascular diseases and type-2-diabetes mellitus in patients with psychiatric disorders
- 2018
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 72:7, s. 455-461
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the incidence of cardiovascular diseases (CVD) and type-2-diabetes in patients with psychiatric disorders.Methods: A population-based study was conducted using the Swedish national health registries. Patients were identified from the Electronic Medical Records (EMR) in 20 primary care centers and were categorized in four diagnosis cohorts according to their first psychiatric diagnosis: bipolar disorder, schizophrenia, major depressive disorder, or other mood disorder. A control cohort of patients with no psychiatric disorders followed in the same primary care centers was also identified. Incident CVD and type-2-diabetes were defined as the presence of a diagnosis of CVD or diabetes during the follow-up period in patients without prior event.Results: The age and sex standardized incidence rate of CVD was 13.5 per 1000 patient-year in the patients with any psychiatric disorder versus 6.3 per 1000 patient-year in the controls. A similar trend was observed for incident diabetes (5.7 versus 3.4 per 1000 patient-year, respectively). The bipolar disorder and the schizophrenia cohorts showed the highest standardized incidence rates.Conclusion: Incidence of CVD and to a lesser extent type-2-diabetes was particularly high in patients with psychiatric disorders. This carries strong clinical implications for the prevention of CVD and type-2-diabetes in these patients.
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| 3. |
- Schmidt, Manuela, et al.
(författare)
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Clinical profiles and temporal patterns of psychiatric emergency room visitors in Sweden
- 2018
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 72:3, s. 197-204
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To describe persons visiting the psychiatric emergency room (PER) in Sweden and to compare persons who frequently (PFV) and infrequently (PIFV) visit PERs in terms of group size, age, gender, PER location inside versus outside the home municipality, diagnosis (ICD 10), temporal patterns of visits and hospital admissions.METHODS: This register study included all visits to PERs in one Swedish county over 3 years, 2013-2015 (N = 67,031 visits). The study employed descriptive statistics as well as Chi-square tests combined with Bonferroni correction to compare PFV with PIFV.RESULTS: Of the total of 27,282 visitors, 2201 (8.1%) were identified as PFV (five or more visits within 12 months) and they accounted for 38.1% of the total visits. The study found differences between PFV and PIFV in gender, diagnostic profile, hospital admissions and temporal patterns. Differences were also detected with regard to distance between PERs and home municipalities. However, no age-related differences were found between the two groups.CONCLUSIONS: PFV and PIFV have different clinical profiles and temporal patterns. These results may be important when planning, developing and evaluating interventions targeting the needs of each group, which is in accordance with a person-centred approach. Such an approach might eventually result in fewer visits to PERs.
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| 4. |
- Bejerholm, Ulrika, et al.
(författare)
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Individual Placement and Support in Sweden-A randomized controlled trial
- 2015
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 69:1, s. 57-66
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered with ClinicalTrials.gov: NCT00960024. Results: One hundred and twenty participants were randomized. Eighty seven per cent were assessed after 6 months, and 73% after 18 months. IPS was more effective than TVR in terms of gaining employment at 18-month follow-up (46% vs. 11%; difference 36%, 95% CI 18-54), along with the amount of working hours and weeks, longer job tenure periods and income. Cox regression analysis showed that IPS participants gained employment five times quicker than those in TVR. Ninety per cent of the IPS participants became involved in work, internships or education, i.e. activities integrated in mainstream community settings, while 24% in the TVR group achieved this. Conclusions: IPS is effective in a Swedish context in terms of gaining employment and becoming integrated within the local community. The welfare system presented obstacles for gaining competitive employment directly and it was indicated that internships delayed time to first competitive employment.
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| 5. |
- Gustafsson, Berit, et al.
(författare)
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The strengths and difficulties questionnaire (SDQ) for preschool children : a Swedish validation
- 2016
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 70:8, s. 567-574
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden, 80–90% of children aged 1–5 years attend preschool, and that environment is well suited to identify behaviours that may be signs of mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is a well-known short and structured instrument measuring child behaviours that indicate mental health problems well suited for preschool use.Aim: To investigate whether SDQ is a reliable and valid instrument for identifying behavioural problems in children aged 1–3 years and 4–5 years in a Swedish population, as rated by preschool teachers.Methods: Preschools situated in different sized municipalities in Sweden participated. The preschool teacher rated each individual child. Concurrent validity was tested using the Child–Teacher Report Form (C-TRF) and Child Engagement Questionnaire (CEQ). Exploratory factor analysis was conducted for age groups, 1–3 years and 4–5 years.Results: The preschool teachers considered most of the SDQ items relevant and possible to rate. For the children aged 1–3 years, the subscales ‘Hyperactivity’ (Cronbach alpha = 0.84, split half = 0.73) and ‘Conduct’ (Cronbach alpha = 0.76, split half = 0.80) were considered to be valid. For the age group 4–5 years, the whole original SDQ scale, 4-factor solution was used and showed reasonable validity (Cronbach alpha = 0.83, split half = 0.87).Conclusion: SDQ can be used in a preschool setting by preschool teachers as a valid instrument for identifying externalizing behavioural problems (hyperactivity and conduct problems) in young children.Clinical implications: SDQ could be used to identify preschool children at high-risk for mental health problems later in life.
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| 6. |
- Nordenskjöld, Axel, 1977-, et al.
(författare)
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Effects of Hesel-coil deep transcranial magnetic stimulation for depression : a systematic review
- 2016
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 70:7, s. 492-497
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Forskningsöversikt (refereegranskat)abstract
- Background: One third of the depressed patients are not improved by antidepressant drugs and psychological treatments, and there is a need for additional treatments. Repetitive transcranial magnetic stimulation (rTMS) is being developed towards an alternative in treatment-resistant depression. Deep transcranial stimulation (dTMS) with the Hesel-coil (H-coil) is a further development of rTMS aiming to enhance the effect by getting the magnetic pulses to penetrate deeper into the brain.Aims: This report aims to assess the evidence-base for dTMS for depression. The report also includes an assessment of the ethical and economic aspects involved.Methods: A systematic review of the effects of H-coil dTMS on depression was conducted and the scientific support was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation).Results: Only one controlled study was identified. In the sham-controlled randomized study, 212 participants with major depression that had not responded to antidepressant medication were enrolled. A two-point superiority in Hamilton Depression Rating Scale was observed in the dTMS arm vs the sham-arm at 4 weeks, but the difference was not statistically significant. No serious adverse events were reported apart from rare cases of epileptic seizures.Conclusions: The existing scientific support for H-coil dTMS therapy for depression is insufficient. The clinical implication is that the use of dTMS in depression should be restricted to the framework of clinical trials pending further studies. Fortunately, additional studies are underway and the evidence base should presumably improve over the next several years.
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| 7. |
- Sonnby, Karin, et al.
(författare)
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Validation of the World Health Organization Adult ADHD Self-Report Scale for adolescents
- 2015
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 69:3, s. 216-223
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization Adult ADHD Self Report Scale (ASRS) is a widely used diagnostic tool for assessment of attention-deficit hyperactivity disorder (ADHD) symptoms in clinical psychiatry in Sweden. The ASRS consists of 18 questions, the first six of which can be used as a short screening version (ASRS-S). There is a version for adolescents—ASRS-Adolescent (ASRS-A)—and the corresponding screening version (ASRS-A-S), which has not been validated to date.Aim: The aim was to validate the ASRS-A and the ASRS-A-S for use in adolescent clinical populations.Methods: Adolescent psychiatric outpatients (n = 134, mean age 15 years, 40% boys) reported on the ASRS-A, and were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), a semi-structured interview, together with a parent.Results: Internal consistency was 0.79 for the ASRS-A-S and 0.92 for the ASRS-A (Cronbach's alpha). Internal consistency values were 0.79 and 0.87 for the inattention subscale, and 0.68 and 0.89 for the hyperactivity subscale, respectively. Concurrent validity values, measured with Spearman's correlation coefficient, between the total K-SADS ADHD symptom severity score and the sum of ASRS-A-S and ASRS-A total scores were 0.51 and 0.60, respectively. Psychometric properties of the ASRS-A-S and the ASRS-A were: sensitivity 74% and 79%; negative predictive value 81% and 84%; specificity 59% and 60%; and positive predictive value 49% and 51%, respectively. Both versions showed better properties for girls than for boys.Conclusion: Both the ASRS-A-S and the ASRS-A showed promising psychometric properties for use in adolescent clinical populations.
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| 8. |
- Thunander Sundbom, Lena, 1970-, et al.
(författare)
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Association between prescribed antidepressants and other prescribed drugs differ by gender : a nationwide register-based study in Sweden
- 2019
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 73:1, s. 73-79
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Forskningsöversikt (refereegranskat)abstract
- Background: People with depression are prescribed more drugs than people in general, partly due to comorbidity with other conditions. However, little research has been done on depression-related drug use from a gender perspective. Aim: Examine the association between antidepressants, other types of prescribed drugs, and polypharmacy, by gender. Methods: Data on drugs dispensed October to December 2016 to all Swedish citizens aged 18-84 years were collected from the Swedish prescribed drug register. Logistic regression analyses were performed to examine the associations between antidepressants and other drugs, by gender. Results: For both men and women, associations were found between antidepressants and drugs for alimentary tract problems, respiratory problems, blood, nervous system, analgesics, and polypharmacy. However, for women, but not men, associations were also found for drugs for diabetes, musculoskeletal problems, dermatological problems, and systemic hormones. Conclusions: Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions. Further, some of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus, physicians need to be aware that the association between antidepressants and other types of drugs are more common among women than men.
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| 9. |
- Afzelius, Maria, et al.
(författare)
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Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
- 2018
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 72:1, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.
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| 10. |
- Claesdotter, Emma, et al.
(författare)
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The effects of ADHD on cognitive performance
- 2018
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 72:3, s. 158-163
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Tidskriftsartikel (refereegranskat)abstract
- Background: Attention-deficit hyperactivity disorder (ADHD) is a common and impairing neurodevelopmental disorder. The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a computerized test battery with standardized procedures and solid psychometric properties targeting multiple neuropsychological functions.Aims: The aim of this study was to look at the effects of ADHD on cognitive performance using CANTAB expressed as a statistical interaction term in regression modeling.Methods: We assessed 112 drug-naive subjects (age: 7-18 years) with ADHD based on DSM IV criteria and compared them to 95 control subjects (age: 7-18 years). All participants were administered five CANTAB tasks designed to capture different aspects of executive functioning: Stockings of Cambridge (SOC), Intra/Extra dimensional shift (IED), Spatial Working Memory (SWM), Simple Reaction Time (SRT) and Stop Signal Task (SST).Results: T-tests showed a difference between ADHD and control subjects in all cognitive measures except SOC. The majority of measures showed a non-linear effect of age. SWM strategy and SST direction errors showed a linear effect of age. ADHD diagnosis had a statistically significant effect on performance. For all tests except SOC, ADHD produced the main effect without interaction with age.Discussion: For all CANTAB measures, ADHD diagnosis had a significant effect on performance and produced this effect without interaction with age in all tests except SOC, indicating that the developmental trajectories were parallel in both groups. The results indicate that cognitive performance is impaired in youth with ADHD and that CANTAB can be a valuable tool in the diagnostic assessment of ADHD.
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