| 1. |
- Durbeej, N., et al.
(author)
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Substance abuse treatment as a predictor of criminal recidivism among psychiatrically examined Swedish offenders
- 2010
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 25:Supplement 1, s. 32-32
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Conference paper (peer-reviewed)abstract
- Background. Substance abuse is clearly associated with criminal recidivism among offenders with and without mental disorder. Treatment for substance abuse correlates with lower rates of re-offending among participants in outpatient-based as well as institution-based substance abuse treatment programs. However, for offenders with mental disorder, research on the possible preventive effect of substance abuse treatment on criminal recidivism is sparse. This paper reports from on an ongoing naturalistic and prospective interview study on the relationship between post-release outpatient substance abuse treatment and re-offending. Methods. The Stockholm county sample comprises 246 offenders of both genders subjected to a forensic psychiatric assessment, who screened positive for substance abuse problems. Eighty-five percent (n=210) agreed to participate in the study. Baseline data and follow-up interview data, collected immediately on release from incarceration (prison/forensic hospital) and 6 and 12 months later, include self-reported substance abuse, treatment involvement and criminality. By February 2010, data will be available from the first follow-up for 150 participants, from the second follow-up for 80 individuals and from the third follow-up for 10 subjects. Results and conclusions. The focus of the presentation will be recidivism comparisons between substance abuse treatment utilizers and those who decline treatment. Data on ongoing levels of substance abuse, mental health problems and offending will serve as dependent variables. Additional analyses will present perceived benefit from and reasons for accepting or rejecting treatment.
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| 2. |
- Ahrén, Jennie C., et al.
(author)
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We are family - parents, siblings and eating disorders : Introducing the Stockholm Youth Cohort
- 2012
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In: European psychiatry. - 0924-9338 .- 1778-3585. ; 27:S1
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Journal article (peer-reviewed)abstract
- Introduction: Eating disorders (ED) are among the leading causes of disease burden, especially in women.Objectives: The overall aim is to explore role of parental social characteristics and family composition in the development of ED in adolescent males and females.Aims: We investigated associations of parental socioeconomic position, family type, number of siblings and half-siblings and history of psychiatric disease in parents with the incidence of eating disorders at age 12–23 years.Methods: The Stockholm Youth Cohort (N = 589,114) is a database created by record-linkage for all children and adolescents, 0–17 years, resident in Stockholm County during the period 2001–2007, their parents and siblings. Hazard rations were calculated using Cox regression. Cases of ED were identified in outpatient care.Results: A total of 3251 cases of ED (2971 females and 280 males) were recorded among 249,884 study subjects. There was an increased risk of ED in both male and female offspring of parents who had a history of alcohol and drug abuse or psychiatric ill-health. Higher parental education was a risk factors in females. Increasing number of full siblings had a protective effect (fully adjusted HR 0.91, 95% CI 0.87–0.96, per sibling) while increasing number of half-siblings appeared to increase risk of eating disorders in females.Conclusions: Risk factors for ED seem to differ between females and males. While parental psychiatric health is related to risk of ED in both sexes, family socioeconomic position and relationships within family appear to be of more importance for influencing risk of ED in females.
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| 3. |
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| 4. |
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| 5. |
- Bejerot, Susanne, 1955-, et al.
(author)
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Personality traits and smoking in patients with obsessive-compulsive disorder
- 2000
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In: European psychiatry. - Paris, France : Elsevier. - 0924-9338 .- 1778-3585. ; 15:7, s. 395-401
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Journal article (peer-reviewed)abstract
- As opposed to other psychiatric populations, subjects with obsessive-compulsive disorder (OCD) smoke less than the general population. The present study aims at further investigating the relationship between smoking in OCD subjects and personality traits. Sixty-four subjects with OCD were interviewed concerning their smoking habits. Personality traits were evaluated using the Karolinska Scales of Personality, and specific obsessive-compulsive personality traits were elicited through self-report questionnaires. Non-smokers were more easily fatigued, more inclined to worry, more remorseful, less self-confident, less impulsive and became uneasy more frequently when urged to speed up, than smokers with OCD. Additionally, non-smokers fulfilled significantly more obsessive-compulsive personality disorder criteria as compared to the smokers (P < 0.001). We propose a clinical subtype of OCD related to non-smoking, psychasthenia, anxiety, and pronounced obsessive-compulsive personality disorder traits.
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| 6. |
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| 7. |
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| 8. |
- Dalmau, A, et al.
(author)
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Psychotic disorders among inpatients with abuse of cannabis, amphetamine and opiates. Do dopaminergic stimulants facilitate psychiatric illness?
- 1999
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In: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 0924-9338. ; 14:7, s. 366-371
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Journal article (peer-reviewed)abstract
- We have studied the occurrence of dual diagnoses (psychoses as well as abuse of either amphetamine, cannabis or opiates) during a 15-year period, among patients treated at Huddinge Hospital, Stockholm, Sweden. The purpose of the study is to evaluate if the different drugs were coupled to different rates of psychiatric co-morbidity. During the period in question, 461, 425 and 371 different patients respectively had been admitted at least once due to dependency on amphetamine, cannabis and opiates. Approximately 30% of the patients with a pure abuse of amphetamine or cannabis and less than 6% of the opiate abusers had been diagnosed at least once with any of the psychoses studied. Comparing the frequency of psychoses among mixed and pure abusers of illegal drugs, with and without a concomitant abuse of alcohol, we found that the co-morbidity rate for mixed opiate abusers increased significantly from 7.2 to 20.2% when alcohol abuse was also present. For abusers of amphetamine and cannabis (both pure and mixed), no differences in co-morbidity rates were seen when an abuse of alcohol was added to that of the drugs. It is difficult to find an explanation for the significant difference between the co-morbidity of pure abuse of amphetamine or cannabis on the one hand and opiates on the other. In conclusion, our findings show that the distribution of psychotic illness is high among abusers of amphetamine and cannabis, in contrast to the generally lower co-morbidity among abusers of opiates. Although these findings are consistent with earlier studies that have shown a propensity for developing psychoses among abusers of amphetamine and cannabis, one should bear in mind that this study is based on inpatients, and is not necessarily representative for all abusers of the drugs in question.
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| 9. |
- Durbeej, N., et al.
(author)
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P02-54 - Is outpatient-based substance abuse treatment a predictor of re-offending and other outcomes among Swedish offenders subjected to psychiatric assessment?
- 2010
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 25:Supplement 1, s. 674-674
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Journal article (peer-reviewed)abstract
- Introduction: Substance abuse is associated with criminal recidivism. Substance abuse treatment has been found to correlate negatively with re-offending among treatment utilizers. However, for offenders with mental health problems and substance abuse, research on how substance abuse treatment affects re-offending is sparse. Objectives: The study aimed to examine the relationship between self-reported outpatient-based substance abuse treatment and self-reported a) re-offending, b) substance use and c) psychiatric problems among offenders with mental health and substance use problems. Methods: Data were gathered from a naturalistic follow-up study with 208 participants, subjected to a court-ordered psychiatric assessment. This analysis covers 91 individuals who were followed-up after an average study period of 17 months. Among these, 68% had been sentenced to institutional imprisonment or forensic psychiatric care. Results: Offences, substance use and psychiatric problems declined between baseline and follow-up. However, the reduction was not associated with self-reported treatment utilization. Among participants who were sentenced to non-institutional corrections, more individuals had utilized outpatient-based treatment compared to individuals who were sentenced to imprisonment or forensic psychiatric care. Conclusions: A definitive conclusion about the effect of treatment is difficult to draw. For instance, self-reported data may not reflect actual treatment consumption. However, one interpretation is that participants naturally recovered over time. Institutional correction might also have resulted in positive outcomes equivalent to outpatient-based treatment.
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| 10. |
- Heilig, M, et al.
(author)
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The dual-diagnosis concept used by Swedish social workers: limited validity upon examination using a structured diagnostic approach
- 2002
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In: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 0924-9338. ; 17:6, s. 363-365
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Journal article (peer-reviewed)abstract
- A co-existence of chemical dependence and other psychiatric syndromes is commonly referred to as “dual-diagnosis.” This categorization is commonly made by social workers in several European countries assigned the primary responsibility for the care of drug and alcohol dependence. Here, we examined the validity of this categorization through systematic, structured patient evaluation following a minimum of 3 weeks of abstinence from drugs and alcohol. Less than one-third of patients originally labelled as suffering from “dual-diagnosis” by the social services did in fact obtain any Axis I DSM IIIR diagnosis, and less than half of the patients had any psychiatric diagnosis other than dependence. Syndromes commonly discussed in the context of self-medication, i.e., unipolar depression and anxiety syndromes, were not over-represented compared to a population sample, while chronic psychoses and bipolar syndromes were highly significantly more common. We conclude that the dual-diagnosis concept, unless substantiated through stringent diagnostic procedures by psychiatrically trained personnel, may be of questionable utility in caring for patients presenting with psychiatric symptoms and substance dependence. A systematic individual evaluation in an alcohol- and drug-free state of sufficient duration is necessary to obtain a basis for an adequate individual treatment plan.
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| 11. |
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| 12. |
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| 13. |
- Iliadis, Stavros I, 1983-, et al.
(author)
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1843 – Depression in the peripartum period in association with salivary cortisol levels
- 2013
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 28:Supplement 1, s. 1-1
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Journal article (other academic/artistic)abstract
- IntroductionThe Hypothalamic-Pituitary-Adrenal Axis (HPA axis) has been implicated in the pathogenesis of many affective disorders. Peripartum depression is a condition that includes depressive episodes occurring during pregnancy and the postpartum period. During uncomplicated pregnancy, mean cortisol levels rise substantially, mostly due to high levels of corticotropin releasing hormone produced by the placenta (p-CRH). The latter also suppresses hypothalamic CRH, leading to hypo-cortisolemia after partus. Cortisol concentration is usually normalised within two weeks after delivery. Failure of the above process results in continuing hypo-cortisolemia, which might increase susceptibility to PPD.Objectives/aimsThe current study aims to investigate the relationship between evening salivary cortisol levels and depression during the peripartum period.MethodsThree hundred and forty six pregnant women were asked to participate in the study. They completed the Edinburgh Postnatal Depression Scale (EPDS) and the Spielberger State-Trait Anxiety Inventory-State version (STAI-S) at the 36th week of pregnancy and the 6th week after delivery. At both times, study subjects were also asked to collect evening salivary samples by using a mail-delivered kit. Moreover, they were interviewed at the 36th week of pregnancy using the Mini International Neuropsychiatric Interview (MINI).ResultsPreliminary results indicate significantly higher evening salivary cortisol levels in depressed women during late pregnancy compared to healthy controls. No difference in cortisol levels was found between women with postpartum depression and healthy controls.ConclusionsOur study results support the hypothesis that depression during pregnancy resembles melancholic depression characterized by hyperactivity of the HPA-axis and hyper-cortisolemia.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Kluge, U, et al.
(author)
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Health services and the treatment of immigrants : data on service use, interpreting services and immigrant staff members in services across Europe
- 2012
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In: European psychiatry. - 0924-9338 .- 1778-3585. ; 27:Suppl 2, s. 56-62
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Journal article (peer-reviewed)abstract
- BACKGROUND:The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from immigrant groups.METHODS:Structured interviews were conducted with 15 health services (9 primary care, 3 emergency departments, 3 mental health) located in areas with high immigrant populations in each of 16 European countries (n=240). Responses were collected on the availability of data on service use by immigrant patients, the provision of interpreting services and immigrant staff members.RESULTS:Data on service use by immigrants were recorded by only 15% of services. More than 40% of services did not provide any form of interpreting service and 54% of the services reported having no immigrant staff. Mental health services were more likely to use direct interpreting services, and both mental health and emergency services were more likely to have immigrant staff members.DISCUSSION:For assessing and improving the quality of care provided for immigrants, there is a need to improve the availability of data on service use by immigrants in health services throughout Europe and to provide more consistent access to interpreting services.
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| 18. |
- Koulouris, Petros, et al.
(author)
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1546 – Personality traits and postpartum depression: results from basic study in sweden
- 2013
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 28:Supplement 1, s. 1-1
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Journal article (other academic/artistic)abstract
- IntroductionPostpartum depression (PPD), with a prevalence of about 10-15% in developed countries, has a major impact on both mother and child. Personality traits, mainly neuroticism, have been associated with affective disorders and in particular postpartum depression.ObjectivesTo examine if neuroticism is associated with depressive symptoms in pregnancy and post-partum, controlling for possible confounding factors.MethodsSince September 2009, all pregnant women in Uppsala, Sweden have been asked to participate in BASIC study, which is a population based, prospective study on mental health during pregnancy and post-partum. Women filled in the Swedish Scales of Personality (SSP), as well as the Edinburg Postnatal Depression Scale (EPDS) in pregnancy week 32. EPDS was also administered 6 weeks and 6 months postpartum. A factor analysis of SSP traits was conducted in our material and the three factor structure comprising neuroticism, aggressiveness and sensation seeking was confirmed. The association between personality traits and depressive symptoms was examined using binary logistic regression. High levels of neuroticism, aggressiveness and sensation seeking were defined as the highest quartile of each factor.ResultsHigh levels of neuroticism were strongly associated with depressive symptoms during pregnancy as well as at 6 weeks and 6 months post-partum, while aggressiveness and sensation seeking were not. After controlling for confounding factors, such as previous history of depression, employment, education, partner support and breastfeeding, neuroticism remained a significant predictor for depressive symptoms, at all three time-points.ConclusionsNeuroticism is an independent strong predictor of depressive symptoms during pregnancy and the postpartum period.
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| 19. |
- Liljenström, Hans
(author)
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Mesoscopic Brain Dynamics and Mental Disorders
- 2011
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In: European Psychiatry. - 0924-9338 .- 1778-3585. ; 26, s. 2225-2225
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Conference paper (peer-reviewed)abstract
- Mesoscopic brain dynamics, typically studied with electro- and magnetoencephalography (EEG and MEG), display a rich complexity of oscillatory and chaotic-like states, including many different frequencies, amplitudes and phases. Presumably, these different dynamical states correspond to different mental states and functions, and studying transitions between such states could provide valuable insights into brain–mind relations that should also be of clinical interest. We use computational methods to investigate these transitions, with the objective of finding relations between structure, dynamics, and function. In particular, we have developed models of paleo- and neocortical structures, in order to study their mesoscopic neurodynamics, as a link between the microscopic neuronal and macroscopic mental events and processes. I will describe several types of models that emphasize network connectivity and structure, but which also include molecular and cellular properties at varying detail, depending on the particular problem and experimental data available. We use these models to study how phase transitions can be induced in the mesoscopic neurodynamics of cortical networks by internal (natural) and external (artificial) factors. I will discuss the models, and relate the simulation results to macroscopic phenomena, such as arousal, attention, anaesthesia, learning, and certain mental disorders
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| 20. |
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| 21. |
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| 22. |
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| 23. |
- Oxenstierna, G, et al.
(author)
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Increased frequency of aberrant CSF circulation in schizophrenic patients compared to healthy volunteers
- 1996
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In: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 0924-9338. ; 11:1, s. 16-20
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Journal article (peer-reviewed)abstract
- In a previous cisternographic study of the cerebrospinal fluid (CSF) circulation in schizophrenic patients, indications for disturbed flow dynamics were found in 10 of 30 subjects. In order to replicate and investigate the clinical and pathophysiological significance of this finding, 39 schizophrenic patients and 42 healthy subjects were examined with an improved method for measurement of CSF circulation. 99mTc-DTPA was injected intrathecally and the gamma cisternograms were evaluated blindly. Correlations between cisternography findings and age, duration of disease, previous hospitalizations, positive or negative symptomatology, exposure to neuroleptics, psychiatric family history, CT findings and CSF levels of protein, tryptophan and monoamine metabolites, were calculated. Seven of the patients showed abnormalities in the cisternograms with a slow or obstructed flow of CSF over the convexities (P < 0.01) whereas none of the healthy volunteers showed abnormalities. There were no correlations between disturbed CSF circulation in the patients and the clinical and biochemical parameters, thus the significance of the deviations, similar to other biological aberrations found in schizophrenic patients, is not known. Recent developments in magnetic resonance imaging offer new possibilities to further examine CSF circulation abnormalities in schizophrenia.
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| 24. |
- Portala, Kamilla, et al.
(author)
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Personality traits in treated Wilson's disease determined by means of the Karolinska Scales of Personality (KSP)
- 2001
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In: European psychiatry. - 0924-9338 .- 1778-3585. ; 16:6, s. 362-371
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim was to elucidate the personality traits of patients with treated Wilsons disease (WD) in comparison to healthy volunteers. METHOD: Twenty-five WD patients, ten females and 15 males, with a mean age of 35.2 +/- 8.3 years completed the Karolinska Scales of Personality (KSP), a self-report inventory comprising 15 separate scales. The results were compared to a control series comprising 200 men and 200 women drawn from the general population. RESULTS: The patients with treated WD scored significantly lower than the healthy controls on aggressivity-hostility-related scales and the scale measuring Psychic Anxiety. Patients with predominantly hepatic symptoms had the lowest aggressivity-related scores and patients with predominantly neurological symptoms had the lowest Irritability, Guilt and Detachment scores and the highest Impulsiveness and Muscular Tension scores. Both groups scored low on the Somatic Anxiety scale. CONCLUSION: The present results illustrate that patients with treated WD have significant deviations in personality traits, especially in aggressivity-hostility-related scales and Psychic Anxiety, compared to healthy controls when investigated by means of a self-report inventory, the KSP. The deviations were not related to age, age at onset or duration of the disease.
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| 25. |
- Saarento, O, et al.
(author)
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The Nordic comparative study on sectorised psychiatry : repeated emergency admissions to inpatient care during a 1-year follow-up.
- 1998
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In: European psychiatry. - 0924-9338 .- 1778-3585. ; 13:8, s. 385-91
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Journal article (peer-reviewed)abstract
- The emergency admissions to hospital care in six psychiatric services in four Nordic countries were explored as a part of a Nordic comparative study on sectorised psychiatry. One year treated incidence cohorts were used, with the total cohort comprising 2,454 patients. Of the 803 patients who were admitted to inpatient care during a 1-year follow-up, 82% had at least one emergency admission and 23% repeated emergency admissions. The definition for the repeated emergency admissions was at least two admissions during the follow-up. The mean length of stay in emergency inpatient care per treatment episode for this patient subgroup was 28 days. Their emergency inpatient episodes constituted 30% of all inpatient days during the follow-up. However, the variations between the services and diagnostic subgroups were large. The results of a logistic regression analysis indicated that the following variables predicted repeated emergency admissions: inpatient care at index contact, emergency outpatient contacts or no planned hospital admissions during the follow-up, psychiatric service, age under 45 years, and a diagnosis of psychosis, personality disorder or dependency. The repeated emergency admissions were related to the existence of a special service unit for abusers but not to the rates of outpatient staff or acute beds in the services, to geographical distances, referral practice or existence of emergency services.
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| 26. |
- Salzmann-Erikson, Martin, 1977-, et al.
(author)
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Intensive psychiatric care
- 2010
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In: European psychiatry. - Paris, France : Elsevier. - 0924-9338 .- 1778-3585. ; 25, s. 635-635
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Journal article (peer-reviewed)abstract
- Introduction: The first psychiatric intensive care unit (PICU) opened in the early 1970's in New York. This ward was designed to manage patient that did not respond to treatment in open psychiatric wards. There are about 15 PICUs in Sweden but the concept has not been specified by any public organs. In many county hospitals, both acute and intensive care units exists parallel.Aims: Therefore, the aim of this study was to describe the core characteristics of PICU in Sweden and to describe the care activities provided for patients admitted to PICU.Method: Critical incident technique was used. In the study, eighteen caregivers at a PICU participated by completing a semi-structured questionnaire. Additional, in-depth interviews with three nurses and two assistant nurses also constitute the data.Results: Four categories were identified that characterise the core of PICU: the dramatic admission, protests and refusal of treatment, escalating behaviours and temporarily coercive measure. Care activities for PICU were also analysed and identified as controlling - establishing boundaries, protecting - warding off, supporting - giving intensive assistance and structuring the environment.Conclusions: PICU were interpreted as a level of care as it is composed by limited structures and closeness in care.
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| 27. |
- Salzmann-Erikson, Martin, et al.
(author)
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Intensive psychiatry : creating, preserving and restoring stability
- 2012
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 27:s1, s. 577-577
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Journal article (peer-reviewed)abstract
- Introduction. Psychiatric intensive care units (PICU) are rarely described since it is secluded from external insight. At the same time, it is highly intensive since staff and patients interact around the clock in the most acute phase of psychiatric illness. The PICUs admit patients who are considered extremely unmanageable within psychosis units or acute psychiatric wards, and who often demonstrate aggressive or other forms of severe behaviors.Objectives. This raises the question: What is going on in these units and what constitutes nursing care?Methods. Spradley's 12-step ethnographic methodology was applied. Data was collected through more than 200 hours of field work on three PICUs including 16 hours of formal interviewing and numerous of informal interviews; data also consisted of writing memos and field notes. The field work aimed to understand the staff member's way of interact with the patients and what they did to care for these patients who was considered as unmanageable.Results. The findings presented here describe how and when nursing care is provided in PICUs. The findings are presented in relation to themes, as these emerged within the psychiatric intensive nursing care. Six themes emerged as frames for nursing care: providing surveillance, soothing, being present, trading information, maintaining security and reducing.Conclusions. These themes are used to strike a balance between turbulence and stability and to achieve equilibrium. As the nursing care intervenes when turbulence emerges, the PICU becomes a sanctuary that offers tranquility, peace and rest.
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| 28. |
- Skalkidou, A., et al.
(author)
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Risk of Postpartum Depression in Association with Serum Leptin Levels: A Nested Case-control Study within the Uppsat Cohort.
- 2009
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In: European psychiatry. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 24:S1, s. 1-1
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Journal article (peer-reviewed)abstract
- Although postpartum depression (PPD) is a common condition, it often goes undiagnosed and untreated, with devastating consequences for the woman's ability to perform daily activities, to bond with her infant and to relate to the infant's father. Leptin, a protein synthesised in the adipose tissue and involved in regulation of food intake and energy expenditure has been related to depressive disorders, but studies report conflicting results. The aim of this study was to evaluate the association between serum leptin levels at the time of delivery and the subsequent development of postpartum depression in women, using data from a population-based cohort of delivering women in Uppsala, Sweden. Three hundred and sixty five women from which serum was obtained at the time of delivery filled out at least one of three pre-coded questionnaires containing the Edinbourgh Scale for Postnatal Depression (EPDS) five days, six weeks and six months after delivery. Crude mean leptin levels did not significantly differ between cases of PPD and controls. Using linear regression analysis and adjusting for maternal age, body-mass index, smoking, interleukin-6 levels, duration of gestation, gender and birth weight of the newborn, the EPDS scores at five days, six weeks and six months after delivery were negatively correlated with leptin levels at delivery (p< 0.05). Serum leptin levels at delivery were found to be negatively correlated with self reported depression during the first six months after delivery.
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| 29. |
- Örmon, Karin, et al.
(author)
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Experiences of the Provided Care in a General Psychiatric Context After Disclosure of Abuse
- 2015
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 30:S1Abstracts of the 23rd European Congress of Psychiatry
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Journal article (other academic/artistic)abstract
- Introduction Experiences of abuse during childhood and/or adulthood has an impact on women's mental health as well as generating frequent hospital admission. Experiences of abuse are common among female patients in general psychiatric care. Aims and Objectives The aim of the study is to elucidate how nine women with experiences of physical, emotional and/or sexual abuse experienced the care provided at a general psychiatric clinic after disclosure of abuse. Method Qualitative design with an inductive approach. Interviews with nine women who were recipients of general psychiatric care in an urban area in Sweden. The women had disclosed experiences of abuse to a member of staff. Qualitative inductive content analysis was used. Results The nine women reported being subjected to abuse during childhood and adulthood, only one of them reported only being abused as an adult. The overall theme emerging from the narratives, 'Dependency as a reality containing a duality of suffering and trust' describe the general psychiatric care as caring and noncaring. In a caring environment was the women acknowledged, listened to and treated with sensitivity. Experiences of noncaring were when the abuse was disregarded, the women were not believed in, offended or self-blamed for the abuse. A noncaring environment focused primarily on the diagnosis and the experienced abuse was seen as secondary. Conclusions Women who have experienced abuse experience the care provided as caring as well as noncaring. General psychiatric could be supportive as well as belittling depending on staff at the clinic.
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| 30. |
- Örmon, Karin, et al.
(author)
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Time Geographic Life Charting : a Computer Program for a Life-course Approach!
- 2015
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 30:S1
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Journal article (other academic/artistic)abstract
- Introduction Life charting seems to be an increasing trend in psychiatric care, and the essential idea is that patients’ life histories are of primary interest for diagnosis, care and treatment and it can also be a helpful tool in the progress of communication. Objectives Patients with a history of suicide behavior were assessed as well as female patients with experiences of physical, emotional and/or sexual abuse in general psychiatric care, in urban areas in Sweden. Aims To create and to evaluate the life course of patients seeking general psychiatric care Method We used the Hägerstand (1985) Time Geography model, and constructed the life charts together with the patient using a computer program covering both time and geographical aspects. Manifest content analysis was used for analyzing the life charts. Results Stressful events as well as social capacities was identified across the life course and provided rich information regarding the lived lives of patients seeking general psychiatric care. The life charts have a therapeutic value due to its focus on both stressful events and capacities. The use of Time Geography life charting can also be a helpful tool in the progress of communication as well as an apparatus for identifying stressful and prosperous life periods. Conclusions A profound knowledge of the patients was illustrated and therefor preventive strategy can be formulated.
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| 31. |
- Andersch, S, et al.
(author)
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A 15-year follow-up study of patients with panic disorder
- 2003
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In: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 0924-9338. ; 18:8, s. 401-408
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Journal article (peer-reviewed)abstract
- BackgroundPanic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms.AimsTo describe the long-term outcome of naturalistically treated PD.MethodsFifty-five outpatients with PD, who participated in a placebo-controlled drug trial of the efficacy of alprazolam and imipramine 15 years ago were reassessed with the same instruments used in the original study.ResultsComplete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported.ConclusionPD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.
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| 32. |
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| 33. |
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| 34. |
- Arvidsson, Hans, et al.
(author)
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Needs and care of migrants considered as severely mentally ill : cross-sectional and longitudinal studies of a Swedish sample
- 2009
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In: European psychiatry. - : Cambridge University Press. - 0924-9338 .- 1778-3585. ; 24:8, s. 533-539
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Journal article (peer-reviewed)abstract
- PurposeHigher incidence of mental illnesses and less access to care is previously reported concerning migrants but few studies focus on the needs and care of migrant groups in psychiatry. The aim of this study was to compare differences in needs and care between migrant and nonmigrant groups of severely and persistently mentally ill (SMI) after the 1995 Swedish mental health care reform.MethodsIn a Swedish area, inventories were made in 2001 and 2006 of persons considered as SMI. These persons were interviewed and their needs were assessed. In a cross-sectional study in 2006, needs and care were compared between migrants and nonmigrants. In a longitudinal study, migrants and nonmigrants interviewed in both 2001 and 2006 were compared concerning the development of needs and care.ResultsThe needs of the migrant group were less taken care of. In 2006, there were more unmet needs in this group concerning accommodation, physical health, psychological distress, basic education and economy.ConclusionThe improvement of groups considered as SMI concerning functional disability and efforts of care found in the actual area did not seem to include the migrant group, at least not to the same degree.
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| 35. |
- Asherson, P., et al.
(author)
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The effects of atomoxetine on emotional control in adults with ADHD : An integrated analysis of multicenter studies
- 2015
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In: European psychiatry. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 30:4, s. 511-520
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Journal article (peer-reviewed)abstract
- Purpose: To investigate the effects of atomoxetine on emotional control in adults with ADHD. Methods: We performed an integrated analysis using individual patient data pooled from three Eli Lilly-sponsored studies. An integrated analysis can be viewed as a meta-analysis of individual patient-level data, rather than study-level summary data. Results: Two populations were identified: a large sample of patients with pre-treatment baseline data (the "overall population''; n = 2846); and a subset of these patients with placebo-controlled efficacy data from baseline to 10 or 12 weeks after initiating treatment (the "placebo-controlled population''; n = 829). At baseline, in the overall population, similar to 50% of ADHD patients had BRIEF-AS (Behavior Rating Inventory of Executive Function-Adult Version Self-Report) Emotional control subscores between 21 and 30, compared with similar to 10% of normative subjects in the BRIEF-A manual. At endpoint, in the placebo-controlled population, atomoxetine led to a small (effect size 0.19) but significant (P = 0.013) treatment effect for emotional control. The effect size was 0.32 in patients with BRIEF-AS Emotional control scores > 20 at baseline. Improvements in emotional control correlated with improvements in the core ADHD symptoms and quality-of-life. Discussion: As deficient emotional control is associated with impaired social, educational and occupational functioning over and above that explained by core ADHD symptoms alone, improvements in emotional control may be clinically relevant. Conclusion: At baseline, adults with ADHD were more likely to have impaired emotional control than normative subjects. In the adult ADHD patients, atomoxetine treatment was associated with improvements in emotional control, as well as in core ADHD symptoms and quality-of-life.
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| 36. |
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| 37. |
- Backlund, Lena, et al.
(author)
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Identifying predictors for good lithium response - A retrospective analysis of 100 patients with bipolar disorder using a life-charting method.
- 2009
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In: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 0924-9338. ; 24:3, s. 171-7
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Journal article (peer-reviewed)abstract
- PURPOSE: Our aim was to investigate bipolar patients in order to test the validity of various outcome measures and to identify prognostic predictors for pharmacological treatment. MATERIAL AND METHOD: One hundred patients were interviewed using a computerized life-charting program in a descriptive, retrospective analysis. The concept "Burden of illness" was defined as a combination of severity and duration of episodes. Response to treatment was defined as the difference in burden before and after treatment, a low burden during treatment, and freedom of episodes for at least 3 years after insertion of treatment. RESULTS: The absence of mixed episodes and a high initial burden predicted a good response measured as the difference in burden. If remission for 3 years or a low burden during lithium treatment was used, the absence of rapid cycling and of mixed episodes were the most important predictors. The severity of illness before treatment had no impact. DISCUSSION AND CONCLUSION: We suggest the use of absolute measures of severity during treatment as the most appropriate measure of the outcome. Furthermore, our data provide corroboration that treatment with lithium ameliorates the prognosis of the illness, but that mixed episodes and rapid cycling predict a poorer response to lithium.
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| 38. |
- Beezhold, J, et al.
(author)
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Editorial: The EPA, Brexit and beyond
- 2017
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In: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 1778-3585. ; 42, s. 27-28
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Journal article (other academic/artistic)
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| 39. |
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| 40. |
- Bejerot, Susanne, 1955-, et al.
(author)
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Pediatric autoimmune neuropsychiatric syndrome (PANS), developmental regression and autism
- 2017
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 41:Suppl., s. S123-S123
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Journal article (other academic/artistic)abstract
- Introduction: Pediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.Objectives: The aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.Methods: Participants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.Results: Twelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.Conclusions: Very early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.
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| 41. |
- Bendz, Hans, et al.
(author)
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Lithium nephropathy in Sweden
- 2008
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In: European Psychiatry. - : Cambridge University Press (CUP). - 1778-3585 .- 0924-9338. ; 23:Suppl. 2, s. 288-288
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Conference paper (peer-reviewed)
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| 42. |
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| 43. |
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| 44. |
- Benlloch, Jose M., et al.
(author)
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The MINDVIEW project : First results
- 2018
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In: European psychiatry. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 50, s. 21-27
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Journal article (peer-reviewed)abstract
- We present the first results of the MINDVIEW project. An innovative imaging system for the human brain examination, allowing simultaneous acquisition of PET/MRI images, has been designed and constructed. It consists of a high sensitivity and high resolution PET scanner integrated in a novel, head-dedicated, radio frequency coil for a 3T MRI scanner. Preliminary measurements from the PET scanner show sensitivity 3 times higher than state-of-the-art PET systems that will allow safe repeated studies on the same patient. The achieved spatial resolution, close to 1 mm, will enable differentiation of relevant brain structures for schizophrenia. A cost-effective and simple method of radiopharmaceutical production from 11C-carbon monoxide and a mini-clean room has been demonstrated. It has been shown that 11C-raclopride has higher binding potential in a new VAAT null mutant mouse model of schizophrenia compared to wild type control animals. A significant reduction in TSPO binding has been found in gray matter in a small sample of drug-naïve, first episode psychosis patients, suggesting a reduced number or an altered function of immune cells in brain at early stage schizophrenia.
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| 45. |
- Bilal, Ayesha, et al.
(author)
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Mom2B: a study of perinatal health via smartphone application and machine learning methods
- 2022
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In: European Psychiatry. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 65:S1
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Journal article (peer-reviewed)abstract
- IntroductionPeripartum depression (PPD) impacts around 12% of women globally and is a leading cause of maternal mortality. However, there are currently no accurate methods in use to identify women at high risk for depressive symptoms on an individual level. An initial study was done to assess the value of deep learning models to predict perinatal depression from women at six weeks postpartum. Clinical, demographic, and psychometric questionnaire data was obtained from the “Biology, Affect, Stress, Imaging and Cognition during Pregnancy and the Puerperium†(BASIC) cohort, collected from 2009-2018 in Uppsala, Sweden. An ensemble of artificial neural networks and decision trees-based classifiers with majority voting gave the best and balanced results, with nearly 75% accuracy. Predictive variables identified in this study were used to inform the development of the ongoing Swedish Mom2B study.ObjectivesThe aim of the Mom2be study is to use digital phenotyping data collected via the Mom2B mobile app to evaluate predictive models of the risk of perinatal depression.MethodsIn the Mom2B app, clinical, sociodemographic and psychometric information is collected through questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS). Audio recordings are recurrently obtained upon prompts, and passive data from smartphone sensors and activity logs, reflecting social-media activity and mobility patterns. Subsequently, we will implement and evaluate advanced machine learning and deep learning models to predict the risk of PPD in the third pregnancy trimester, as well as during the early and late postpartum period, and identify variables with the strongest predictive value.ResultsAnalyses are ongoing.ConclusionsPending results.DisclosureNo significant relationships.
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| 46. |
- Birgegard, A, et al.
(author)
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Self-image and risk of suicide in eating disorders
- 2017
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In: EUROPEAN PSYCHIATRY. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 41, s. S281-S281
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Conference paper (other academic/artistic)abstract
- Suicide risk is increased in eating disorders (ED), and detection is key to prevention. Self-image as operationalized in the structural analysis of social behavior (SASB) model has been shown to be associated with symptoms, treatment dropout, and outcome. SASB is a circumplex organizing self-directed behaviors along affiliation (love vs. hate) and autonomy (set free vs. control) dimensions. In a recent study, SASB related to health care-detected suicide attempts in ED. Methodology in that study ensured high specificity but risked lower sensitivity in suicide variables, and with such a high-threat outcome, research is needed on additional variables related to risk.Objectives and aimsWe aimed to study associations between SASB self-image and clinician- and self-rated suicidality at presentation and predicted over 12 months in ED patients.MethodsAdult patients (n = 551) from a Swedish clinical database included 19% anorexia, 32% bulimia, 7% binge ED, and 42% other ED. We ran separate regression models for these diagnostic groups using SASB questionnaire data, also controlling for general psychiatric and ED symptoms, and in longitudinal models including baseline of each outcome.ResultsSASB alone was associated with suicidality at presentation (9–67% variance explained) and predictively over 12 months (7–29%), and in the majority of models explained additional variance beyond baseline and clinical variables. Both affiliation and autonomy related to dependent variables in diagnosis-specific patterns.ConclusionsThe findings have implications for both theory and detection tools for suicide risk, as well as suggesting intervention targets to mitigate risk in treatment based on the well-validated SASB theory.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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| 47. |
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| 48. |
- Bodén, Robert, 1973-, et al.
(author)
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Electrocardiographic signs of autonomic imbalance in medicated patients with first-episode schizophrenia spectrum disorders : relations to first treatment discontinuation and five-year remission status
- 2012
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In: European psychiatry. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 27:3, s. 213-218
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Journal article (peer-reviewed)abstract
- PURPOSE:To explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.SUBJECTS AND METHODS:Twelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.RESULTS:Patients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.DISCUSSION AND CONCLUSION:In this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.
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| 49. |
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| 50. |
- Bornehag, Carl-Gustaf, 1957-, et al.
(author)
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Prenatal exposure to acetaminophen and children's language development at 30 months
- 2018
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 51, s. 98-103
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To examine prenatal APAP exposure in relation to language development in offspring at 30 months of age.METHOD: A population-based pregnancy cohort study including 754 women who enrolled in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study in pregnancy week 8-13. Two exposure measures were used: (1) maternally reported number of APAP tablets taken between conception and enrollment; (2) APAP urinary concentration at enrollment. Language development at 30 months was assessed by nurse's evaluation and parental questionnaire, including the number of words the child used (<25, 25-50 and >50). Main study outcome; parental report of use of fewer than 50 words, termed language delay (LD).RESULTS: 59.2% of women enrolled in weeks 8-13 reported taking APAP between conception and enrollment. APAP was measurable in all urine samples and urinary APAP was correlated with the number of APAP taken during pregnancy (P<0.01). Language delay was more prevalent in boys (12.6%) than girls (4.1%) (8.5% in total). Both the number of APAP tablets and urinary APAP concentration were associated with greater LD in girls but not in boys. The adjusted odds ratio (OR) for LD among girls whose mothers reported >6 vs. 0 APAP tablets was 5.92 (95% confidence interval (CI) 1.10-31.94). The OR for LD in girls whose mothers' urinary APAP was in the highest compared to the lowest quartile was 10.34 (95% CI 1.37-77.86). While it cannot be ruled out, our available data do not support confounding by indication.CONCLUSIONS: Given the prevalence of prenatal APAP use and the importance of language development, these findings, if replicated, would suggest that pregnant women should limit their use of this analgesic during pregnancy.
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