Träfflista för sökning "AMNE:(MEDICAL AND HEALTH SCIENCES Health Sciences Substance Abuse) "

Search: AMNE:(MEDICAL AND HEALTH SCIENCES Health Sciences Substance Abuse)

Result 1-50 of 1215

Sort/group result

Sort by: Hits per page:

Enumeration	Reference	Cover	Find
1.	Forsström, David, 1981-, et al. (author) Feasibility and results of a pilot online survey to examine prevalence of gambling and problem gambling among Swedish substance abuse inpatients in compulsory care 2024 In: Cogent Psychology. - : Taylor & Francis. - 2331-1908. ; 11:1 Journal article (peer-reviewed)abstract The comorbidity between problem gambling and substance use/abuse is high in many populations previously studied. However, the occurrence of problem gambling among individuals with substance abuse has not been thoroughly studied, which is especially true for individuals in inpatient or compulsory care. The present early-stage study explored the presence of gambling and problem gambling among inpatients in compulsory care in Sweden who has been court-ordered to treatment for their substance abuse (alcohol and/or drugs). The study furthermore investigates the use of preventive measures and treatment seeking. The most effective strategy to recruit participants (no incentive, incentive and incentive and face-to-face recruitment) was also explored. Twenty-one participants were recruited and seven of them had at-risk or problem gambling and none of them had accessed treatment. The best way of recruiting was to offer a gift certificate and inform about the study face-to-face. The implications are that individuals in compulsory care for substance abuse need to be screened for problem gambling, that recruitment for studies in this population is best carried out by offering incentives and educational efforts and that it might be beneficial for the clients in compulsory care to be offered gambling treatment.
2.	Hedman, Linnea, et al. (author) Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms 2018 In: Jama Network Open. - : American Medical Association (AMA). - 2574-3805. ; 1:3 Journal article (peer-reviewed)abstract IMPORTANCE There is an ongoing debate about whether electronic cigarettes (e-cigarettes) are the solution to the tobacco epidemic or a new public health threat. Large representative studies are needed to study e-cigarette use in the general population, but hardly any have been published. OBJECTIVES To estimate the prevalence of e-cigarette use and to investigate the association of e-cigarette use with smoking habits, demographic factors, and respiratory symptoms. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based study of random samples of the population, performed within the Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). The same validated questionnaire including identical questions was used in OLIN and WSAS. In 2016, OLIN and WSAS conducted postal questionnaire surveys in random samples of adults aged 20 to 75 years. In OLIN, 6519 participated (response rate, 56.4%); in WSAS, 23 753 participated (response rate, 50.1%). MAIN OUTCOMES AND MEASURES Electronic cigarette use, smoking habits, and respiratory symptoms. RESULTS Of 30 272 participants (16 325 women [53.9%]). 3897 (12.9%) were aged 20 to 29 years; 4242 (14.0%). 30 to 39 years; 5082 (16.8%). 40 to 49 years; 6052 (20.0%), 50 to 59 years; 6628 (21.9%), 60 to 69 years; and 4371(14.4%), 70 to 75 years. The number of current smokers was 3694 (12.3%), and 7305 (24.4%) were former smokers. The number of e-cigarette users was 529 (2.0%). and e-cigarette use was more common among men (275 of 12 347 [2.2%; 95% CI, 2.0%-2.5%]) than women (254 of 14 022 [1.8%; 95% CI, 1.6%-2.0%]). Among current smokers. 350 of 3566 (9.8%; 95% CI, 8.8%10.8%) used e-cigarettes compared with 79 of 6875 (1.1%; 95% CI, 0.9%-1.3%) in former smokers and 96 of 15 832 (0.6%; 95% CI, 0.5%-0.7%) in nonsmokers (P < .001). Among e-cigarette users who answered the survey question about cigarette-smoking habits (n = 525). 350 (66.7%; 95% CI, 62.7%-70.7%) were current smokers, 79 (15.0%; 95% CI, 11.9%-18.1%) were former smokers, and 96 (18.3%; 95% CI, 15.0%-21.6%) were nonsmokers (P < .001 for trend). In a regression analysis, e-cigarette use was associated with male sex (odds ratio [OR], 1.35; 95% CI. 1.12-1.62); age groups 20 to 29 years (OR. 2.77; 95% CI, 1.90-4.05), 30 to 39 years (OR, 2.27; 95% CI, 1.53-3.36), 40 to 49 years (OR, 1.65; 95% CI, 1.11-2.44). and 50 to 59 years (OR, 1.47; 95% CI, 1.01-2.12); educational level at primary school (OR, 1.99; 95% CI, 1.51-2.64) and upper secondary school (OR, 1.57; 95% CI, 1.25-1.96); former smoking (OR. 2.37; 95% CI, 1.73-3.24); and current smoking (OR. 18.10; 95% CI, 14.19-23.09). All respiratory symptoms were most common among dual users and former smokers and nonsmokers who used e-cigarettes. CONCLUSIONS AND RELEVANCE Use of e-cigarettes was most common among smokers, and dual users had the highest prevalence of respiratory symptoms. On a population level, this study indicates that the present use of e-cigarettes does not adequately serve as a smoking cessation tool.
3.	El Ansari, Walid, et al. (author) Prevalence and socio-demographic, academic, health and lifestyle predictors of illicit drug/s use among university undergraduate students in Finland 2020 In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:14, s. 1-20 Journal article (peer-reviewed)abstract Illicit drug/s use (IDU) among university students is a public health concern. We assessed the associations between socio-demographic, academic, and health and lifestyle characteristics (independent variables) and regular, occasional or never IDU (dependent variables). Data were collected across seven faculties (1177 students) at the University of Turku (Finland) via an online questionnaire. About 1.5% of the sample had regular IDU, 19% occasional IDU, and 79% never IDU. Independent predictors of ever (lifetime) IDU included males [adjusted odds ratio (AOR) 1.82, P = 0.001], not living with parents (AOR 2.59, P < 0.001), singles (AOR 0.51, P < 0.001), lower religiosity (AOR 1.49, P = 0.022), better self-rated general health (AOR 0.41, P = 0.003), higher health awareness (AOR 1.93, P = 0.014), more depressive symptoms (AOR 1.82, P = 0.004), daily smokers (AOR 3.69, P < 0.001), heavy episodic drinking (AOR 2.38, P < 0.001) and possible alcohol dependency (AOR 2.55, P < 0.001). We observed no independent associations between ever IDU with age, study discipline, perceived stress or academic performance. The 20.5% ever IDU is concerning. The compelling independent predictors of ever IDU included not living with parents, lower religiosity, daily smokers, heavy episodic drinking and possible alcohol dependency (AOR range 2.38–3.69). Education and prevention need to emphasize the negative consequences to reinforce abstinence from IDU. Health promotion could focus on beliefs and expectations about IDU and target students at risk for successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
4.	Jemberie, Wossenseged Birhane, 1985-, et al. (author) Substance Use Disorders and COVID-19 : Multi-Faceted Problems Which Require Multi-Pronged Solutions 2020 In: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 11 Journal article (peer-reviewed)abstract COVID-19 shocked health and economic systems leaving millions of people without employment and safety nets. The pandemic disproportionately affects people with substance use disorders (SUDs) due to the collision between SUDs and COVID-19. Comorbidities and risk environments for SUDs are likely risk factors for COVID-19. The pandemic, in turn, diminishes resources that people with SUD need for their recovery and well-being. This article presents an interdisciplinary and international perspective on how COVID-19 and the related systemic shock impact on individuals with SUDs directly and indirectly. We highlight a need to understand SUDs as biopsychosocial disorders and use evidence-based policies to destigmatize SUDs. We recommend a suite of multi-sectorial actions and strategies to strengthen, modernize and complement addiction care systems which will become resilient and responsive to future systemic shocks similar to the COVID-19 pandemic.
5.	Boson, Karin, 1984, et al. (author) Adolescents with substance use problems in outpatient treatment: a one-year prospective follow-up study focusing on mental health and gender differences 2022 In: Substance Abuse Treatment, Prevention, and Policy. - : Springer Science and Business Media LLC. - 1747-597X. ; 17:1 Journal article (peer-reviewed)abstract Background Although several studies have found a high incidence of coexisting mental health problems among adolescents with substance use problems, follow-up studies addressing how these conditions change over time are rare. The study will describe and analyze indications of mental health problems and how various risk factors predict outcomes 1 year after initial treatment contact. In addition, gender-specific risk factors are explored. Methods A clinical sample of 455 adolescents (29% girls, median age 17 years) answered a structural interview at baseline and were followed up using official records 1 year after initiated treatment. Bivariate associations and logistic regressions were conducted to analyse the links between risk factors at the individual, social, and structural levels as well as links between various mental illness symptoms at treatment start and indications of mental health problems 1 year later were analysed. Results The results show that mental health problems among adolescents largely persisted 1 year after start of outpatient care for substance use problems. Forty-two per cent of the sample displayed indications of mental health problems at follow-up, and registrations for both outpatient treatment and psychiatric medication were more common among the girls. Girls also reported more mental illness symptoms at treatment start than boys did, especially anxiety. Depression and suicidal thoughts had predictive values regarding indications of mental health problems and small cumulative effects were found for 6-10 co-occurring risk factors. Conclusions Adolescents with depression and suicidal thoughts at treatment start should yield attention among clinicians as these general risk factors could predict indication of mental health problems at 1 year follow-up effectively. Also, patients with more than six co-occurring risk factors seem more vulnerable for continued mental health problems. Generally, girls displayed a greater mental health and psychosocial burden at treatment initiation and were more likely to show indication of mental health problems at follow-up. These results suggests that girls are more likely to get psychiatric out-treatment parallel to, or after, substance abuse treatment. We recommend further investigation of gender differences and gender-specific needs in substance use treatment.
6.	Billsten, Johan, 1971-, et al. (author) Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study 2018 In: Journal of Substance Abuse Treatment. - Amsterdam : Elsevier. - 0740-5472 .- 1873-6483. ; 84, s. 9-16 Journal article (peer-reviewed)abstract Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. Aim The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. Design and recruitment The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Statistics Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. Results A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α = 0.67 to α = 0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α = 0.64), institutional resources (α = 0.52), staff attributes (α = 0.76), and organizational climate (α = 0.74). An LPA analysis of the four factors with their three distinct profiles provided the best data fit: Profile 3 (n = 614), Profile 2 (n = 934), and Profile 1 (n = 246). Respondents with the most favorable ORC scores (Profile 3) used significantly more instruments and more treatment methods and had a better collaborating network in 2011 as well as in 2013 compared to members in Profile 1, the least successful profile. Conclusion In a large sample of social work and healthcare professionals, ORC scores reflecting higher institutional resources, staff attributes and organizational climate and lower motivational readiness for change were associated with a successful implementation of good practice guidelines for the care and treatment of substance users in Sweden. Low motivational readiness as a construct may indicate satisfaction with the present situation. As ORC proved to be an indicator of successful dissemination of evidence-based guidelines into routine and specialist healthcare, it can be used to tailor interventions to individual employees or services and to improve the dissemination of and compliance with guidelines for the treatment of substance users. © 2017
7.	Tedgård, Eva, et al. (author) Struggling with one’s own parenting after an upbringing with substance abusing parents 2018 In: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 13:1 Journal article (peer-reviewed)abstract Aim: To add to our knowledge concerning the key elements involved in the individual’s experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. Methods: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Result: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. Conclusions: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children’s ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.
8.	Cruce, Gunilla, et al. (author) Recovery-promoting Care as Experienced by Persons with Severe Mental Illness and Substance Misuse 2012 In: International Journal of Mental Health and Addiction. - : Springer Science and Business Media LLC. - 1557-1874 .- 1557-1882. ; 10:5, s. 660-669 Journal article (peer-reviewed)abstract This paper explores recovery-promoting care as experienced by persons with concomitant severe mental illness and substance misuse. Sixteen in-depth interviews, based on an interview guide concerning their experiences of health, life situation and care, were held with eight participants in an outpatient treatment programme. The analysis aimed to identify themes reflecting the diversity and complexity of the phenomenon recovery-promoting care. Six themes emerged: "entirety", "participation and reciprocal relations", "stability", "symptom control", "mindfulness", and "dignity and autonomy". The participants reported that care conveying experiences of meaningfulness and providing empowerment increased their motivation and their capacity to take an active part in the recovery process. The findings of the study underscore the importance of incorporating the patients' perspectives on what promotes recovery when offering mental health services.
9.	Blindow, Katrina J., et al. (author) Gender-based harassment in Swedish workplaces and alcohol-related morbidity and mortality : A prospective cohort study 2023 In: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 49:6, s. 395-404 Journal article (peer-reviewed)abstract Objective: The study investigated experiences of different types of work-related gender-based harassment (GBH), specifically sexual and gender harassment, as risk factors for alcohol-related morbidity and mortality (ARMM).Methods: Information about experiences of (i) sexual harassment (SH-I) and (ii) gender harassment (GH-I) from inside the organization and (iii) sexual harassment from a person external to the organization (SH-E) were obtained from the Swedish Work Environment Survey 1995–2013, a biannual cross-sectional survey, administered to a representative sample of the Swedish working population. The survey responses from 86 033 individuals were connected to multiple registers containing information about alcohol-related diagnoses, treatment, or cause of death. Cox proportional hazard models were fitted to assess hazard ratios (HR) of incident ARMM during a mean follow-up of eight (SH-I and GH-I) and ten (SH-E) years.Results: A higher prospective risk estimate of ARMM was found among participants who reported experiences of SH-E [HR 2.01, 95% confidence interval (CI) 1.61–2.52], GH-I (HR 1.33, CI 1.03–1.70), or SH-I (HR 2.37, CI 1.42–3.00). Additional analyses, distinguishing one-time from reoccurring harassment experiences, indicated a dose–response relationship for all three harassment types. Gender did not modify the associations. Under the assumption of causality, 9.3% (95% CI 5.4–13.1) of the risk of ARMM among Swedish women and 2.1% (95% CI 0.6–3.6) among Swedish men would be attributable to any of the three types of GBH included in this study.Conclusions: Experiences of GBH in the work context may be a highly relevant factor in the etiology of ARMM.
10.	Påhlsson-Notini, Andreas, et al. (author) Substance use-related problems in mild intellectual disability : A Swedish nationwide population-based cohort study with sibling comparison 2024 In: JCPP Advances. - Chichester : John Wiley & Sons. - 2692-9384. ; 4:2 Journal article (peer-reviewed)abstract BACKGROUND: Evidence for substance use-related problems in individuals with mild intellectual disability is sparse and mainly limited to selected psychiatric populations. We evaluated the risk of substance use-related problems in individuals with mild intellectual disability compared to the general population. Additionally, we have performed secondary sibling comparison analyses to account for familial confounding.METHODS: We conducted a population-based cohort study of individuals born in Sweden between 1973 and 2003. A total of 18,307 individuals with mild intellectual disability were compared to 915,350 reference individuals from the general population and 18,996 full siblings of individuals with mild intellectual disability. Information on mild intellectual disability and substance use-related problems was obtained from several Swedish national and regional school and healthcare registers. Substance use-related problems were measured via corresponding diagnostic and legal codes and included alcohol use disorder, drug use disorder, alcohol-related somatic disease, conviction for a substance-related crime, and substance-related death.RESULTS: Individuals with mild intellectual disability had a higher risk of any substance use-related problem compared to the general population (HR, 1.81; 95% CI, 1.72-1.91), both in males (HR, 1.76; 95% CI, 1.65-1.89) and females (HR, 1.89; 95% CI, 1.74-2.05). The risks of substance use-related problems were particularly elevated among individuals with mild intellectual disability and psychiatric comorbidities (HR, 2.21-8.24). The associations were attenuated in the sibling comparison models.CONCLUSIONS: Individuals with mild intellectual disability, especially those with psychiatric comorbidity, are at an elevated risk of substance use-related problems. Familial factors shared by full siblings contribute considerably to the association between mild intellectual disability and substance use-related problems.
11.	Wall, Håkan, et al. (author) Effectiveness of a Web-Based Individual Coping and Alcohol Intervention Program for Children of Parents With Alcohol Use Problems : Randomized Controlled Trial 2024 In: Journal of Medical Internet Research. - 1438-8871. ; 26:1 Journal article (peer-reviewed)abstract Background: Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce. We have developed a novel digital therapist-assisted self-management intervention targeting adolescents whose parents had alcohol use problems. This program aims to strengthen coping behaviors, improve mental health, and decrease alcohol consumption in adolescents. Objective: This study aims to examine the effectiveness of a novel web-based therapist-assisted self-management intervention for adolescents whose parents have alcohol use problems. Methods: Participants were recruited on the internet from social media and websites containing health-related information about adolescents. Possible participants were screened using the short version of the Children of Alcoholics Screening Test-6. Eligible participants were randomly allocated to either the intervention group (n=101) or the waitlist control group (n=103), and they were unblinded to the condition. The assessments, all self-assessed, consisted of a baseline and 2 follow-ups after 2 and 6 months. The primary outcome was the Coping With Parents Abuse Questionnaire (CPAQ), and secondary outcomes were the Center for Epidemiological Studies Depression Scale, Alcohol Use Disorders Identification Test (AUDIT-C), and Ladder of Life (LoL). Results: For the primary outcome, CPAQ, a small but inconclusive treatment effect was observed (Cohen d=–0.05 at both follow-up time points). The intervention group scored 38% and 46% lower than the control group on the continuous part of the AUDIT-C at the 2- and 6-month follow-up, respectively. All other between-group comparisons were inconclusive at either follow-up time point. Adherence was low, as only 24% (24/101) of the participants in the intervention group completed the intervention. Conclusions: The findings were inconclusive for the primary outcome but demonstrate that a digital therapist-assisted self-management intervention may contribute to a reduction in alcohol consumption. These results highlight the potential for digital interventions to reach a vulnerable, hard-to-reach group of adolescents but underscore the need to develop more engaging support interventions to increase adherence.
12.	Ahlner, Felicia, 1987, et al. (author) Patterns of Alcohol Consumption and Associated Factors in a Population-Based Sample of 70-Year-Olds: Data from the Gothenburg H70 Birth Cohort Study 2014-16 2022 In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 19:14 Journal article (peer-reviewed)abstract Older adults of today consume more alcohol, yet knowledge about the factors associated with different consumption levels is limited in this age group. Based on the data from a population-based sample (n = 1156, 539 men and 617 women) in The Gothenburg H70 Birth Cohort Study 2014-16, we examined sociodemographic, social, and health-related factors associated with alcohol consumption levels in 70-year-olds, using logistic regression. Total weekly alcohol intake was calculated based on the self-reported amount of alcohol consumed. Alcohol consumption was categorized as lifetime abstention, former drinking, moderate consumption (<= 98 g/week), and at-risk consumption (>98 g/week). At-risk consumption was further categorized into lower at-risk (98-196 g/week), medium at-risk (196-350 g/week), and higher at-risk (>= 350 g/week). We found that among the 1156 participants, 3% were lifetime abstainers, 3% were former drinkers, 64% were moderate drinkers, and 30% were at-risk drinkers (20% lower, 8% medium, 2% higher). Among several factors, former drinking was associated with worse general self-rated health (OR 1.65, 95% CI 1.08-2.51) and lower health-related quality of life (measured by physical component score) (OR 0.94, 95% CI 0.91-0.97), higher illness burden (OR 1.16, 95% CI 1.07-1.27), and weaker grip strength (OR 0.96, 95% CI 0.94-0.98). Higher at-risk drinkers more often had liver disease (OR 11.41, 95% CI 3.48-37.37) and minor depression (OR 4.57, 95% CI 1.40-14.95), but less contacts with health care (OR 0.32, 95% CI 0.11-0.92). Our findings demonstrate the importance of classifications beyond abstinence and at-risk consumption, with implications for both the prevention and clinical management of unhealthy consumption patterns in older adults.
13.	Rantala, Pauliina, et al. (author) Päihde- ja riippuvuushuollon kipupisteet: Ammattilaisten ja asiantuntijoiden tilannearviointi muuttuvasta kentästä : [Sore spots in addiction service provision: professionals' and experts' views on a changing field] 2023 In: Sosiaalilääketieteellinen aikakauslehti. - : Sosiaalilääketieteen yhdistys. - 0355-5097. ; 60:4 Journal article (peer-reviewed)abstract The Finnish substance use and addiction service field is in a state of transition. In this study, we map how professionals in this field evaluate its current state. The results point to two sore spots in the realization of the service system’s responsibilities. These pertain to: (i) the internal systemic division of roles and tasks and adherent conflicts, and (ii) the accessibility of services and the preparedness of the system. The participants saw that it is especially important to ensure the functioning of the system through multi-professionalism, to secure a suitable role division between actors and sectors, to balance corrective and preventive services with an emphasis on prevention, and to be aware of and take into account the risk of service fragmentation. In the concluding discussion, we summarize our views on how the principles of welfare state accountability underpin the participants’ reasoning concerning the value of welfare pluralism and the readiness of the system to deal with tensions between universalism and particularism. By emphasizing fairness and possible competition between social and health perspectives, the participants identified a role for the substance use and addiction service field in terms of shifting the responsibility from the individual to the service structures.
14.	Dahlberg, Mikael, 1965- (author) Ensamkommande ungdomar med alkohol- och narkotikaproblem – en riskgrupp? 2020 In: Socialmedicinsk Tidskrift. - Stockholm : Stiftelsen Socialmedicinsk tidskrift. - 0037-833X .- 2000-4192. ; 97:2, s. 287-302 Journal article (peer-reviewed)abstract Droganvändning bland ensamkommande ungdomar har varit föremål för en omfattande rapportering i media de senaste åren och har ofta framställts som ett eskalerande socialt problem. I artikeln beskrivs likheter och skillnader mellan ensamkommande ungdomar och andra ungdomar som påbörjar öppenvård för missbruk i relation till social situation, användning av droger, brottslighet, våldsutsatthet samt fysisk och psykisk hälsa. Studien är baserad på strukturerade intervjuer med 1 255 ungdomar på tolv öppenvårdsverksamheter i Sverige, 93 av dessa individer är ensamkommande ungdomar. Studien visar att ensamkommande ungdomar, trots traumatiska upplevelser och betydande psykologiska besvär, använder alkohol och droger i mindre utsträckning än andra ungdomar som påbörjar öppenvård. Det kan således vara problematiskt att betrakta dessa ungdomar som en särskild högriskgrupp som utgör stora utmaningar för det svenska välfärdssystemet.
15.	Dahlberg, Mikael, 1965-, et al. (author) Long-Term Outcomes for Young People With Substance Use Problems in Outpatient Treatment: Gender-Specific Patterns 2022 In: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13 Journal article (peer-reviewed)abstract This study presents the results of a longitudinal research project focusing on long-term outcomes among young people after initiation of outpatient treatment for substance use problems (SUP) in Sweden. Young people are defined with the age group 13-25 years. A clinical sample of 451 young people (29% girls, median age 17 years) completed a structured interview at baseline and was followed using official records one, two, and 3 years after initiation of treatment. Gender-specific patterns at intake were described and bivariate associations and logistic regressions were calculated to analyse the links between risk factors at treatment start and indications of substance use problems 3 years later. Significantly more boys than girls displayed indications of continued SUP at 3-year follow-up. More specifically, 49% of the boys vs. 35% of the girls were identified through records as still having problems with substance use. Predictive risk factors also displayed gender-specific patterns. Primary drug use frequency and age at intake predicted indications of SUP among boys but not among girls. Placement in foster care/residential homes, depression, and early drug debut had significant predictive value regarding indications of SUP among females but not among males. Girls also displayed a greater psychosocial burden at treatment start, but a more favorable treatment outcome at follow-up. Youths with a heavy risk load at treatment start (i.e., over six risk factors) did not display a greater risk of SUP at 3-year follow-up, although our results suggest that this subgroup has indications of continued problems with mental health. Consequently, future studies should further explore gender-specific treatment pathways for young people with substance use problems. Since women and girls seem to have different risk factors, co-occurring psychiatric problems and more experiences of trauma compared to men, they might need multidimensional and more comprehensive treatment interventions that run over a longer period of time.
16.	Hodgins, S., et al. (author) Individuals developing schizophrenia are hidden among adolescent substance misusers 2016 In: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 46:14, s. 3041-3050 Journal article (peer-reviewed)abstract Background Strategies are needed to identify youth developing schizophrenia. The present study aimed to determine whether adolescents treated for substance misuse were at elevated risk to develop schizophrenia, whether this risk has changed since the late 1960s, and whether substance misuse in adolescence predicted poorer outcomes through adulthood. Method In a Swedish city, since the mid-1960s there has been only one clinic for adolescent substance misuse. Three samples from this clinic were studied: 1992 individuals treated from 1968 to 1971 followed to age 50 years; 1576 treated from 1980 to 1984 followed to age 35 years; and 180 treated in 2004 followed to age 22 years. Each clinical sample was matched on age, sex and place of birth to an equal, or larger, number of randomly selected individuals from the general population. Schizophrenia, substance use disorders, physical disorders related to substance misuse, criminal convictions, poverty and death were identified using national registers. Results Individuals treated for substance misuse in adolescence were at increased risk to subsequently develop schizophrenia: in males the increase was approximately four-fold and in females between five- and seven-fold. There was no difference in risk for those treated in 1968-1971 and from 1980 to 1984 when cannabis use increased from 37.6% to 49.8% of the clinical samples. Among males who developed schizophrenia, treatment for substance misuse was associated with increased risk of substance use disorders and criminal convictions through adulthood. Conclusions Treatment programmes for adolescents misusing substances include a disproportionate number developing schizophrenia. Early detection and treatment have the potential to improve long-term outcomes.
17.	Larm, Peter, et al. (author) How are social capital and sense of coherence associated with hazardous alcohol use? : Findings from a large population-based Swedish sample of adults 2016 In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:5, s. 525-533 Journal article (peer-reviewed)abstract Aims: This study examined whether social capital and a sense of coherence are associated with hazardous alcohol use in a large population-based Swedish sample. In particular, the objectives were (a) to examine which of five subdimensions of social capital is associated with hazardous alcohol use, (b) to investigate the moderating role of sense of coherence and (c) to examine possible sex differences. Methods: A postal survey was distributed to a sample of respondents (aged 18-84 years) from five Swedish counties that was stratified by sex, age and city; 40,674 (59.2%) participants responded, of which 45.5% were men and 54.5% were women with a mean +/- SD age of 53.8 +/- 17.9 years. Results: Structural dimensions of social capital were associated with an increased probability of hazardous alcohol use among both men and women, whereas the increased probability associated with cognitive dimensions occurred mostly among women. Sense of coherence was robustly associated with a decreased probability of hazardous alcohol use among both men and women. There were few moderating effects of sense of coherence and sex differences emerged mainly for the cognitive dimension of social capital. Conclusions: Associations between social capital dimensions and hazardous alcohol use were partly sex-specific, whereas the benefits of a sense of coherence accrued to both sexes. Social capital dimensions and sense of coherence were generally unrelated to each other. Only associations between the cognitive dimensions of social capital and hazardous alcohol use differed by sex.
18.	Agahi, Neda, et al. (author) Social integration and alcohol consumption among older people : A four-year follow-up of a Swedish national sample 2019 In: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 196, s. 40-45 Journal article (peer-reviewed)abstract Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.
19.	Jemberie, Wossenseged Birhane, 1985- (author) Alcohol and aging : a multimethod study on heterogeneity and multidimensionality 2023 Doctoral thesis (other academic/artistic)abstract Background and Objectives: With an ageing population, the number of older persons with substance use problems, particularly problematic alcohol use, is increasing. Despite growing recognition of the negative consequences of problematic alcohol use on older persons, there is a dearth of knowledge about the alcohol use profiles and the dimensionality of alcohol problems in older people. Moreover, little is known about older persons’ experiences and perspectives on alcohol use in relation to their ageing and their personal goals regarding treatment and recovery. This thesis aimed to (i) describe the characteristics of older persons who accessed municipal substance use treatment and care services (addiction services) and to investigate their future hospitalization; (ii) examine the heterogeneity and multidimensionality of problematic alcohol use among older persons; and (iii) to shed light on the experiences and perspectives of older persons regarding ageing, alcohol problems and recovery.Methods: For studies I-III, municipal Addiction Severity Index (ASI) assessment data (between 2003 and 2017) from adults aged 50 years and older were used to select the study samples. Generalized linear regression models investigated hospitalization related outcomes among 3624 older persons in Study-I. In Study-II, a latent class analysis was applied on ASI data from 1747 individuals with alcohol problems. Study-III linked the ASI data from Study-II to hospital discharge and mortality data forming time-to-repeated-event dataset; Andersen-Gill regression model with a robust variance estimator was used for the analysis. Study-IV applied qualitative content analysis on interview data from ten older persons recruited from a specialist outpatient clinic for alcohol treatment. Results: Nearly three-fourth of older persons assessed for substance use severity at municipal addiction services were later hospitalized (Study-I). Individuals diagnosed with substance use disorders, psychiatric or dual diagnoses had more cumulative hospitalized days, higher rates of hospital readmissions, and shorter time to first admission following an initial ASI assessment at municipal addiction services (Study-I). Five distinct groups of older persons with comparable alcohol problem severity but with variation in onset age, psychiatric comorbidities, polysubstance use, social support and gender composition were identified (Study-II). The five groups varied in risks of repeated hospitalizations due to substance use and psychiatric disorders (Study-III). Older persons experienced their ageing and alcohol use having a dynamic interplay (Study-IV). They needed to constantly negotiate with their environment to maintain a positive ageing trajectory. They perceived moderate alcohol use fosters healthy ageing, but over time, experienced their alcohol use as unsustainable and a threat to their pursuit of healthy ageing. Stigma and ambivalence delayed treatment seeking (Study-IV). They accessed treatment programs which respected their preferences and autonomy, engaged them in goal setting and strengthened their agency. After reducing their alcohol use, positive changes in their biopsychosocial functioning encouraged them to continue their recovery journey even in the presence of setbacks (Study-IV).Conclusion: Most older persons who access municipal addiction services are hospitalized repeatedly. Many older persons with alcohol problems live with medical and psychiatric comorbidities suggesting multiple care needs from health and social care services. Incorporating older persons’ desire for healthy ageing into alcohol treatment plan can facilitate treatment engagement and recovery. Many older persons aim to moderate their alcohol consumption. Clinicians can deliver person-centered care for older persons, by considering their heterogeneity in treatment goals, biopsychosocial functioning, and available resources. A multidimensional identification of alcohol use profiles could improve treatment by establishing the variation in alcohol problems among older treatment seekers. Older persons stay engaged in alcohol treatment programs which value their experiences and expertise, incorporate their personal treatment and life goals, respect their autonomy and agency, and involve them as active participants. Sensitizing service providers on old age substance use problems could provide multiple points of contact for screening of older persons and earlier referral to treatment. A streamlined data sharing within and between health and social care services fosters timely and equitable care and facilitates an integrated and person-centered care across the continuum.
20.	Lindström, M., et al. (author) Addictive behaviors, social and psychosocial factors, and electronic cigarette use among adolescents: a population-based study 2018 In: Public Health. - : Elsevier BV. - 0033-3506. ; 155, s. 129-132 Journal article (peer-reviewed)abstract Objectives: The aim was to investigate associations between e-cigarette use and social and psychosocial factors and cigarette smoking, alcohol consumption, and narcotics use among adolescents attending 9th grade in primary school and 2nd grade in secondary school. Study design: Cross-sectional study. Methods: The public health survey among adolescents in Scania in 2016 includes pupils in grades 9 and 2. The associations between e-cigarette use and lifestyle, social and psychosocial factors, and trust were investigated with logistic regressions. Results: In 9th grade, 32% of male pupils and 27% of female pupils had ever used e-cigarettes, and in 2nd grade, 43% of males and 31% of females had ever used e-cigarettes. E-cigarette use was significantly associated with current smoking, snus (a moist powder tobacco product originating in Sweden) use, water pipe use, intensive alcohol consumption, and narcotics and also with psychosocial conditions related to home and parents, peers, and school. Conclusions: The prevalence of ever e-cigarette use was high among adolescents attending both grades. E-cigarette use was most strongly associated with health-related lifestyles. It was also associated with psychosocial factors such as study difficulties, school stress, problems talking with parents, and generalized trust. © 2017 The Royal Society for Public Health
21.	Swahnberg, Katarina, et al. (author) Minimizing human dignity : staff perception of abuse in health care 2012 In: Clinical Ethics. - : SAGE Publications. - 1477-7509 .- 1758-101X. ; 7:1, s. 33-38 Journal article (peer-reviewed)abstract In earlier studies we have shown that abuse in health care (AHC) is commonly reported among both male and female patients. In this study, we present an evaluation of an intervention against AHC based on Forum Play. The evaluation was conducted by means of pre- and postintervention interviews with the staff at a woman's clinic. The interviews were analysed using the constant comparative method. The results of this postintervention study stand out in loud contrast to the results of the preintervention studies. Staff had moved from a distant and fluctuating awareness of AHC to a standpoint characterized by both moral imagination and a sense of responsibility.
22.	Berglund, Kristina, 1969, et al. (author) Is There a Need for Congruent Treatment Goals Between Alcohol-Dependent Patients and Caregivers? 2016 In: Alcoholism-Clinical and Experimental Research. - : Wiley. - 0145-6008. ; 40:4, s. 874-879 Journal article (peer-reviewed)abstract BackgroundAlcohol-dependent patients have different treatment goals when entering treatment. Furthermore, different treatment settings advocate different treatment goals. Earlier studies have pointed out that treatment goal is important for treatment outcome, both in the treatment setting as well as in the patients themselves. However, to our knowledge, no study has so far investigated the interaction between patient's goal and the goal of the treatment setting. The aim of the study was therefore to study the interaction between these 2 factors on treatment outcome. MethodsPatients' (n=201) goals from 2 treatment settingsone that had an abstinence-oriented goal and one with a low-risk drinking goalwere investigated. The patients were followed up 2.5years after treatment entry and effectiveness of congruent treatment goals on treatment outcome was investigated. ResultsThere was no significant association between congruent goals and treatment outcomes (p=0.060). However, when comparing the effectiveness of congruent treatment goal between the 2 treatment settings, the abstinence-oriented treatment setting was significantly more effective (p<0.01). ConclusionsThe major finding was that there appeared to be no association between congruence itself and treatment outcome. On the other hand, we found that the treatment outcome was more successful if the patient as well as the treatment setting had abstinence as a goal (i.e., congruent goals of abstinence).
23.	Schückher, Fides, 1956-, et al. (author) Predictors for Abstinence in Socially Stable Women Receiving Treatment for Alcohol Use Disorder 2022 In: Alcoholism Treatment Quarterly. - : Informa UK Limited. - 0734-7324 .- 1544-4538. ; 40:2, s. 244-257 Journal article (peer-reviewed)abstract There is a knowledge gap about predictors of treatment outcomes in alcohol use disorder (AUD) in socially stable women. This study examined factors that may predict abstinence 12 months after the end of treatment for AUD in socially stable women. Fifty-seven women with AUD participated in 12-month follow-up. Information about sociodemographic, alcohol-related, psychiatric symptoms, psychological functioning, and participants' treatment goals and ability to change alcohol habits were gathered from structured interviews and self-report instruments. Predictors for abstinence at the 12-month follow up were calculated by univariable and multivariable logistic regression models. Significant predictors for abstinence were having no history of childhood abuse (OR: 8.13; 95%CI: 2.22-29.75; p < .01) and a goal of abstinence at the end of treatment (OR: 15.17; 95%CI: 3.45-66.69; p < .001). Most participants (>60%) achieved their goals of abstinence or low-risk drinking. The results highlight the significance of identifying patients with experiences of childhood abuse, since such experiences may adversely affect the outcome of AUD treatment. Our findings also emphasize the importance of patients' own goals of abstinence, since it resulted in the most stable outcome. Treatment could, therefore, also focus on motivating individuals to aim for abstinence.
24.	Sundström, Christopher, et al. (author) What Predicts Treatment Adherence and Low-Risk Drinking? An Exploratory Study of Internet Interventions for Alcohol Use Disorders 2023 In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 29:1 Journal article (peer-reviewed)abstract Introduction: Internet interventions for alcohol problems are effective, but not all participants are helped. Further, the importance of adherence has often been neglected in research on internet interventions for alcohol problems. Prediction analysis can help in prospectively assessing participants' probability of success, and ideally, this information could be used to tailor internet interventions to individual needs. Methods: Data were obtained from a randomized controlled trial on internet interventions for alcohol use disorders. Twenty-nine candidate predictors were run in univariate logistic regressions with two dichotomous dependent outcomes: adherence (defined as completing at least 60% of the treatment modules) and low-risk drinking (defined as drinking within national public health guidelines) at two time points - immediately post-treatment and at the 6-month follow-up. Significant predictors were entered hierarchically into domain-specific logistic regressions. In the final models, predictors still showing significant effects were run in multiple logistic regressions. Results: One predictor significantly predicted adherence: treatment credibility (as in how logical the treatment is and how successful one perceives the treatment to be) assessed during the third week of the intervention. Four predictors significantly predicted low-risk drinking at the post-treatment follow-up: pre-treatment abstinence (i.e., not drinking during the 7 days before treatment started), being of the male gender, and two personality factors - a low degree of antagonism and a high degree of alexithymia. At the 6-month follow-up, pre-treatment abstinence was the only significant predictor. Conclusion: Adherence was not predictive of low-risk drinking. Personality variables may have predictive value and should be studied further. Those who abstain from alcohol during the week before treatment starts have a higher likelihood of achieving low-risk drinking than people who initially continue drinking.
25.	Philipson, Anna, 1978-, et al. (author) Adolescent depression and subsequent earnings across early to middle adulthood: A 25-year longitudinal cohort study 2020 In: Epidemiology and Psychiatric Sciences. - : Cambridge University Press. - 2045-7979 .- 2045-7960. ; 29 Journal article (peer-reviewed)abstract Aims: The few available studies on early-onset depression and future earnings offer ambiguous findings, and potential sources of heterogeneity are poorly understood. We examined the differences in adult earnings of males and females with and without a history of depressive disorder in adolescence, with specific focuses on (1) future earnings in clinical subtypes of adolescent depression; (2) the growth and distribution of earnings over time within these subgroups and (3) the mediating role of subsequent depressive episodes occurring in early adulthood. Methods: Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort study initiated in Uppsala, Sweden, in the early 1990s. Comprehensive diagnostic assessments were conducted at age 16-17 and in follow-up interviews 15 years later, while consecutive data on earnings for the years 1996 to 2016 (ages 20-40) were drawn from population-based registries. The current study included participants with a history of persistent depressive disorder (PDD) (n = 175), episodic major depressive disorder (MDD) (n = 82), subthreshold depression (n = 64) or no depression (n = 218) in adolescence. The association of adolescent depression with earnings in adulthood was analysed using generalised estimating equations. Estimates were adjusted for major child and adolescent psychiatric comorbidities and parental socioeconomic status. The indirect (mediated) effect of depression in early adulthood (ages 19-30) on earnings in mid-adulthood (31-40) was estimated in mediation analysis. The study followed the 'STrengthening the Reporting of OBservational studies in Epidemiology' (STROBE) guidelines. Results: Earnings across early to middle adulthood were lower for participants with a history of a PDD in adolescence than for their non-depressed peers, with an adjusted ratio of mean earnings of 0.85 (0.77-0.95) for females and 0.76 (0.60-0.95) for males. The differences were consistent over time, and more pronounced in the lower percentiles of the earnings distributions. The association was partially mediated by recurrent depression in early adulthood (48% in total; 61% for females, 29% for males). No reduction in earnings was observed among participants with episodic MDD in adolescence, while results for subthreshold depression were inconclusive. Conclusions: Our findings suggest that future earnings of adolescents with depressive disorders are contingent on the duration and natural long-term course of early-onset depression, emphasising the need for timely and effective interventions to avoid loss of human capital.
26.	Tjäderborn, Micaela, 1983- (author) Psychoactive prescription drug use disorders, misuse and abuse : Pharmacoepidemiological aspects 2016 Doctoral thesis (other academic/artistic)abstract Background: There is a widespread and increasing use of psychoactive prescription drugs, such as opioid analgesics, anxiolytics, hypnotics and anti-epileptics, but their use is associated with a risk of drug use disorder, misuse and abuse. Today, these are globally recognized and emerging public health concerns.Aim: The aim of this thesis is to estimate the prevalence of psychoactive prescription drug (PPD) use disorders, misuse and abuse, and to investigate the association with some potential risk factors.Methods: A study using register data from forensic cause of death investigations investigated and described cases of fatal unintentional intoxication with tramadol (Study I). Based on register data on spontaneously reported adverse drug reactions (ADRs) reported cases of tramadol dependence were investigated and summarised (Study II). In a study in suspected drug-impaired drivers with a toxicology analysis confirming the intake of one out of five pre-specified PPDs, the prevalence of non-prescribed use was assessed and associated factors were investigated (Study III). From a cohort of patients initiating prescribed treatment with pregabalin, using data on prescription fills, a study investigated longitudinal utilisation patterns during five years with regards to use of the drug above the maximum approved daily dose (MAD), and factors associated with the utilisation patterns (Study IV).Results: In the first study, 17 cases of unintentional intoxications were identified, of which more concerned men, the median age was 44 years and the majority used multiple psychoactive substances (alcohol, illicit drugs and prescription drugs). The second study identified 104 spontaneously reported cases of tramadol dependence, in which more concerned women, the median age was 45 years, and a third reported a history of substance abuse and 40% of past psychoactive medication use. In the third study, more than half of the individuals suspected of drug-impaired driving used the drug without a recent prescription. Non prescribed use was most frequent in users of benzodiazepines and tramadol, and was more likely in younger individuals and in multiple-substance users. In the last paper five longitudinal utilisation patterns were found in pregabalin users, with two patterns associated with a particularly high risk of doses above the maximum approved dosing recommendation. This pattern of use was associated with male sex, younger age, non-urban residency and a recent prescribed treatment with an antiepileptic or opioid analgesic drug.Conclusions: This thesis shows that psychoactive prescription drug use disorders, misuse and abuse occur and may have serious and even fatal consequences. The prevalence varies between different drugs and populations. Abuse and misuse seem to be more common in young people. Fatal intoxications and misuse of prescribed drugs may be more common in men, while drug use disorders following prescribed treatment may be more common in women and non-prescribed use equally distributed between women and men. Individuals with a history of mental illness, substance use disorder or abuse, or of past use of psychoactive medications are likely important risk groups. In summary, the findings suggest a potential for improvements in the utilisation of psychoactive prescription drugs. The results may be useful in the planning of clinical and regulatory preventive interventions to promote the rational, individualised and safe use of such drugs.
27.	Klingstedt, Marie-Louise, et al. (author) Reliability and construct validity of five life domains in the adolescent drug abuse diagnosis instrument in a sample of Swedish adolescent girls in special residential care 2020 In: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 37:4, s. 411-426 Journal article (peer-reviewed)abstract Aim: This cross-sectional study investigates the psychometric properties of the Swedish edition of the Adolescent Drug Abuse Diagnosis (ADAD), and specifically examines the internal consistency and construct validity of five life domains reported by female adolescents in special residential care in Sweden (N= 780;M-age= 16 years old).Methods: Principal component analysis and entropy-based analysis were used to test construct validity.Conclusion: Results indicate that ADAD may be able to reliably distinguish between areas that are important targets for intervention.
28.	Ahorsu, Daniel Kwasi, et al. (author) Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands : An Actor-Partner Interdependence Modelling 2022 In: International Journal of Mental Health and Addiction. - : Springer. - 1557-1874 .- 1557-1882. ; 20, s. 68-82 Journal article (peer-reviewed)abstract The present cross-sectional study examined the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviours during the first wave of the COVID-19 pandemic in 2020. A total of 290 pregnant women and their husbands (N = 580) were randomly selected from a list of pregnant women in the Iranian Integrated Health System and were invited to respond to psychometric scales assessing fear of COVID-19, depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. The findings demonstrated significant dyadic relationships between husbands and their pregnant wives' fear of COVID-19, mental health, and preventive behaviours. Pregnant wives' actor effect of fear of COVID-19 was significantly associated with depression, suicidal intention, mental quality of life, and COVID-19 preventive behaviours but not anxiety. Moreover, a husband actor effect of fear of COVID-19 was significantly associated with depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. Additionally, there were significant partner effects observed for both the pregnant wives and their husbands concerning all outcomes. The present study used a cross-sectional design and so is unable to determine the mechanism or causal ordering of the effects. Also, the data are mainly based on self-reported measures which have some limitations due to its potential for social desirability and recall biases. Based on the findings, couples may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women and the foetus.
29.	Binde, Per, 1956 (author) A mutual support group for young problem gamblers 2012 In: International Journal of Mental Health and Addiction. - : Springer Science and Business Media LLC. - 1557-1874 .- 1557-1882. ; 10:4, s. 524-536 Journal article (peer-reviewed)abstract A Swedish mutual support group for young problem gamblers is described and discussed. During the study period, 116 weekly meetings occurred, usually involving six to ten participants; in total, 69 problem gamblers (66 male and three female), aged 17–25, and 23 partners and friends attended the meetings. Half the gamblers had problems with Internet poker, one fifth with electronic gambling machines, and the rest with other forms of gambling and computer gaming. Nearly half the problem gamblers participated in under five mutual support meetings, while just over a third attended ten or more meetings. Gambling problems ceased or lessened among most participants in ten or more meetings. In some cases, attending just one or a few meetings had a positive impact on the problems. This mutual support group provides relatively effective help to adolescents and young adults with gambling problems, offering a valuable alternative and complement to professional treatment.
30.	Binde, Per, 1956 (author) A Swedish mutual support society of problem gamblers 2012 In: International Journal of Mental Health and Addiction. - : Springer Science and Business Media LLC. - 1557-1874 .- 1557-1882. ; 10:4, s. 512-523 Journal article (peer-reviewed)abstract Mutual support societies for problem gamblers have existed in Sweden for 20 years. They have helped more people with gambling problems than any other institution inside or outside the Swedish health care system. This paper outlines the background of these societies and describes the meetings of one of them. Data come from interviews with members of a local society and participation in mutual support meetings. It is argued that these mutual support societies provide help in a variety of ways and in all phases of recovery from gambling problems. In particular, they help people form personal narratives about the origin, progression, and resolution of their problems, narratives that give insight and guide recovery. These mutual support societies are valuable complements and alternatives to professional treatment.
31.	Mohamed, Mohamed S., et al. (author) Differential change in alcohol consumption during the COVID-19 pandemic : the role of loneliness, socialization, and mental well-being 2024 In: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 15 Journal article (peer-reviewed)abstract Introduction: The COVID-19 pandemic led to a surge in mental health issues and psychological distress, disruption to work/studying conditions, and social isolation particularly among young adults. Changes in these factors are differentially associated with alcohol use. Moreover, the relationship between these factors are bidirectional and may have fluctuated throughout the different phases of the pandemic. However, studies focusing on young adults had conflicting results, short follow-up periods, and lacked comprehensive data to describe underlying mechanisms.Methods: 1067 young adults participated in repetitive measures termed wave 4 (2021) of the Survey of Adolescent Life in Västmanland Cohort “SALVe” Cohort. Of these, 889 also completed pre-pandemic measurements termed wave 3 (2018). Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to evaluate alcohol consumption and harmful use. Cross-sectional associations between perceived changes in alcohol use and shift in individual, mental health, and work environment factors were examined using Chi-square tests. Logistic regression was utilized to identify pre-pandemic predictors of harmful consumption during the pandemic.Results: Harmful consumption decreased only in females following the COVID-19 pandemic. Participants who reported increased feelings of depression, anxiety, and loneliness were more likely to increase their alcohol use. Interestingly, the subgroup who felt less lonely and met their friends more often, as well as those who continued working/studying from their regular workplace also had an increased likelihood of higher consumption. Only pre-pandemic ADHD and delinquency symptoms predicted harmful alcohol consumption following the pandemic.Conclusion: Females reduced harmful alcohol consumption during the COVID-19 pandemic. While those who suffered the burden of social isolation and distress were more likely to increase their alcohol use, young adults who felt less lonely and met their friends more often also had a similar outcome. The relationship between loneliness and alcohol consumption among young adults is influenced by the social factors that may be facilitated by drinking.
32.	Rauschert, Christian, et al. (author) Abuse of Non-opioid Analgesics in Germany : Prevalence and Associations Among Self-Medicated Users 2022 In: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13 Journal article (peer-reviewed)abstract Background: Abuse of non-opioid analgesics (NOA) is associated with serious health consequences. However, due to inconsistent definitions of NOA abuse, prevalence estimates for the German population are unclear.Objectives: This study aimed to estimate the 12-month prevalence of NOA abuse among self-medicated users of these drugs in the general German population and to identify risk factors.Methods: Data are from the 2015 Epidemiological Survey of Substance Abuse, a nationally representative sample with 9,204 individuals aged 18–64 years. Classification of NOA abuse was based on self-reported information according to the definition of the ICD-10-GM diagnosis F55.2 abuse of non-dependence producing substances. Multiple logistic regression was performed to examine associations between NOA abuse and sociodemographic, behavioral, and health-related variables.Results: The weighted 12-month prevalence of NOA abuse was 14.6% (95%-CI [13.2- 16.0]) among self-medicated users of these drugs. Extrapolation of the proportion of individuals abusing NOA to the German population aged 18 to 64 is 3,243,396 individuals or 6.4% (95%-CI [5.7- 7.1]). Inexplicable physical pain, being underweight, depression, hazardous alcohol use, daily smoking, illegal drug use, and frequent use of NOA (one or more times per week and daily use) were associated with an increased probability of NOA abuse. The use of cannabis was associated with a lower probability of NOA abuse.Conclusion: Abuse of NOA is highly prevalent in the German population. Against the background of increasing self-medication of NOA, healthcare providers need to be aware of potential risk factors of abuse to better identify and prevent this problem.
33.	Spelberoendes riksförbund 10 år: En jubileumsskrift 2010 Editorial collection (other academic/artistic)abstract Den svenska spelmarknaden har förändrats och växt kraftigt den senaste tioårsperioden. Vi har fått statliga kasinon och på Internet går det att spela på det mesta från bingo till poker. Så gott som dagligen rapporterar massmedia om spelpolitik och spelberoende. Medvetenheten om spelberoende har ökat och starkt bidragande till det är Spelberoendes riksförbund. Förbundet har i tio år informerat om spelberoende och gett stöd till människor med spelproblem och deras anhöriga. Den här jubileumsskriften ger en bild av spelproblem i Sverige och kamratstödet i spelberoendes föreningar. Ungas spelande och de anhörigas situation tas upp av flera författare. Läsaren får också veta hur medvetenheten om spelberoende växte fram i Sverige och ta del av diskussioner om hur framtidens spelande kan gestalta sig. I boken medverkar aktiva inom förbundet, eldsjälar från lokalföreningar och spelberoende som har fått hjälp. Även spelforskare och personer som på olika sätt arbetat med spelfrågor har bidragit med kapitel. Skriften är utgiven med stöd av Statens folkhälsoinstitut.
34.	Tedgård, Eva, et al. (author) An upbringing with substance-abusing parents: Experiences of parentification and dysfunctional communication 2019 In: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 36:3, s. 223-247 Journal article (peer-reviewed)abstract Aim: To increase understanding of the consequences of growing up with substance-abusing parents, including how this can influence the experience of becoming a parent. Methods: In-depth interviews were conducted with 19 parents who had participated in an Infant and Toddler Psychiatry Unit intervention programme and who had experienced substance-abusing parents in their family of origin. Directed qualitative content analysis was used to analyse the data. Results: Analysis of the interview material revealed both a high incidence of parentification and a conspiracy of silence concerning the substance abuse that helped generate symptoms of cognitive dissonance in the children. As parents they experience a high degree of inadequacy, incompetence and stress. Conclusion: A majority of the children who had grown up with substance-abusing parents responded by taking a parenting role for themselves, their siblings and their parents. These children, often well-behaved and seemingly competent, need to be identified and offered support as they risk developing significant psychological and emotional difficulties that can extend into adulthood. They form an extra sensitive group who may need special support up to and including the time when they become parents themselves. This finding underlines the importance of further research on parenting among those who have grown up with abusive parents.
35.	Agahi, Neda, et al. (author) Alcohol Consumption Over the Retirement Transition in Sweden : Different Trajectories Based on Education 2022 In: Work, Aging and Retirement. - : Oxford University Press. - 2054-4642 .- 2054-4650. ; 8:1, s. 74-81 Journal article (peer-reviewed)abstract Retirement is a major life transition that involves changes to everyday routines, roles, and habits. Previous studies suggest that retirement may influence drinking habits. Many natural inhibitors of alcohol consumption disappear with the removal of work constraints. The potential impact depends on both individual and contextual factors. Women in the cohorts undergoing retirement now have been more active on the labor market, including the occupation of higher status jobs, which indicates more financial resources as well as a larger role loss after retirement. Also, the current cohorts who retire have had more liberal drinking habits throughout their lives compared to previous cohorts. We therefore examined changes in alcohol consumption surrounding retirement in different education groups among women and men undergoing retirement using annual data from the Health, Aging and Retirement Transitions in Sweden (HEARTS) study, a longitudinal national study of 60- to 66-year-olds (n = 5,913), from 2015 to 2018. Latent growth curve models were used to estimate trajectories of alcohol consumption. Results showed that those who retired during the follow-up increased their usual weekly alcohol consumption while those who worked or were retired throughout the period had stable drinking habits. Those who were retired reported the highest alcohol consumption. The increase surrounding retirement was driven by people with higher education. Women with tertiary education and men with intermediate or tertiary education increased their weekly alcohol intake after retirement, while those with low education had unchanged drinking habits. Mechanisms and motivations that may fuel increased alcohol intake among people with higher education should be further investigated.
36.	Elam, Mark, 1960 (author) How the Brain Disease Paradigm Remoralizes Addictive Behaviour 2015 In: Science as Culture. - : Informa UK Limited. - 0950-5431 .- 1470-1189. ; 24:1, s. 46-64 Journal article (peer-reviewed)abstract In recent decades, addiction has been medicalized anew through the rise of an influential ‘brain disease paradigm’. This questions the equivalence of addiction to drug dependence by re-emphasizing loss of self-control over unhealthy impulses as the disease locus. While showing continuities with the nineteenth-century vision of addictions as ‘diseases of the will’, neurobiology objectifies disease as disrupted neurochemical transmission and lasting neuroadaptation. The brain disease paradigm emerged together with rapid advances in neuroimaging technology as well as intensified research efforts to confirm cigarette smoking as nicotine addiction. After smoking achieved such recognition in the late 1980s, numerous other unhealthy impulses and appetites have likewise come under neurobiological investigation as prospective cases of addiction. Despite its technoscientific sophistication, neurobiology's biomedicalization of addiction remains as partial and ambiguous as past medicalizations. By confirming moral self-transformation anew as an indispensable component of treatment and recovery, neurobiology revives addiction as a moral disease in the process of its objectification. Furthermore, through its rediscovery of a classic nineteenth-century ‘liberal disease’ at the molecular level, the neurobiology of addiction is acting as a vital moralizing resource in the biomedicalization of health and illness more generally today.
37.	Dahlberg, Mikael, 1965-, et al. (author) Psychometric properties of the UngDOK : A structured interview for adolescents with substance-use problems 2017 In: Nordic Studies on Alcohol and Drugs. - : Sage Publications. - 1455-0725 .- 1458-6126. ; 34:2, s. 160-172 Journal article (peer-reviewed)abstract Aim: This article describes and discusses the Swedish UngDOK interview and its psychometric properties. Method: The study is based on empirical data from 1633 intake interviews collected by 15 units in ten cities and focused primarily on the two central sections of intake form: alcohol and drug use and mental health. The statistical analyses concern internal consistency, test–retest reliability, discriminant validity and internal non-response. Results: The reliability of AUDIT-C and the mental health domain was good with regard to both internal consistency and test–retest. The test–retest values were generally satisfactory, except for frequency of drug use and association with peers who use drugs. The discriminant validity shows that the interview clearly distinguishes adolescents with more profound problems from a group with milder problems and that a minor degree of inconsistency and non-response bias may occur in empirical material based upon self-reported information. Conclusion: The study showed that the psychometric properties of the UngDOK interview are generally satisfactory and may be regarded as a valuable option for practices engaged in treating adolescents with substance-use problems.
38.	Hesse, M., et al. (author) The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment : A secondary analysis 2023 In: Addictive Behaviours. - : Elsevier Ltd. - 0306-4603 .- 1873-6327. ; 139 Journal article (peer-reviewed)abstract Background: Identifying people at risk of poor outcomes following treatment for substance use disorders is important for developing tailored services. The aim of this study was to test whether a brief measure of internalizing and externalizing behavior could identify young adults at high risk of psychiatric care episodes and criminal offending up to four years after enrolment in treatment for substance use disorder. Methods: Clients aged 15–25 years from a randomized multicenter study were included (N = 457). At baseline, all completed the YouthMap12 screener, a measure of internalizing symptoms (IP6) and externalizing problems (EP6). We used accelerated failure time regression to assess time to psychiatric care and criminal offending, adjusting for baseline occurrence, gender, age, treatment group, and uptake area. Youden's J was used to assess optimal cut-points for risk of events. Results: The IP6 was associated with shorter time to psychiatric care following treatment enrolment (beta = −0.71, 95% confidence interval [CI] = −0.94 to −0.48; adjusted beta = −0.45, 95% CI = −0.66 to −0.25). The EP6 was associated with shorter time to criminal offending, coefficient = −0.32, 95% CI = −0.44 to −0.19; adjusted coefficient = −0.18, 95% CI = −0.30 to −0.06). Optimal cut-points were two or more for the IP6 and three or more for the EP6. Conclusions: The IP6 and the EP6, two simple and easily administered instruments, can identify young adults who are at an increased risk of future criminal offending or in need of psychiatric care. The findings lend support to using the 12-item YouthMap, as it identifies relevant risks, is compatible with local service delivery needs, and is theoretically and empirically supported. © 2022 The Author(s)
39.	Högberg, Hjördis, et al. (author) Alcohol consumption among partners of pregnant women in Sweden: a cross sectional study 2016 In: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16 Journal article (peer-reviewed)abstract Background: Antenatal care in Sweden involves a visit in pregnancy week 6-7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perceptions of the midwife's counseling about alcohol. Method: The study was conducted at 30 antenatal care centers across Sweden in 2009-2010. All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption. Results: Questionnaires from 444 partners were analyzed. Most, 95 %, of the partners reported alcohol consumption before pregnancy; 18 % were binge drinking (6 standard drinks or more per occasion, each drink containing 12 grams of pure alcohol) at least once every month during the last year. More than half, 58 %, of all partners had decreased their alcohol consumption following pregnancy recognition and a higher proportion of binge drinkers decreased their consumption compared to non-frequent binge drinkers (p = 0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving alcohol consumption) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37 % reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Further, most partners appreciated the midwife's counseling on alcohol. Conclusion: A majority of partners decreased their alcohol consumption in transition to parenthood, which also appears to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife's talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption, and promote interventions for decreased drinking, also for the partners. Written information addressing alcohol use and directed to partners is needed.
40.	Jemberie, Wossenseged Birhane, 1985- (author) Multiple indicators focusing on different alcohol-related domains should be used to describe alcohol use profiles among older patients 2020 In: popnad. - Helsinki. Journal article (pop. science, debate, etc.)abstract Grouping older adults with alcohol use disorder as those with early versus late onset problem drinking does not capture the multiple intervention needs these patients present to service providers. We should instead use a range of indicators focusing on different alcohol-related domains to describe alcohol use profiles among older patients. This is the key finding of a recent study from Umeå University and the University of Denver, published in the Journal of Addiction Medicine.
41.	Lindner, Stephan R., et al. (author) Addiction severity and re-employment in Sweden among adults with risky alcohol and drug use 2024 In: Journal of Substance Use and Addiction Treatment. - : Elsevier. - 2949-8767 .- 2949-8759. ; 156 Journal article (peer-reviewed)abstract Background: The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment.Methods: We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics.Results: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629–0.956), employment (estimate: 0.669, confidence interval: 0.532–0.841), drug use (estimate: 0.628, confidence interval: 0.428–0.924), and health (estimate: 0.798, confidence interval: 0.699–0.912).Conclusions: This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.
42.	Manning, Victoria, et al. (author) Improved Quality of Life Following Addiction Treatment Is Associated with Reductions in Substance Use 2019 In: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 8:9 Journal article (peer-reviewed)abstract People seeking treatment for substance use disorders (SUD) ultimately aspire to improve their quality of life (QOL) through reducing or ceasing their substance use, however the association between these treatment outcomes has received scant research attention. In a prospective, multi-site treatment outcome study (Patient Pathways'), we recruited 796 clients within one month of intake from 21 publicly funded addiction treatment services in two Australian states, 555 (70%) of whom were followed-up 12 months later. We measured QOL at baseline and follow-up using the WHOQOL-BREF (physical, psychological, social and environmental domains) and determined rates of SUD treatment success (past-month abstinence or a statistically reliable reduction in substance use) at follow-up. Mixed effects linear regression analyses indicated that people who achieved SUD treatment success also achieved significantly greater improvements in QOL, relative to treatment non-responders (all four domains p < 0.001). Paired t-tests indicated that non-responders significantly improved their social (p = 0.007) and environmental (p = 0.033) QOL; however, their psychological (p = 0.088) and physical (p = 0.841) QOL did not significantly improve. The findings indicate that following treatment, QOL improved in at least some domains, but that reduced substance use was associated with both stronger and broader improvements in QOL. Addressing physical and psychological co-morbidities during treatment may facilitate reductions in substance use.
43.	Jemberie, Wossenseged Birhane, 1985-, et al. (author) Studying the trajectories and mediators of old-age problematic alcohol use and the agency of older persons 2023 Other publicationabstract Unit of analysis: IndividualPopulation: Older people aged between 61 and 73 years who have sought treatment for alcohol at a specialist outpatient clinic in a metropolitan city in Sweden.Time Method: Cross-sectionSampling procedure: Non-probability: PurposiveThe study participants were purposefully recruited from a specialist outpatient alcohol treatment clinic located in a Swedish metropolitan city. To be eligible for the study, participants had to be 55 years or older, had to self-report a history of problematic alcohol use and treatment for alcohol use after the age of 50. Individuals who were unable or unwilling to provide informed consent or participate in the interview via Zoom, Skype, or telephone were excluded from the study.Time period(s) investigated: 2021-12 – 2022-04Number of individuals/objects: 10Data format / data structure: Text
44.	Lundgren, Lena, et al. (author) Integrating addiction and mental health treatment within a national addiction treatment system : Using multiple statistical methods to analyze client and interviewer assessment of co-occurring mental health problems 2014 In: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 31:1, s. 59-79 Journal article (peer-reviewed)abstract AIMS - For a Swedish national sample of 12,833 individuals assessed for a substance use disorder (SUD) (2002-2008) in the Swedish welfare system, client self-report and clinical staff Addiction Severity Index (ASI) assessment data were used to assess mental health problem severity and needs. METHODS - Analysis of client self-report data using regression methods identified demographic characteristics associated with reporting significant mental health problems. Clinical staff assessment data from the ASI Interviewer Severity Rating (ISR) score were used to develop a K-means cluster analysis with three client cluster profiles: Narcotics (n=4795); Alcohol (n=4380); and Alcohol and Psychiatric Problems (n=3658). Chi-square and one-way ANOVA analyses identified self-reported mental health problems for these clusters. RESULTS - 44% of clients had a history of using outpatient mental health treatment, 45% reported current mental health symptoms, and 19% reported significant mental health problems. Women were 1.6 times more likely to report significant mental health problems than men. Staff assessed that 74.8% of clients had current mental health problems and that 13.9% had significant mental health problems. Client and staff results were congruent in identifying that clients in the Alcohol profile were less likely (5%) to report having significant mental health problems compared to the other two profiles (30% each). CONCLUSIONS - About 19% of clients with SUDs reported significant mental health problems, need integrated addiction and mental health treatment, and these clients are clustered in two population groups. An additional 25% of the addiction treatment population report current mental health symptoms and have at some point used mental health treatment. This national level assessment of the extent and severity of co-occurring disorders can inform decisions made regarding policy shifts towards an integrated system and the needs of clients with co-occurring disorders.
45.	Carlsson, S, et al. (author) Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes : results from five pooled cohorts 2017 In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 281:4, s. 398-406 Journal article (peer-reviewed)abstract BACKGROUND: Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk.OBJECTIVE: To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts.METHODS: Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity.RESULTS: Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00-1.32) in current users of snus. In individuals consuming 5-6 boxes per week, the HR was 1.42 (95% CI: 1.07-1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17-2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01-1.16).CONCLUSION: Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.
46.	Muhsin, Huda Ahmed, et al. (author) Air pollution and increased number of psychiatric emergency room visits: A case-crossover study for identifying susceptible groups 2022 In: Environmental Research. - : Elsevier. - 0013-9351 .- 1096-0953. ; 204 Journal article (peer-reviewed)abstract Background: Ambient particulate matter is a leading risk factor for disease globally. Particulate matter 10 (PM10) and particulate matter 2.5 (PM2.5) are derived from different sources, including operating motor vehicles as well as from industrial activities. In this study we investigate the association between increased concentrations of PM and total daily visits to the psychiatric emergency unit (PEV). Further, the aim is to identify specific risk groups who are more susceptible to the effects of air pollution exposure by studying sex, age, ongoing psychiatric follow-up and diagnoses of depression/anxiety or substance use.Material and methods: The sample was comprised of data from 2740 days to 81 548 PEVs at Sahlgrenska University Hospital in Gothenburg and daily mean concentrations of PM10 and PM2.5. A time-stratified case-crossover design was used to analyse associations between air pollution and PEVs.Results: Mean number of daily PEVs were 35 and sex distribution was even. PM exposure was associated with total PEV at lag 0 (the same day), by RR 1.016 (95% confidence interval [CI] 1.004–1.028) and RR 1.020 (95%CI 1.003–1.038) per 10 μg/m3 increase in PM10 and PM2.5, respectively. In females, PEV were increased at lag 0 and lag 1, and in males at lag 1 and lag 2. In the age-stratified analysis, PEVs significantly increased following PM exposure amongst individuals aged 35–65 years by lag 0–2 and in individuals who had contact with outpatient care at lag 0 to lag 1. There were no associations between air pollution and PEVs for any specific diagnostic group evaluated (amongst depression, anxiety and substance use disorder).Conclusions: The results indicate that acute exposure to PM10 and PM2.5 may trigger acute worsening in mental health in both males and females, especially among 35–65 year old individuals. However, in subgroups of the most common psychiatric diagnoses, we did not observe statistically significant associations with PM exposure.
47.	Hilbrecht, Margo, et al. (author) The Conceptual Framework of Harmful Gambling: A revised framework for understanding gambling harm 2020 In: Journal of Behavioral Addictions. - : Akademiai Kiado Zrt.. - 2063-5303 .- 2062-5871. ; 9:2, s. 190-205 Journal article (peer-reviewed)abstract Background and aims: The Conceptual Framework of Harmful Gambling moves beyond a symptoms-based view of harm and addresses a broad set of factors related to the risks and effects of gambling harmfully at the individual, family, and community levels. Coauthored by international research experts and informed by multiple stakeholders, Gambling Research Exchange (GREO) facilitated the framework development in 2013 and retains responsibility for regular updates and mobilization. This review article presents information about the revised version of the Conceptual Framework of Harmful Gambling completed in late 2018. Methods: We describe eight interrelated factors depicted in the framework that represent major themes in gambling ranging from the specific (gambling environment, exposure, gambling types, and treatment resources) to the general (cultural, social, psychological, and biological influences). After outlining the framework development and collaborative process, we highlight new topics for the recent update that reflect changes in the gambling landscape and prominent discourses in the scientific community. Some of these topics include social and economic impacts of gambling, and a new model of understanding gambling related harm. Discussion and conclusions: We address the relevance of the CFHG to the gambling and behavioral addictions research community. Harm-based frameworks have been undertaken in other areas of addiction that can both inform and be informed by a model dedicated to harmful gambling. Further, the framework brings a multi-disciplinary perspective to bear on antecedents and factors that co-occur with harmful gambling.
48.	Svanberg, G., et al. (author) Acceptance and commitment therapy for clients institutionalized for severe substance-use disorder: a pilot study 2017 In: Substance Abuse and Rehabilitation. - : Informa UK Limited. - 1179-8467. ; 8, s. 45-51 Journal article (peer-reviewed)abstract Background: Individuals with substance-use disorder (SUD) often have co-occurring mental health disorders and decreased executive function, both of which are barriers to sustained rehabilitation. Clients with severe SUD can be institutionalized in The Swedish National Board of Institutional Care but are difficult to engage and dropout rates remain high. Recent studies suggest that acceptance and commitment therapy (ACT) is an effective treatment for mental health and SUD. Objectives: The overall aims of the present pilot study were to explore a manual-based ACT intervention for clients institutionalized for severe SUD and to describe the effects on mental health, psychological flexibility, and executive function. This pilot study is the first to use a manual-based ACT intervention within an inpatient context. Methods: Eighteen participants received a seven-session ACT intervention tailored for SUD. Statistical analyses were performed for the complete data (n=18) and on an individual level of follow-up data for each participant. In order to follow and describe changes, the strategy was to assess the change in 13 clinical scales from pre-intervention to post-intervention. Results: Results suggested that there was no change in mental health and a trend implying positive changes for psychological flexibility and for 9 of 10 executive functions (e.g., inhibitory control, task monitoring, and emotional control). Conclusion: The pilot study suggests clinical gains in psychological flexibility and executive functions both at the Institution regulated by the Care of Alcoholics and Drugabuser Act (also known as LVM home) and at the individual level. Since the sample size does not provide adequate statistical power to generalize and to draw firm conclusions concerning intervention effects, findings are descriptive and preliminary in nature. Further development and implementation of ACT on a larger scale study, including the maintenance phase and a follow-up, is needed.
49.	Spak, Fredrik, 1948, et al. (author) [The Gothenburg study of women and alcohol: problems during childhood and adolescence important risk factors] 2001 In: Lakartidningen. - 0023-7205. ; 98:10, s. 1109-14 Journal article (peer-reviewed)abstract This is a part of longitudinal study concerning women and alcohol in Gothenburg. The aim was to find out more about risk factors for alcohol dependence and abuse (ADA) among women in the general population, as well as social conditions and life style among these women. Several indicators of dissatisfactory childhood conditions, and particularly sexual abuse before age 13, were related to ADA in adulthood. Early substance abuse, such as having been intoxicated before age 15 and having used narcotics before 18, was strongly related to future ADA. Our findings point to the need of paying attention to mental health problems in childhood and youth, and to prevent early use of alcohol and drugs.
50.	Bäckström, Eric, et al. (author) Healthcare contacts regarding circulatory conditions among swedish patients in opioid substitution treatment, with and without on-site primary healthcare 2021 In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9 Journal article (peer-reviewed)abstract Patients in Opioid Substitution Treatment (OST) have increased mortality and morbidity, with circulatory conditions suggested to be a contributing factor. Since OST patients tend to have unmet physical healthcare needs, a small-scale intervention providing on-site primary healthcare (PHC) in OST clinics was implemented in Malmö, Sweden in 2016. In this study, we assessed registered circulatory conditions and healthcare utilization in OST patients with and without use of on-site PHC. Patients from four OST clinics in Malmö, Sweden, were recruited to a survey study in 2017–2018. Medical records for the participants were retrieved for one year prior to study participation (n = 192), and examined for circulatory diagnoses, examinations and follow-ups. Patients with and without on-site PHC were compared through descriptive statistics and univariate analyses. Eighteen percent (n = 34) of the sample had 1≤ registered circulatory condition, and 6% (n = 12) attended any clinical physiology examination or follow-up, respectively. Among patients utilizing on-site PHC (n = 26), the numbers were 27% (n = 7) for circulatory diagnosis, 15% (n = 4) for examinations, and 12% (n = 3) for follow-up. OST patients seem underdiagnosed in regard to their circulatory health. On-site PHC might be a way to diagnose and treat circulatory conditions among OST patients, although further research is needed.

Skapa referenser, mejla, bekava och länka

Permalink

Result 1-50 of 1215

Refine your search

Type of publication: journal article (1050); reports (33); research review (33); book chapter (31); conference paper (25); doctoral thesis (22); show more...; other publication (9); editorial collection (5); book (5); review (2); show less...

Type of content: peer-reviewed (1057); other academic/artistic (148); pop. science, debate, etc. (9)

Author/Editor: Room, Robin (65); Sundquist, Kristina (54); Sundquist, Jan (53); Kendler, Kenneth S. (50); Berglund, Mats (47); Kraus, Ludwig (46); show more...; Söderpalm, Bo, 1959 (41); Ohlsson, Henrik (34); Gerdner, Arne (32); Room, Robin, 1939- (32); Håkansson, Anders C (30); Ericson, Mia, 1970 (28); Callinan, Sarah (27); Binde, Per, 1956 (25); Livingston, Michael (25); Tønnesen, Hanne (23); Rehm, Jürgen (23); Öjehagen, Agneta (22); Piontek, Daniela (22); Alling, Christer (21); Jiang, Heng (20); Håkansson, Anders (19); Larsson, Henrik, 197 ... (19); Lichtenstein, Paul (19); Wennberg, Peter (17); Laslett, Anne-Marie (17); Pakpour, Amir H. (16); Kraus, Ludwig, 1955- (16); Berman, Anne H. (15); Nylander, Ingrid (14); Adermark, Louise, 19 ... (14); Fahlke, Claudia, 196 ... (14); Anderberg, Mats, 196 ... (14); Engel, Jörgen, 1942 (13); Dahlberg, Mikael, 19 ... (13); Fridell, Mats (13); Löf, Elin, 1974 (13); Törrönen, Jukka (13); Andreasson, Sven (12); Spak, Fredrik, 1948 (12); Berman, Anne H., Pro ... (12); Raninen, Jonas (12); Johnsson, Kent (11); Heilig, Markus (10); Lin, Chung-Ying (10); Berglund, Kristina, ... (10); Andersson, Claes (10); Chikritzhs, Tanya (10); Franck, Johan (10); Dahlman, Disa (10); show less...

University: Stockholm University (323); Lund University (304); Karolinska Institutet (288); University of Gothenburg (203); Uppsala University (148); Linköping University (86); show more...; Jönköping University (64); Örebro University (63); Umeå University (62); Linnaeus University (41); Malmö University (23); Mid Sweden University (23); University of Gävle (15); Mälardalen University (13); Södertörn University (11); VTI - The Swedish National Road and Transport Research Institute (8); Royal Institute of Technology (6); Halmstad University (6); Chalmers University of Technology (6); Luleå University of Technology (5); University of Skövde (4); The Swedish School of Sport and Health Sciences (4); Karlstad University (4); Högskolan Dalarna (4); Swedish University of Agricultural Sciences (4); Red Cross University College (4); University West (3); Sophiahemmet University College (3); Kristianstad University College (2); Stockholm School of Economics (1); RISE (1); Marie Cederschiöld högskola (1); show less...

Language: English (1116); Swedish (88); German (6); Finnish (3); French (1); Danish (1)

Research subject (UKÄ/SCB): Medical and Health Sciences (1213); Social Sciences (293); Humanities (9); Natural sciences (6); Engineering and Technology (3)

Year

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se

Copy and save the link in order to return to this view