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  • 1. Bergström, J
    et al.
    Andersson, G
    Karlsson, Andreas
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Andreevitch, S
    Ruck, C
    Carlbring, P
    Lindefors, N
    An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting2009Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, nr 1, s. 44-50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Panic Disorder with or without or without agoraphobia (PD/A) is common and can be treated effectively with SSRI medication or cognitive behavior therapy (CBT). There is however a great lack of access to CBT services, which has motivated the development of self-help approaches requiring less therapist contact. A novel treatment modality in this field, showing efficacy in several randomised trials but until now not evaluated within the context of regular psychiatric care, is Internet-based treatment. The present study evaluated the effectiveness of Internet-based CBT for 20 consecutively referred PD patients in a psychiatric setting. At post-treatment, 94% of patients no longer met DSM-IV criteria for PD (82% at 6-month follow up). The within-group effect sizes (for the main outcome PDSS; Panic Disorder Severity Scale) were Cohens d=2.5 (pre- to posttreatment) and 2.8 (pre-treatment to follow up) respectively. The proportion of responders on the PDSS was 75% at posttreatment and 70% at 6-month follow up. These results indicate that Internet-based CBT can be both an effective, feasible and potentially cost-effective alternative within regular psychiatric care for patients with PD.

  • 2.
    Gerdner, Arne
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för socialt arbete.
    Allgulander, C
    Karolinska Institutet.
    Psychometric properties of the Swedish version of the Childhood Trauma Questionnaire - Short Form (CTQ-SF).2009Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, nr 2, s. 160-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Childhood maltreatment is delicate to assess both in clinical work and in research. There is a need for assessment tools that can be easily administered in an ethical and non-intrusive way that meets requirements of conceptual validity for various types of maltreatment and is sensitive to levels of severity. This study explores the psychometric properties of the Swedish translation of one such toolthe Childhood Trauma QuestionnaireShort Form (CTQ-SF; Bernstein and Fink, 1998). The CTQ-SF was administered to seven samples (total n=659)five clinical samples and two non-clinical student samples. The factor structure supports the construct validity of the global maltreatment scale, four of the five maltreatment subscales (emotional abuse, physical abuse, sexual abuse and emotional neglect) and the minimization/denial (MD) scale, but not the physical neglect (PN) subscale. All items are highly correlated with their respective subscale. The discriminant validity is satisfactory. Highly significant correlation with social desirability gives further support for the MD-scale and to the recommendation of how to apply it. Internal consistency of PN is acceptable and for all other scales satisfactory. Swedish norm groups tend to score lower than similar American norm groups on abuse scales but higher on the neglect scales. Percentiles for seven gender-specific norm groups are presented. The weaknesses of the PN-scale are discussed and new constructs are proposed. The Swedish version of the CTQ-SF has the same construct validity and internal consistency as the original, including less homogeneity of the PN scale.

  • 3. Högberg, Göran
    et al.
    Pagani, Marco
    Sundin, Örjan
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Soares, Joaquim
    Åberg-Wistedt, Anna
    Tärnell, Berit
    Hällström, Tore
    On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers: a randomized controlled trial2007Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, nr 1, s. 54-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previous studies on post-traumatic stress disorder (PTSD) investigated a variety of treatments and included mostly patients victims of sexual and combat assault. This study aimed to determine the short-term efficacy of eye movement desensitization and reprocessing (EMDR) in occupation-based PTSD. Employees of the public transportation system in Stockholm, who had been experiencing a person-under-train accident or had been assaulted at work were recruited. Subjects with trauma exposure since more than 3 months but less than 6 years were included. Twenty-four subjects who fulfilled the DSM-IV criteria for PTSD were randomized to either EMDR therapy (n=13) or waiting list (WL, n=11). They were assessed pre-treatment and shortly after completion of treatment or WL period. The pre-defined primary outcome variable was full PTSD diagnosis. Secondary outcome variables were the results of various psychometric scales. Twelve participants began and completed five sessions of EMDR and nine completed the WL. After therapy, eight subjects in the EMDR group (67%) and one (11%) in WL did not fulfil the criteria for PTSD diagnosis (difference, P=0.02). Among the secondary outcome variables, there were significant differences post-treatment between the groups EMDR/WL in Global Assessment of Function (GAF) score and Hamilton Depression (HAM-D) score. This study indicates that EMDR has a short-term effect on PTSD in public transportation workers exposed to occupational traumatic events. Such intensive and brief therapy might be further validated in larger samples of exposed workers with longer periods of follow-up.

  • 4. Johansson, Inger M
    et al.
    Skarsäter, Ingela
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    The meaning of care on a locked acute psychiatric ward: Patients' experiences2009Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, nr 6, s. 501-507Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The deinstitutionalization of psychiatric care has led to a

    concentration of patients to fewer wards. This leads to difficulties in

    separating voluntarily and involuntarily admitted patients, and there

    is a risk that the interest in safeguarding patients' autonomy will

    decrease. Aims: The aim of this study was to elucidate the meaning care

    has to patients on a locked acute psychiatric ward. The study was

    performed on a ward for patients with affective and eating disorders

    who were admitted both voluntarily and involuntarily. Methods:

    Interviews were conducted and analysed using qualitative content

    analysis. Results: The results show that to the patients, care had

    contradictory qualities some alleviated their suffering while others

    contributed to stress. The alleviation from suffering originated from

    the experiences of strengthened integrity and self-determination, from

    being supported, and having a place of refuge on the ward. In contrast

    to this, there were experiences of being dependent and trapped because

    of lack of influence and choice, and being controlled. Conclusions: In

    conclusion, this qualitative study shows that to the patients, care can

    mean being disciplined in a way that risks undermining the alleviation

    of suffering that care can provide. It is thus important to be

    observant when it comes to manifestations of control in care. The study

    also shows that the support of fellow patients has a value as a

    complement to the care given by staff members and next of kin,

    something that needs to be further investigated.

     

  • 5.
    Nordström, Tanja
    et al.
    University of Oulu, Oulu, Finland.
    Ebeling, Hanna
    University and University Hospital of Oulu, Oulu, Finland.
    Hurtig, Tuula
    University of Oulu, Oulu, Finland.
    Rodriguez, alina
    Uppsala University, Uppsala, Sweden.
    Savolainen, Jukka
    University of Nebraska, Omaha, Nebraska, USA.
    Moilanen, Irma
    University and University Hospital of Oulu, Oulu, Finland.
    Taanila, Anja
    University and University Hospital of Oulu, Oulu, Finland.
    Comorbidity of disruptive behavioral disorders and attention-deficit hyperactivity disorder: Indicator of severity in problematic behavior?2013Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 67, nr 4, s. 240-248Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Disruptive behavioral disorders (DBD) and attention-deficit hyperactivity disorder (ADHD) are both characterized by certain patterns of misbehavior among adolescents. Aims: The aim of this study was to examine how the comorbidity of DBD and ADHD affects in misbehavior among adolescents. Methods: A total of 158 adolescents aged 16–18 years, from a subsample of the Northern Finland Birth Cohort 1986 (NFBC 1986), were interviewed with the Finnish translation of the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime (K-SADS-PL) in order to obtain DBD, including conduct disorder (CD) and oppositional defiant disorder (ODD), and ADHD diagnoses. The structure of the CD symptoms, obtained from the K-SADS-PL, was compared with the previously formed model about the development of the problematic behavior. The severity of the CD symptoms was compared with adolescents diagnosed with only DBD, only ADHD and with both DBD and ADHD. Also, the associations with other psychiatric disorders diagnosed at age 16 were evaluated. Results: The boys in the study sample were diagnosed with ADHD or with comorbid DBD and ADHD more often than girls. The severity of CD symptoms was statistically significantly associated with the comorbid DBD and ADHD group. The adolescents diagnosed with comorbid DBD and ADHD had an increased risk for anxiety disorders, depressive disorders and substance abuse disorders. Conclusions: The comorbidity of DBD and ADHD seems to indicate the severity of CD symptoms. Clinical implications: The comorbidity between DBD and ADHD should be considered in clinical practice because it could indicate more serious problematic behavior than pure disorders alone.

  • 6.
    Selenius, Heidi
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Strand, Susanne
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Superficiality in forensic psychiatric patients is related to superior phonological, semantic, and syntactic skills2015Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, nr 5, s. 392-396Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Psychopaths are reported to have unusual language processing, and they have been suggested to have better phonological awareness than do non-psychopaths. Phonological processing skills have not been studied among psychopathic persons, and it is unclear how the degree of psychopathy is related to such skills. Aims: One aim of the present study was to investigate this relationship. An additional aim was to investigate how affective-interpersonal traits and antisocial lifestyle of psychopaths are related to verbal skills such as reading and spelling, as well as to phonological processing skills. Material and methods: Forty (80% male) forensic psychiatric patients participated. They were all Swedish-speaking, and their mean age was 36 years. The patients performed reading and spelling tests as well as a battery of tasks assessing phonological processing. The patients were also assessed using the Psychopathy Checklist Screening Version (PCL:SV). Results: The patients scores on Factor 1 (affective and interpersonal traits) of the PCL:SV were significantly positively correlated with results on decoding of sentences and reading speed tests as well as with phonological processing skills. However, the only item that was significantly related to phonological processing skills as well as semantic and syntactic skills was Superficial. Conclusions: In general, psychopaths easily shift conversational topics, and it may be due to a certain cognitive skill such as rapid automatized naming. We suggest that further studies focus on rapid automatized naming in psychopaths to clarify whether their superficial character might be related to rapid naming.

  • 7.
    Selenius, Heidi
    et al.
    School of Law, Psychology and Social Work, Örebro University.
    Östman, Sari Leppänen
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för samhällsvetenskap.
    Strand, Susanne
    School of Law, Psychology and Social Work, Örebro University; Centre for Forensic Behavioural Science at Swinburne University of Technology, Melbourne, Australia.
    Self-harm as a risk factor for inpatient aggression among women admitted to forensic psychiatric care2016Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, nr 7, s. 554-560Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Inpatient aggression among female forensic psychiatric patients has been shown to be associated with self-harm, that is considered to be a historical risk factor for violence. Research on associations between previous or current self-harm and different types of inpatient aggression is missing.Aim: The aim of this register study was to investigate the prevalence of self-harm and the type of inpatient aggression among female forensic psychiatric inpatients, and to study whether the patients' self-harm before and/or during forensic psychiatric care is a risk factor for inpatient aggression.Methods: Female forensic psychiatric patients (n=130) from a high security hospital were included.Results: The results showed that 88% of the female patients had self-harmed at least once during their life and 57% had been physically and/or verbally aggressive towards staff or other patients while in care at the hospital. Self-harm before admission to the current forensic psychiatric care or repeated self-harm were not significantly associated with inpatient aggression, whereas self-harm during care was significantly associated with physical and verbal aggression directed at staff.Conclusions: These results pointed towards self-harm being a dynamic risk factor rather than a historical risk factor for inpatient aggression among female forensic psychiatric patients. Whether self-harm is an individual risk factor or a part of the clinical risk factor Symptom of major mental illness' within the HCR-20V3 must be further explored among women. Thus, addressing self-harm committed by female patients during forensic psychiatric care seems to be important in risk assessments and the management of violence, especially in reducing violence against staff in high-security forensic psychiatric services.

  • 8.
    Soares, Joaquim
    et al.
    Uppsala universitet.
    Pauli Stintzing, Camilla
    Jackson, Chris
    Sköldin, Barbro
    Psychoeducation for patients with bipolar affective disorder: An explorative study1997Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 51, nr 6, s. 439-46Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We explored the effects of an education package on outpatients with bipolar disorder. The primary goals were to determine whether the patients' knowledge of the illness would be improved after an educational intervention and whether education would lead to changes in such areas as attitudes to lithium and psychiatric well-being. We also examined whether changes would be maintained at follow-up. This study included 10 patients with a DSM-III-R diagnosis of bipolar disorder. The patients were given a six-session education package that covered the following areas: 1) demographics; 2) aetiology; 3) illness (course and symp toms); 4) treatment; 5) hospital procedures; and 6) coping (including problem-solving) with the illness and stress. Patients were assessed immediately before and after the intervention, and at a 6-month follow-up. The measures used were The Bipolar Knowledge Questionnaire, The Lithium Attitudes Questionnaire, The Rosenberg Self-Esteem Scale. The Hopelessness Scale, The General Health Questionnaire, and The Use of Inpatient Psychiatric Services. The results show significant improvements in knowledge about the illness, attitudes towards lithium, and self-esteem. These effects were maintained at follow-up. There were modest reductions in pessimism about the future and psychiatric morbidity. The utilization of inpatient psychiatric services decreased for three patients, whereas the other seven patients did not use the services at all. There were no significant correlations between any of the variables. The findings suggest that the educational intervention was beneficial for manic depressives. However, a larger control study needs to be performed to confirm these reliminary findings.

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