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Lindh, Å. U., Dahlin, M., Beckman, K., Strömsten, L. M. J., Jokinen, J., Wiktorsson, S., . . . Runeson, B. (2019). A Comparison of Suicide Risk Scales in Predicting Repeat Suicide Attempt and Suicide: A Clinical Cohort Study. Journal of Clinical Psychiatry, 80(6), Article ID 18m12707.
Åpne denne publikasjonen i ny fane eller vindu >>A Comparison of Suicide Risk Scales in Predicting Repeat Suicide Attempt and Suicide: A Clinical Cohort Study
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2019 (engelsk)Inngår i: Journal of Clinical Psychiatry, ISSN 0160-6689, E-ISSN 1555-2101, Vol. 80, nr 6, artikkel-id 18m12707Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

OBJECTIVE: To compare the predictive accuracy of the Suicide Intent Scale (SIS), the Suicide Assessment Scale (SUAS), the Karolinska Interpersonal Violence Scale (KIVS), and the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicide attempts and suicides within 3 and 12 months of an episode of self-harm.

METHODS: This prospective multicenter cohort study included patients (N = 804) aged 18-95 years with a recent episode of self-harm assessed in psychiatric emergency settings from April 2012 to April 2016. Suicide attempts and suicides were identified in medical records and in the National Cause of Death Register. Receiver operating characteristic curves were constructed, and accuracy statistics were calculated. A sensitivity of at least 80% combined with a specificity of at least 50% were considered minimally acceptable.

RESULTS: At least 1 suicide attempt was recorded for 216 participants during follow-up, and 19 participants died by suicide. The SUAS and C-SSRS were better than chance in classifying the 114 suicide attempts occurring within the first 3 months; a C-SSRS score ≥ 27 yielded a sensitivity/specificity of 79.8%/51.5% (P < .001). During 1-year follow-up, the SUAS and C-SSRS also performed better than chance, but no cutoff on either instrument gave a sensitivity/specificity of ≥ 80%/≥ 50%. The SIS was the only instrument that could classify suicides correctly. At 3 months, the area under the curve (AUC) was 0.94 (95% CI, 0.89-0.99), and a score ≥ 21 predicted suicide with a sensitivity/specificity of 100%/81.9%, based on only 4 suicides. At 1-year follow-up, the AUC was 0.74 (95% CI, 0.61-0.87), and a score ≥ 17 predicted suicide with a sensitivity/specificity of 72.2%/57.9%.

CONCLUSIONS: Instruments that predicted nonfatal repeat suicide attempts did not predict suicide and vice versa. With the possible exception of the prediction of suicide by the SIS in a short time frame, the specificity of these instruments was low, giving them a limited relevance in the prediction of suicidal behaviors.

HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-165430 (URN)10.4088/JCP.18m12707 (DOI)31747488 (PubMedID)
Tilgjengelig fra: 2019-11-25 Laget: 2019-11-25 Sist oppdatert: 2019-12-12bibliografisk kontrollert
Hallberg, J., Kaldo, V., Arver, S., Dhejne, C., Jokinen, J. & Oberg, K. G. (2019). A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men. Journal of Sexual Medicine, 16(5), 733-745
Åpne denne publikasjonen i ny fane eller vindu >>A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men
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2019 (engelsk)Inngår i: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 16, nr 5, s. 733-745Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously.

Aim: To investigate the efficacy of group-administered CBT for HD.

Methods: Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months.

Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery–Åsberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8).

Results: A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment.

Clinical Implications: CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings.

Strengths & Limitations: This is the first randomized controlled study evaluating the efficacy of a CBT program in a rather large sample of HD-specific diagnosed men. The long-term treatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown.

Conclusion: This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet.

sted, utgiver, år, opplag, sider
Elsevier, 2019
Emneord
Male Sexual Desire Disorders, Basic science male behavioral, Mental Health and Male Sexuality
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-160310 (URN)10.1016/j.jsxm.2019.03.005 (DOI)000469936400015 ()30956109 (PubMedID)
Tilgjengelig fra: 2019-06-17 Laget: 2019-06-17 Sist oppdatert: 2019-06-17bibliografisk kontrollert
Pahnke, J., Hirvikoski, T., Bjureberg, J., Bölte, S., Jokinen, J., Bohman, B. & Lundgren, T. (2019). Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context. Journal of Contextual Behavioral Science, 13, 34-41
Åpne denne publikasjonen i ny fane eller vindu >>Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context
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2019 (engelsk)Inngår i: Journal of Contextual Behavioral Science, ISSN 2212-1447, Vol. 13, s. 34-41Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Highlights:

Feasibility and credibility of the NeuroACT protocol was high.

Symptoms of stress and depression were significantly reduced.

Cognitive defusion and psychological flexibility significantly increased.

Quality of life and social functioning were significantly improved.

HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-164547 (URN)10.1016/j.jcbs.2019.04.002 (DOI)000483320600005 ()
Tilgjengelig fra: 2019-10-23 Laget: 2019-10-23 Sist oppdatert: 2019-10-23bibliografisk kontrollert
Stenbacka, M., Moberg, T. & Jokinen, J. (2019). Adolescent criminality: multiple adverse health outcomes and mortality pattern in Swedish men. BMC Public Health, 19, Article ID 400.
Åpne denne publikasjonen i ny fane eller vindu >>Adolescent criminality: multiple adverse health outcomes and mortality pattern in Swedish men
2019 (engelsk)Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikkel-id 400Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70.

Methods: The cohort consisted of 49,398 18-year-old Swedish conscripts followed up for morbidity and mortality up to the age of 55 years in Swedish national registers. Information about convictions for crime before conscription was obtained from national crime registers. Data from a survey at conscription were scrutinized to get information on potential confounders.

Results: Hospitalization due to alcohol and drug related diagnoses and attempted suicide were significantly more evident in the violent group compared to non-violent criminals and non-criminals. More than one fifth (21.13%) of the young violent offenders, 12.90% of the non-violent offenders and 4.96% of the non-criminals had died during the follow-up period. In Cox proportional multivariate analyses, young violent offenders had twice the hazard (HR = 4.29) of all-cause mortality than the non-violent offenders (HR = 2.16) during the follow-up period. Alcohol and drug related mortality, suicide and fatal accidents were most evident in both violent and non-violent offenders.

Conclusions: Men with adolescent criminality received more inpatient care due to alcohol and drug related diagnoses and attempted suicide as adults. Mortality due to unnatural causes, alcohol, and drug related diagnoses, suicide and accidents was most evident in violent offenders, while these causes of death were much lower in non-criminals. Men with adolescent criminality are a high-risk group for multiple adverse health outcomes and for early death. Efforts for detection of substance use and psychiatric disorders in this group is important for the prevention work in both local- and community levels as well as national prevention programs.

sted, utgiver, år, opplag, sider
BioMed Central, 2019
Emneord
Alcohol, Criminality, Violence, Substance use, Mortality
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-158573 (URN)10.1186/s12889-019-6662-z (DOI)000464880000011 ()30975117 (PubMedID)
Tilgjengelig fra: 2019-05-27 Laget: 2019-05-27 Sist oppdatert: 2019-05-27bibliografisk kontrollert
Bjureberg, J., Ohlis, A., Ljotsson, B., D'Onofrio, B. M., Hedman-Lagerlöf, E., Jokinen, J., . . . Hellner, C. (2019). Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register. Journal of Child Psychology and Psychiatry and Allied Disciplines, 60(3), 295-304
Åpne denne publikasjonen i ny fane eller vindu >>Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register
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2019 (engelsk)Inngår i: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 60, nr 3, s. 295-304Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Self-harm is common and there is a need for studies that investigate the relevance of this behavior in clinical samples to inform risk assessment and treatment. The objectives in the current studies were to compare clinical and psychosocial correlates and subsequent adverse outcomes in youth who present to child and adolescent mental health services (CAMHS) with self-harm only (SH), self-harm with suicidality (SH+SU), with those without any indication of SH or SH+SU.

Methods: We conducted a case-control study and a longitudinal cohort study using data from a regional clinical care register, and Swedish national registers. The case-control study included all patients (5-17 years) between 2011 and 2015 (N = 25,161). SH and SH+SU cases were compared with controls (patients without SH) regarding a range of correlates. The longitudinal study included former CAMHS patients (N = 6,120) who were followed for a median time of 2.8 years after termination of CAMHS contact regarding outcomes such as clinical care consumption, social welfare recipiency, and crime conviction.

Results: In the case-control study, both the SH and SH+SU groups received more clinical care, had lower global functioning, and higher odds of having mental disorders compared to controls. In most comparisons, the SH+SU group had more problems than the SH group. In the longitudinal study, the same pattern emerged for most outcomes; for example, the adjusted hazard ratio for recurrent care due to self-harm was 23.1 (95% confidence interval [CI], 17.0-31.4) in the SH+SU group compared to 3.9 (95% CI, 2.3-6.7) in the SH group.

Conclusions: Adolescent patients presenting with self-harm have higher risks for adverse outcomes than patients without self-harm. Suicidality in addition to self-harm is associated with more severe outcomes, importantly recurrent episodes of care for self-harm.

sted, utgiver, år, opplag, sider
John Wiley & Sons, 2019
Emneord
Self-harm, self-injurious behavior, suicidal ideation, epidemiology, cohort study
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-157201 (URN)10.1111/jcpp.12967 (DOI)000459224900008 ()30207392 (PubMedID)
Tilgjengelig fra: 2019-04-08 Laget: 2019-04-08 Sist oppdatert: 2019-04-08bibliografisk kontrollert
Budhiraja, M., Pereira, J. B., Lindner, P., Westman, E., Jokinen, J., Savic, I., . . . Hodgins, S. (2019). Cortical structure abnormalities in females with conduct disorder prior to age 15. Psychiatry Research: Neuroimaging, 289, 37-44
Åpne denne publikasjonen i ny fane eller vindu >>Cortical structure abnormalities in females with conduct disorder prior to age 15
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2019 (engelsk)Inngår i: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 289, s. 37-44Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Among females, conduct disorder (CD) before age 15 is associated with multiple adverse outcomes in adulthood. The few existing structural neuroimaging studies of females with CD report abnormalities of gray matter volumes. The present study compared cortical thickness and surface area of young women with childhood/adolescent CD and healthy women to determine whether cortical abnormalities were present in adulthood and whether they were related to prior CD. Structural brain images from 31 women with CD and 25 healthy women were analyzed using FreeSurfer. Group differences between cortical thickness and surface area were assessed using cluster-wise corrections with Monte Carlo simulations. Women with prior CD, relative to healthy women, showed: (1) reduced cortical thickness in left fusiform gyrus extending up to entorhinal cortex and lingual gyrus; (2) reduced surface area in right superior parietal cortex; (3) increased surface area in left superior temporal gyrus, and right precentral gyrus. These differences remained significant after adjusting for past comorbid disorders, current symptoms of anxiety and depression, current substance use as well as maltreatment. The study suggests that among females, CD prior to age 15 is associated with cortical structure abnormalities in brain regions involved in emotion processing and social interaction.

sted, utgiver, år, opplag, sider
Elsevier, 2019
Emneord
Conduct disorder, Structural MRI, Freesurfer, Cortical thickness, Surface area, Fusiform gyms
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-160596 (URN)10.1016/j.pscychresns.2018.12.004 (DOI)000470122700006 ()31101397 (PubMedID)
Forskningsfinansiär
Stockholm County CouncilSwedish Foundation for Strategic Research VinnovaSwedish Research Council
Tilgjengelig fra: 2019-06-24 Laget: 2019-06-24 Sist oppdatert: 2019-06-24bibliografisk kontrollert
Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman-Lagerlöf, E., Bjärehed, J., . . . Ljotsson, B. (2019). Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy. Cognitive Behaviour Therapy, 48(4), 322-336
Åpne denne publikasjonen i ny fane eller vindu >>Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy
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2019 (engelsk)Inngår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 48, nr 4, s. 322-336Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes.

We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment (b = 0.998, SE = 0.00, p = 0.03) and follow-up (b = 0.997, SE = 0.00, p < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment (b = 0.84, SE = 0.06, p = 0.02) and in emotion dysregulation at follow-up (b = −3.05, SE = 1.47, p = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD.

sted, utgiver, år, opplag, sider
Routledge, 2019
Emneord
Emotion regulation group therapy, predictors of treatment response, borderline personality disorder, deliberate self-harm, non-suicidal self-injury, emotion regulation
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-161484 (URN)10.1080/16506073.2018.1509119 (DOI)000470850800005 ()30230412 (PubMedID)
Forskningsfinansiär
Stockholm County Council, SLL20140428
Tilgjengelig fra: 2019-07-09 Laget: 2019-07-09 Sist oppdatert: 2019-07-09bibliografisk kontrollert
Ehlert, U. & Jokinen, J. (2019). Sexual steroids during the course of female life. Paper presented at 49th Annual Conference of the International-Society-of-Psychoneuroendocrinology - 50 Years of Psychoneuroendocrinology - Returning to Where It All Began, AUG 29-31, 2019, Milan, ITALY. Psychoneuroendocrinology, 107, 67-67
Åpne denne publikasjonen i ny fane eller vindu >>Sexual steroids during the course of female life
2019 (engelsk)Inngår i: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 107, s. 67-67Artikkel i tidsskrift, Meeting abstract (Annet vitenskapelig) Published
sted, utgiver, år, opplag, sider
PERGAMON-ELSEVIER SCIENCE LTD, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-164513 (URN)10.1016/j.psyneuen.2019.07.192 (DOI)000483655400191 ()
Konferanse
49th Annual Conference of the International-Society-of-Psychoneuroendocrinology - 50 Years of Psychoneuroendocrinology - Returning to Where It All Began, AUG 29-31, 2019, Milan, ITALY
Tilgjengelig fra: 2019-11-20 Laget: 2019-11-20 Sist oppdatert: 2019-11-20bibliografisk kontrollert
Chatzittofis, A., Boström, A., Öberg, K., Flanagan, J., Schioth, H., Arver, S. & Jokinen, J. (2019). Testosterone, luteinizing hormone levels and methylation status in men with hypersexual disorders. Paper presented at 31st ECNP Congress, Barcelona, Spain, 6-9 October, 2018. European Neuropsychopharmacology, 29, S135-S135
Åpne denne publikasjonen i ny fane eller vindu >>Testosterone, luteinizing hormone levels and methylation status in men with hypersexual disorders
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2019 (engelsk)Inngår i: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 29, s. S135-S135Artikkel i tidsskrift, Meeting abstract (Annet vitenskapelig) Published
sted, utgiver, år, opplag, sider
Elsevier, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-156895 (URN)10.1016/j.euroneuro.2018.11.247 (DOI)000458400500192 ()
Konferanse
31st ECNP Congress, Barcelona, Spain, 6-9 October, 2018
Merknad

Supplement 1

Meeting abstract P.134

Tilgjengelig fra: 2019-03-11 Laget: 2019-03-11 Sist oppdatert: 2019-03-11bibliografisk kontrollert
Lindner, P., Flodin, P., Larm, P., Budhiraja, M., Savic-Berglund, I., Jokinen, J., . . . Hodgins, S. (2018). Amygdala-orbitofrontal structural and functional connectivity in females with anxiety disorders, with and without a history of conduct disorder. Scientific Reports, 8, 1-12, Article ID 1101.
Åpne denne publikasjonen i ny fane eller vindu >>Amygdala-orbitofrontal structural and functional connectivity in females with anxiety disorders, with and without a history of conduct disorder
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2018 (engelsk)Inngår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, s. 1-12, artikkel-id 1101Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Conduct disorder (CD) and anxiety disorders (ADs) are often comorbid and both are characterized by hyper-sensitivity to threat, and reduced structural and functional connectivity between the amygdala and orbitofrontal cortex (OFC). Previous studies of CD have not taken account of ADs nor directly compared connectivity in the two disorders. We examined three groups of young women: 23 presenting CD and lifetime AD; 30 presenting lifetime AD and not CD; and 17 with neither disorder (ND). Participants completed clinical assessments and diffusion-weighted and resting-state functional MRI scans. The uncinate fasciculus was reconstructed using tractography and manual dissection, and structural measures extracted. Correlations of resting-state activity between amygdala and OFC seeds were computed. The CD + AD and AD groups showed similarly reduced structural integrity of the left uncinate compared to ND, even after adjusting for IQ, psychiatric comorbidity, and childhood maltreatment. Uncinate integrity was associated with harm avoidance traits among AD-only women, and with the interaction of poor anger control and anxiety symptoms among CD + AD women. Groups did not differ in functional connectivity. Reduced uncinate integrity observed in CD + AD and AD-only women may reflect deficient emotion regulation in response to threat, common to both disorders, while other neural mechanisms determine the behavioral response.

sted, utgiver, år, opplag, sider
NATURE PUBLISHING GROUP, 2018
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-144347 (URN)10.1038/s41598-018-19569-7 (DOI)000422739300064 ()29348532 (PubMedID)
Tilgjengelig fra: 2018-02-07 Laget: 2018-02-07 Sist oppdatert: 2018-08-08bibliografisk kontrollert
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0001-6766-7983