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Bodlund, Owe
Publications (10 of 36) Show all publications
Naesström, M., Blomstedt, P., Hariz, M. & Bodlund, O. (2017). Deep brain stimulation for obsessive-compulsive disorder: knowledge and concerns among psychiatrists, psychotherapists and patients. Surgical neurology international, 8, Article ID 298.
Open this publication in new window or tab >>Deep brain stimulation for obsessive-compulsive disorder: knowledge and concerns among psychiatrists, psychotherapists and patients
2017 (English)In: Surgical neurology international, ISSN 2229-5097, Vol. 8, article id 298Article in journal (Refereed) Published
Abstract [en]

Background: Deep brain stimulation (DBS) is under investigation for severe obsessive-compulsive disorder (OCD) resistant to other therapies. The number of implants worldwide is slowly increasing. Therefore, it is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. Especially, for future study designs and the creation of information targeting healthcare professionals and patients. The aim of this study was to explore the knowledge and concerns toward DBS among patients with OCD, psychiatrists, and cognitive behavioral therapists.

Methods: The study was conducted through web-based surveys for the aimed target groups -psychiatrist, patients, and cognitive behavioral therapists. The surveys contained questions regarding previous knowledge of DBS, source of knowledge, attitudes, and concerns towards the therapy.

Results: The main source of information was from scientific sources among psychiatrists and psychotherapists. The patient's main source of information was the media. Common concerns among the groups included complications from surgery, anesthesia, stimulation side effects, and the novelty of the treatment. Specific concerns for the groups included; personality changes mentioned by patients and psychotherapists, and ethical concerns among psychiatrists.

Conclusion: There are challenges for DBS in OCD as identified by the participants of this study; source and quality of information, efficacy, potential adverse effects, and eligibility. In all of which the current evidence base still is limited. A broad research agenda is needed for studies going forward.

Place, publisher, year, edition, pages
Medknow Publications, 2017
Keywords
attitude, deep brain stimulation, obsessive-compulsive disorder, patient, psychiatrist, psychotherapist
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-146475 (URN)29285414 (PubMedID)
Available from: 2018-04-10 Created: 2018-04-10 Last updated: 2019-11-19Bibliographically approved
Blomstedt, P., Naesström, M. & Bodlund, O. (2017). Deep brain stimulation in the bed nucleus of the stria terminalis and medial forebrain bundle in a patient with major depressive disorder and anorexia nervosa. Clinical Case Reports, 5(5), 679-684
Open this publication in new window or tab >>Deep brain stimulation in the bed nucleus of the stria terminalis and medial forebrain bundle in a patient with major depressive disorder and anorexia nervosa
2017 (English)In: Clinical Case Reports, E-ISSN 2050-0904, Vol. 5, no 5, p. 679-684Article in journal (Refereed) Published
Abstract [en]

Key Clinical Message Deep brain stimulation (DBS) may be considered in severe cases of therapy-refractory major depressive disorder (MDD). However, DBS for MDD is still an experimental therapy. Therefore, it should only be administered in clinical studies driven by multidisciplinary teams, including surgeons with substantial experience of DBS in the treatment of other conditions.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Anorexia nervosa, bed nucleus of the stria terminalis, deep brain stimulation, depression, medial forebrain bundle
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-136065 (URN)10.1002/ccr3.856 (DOI)000400580800028 ()28469875 (PubMedID)
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-06-09Bibliographically approved
Naesström, M., Blomstedt, P. & Bodlund, O. (2016). A systematic review of psychiatric indications for deep brain stimulation, with focus on major depressive and obsessive-compulsive disorder. Nordic Journal of Psychiatry, 70(7), 483-491
Open this publication in new window or tab >>A systematic review of psychiatric indications for deep brain stimulation, with focus on major depressive and obsessive-compulsive disorder
2016 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 7, p. 483-491Article, review/survey (Refereed) Published
Abstract [en]

Background: Deep brain stimulation is a treatment under investigation for a range of psychiatric disorders. It has shown promising results for therapy-refractory obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Other indications under investigation include Tourette's syndrome, anorexia nervosa and substance use disorders.Aims: To review current studies on psychiatric indications for deep brain stimulation (DBS), with focus on OCD and MDD.Method: A systematic search was carried out in MEDLINE, and the literature was searched to identify studies with DBS for psychiatric disorders. The identified studies were analysed based on patient characteristics, treatment results and adverse effects of DBS.Results: A total of 52 papers met the inclusion criteria and described a total of 286 unique patients treated with DBS for psychiatric indications; 18 studies described 112 patients treated with DBS for OCD in six different anatomical targets, while nine studies presented 100 patients with DBS for MDD in five different targets.Conclusion: DBS may show promise for treatment-resistant OCD and MDD but the results are limited by small sample size and insufficient randomized controlled data. Deep brain stimulation for OCD has received United States Food and Drug Administration approval. Other psychiatric indications are currently of a purely experimental nature.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Systematic review, Deep brain stimulation, Psychiatric indications, Obsessive-compulsive disorder, Major depressive disorder
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-126736 (URN)10.3109/08039488.2016.1162846 (DOI)000383037300001 ()27103550 (PubMedID)
Available from: 2016-10-20 Created: 2016-10-13 Last updated: 2018-06-09Bibliographically approved
Naesström, M., Blomstedt, P. & Bodlund, O. (2016). Djup hjärnstimulering vid psykiska sjukdomar visar lovande resultat - Men behandlingen är fortfarande experimentell. Läkartidningen, 113(40), Article ID DYHL.
Open this publication in new window or tab >>Djup hjärnstimulering vid psykiska sjukdomar visar lovande resultat - Men behandlingen är fortfarande experimentell
2016 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 40, article id DYHLArticle in journal (Refereed) Published
Abstract [sv]

Deep brain stimulation is an established treatment for movement disorders. It has been proven to be a safe method; only minor complications have been reported in larger studies. New indications for deep brain stimulation are under investigation; among them major depressive disorder and obsessive-compulsive disorder. Deep brain stimulation for severe and therapy-resistant major depressive disorder and obsessive compulsive-disorder shows promising results. However, the experience of deep brain stimulation in psychiatric disorders is limited. Several potential target areas for stimulation have been presented; which are the most effective is still an open question. Deep brain stimulation in psychiatric disorders is a highly experimental treatment and should only be performed by a multidisciplinary team with extensive experience with deep brain stimulation in other conditions.

National Category
Psychiatry Neurology
Identifiers
urn:nbn:se:umu:diva-135001 (URN)27551867 (PubMedID)
Available from: 2017-05-15 Created: 2017-05-15 Last updated: 2018-06-09Bibliographically approved
Kuckertz, J. M., Gildebrant, E., Liliequist, B., Karlström, P., Väppling, C., Bodlund, O., . . . Carlbring, P. (2014). Moderation and mediation of the effect of attention training in social anxiety disorder. Behaviour Research and Therapy, 53, 30-40
Open this publication in new window or tab >>Moderation and mediation of the effect of attention training in social anxiety disorder
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2014 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 53, p. 30-40Article in journal (Refereed) Published
Abstract [en]

While attention modification programs (AMP) have shown promise as laboratory-based treatments for social anxiety disorder, trials of internet-delivered AMP have not yielded significant differences between active and control conditions. To address these inconsistencies, we examined the moderational and mediational role of attention bias in the efficacy of attention training. We compared data reported by Carlbring et al. (2012) to an identical AMP condition, with the exception that participants were instructed to activate social anxiety fears prior to each attention training session (AMP + FACT; n = 39). We also compared all attention training groups to an internet-delivered cognitive-behavioral therapy (iCBT) condition (n = 40). Participants in the AMP + FACT group experienced greater reductions in social anxiety symptoms than both active (n = 40) and control (n = 39) groups reported by Carlbring et al., and did not differ in symptom reductions from the iCBT group. Higher attention bias predicted greater symptom reductions for participants who completed AMP, but not for the control group. Moreover, change in attention bias mediated the relationship between AMP group (active condition reported by Carlbring et al. versus AMP + FACT) and change in social anxiety symptoms. These results suggest the importance of interpreting findings related to symptom change in attention training studies in the context of bias effects. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Social phobia, Social anxiety disorder, Attention, Treatment, Information processing
National Category
Psychology Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-87412 (URN)10.1016/j.brat.2013.12.003 (DOI)000331680500004 ()24373984 (PubMedID)
Available from: 2014-04-02 Created: 2014-03-31 Last updated: 2019-03-05Bibliographically approved
Månsson, K. N., Carlbring, P., Frick, A., Engman, J., Olsson, C.-J., Bodlund, O., . . . Andersson, G. (2013). Altered neural correlates of affective processing after internet-delivered cognitive behavior therapy for social anxiety disorder. Psychiatry Research: Neuroimaging, 214(3), 229-237
Open this publication in new window or tab >>Altered neural correlates of affective processing after internet-delivered cognitive behavior therapy for social anxiety disorder
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2013 (English)In: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 214, no 3, p. 229-237Article in journal (Refereed) Published
Abstract [en]

Randomized controlled trials have yielded promising results for internet-delivered cognitive behavior therapy (iCBT) forpatients with social anxiety disorder (SAD). The present study investigated anxiety-related neural changes after iCBT for SAD. The amygdala is a critical hub in the neural fear network, receptive to change using emotion regulation strategies and a putative target for iCBT.

Twenty-two subjects were included in pre- and post-treatment functional magnetic resonance imaging at 3T assessingneural changes during an affective face processing task. Treatment outcome was assessed using social anxiety self-reports and the Clinical Global Impression-Improvement (CGI-I) scale.

ICBT yielded better outcome than ABM (66% vs. 25% CGI-I responders). A significant differential activation of the left amygdala was found with relatively decreased reactivity after iCBT. Changes in the amygdala were related to a behavioral measure of social anxiety. Functional connectivity analysis in the iCBT group showed that the amygdala attenuation was associated with increased activity in the medial orbitofrontal cortex and decreased activity in the right ventrolateral and dorsolateral (dlPFC) cortices. Treatment-induced neural changes with iCBT were consistent with previously reported studies on regular CBT and emotion regulation in general.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Amygdala, Cognitive behavior therapy, dlPFC, fMRI, mOFC, vlPFC
National Category
Psychology Neurology
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-81639 (URN)10.1016/j.pscychresns.2013.08.012 (DOI)000327531600008 ()24064198 (PubMedID)
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare, FAS 2009-0222
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2018-06-08Bibliographically approved
Mansson, K. N. T., Carlbring, P., Frick, A., Engman, J., Olsson, C.-J., Bodlund, O., . . . Andersson, G. (2013). Amygdala Changes After Cognitive Behavior Therapy and Attention Bias Modification via the Internet: An fMRI-Study. Paper presented at 68th Annual Scientific Meeting of the Society-of-Biological-Psychiatry, MAY 16-18, 2013, San Francisco, CA. Biological Psychiatry, 73(9), 72S-72S
Open this publication in new window or tab >>Amygdala Changes After Cognitive Behavior Therapy and Attention Bias Modification via the Internet: An fMRI-Study
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2013 (English)In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 73, no 9, p. 72S-72SArticle in journal (Refereed) Published
Place, publisher, year, edition, pages
New York, NY, USA: Elsevier, 2013
National Category
Neurology Psychiatry Neurosciences
Identifiers
urn:nbn:se:umu:diva-73581 (URN)000318671800222 ()
Conference
68th Annual Scientific Meeting of the Society-of-Biological-Psychiatry, MAY 16-18, 2013, San Francisco, CA
Note

Meeting Abstract: 222.

Available from: 2013-06-25 Created: 2013-06-25 Last updated: 2018-06-08Bibliographically approved
Blomstedt, P., Sjöberg, R. L., Hansson, M., Bodlund, O. & Hariz, M. I. (2013). Deep brain stimulation in the treatment of obsessive-compulsive disorder. World Neurosurgery, 80(6), e245-e253
Open this publication in new window or tab >>Deep brain stimulation in the treatment of obsessive-compulsive disorder
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2013 (English)In: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 80, no 6, p. e245-e253Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Deep brain stimulation (DBS) has emerged as a treatment for severe cases of therapy-refractory obsessive-compulsive disorder (OCD), and promising results have been reported. The literature might, however, be somewhat unclear, considering the different targets used, and due to repeated inclusion of individual patients in multiple publications. The aim of this report was to review the literature on DBS for OCD.

METHODS: The modern literature concerning studies conducted on DBS in the treatment of OCD was reviewed.

RESULTS: The results of DBS in OCD have been presented in 25 reports with 130 patients, of which, however, only 90 contained individual patients. Five of these reports included at least 5 individual patients not presented elsewhere. Sixty-eight of these patients underwent implantation in the region of the internal capsule/ventral striatum, including the nucleus accumbens. The target in this region has varied between groups and over time, but the latest results from bilateral procedures in this area have shown a 50% reduction of OCD scores, depression, and anxiety. The subthalamic nucleus has been suggested as an alternative target. Although beneficial effects have been demonstrated, the efficacy of this procedure cannot be decided, because only results after 3 months of active stimulation have been presented so far.

CONCLUSIONS: DBS is a promising treatment for therapy-refractory OCD, but the published experience is limited and the method is at present an experimental therapy.

Keywords
DBS, OCD, Stereotaxy
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-83412 (URN)10.1016/j.wneu.2012.10.006 (DOI)000329733300026 ()23044000 (PubMedID)
Available from: 2013-11-25 Created: 2013-11-25 Last updated: 2018-06-08Bibliographically approved
Hansson, M., Chotai, J. & Bodlund, O. (2012). What made me feel better?: patients' own explanations for the improvement of their depression. Nordic Journal of Psychiatry, 66(4), 290-296
Open this publication in new window or tab >>What made me feel better?: patients' own explanations for the improvement of their depression
2012 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, no 4, p. 290-296Article in journal (Refereed) Published
Abstract [en]

Background: Depression is common among primary care patients and the usual treatment often consists of antidepressant medication and supportive counselling/follow-ups. Previous studies have shown that patients and professionals have different beliefs about treatment, which in turn can decrease acceptance of the diagnosis, compliance and treatment outcome. Aims: The purpose of this study was to investigate previously depressed patients' beliefs about the cause of their improvement. Methods: Depressed primary care patients (n = 184) who considered themselves improved at follow-up answered an open-ended question about what they believed had made them better. Among these 117 patients had, in addition to treatment as usual, participated in an intervention with patient education and group counselling (the Contactus programme), whereas 67 were controls. The groups were comparable at baseline and 82% were on antidepressants. Results: In total, the patients mentioned 14 separate improving factors, which could be organized to the larger themes external factors, self-management, passing spontaneously and professional help. The most frequently mentioned factors for improvement were the Contactus programme (53.0%), antidepressants (40.2%) and personal development (27.2%). Few gender and age differences were seen. The controls who mentioned professional help were more likely to have a better outcome. Conclusions: The patients were generally positive to professional help such as antidepressants and the Contactus programme. Patient education and group counselling seems to be a valuable supplement to treatment of depressed patients in primary care.

Keywords
antidepressants; depression; group counselling; improvement factors; patient education; patients' beliefs; primary care
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-60653 (URN)10.3109/08039488.2011.644807 (DOI)000308413100010 ()
Available from: 2012-10-26 Created: 2012-10-22 Last updated: 2018-06-08Bibliographically approved
Blomstedt, P., Sjöberg, R., Hansson, M., Bodlund, O. & Hariz, M. I. (2011). Deep brain stimulation in the treatment of depression. Acta Psychiatrica Scandinavica, 123(1), 4-11
Open this publication in new window or tab >>Deep brain stimulation in the treatment of depression
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2011 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 123, no 1, p. 4-11Article in journal (Refereed) Published
Abstract [en]

Objective:  To present the technique of deep brain stimulation (DBS) and to evaluate the studies conducted on DBS in the treatment of therapy-refractory major depressive disorder (MDD).

Method:  A review of the literature on DBS in the treatment of MDD was conducted.

Results:  The results of DBS in MDD have been presented in 2 case reports and 3 studies of 47 patients operated upon in 5 different target areas. Positive effects have been presented in all studies and side effects have been minor. DBS in the nucleus accumbens resulted in a mean reduction of Hamilton depression rating scale (HDRS) of 36% after 1 year and 30% of the 10 patients achieved remission. DBS in the internal capsule/ventral striatum resulted in a reduction of 44% after 1 year, and at the last evaluation after in mean 2 years, 40% of the 15 patients were in remission. The 20 patients with subcallosal cingulated gyrus DBS had a reduction of HDRS of 52% after 1 year, and 35% were within 1 point from remission or in remission.

Conclusion:  DBS is a promising treatment for therapy-refractory MDD. The published experience is, however, limited, and the method is at present an experimental therapy.

Keywords
deep brain stimulation; depression; stereotaxy
National Category
Neurology Psychiatry
Identifiers
urn:nbn:se:umu:diva-42507 (URN)10.1111/j.1600-0447.2010.01625.x (DOI)
Available from: 2011-04-08 Created: 2011-04-08 Last updated: 2018-06-08Bibliographically approved
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