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  • 1.
    Alem, Atalay
    et al.
    Amanuel Psychiatric Hospital, Addis Ababa. Ethiopia.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Araya, Mesfin
    Kebede, D
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    How are mental disorders seen and where is help sought in a rural Ethiopian community? A key informant study in Butajira, Ethiopia.1999In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 100, no S397, p. 40-47Article in journal (Refereed)
    Abstract [en]

    One hundred key informants were interviewed about their awareness, attitudes and practices regarding mental illness using the Key Informant Questionnaire developed by WHO. Case vignettes of seven common neuropsychiatric disorders were presented to the key informants. Informants' awareness about these disorders and help-seeking practices for mental and physical symptoms or conditions were assessed. An additional question on the prototype symptoms of mental disorders was also posed. Among the presented seven conditions, epilepsy was perceived as the most common condition and major depression was regarded as the least common one. Schizophrenia was judged as the most severe problem, and mental retardation was considered the second most severe condition. Talkativeness, aggression and strange behaviour were the most frequently perceived prototype symptoms of mental illness. Traditional treatment methods were preferred more often for treating symptoms of mental disorders and modern medicine was preferred more often for treating physical diseases or symptoms. Findings of this study are similar to other studies conducted in socio-culturally different communities. Working in close connection with traditional healers would give the primary health care worker a better opportunity to gain acceptance from the community and modify certain harmful practices.

  • 2. Alem, Atalay
    et al.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Hanlon, Charlotte
    Community-based mental health care in Africa: mental health workers' views2008In: World Psychiatry, ISSN 1723-8617, E-ISSN 2051-5545, Vol. 7, no 1, p. 54-57Article in journal (Refereed)
    Abstract [en]

    The World Health Organization (WHO) has for long proposed the development of community-based mental health services worldwide. However, the progress toward community mental health care in most African countries is still hampered by a lack of resources, with specialist psychiatric care essentially based in large, centrally located mental hospitals. It is again time to reconsider the direction of mental health care in Africa. Based on a small inquiry to a number of experienced mental health professionals in sub-Saharan Africa, we discuss what a community concept of mental health care might mean in Africa. There is a general agreement that mental health services should be integrated in primary health care. A critical issue for success of this model is perceived to be provision of appropriate supervision and continuing education for primary care workers. The importance of collaboration between modem medicine and traditional healers is stressed and the paper ends in a plea for WHO to take the initiative and develop mental health services according to the special needs and the sociocultural conditions prevailing in sub-Saharan Africa.

  • 3.
    Alem, Atalay
    et al.
    Amanuel Psychiatric Hospital, Addis Ababa. Ethiopia.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kebede, D
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour. A key informant study in Butajira, Ethiopia.1999In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 100, no S397, p. 65-69Article in journal (Refereed)
    Abstract [en]

    One hundred key informants were interviewed regarding their awareness and attitudes toward suicidal behaviour. Eighty-eight informants were male, 58 were Muslim and 42 were Christian. Informants on average, claimed to know more persons who had completed suicide than those who had attempted suicide. Almost all informants mentioned more than one cause for suicide. Of these, frustration was the most frequently mentioned cause. Most informants believed that suicide attempters are cruel, feared and not trustworthy. Their attitude toward suicide completers was expressed as condemned sinners, do not deserve funeral ceremony, and should be buried separately from others. Christians gave importance to the funeral issue more than did the Muslims. Generally, the attitudes of informants were punitive and disapproving.

  • 4.
    Alem, Atalay
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lynöe, Niels
    Kohn, Robert
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Attitudes and practices among Ethiopian health care professionals in psychiatry regarding compulsory treatment.2002In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 25, no 6, p. 599-610Article in journal (Refereed)
  • 5.
    Alem, Atalay
    et al.
    Arnanuel Psychiatric Hospital, Addis Ababa, Ethiopia.
    Kebede, D
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kullgren, Gunnar
    Suicide attempts among adults in Butajira, Ethiopia.1999In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 100, no S397, p. 70-76Article in journal (Refereed)
    Abstract [en]

    In a cross-sectional survey, 10,468 adults of a rural and semi-urban community were interviewed to determine lifetime suicide attempts. Among the study population, 58% were female, 74.4% were Muslim and 79.3% had had no formal education. The majority of the population were in the age group 25-59 years. Lifetime suicide attempt was reported by 3.2% (n = 332) of the study population. Of these, 63% (n = 208) were women. The most frequent age of attempt was between 15 and 24 years and the frequency of attempt decreased with increasing age. Hanging and poisoning were the most frequently reported methods of attempting suicide. Marital or family conflict was the most frequently reported cause for attempting suicide and most of those who reported this cause were women (Chi-square = 17.42; P < 0.001). Men were significantly more likely to use hanging to attempt suicide than women (Chi-square = 8.21; P < 0.001). Among Christians 3.9% had a lifetime suicide attempt compared to 2.9% among Muslims (Chi-square = 6.15; P < 0.05). People who currently had mental distress and problem drinking reported lifetime suicide attempt more often than others.

  • 6.
    Alem, Atalay
    et al.
    Amanuel Psychiatric Hospital, Addis Ababa, Ethiopia.
    Kebede, D
    Woldesemiat, G
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia.1999In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 100, no S397, p. 48-55Article in journal (Refereed)
    Abstract [en]

    A cross-sectional survey was conducted on 10,468 rural and semi-urban adults in an Ethiopian district using the Self Reporting Questionnaire (SRQ) to detect the prevalence of mental distress and its association with socio-demographic risk factors. Fifty-eight per cent of the study population were women, 74% were Muslim, 79% were illiterate. Those experiencing 11 or more symptoms out of the 20 SRQ items were considered as having mental distress. Accordingly, the prevalence of mental distress was 17%, which is comparable with the previous hospital-based studies in Ethiopia and elsewhere. However, it was higher than the previous community-based studies in Ethiopia. Mental distress was more prevalent among women. Part of the explanation was that women in the study population were older and that they were more often widowed or divorced, which were factors associated with mental distress. Illiteracy, which was more common among women and older individuals, was also independently associated with mental distress.

  • 7. Allard, Christina
    et al.
    Axelsson, Per
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Brännlund, Isabelle
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Cocq, Coppélie
    Umeå University, Faculty of Arts, Department of language studies.
    Hjortfors, Lis-Mari
    Umeå University, Faculty of Arts, Department of language studies. Umeå University, Faculty of Arts, Centre for Sami Research.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Ledman, Anna-Lill
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Löf, Annette
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Johansson Lönn, Eva
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Moen, Jon
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    Nordin, Gabriella
    Umeå University, Arctic Research Centre at Umeå University.
    Nordlund, Christer
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Norlin, Björn
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Outakoski, Hanna
    Umeå University, Faculty of Arts, Department of language studies.
    Reimerson, Elsa
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Sandström, Camilla
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Sandström, Moa
    Umeå University, Faculty of Arts, Centre for Sami Research. Umeå University, Faculty of Arts, Department of language studies.
    Sehlin MacNeil, Kristina
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Sköld, Peter
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Stoor, Krister
    Umeå University, Faculty of Arts, Department of language studies.
    Storm Mienna, Christina
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Svonni, Charlotta
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Vinka, Mikael
    Össbo, Åsa
    Umeå University, Faculty of Arts, Department of language studies.
    Rasbiologiskt språkbruk i statens rättsprocess mot sameby2015In: Dagens Nyheter, ISSN 1101-2447Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.

  • 8. Bergkvist, Per Henrik
    et al.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kling, Sofia
    Silviken, Anne
    Sköld, Peter
    Umeå University, Faculty of Arts, Centre for Sami Research. Umeå University, Arctic Research Centre at Umeå University.
    Stoor, Jon Petter
    Breaking the silence: suicide prevention through storytelling among indigenous Sami2016In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, p. 56-56Article in journal (Refereed)
  • 9.
    Caldera, Trinidad
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Penayo, Ulises
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Is treatment in groups a useful alternative for psychiatry in low-income countries? An evaluation of a psychiatric outpatient unit in Nicaragua.1995In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 92, no 5, p. 386-91Article in journal (Refereed)
    Abstract [en]

    Centro de Atención Psicosocial in León, Nicaragua is a psychiatric outpatient unit that has developed a group-oriented model of working, in which 80% of all visits are in groups: first-admission groups, insight-oriented group psychotherapy, psycho-educative, family groups and relatives groups. The aim of the present study was to analyze patient characteristics and make a preliminary study of improvement, compliance and patient satisfaction in a 1-year perspective. One hundred consecutive visits were assessed, 44 of them first admissions. They were assessed according to all axes of DSM-III-R plus the Structural Clinical Interview for DSM-III Disorders. A 1-year follow up was conducted on 39 of 41 selected patients within the major diagnostic groups. One of 4 patients had a psychotic disorder where schizophrenia dominated. Among nonpsychotics major depression, anxiety and adjustment disorders were most frequent. Personality disorders were common (80%) among nonpsychotic patients, paranoid, obsessive-compulsive, passive-aggressive and masochistic personality disorders dominating. The illiteracy rate was 10%, but 50% had high school or university background. Severity of mental disorders and functional level did not differ between educational levels. There was a strong male dominance in all diagnostic, socioeconomic and educational level strata and few old patients. Improvement in functional level was clinically and statistically significant in all groups, and more than two thirds were very satisfied with the group treatment offered.

  • 10. Daerga, Laila
    et al.
    Sjolander, Per
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Edin-Liljegren, Anette
    The confidence in health care and social services in northern Sweden: a comparison between reindeer-herding Sami and the non-Sami majority population2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 6, p. 516-522Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate the confidence in primary health care, psychiatry and social services among the reindeer-herding Sami and the non-Sami population of northern Sweden. Methods: A semi-randomized, cross-sectional study design comprising 325 reindeer-herding Sami (171 men, 154 women) and a control population of 1,437 non-Sami (684 men, 753 women). A questionnaire on the confidence in primary health care, psychiatry, social services, and work colleagues was distributed to members of reindeer-herding families through the Sami communities and to the control population through the post. The relative risk for poor confidence was analyzed by calculating odds ratios with 95% confidence intervals adjusted for age and level of education. Results: The confidence in primary health care and psychiatry was significantly lower among the reindeer-herding Sami compared with the control group. No differences were found between men and women in the reindeer-herding Sami population. In both the reindeer-herding Sami and the control population, younger people (<= 48 years) reported significantly lower confidence in primary health care than older individuals (>48 years). Conclusions: A conceivable reason for the poor confidence in health care organizations reported by the reindeer-herding Sami is that they experience health care staff as poorly informed about reindeer husbandry and Sami culture, resulting in unsuitable or unrealistic treatment suggestions. The findings suggest that the poor confidence constitutes a significant obstacle of the reindeer-herding Sami to fully benefit from public health care services.

  • 11.
    Edin-Liljegren, Anette
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Västerbottens läns landsting.
    Daerga, Laila
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Västerbottens läns landsting.
    Sahlén, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Institutionen för omvårdnad.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Psychosocial Perspectives on Working Conditions among Men and Women in Reindeer Breeding in Sweden2017In: Journal of Northern Studies, ISSN 1654-5915, Vol. 11, no 2, p. 31-47Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this project was to describe the work organisation in the Sami communities and in reindeer-herding work and to explore the range of female duties and compare how men and women experience their psychosocial working conditions. Design: A kind of intervention study was performed by means of a questionnaire sent out to 200 individuals from seven Sami communities. Questions were asked about work organisation, communication, personal relations, solitary work, support, participation and appreciation from colleagues and women's tasks. Meetings and discussions were held about what was perceived as being important in the life of the Sami communities. Notes from 16 group discussions were written down and analysed according to themes of topics relating to how men and women in the Sami communities experience their lives. Results: Communication and relations were described as being inadequate and some respondents experienced a heavy workload. The women reported more troubled relations, less participation in decision-making and less appreciation from colleagues. Positive issues reported were the Sami identity and a strong connection to the reindeer and to nature. Conclusions: This study indicates a need for a more systematic study of the psychosocial work conditions in the Sami communities in Sweden. Measures should be taken to develop the organisation of work, e.g. through developing communication strategies and conflict management, which has been requested by several Sami communities.

  • 12.
    Edin-Liljegren, Anette
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sahlen, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Daerga, Laila
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Reindeer-herding Sami experiences of seeking care in the mainstream society2016In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, no 33200Article in journal (Refereed)
  • 13.
    Forsgren, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Ghanean, Helia
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Richter, Jorg
    On the experience of stigma by persons with epilepsy in Sweden and Iran: a comparative study2013In: Seizure, ISSN 1059-1311, E-ISSN 1532-2688, Vol. 22, no 9, p. 748-751Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this paper is to compare the experience of stigma by persons with epilepsy in Sweden and Iran.

    METHOD: An adapted version of the Internalized Stigma of Mental Illness Scale was completed by 130 persons with epilepsy in Tehran and 93 patients at a neurology clinic in Sweden.

    RESULTS: The Swedish subjects reported a significantly lower level of experienced stigmatization than the Iranian patients, which we think is an effect of a more individualized medical treatment and a longer experience of health education in the Swedish society.

    CONCLUSION: Improved seizure control, legislative measures and health education are major contributory factors for stigma reduction in a society as regards epilepsy and probably also other medical conditions.

  • 14.
    Ghanean, Helia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nojomy, Marzieh
    Self-perception of stigma in persons with epilepsy in Tehran, Iran2013In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 28, no 2, p. 163-167Article in journal (Refereed)
    Abstract [en]

    Epilepsy is one of the most stigmatizing medical conditions worldwide. It could be argued that the problem of stigma and discrimination might be different in an Islamic culture. A cross-sectional study of 130 patients with epilepsy was performed using the Internalized Stigma of Mental Illness (ISMI) questionnaire that was adapted for epilepsy. The questionnaire contained 29 items on a 4-point scale in addition to an open-ended question about experience of discrimination. An average score above the midpoint (2.5) is suggested to indicate a high level of stigma. Approximately 23.7% of the patients reported a score above the midpoint. Unemployment and low education were significantly associated with a high level of internalized stigma. Although epilepsy can be effectively treated, patients in Tehran still experience much stigma. For this reason, strategies for reducing self-perception of stigma should be included in a treatment plan.

    (C) 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  • 15.
    Ghanean, Helia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nojomi, M
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Community study on attitudes to and knowledge of mental illness in TehranIn: Stigma Research and Action, ISSN 2210-5174Article in journal (Refereed)
  • 16.
    Ghanean, Helia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nojomi, M
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Internalized stigma of mental illness in Tehran, Iran2011In: Stigma Research and Action, ISSN 2210-5174, Vol. 1, no 1, p. 11-17Article in journal (Refereed)
  • 17.
    Ghanean, Helia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nojomi, M.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Public awareness and attitudes towards epilepsy in Tehran, Iran2013In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Background: Epilepsy is a prototypical, stigmatised disorder. Numerous studies have been conducted regarding the public perception of epilepsy, but they are primarily from high-income western countries; few studies have taken place in low-to middle-income countries with a traditional culture and a religious orientation. Objective: The public knowledge and attitudes towards epilepsy in Tehran, Iran, is studied. Design: A survey of 800 subjects ranging from 18 to 85 years was randomly chosen from households in Tehran in 2009. The questionnaire used was based on the Caveness and Gallup's studies conducted in the United States in 1949 and it has been used in numerous similar studies all over the world. The mean age of the participants was 37.5 years and 46.7% were female. Pearson's Chi-squared test was used for subgroup analyses. Results: The majority of subjects cited brain disorders as a cause of epilepsy, while 17% indicated the will of God as the cause. Most individuals were willing to work with a person with epilepsy, allow their children to play with a child with epilepsy, and allow people with epilepsy to use public transportation (78-82%). However, only 28% were willing to accept the marriage of a family member to someone with epilepsy. Conclusion: The knowledge and attitudes towards epilepsy are similar to those in Europe, with the exception of a much lower acceptance regarding marriage to a person with epilepsy. However, the low acceptance for marrying someone with epilepsy reveals the remaining misconceptions about the nature of epilepsy in Iran, despite the high educational level in the studied population. Therefore, informational efforts must be employed to change the perception of epilepsy.

  • 18. Grunewald, Karl
    et al.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Markström, Urban
    [The child or the bathing water? - The psychiatry reform again]2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 6, p. 496-8Article in journal (Refereed)
  • 19. Grunewald, Karl
    et al.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Markström, Urban
    [The psychiatric reform was necessary! Normalized life conditions for tens of thousands of persons].2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 4, p. 307-8Article in journal (Refereed)
  • 20. Ineland, Lisa
    et al.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Sjölander, Per
    Attitudes towards mental disorders and psychiatric treatment--changes over time in a Swedish population.2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 3, p. 192-7Article in journal (Refereed)
    Abstract [en]

    Over the years a lot of research of attitudes towards mental disorders, towards people with mental illness and towards psychiatric services and treatment have shown a persistent negative attitude. There are, however, few studies on changes over time. The aim of this study was to compare responses to a questionnaire on attitudes towards mental disorders and psychiatric patients and the perception of psychiatric treatment in a community in northern Sweden in 1976 and 2003. In 1976 a random sample of 391 persons 18-70 years of age were asked and in 2003 a new sample of 500 persons from the same community were approached with the same questions. There are considerable changes over time. In 2003, almost 90% agree to the statement that mental illness harms the reputation more than physical illness, compared with 50% in 1976. In 2003, 51% agreed to the statement "Most people with mental disorders commit violent acts more than others" compared with 24% in 1976. There is an apparent ambivalence towards psychiatric treatment. Whilst 88% would advice a person with mental problems to contact a psychiatrist, still 26% would not like themselves to be referred to a psychiatrist. We argue that improving treatment methods is as important as changing attitudes through accurate information.

  • 21.
    Jacobsson, L
    Umeå University, Faculty of Medicine, Department of Clinical Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    The transition from mental hospital based to community based psychiatry.1999In: Medicinski arhiv, ISSN 0350-199X, Vol. 53, no 3, p. 131-3Article in journal (Refereed)
    Abstract [en]

    The reformation of psychiatry has been a central topic in health planning and care in most industrialized countries during the last decades. A short review of the political, professional and other forces behind this development is done. A short history of the development in Sweden is given as an example of the general tendencies in this change and the actors involved. There is now a rapidly growing scientific basis for the psychiatric service with a definite shift into a community based orientation. It is concluded that early intervention and prevention will be in focus for the development during the next decades.

  • 22.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    [Also physicians must interpret laws: not only the lawyers]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 22, p. 1448-1449Article in journal (Refereed)
  • 23.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    "Bra karl reder sig själv - om inte så...!?": om det manliga självmordet2014In: Psykisk hälsa, ISSN 0033-3212, Vol. 55, no 3, p. 28-33Article in journal (Other academic)
  • 24.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Existentiella samtal lika viktiga som suicidpreventiva riskbedömningar2014In: Psykisk hälsa, ISSN 0033-3212, Vol. 55, no 1, p. 62-66Article in journal (Other academic)
  • 25.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    [How we can get more researching psychiatrists].2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 7, p. 464-5Article in journal (Refereed)
  • 26.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Law and mental health: on the role of lawmaking in the process of developing psychiatric care1998In: Medicine and law, ISSN 0723-1393, Vol. 17, no 4, p. 571-579Article in journal (Refereed)
    Abstract [en]

    Mental health (as well as somatic health) depends on individual biological, psychological and social factors as well as more general societal factors. If one wishes to promote health, it is necessary to work in many different fields hopefully in a synergistic way. As a psychiatrist and clinician one is inclined to believe that developments in psychiatric science and practice are the most important activities to improve the mental health situation in a population. But, at the same time it is apparent that societal processes of social, political and economic nature also play a decisive role. One of the most important factors in the development of society is lawmaking by which its nature is setting the norms in a society and which is also usually combined with some kind of sanction system to support the norms. Lawmakers also have the possibility to interfere in the process of developing knowledge and practice in different fields, for example through supporting treatment and research of a special kind or even to forbid special kinds of treatment and research in certain areas. Lawmakers are also inclined to believe that if there is a law this will be enough to answer these challenges. I think it is extremely important that lawmaking in the field of mental health is in broad agreement with the development in the scientific and practical field of psychiatry and other mental health disciplines. This is the subject of this paper.

  • 27.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Living in conflict: talks with reindeer herding sami in southern Swedish Sápmi with special reference to psychosocial conditions2012In: Rivers to cross: Sami land use and the human dimension / [ed] Peter Sköld & Krister Stoor, Umeå: Vaartoe, Centrum för samisk forskning, Umeå universitet , 2012, p. 30-39Chapter in book (Other academic)
  • 28.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Om kritiken av psykvården2014In: Västerbotten, ISSN 0346-493-8, no 3, p. 49-53Article in journal (Other (popular science, discussion, etc.))
  • 29.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    On the picture of depression and suicide in traditional societies1988In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 344, p. 55-63Article in journal (Refereed)
    Abstract [en]

    The paper deals with three problem areas regarding depression and suicide in traditional society; 1) What is the relation between the depression and suicide? 2) Is there any illness like depression all over the world? 3) What do we know about suicide in traditional societies? The author agrees with Dürkheim's classical conclusion that the incidence of suicide in a society has no clear correlation with the prevalence of mental disorders and no clear correlation with different forms of mental disorders. There are a number of studies showing that depressive syndromes exist in traditional societies. However, there is a clear difference in symtomatology between different cultures which might be the result of differences in the conception of illness. The suicide rate is generally very low in traditional societies. The ultimate solution to an unbearable life situation is apparently known to all human cultures and the suicide rate is an important indication in every society of the existential conditions of life.

  • 30.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    [Suicide not only psychiatry's responsibility!]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 3, p. 84-85Article in journal (Refereed)
  • 31.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    The roots of stigmatization.2002In: World psychiatry : official journal of the World Psychiatric Association (WPA), ISSN 1723-8617, Vol. 1, no 1, p. 25-Article in journal (Refereed)
  • 32.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    "Therapeutic abortion" on demand: a social-psychiatric study of some background factors in legal abortion1975Doctoral thesis, comprehensive summary (Other academic)
  • 33.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Umeå University, Arctic Research Centre at Umeå University.
    Fagerström, Anna
    Centre for Rural Medicine, County Council of Västerbotten, Umeå University, Umeå , Sweden.
    Daerga, Laila
    Centre for Rural Medicine, County Council of Västerbotten, Umeå University, Umeå , Sweden.
    Edin-Liljegren, Anette
    Centre for Rural Medicine, County Council of Västerbotten, Umeå University, Umeå , Sweden.
    Experiences of Psychiatric Care among Young Sami in Northern Sweden2016In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, no 33200Article in journal (Refereed)
  • 34.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Ghanean, Helia
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Törnkvist, Birgitta
    Internalized stigma of mental illness in Sweden and Iran: a comparative study2013In: Open Journal of Psychiatry, ISSN 2161-7325, E-ISSN 2161-7333, Vol. 3, no 4, p. 370-374Article in journal (Refereed)
  • 35.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lagerkvist, Bengt
    Folke Bernadottehemmet, Uppsala.
    [Support for ambulatory psychiatry and social work in Bosnia-Herzegovina. About 70 different projects are assisted by Sweden]1998In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 95, no 50, p. 5785-5786Article in journal (Other academic)
  • 36.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Merdasa, F
    Traditional perceptions and treatment of mental disorders in western Ethiopia before the 1974 revolution1991In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 84, no 5, p. 475-481Article in journal (Refereed)
    Abstract [en]

    This article describes the traditional concepts and treatment of mental disorders in the Oromo areas in western Ethiopia before the revolution in 1974. There are three traditional cultural influences operating: traditional Oromo thinking, the Coptic church and the Islamic culture. One important element in traditional Oromo thinking is that each person is believed to possess an ayana, which is a special divine agent that can descend upon people, but also means a person's character and personality. In the traditional Oromo society, the Kallu is the religious leader who, through an ecstatic ritual technique, can investigate the causes of the disorder and advise what to do. Mental disorders are generally explained as resulting from disturbances in the relationship between people and divinity. The second important cultural element in western Ethiopia is the orthodox Coptic church, which usually looks upon mental disorders as possession by evil spirits, which are thus treated by specially gifted priests and monks by praying and giving holy water or eventually exhortation. According to Islamic teaching in the area, mental disorders are caused by evil spirits sent by God to punish the unfaithful people. Some Muslim sheiks treat mental cases with prayers, but herbal remedies are also used. There is a great intermingling of these different cultural and religious elements and people attend different healers and religious leaders more depending on the reputation of the person than on cultural and religious affiliation.

  • 37.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    On suicide and suicide prevention as a public health issue.1999In: Medicinski arhiv, ISSN 0350-199X, Vol. 53, no 3, p. 175-7Article in journal (Refereed)
    Abstract [en]

    Suicide is becoming one of the major causes of death especially amongst men. In Europe suicide is the second most common cause of death in the ages of 15-44 years. For women in the same age group suicide is the fourth most common cause of death. Suicide causes a lot of suffering not only in the victim but also in persons close to him. As the causative factors are complex, and suicide also costs the community a lot of money suicide and self destructive behavior must be considered an important public health issue. A couple of models which are helpful when trying to develop treatment and preventive strategies for suicided persons are presented. The basic principles for contemporary suicide prevention programmes are also described.

  • 38.
    Kaiser, Niclas
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nordström, Annika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Renberg, Ellinor Salander
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Hazardous drinking and drinking patterns among the reindeer-herding Sami population in Sweden2011In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 46, no 10, p. 1318-1327Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate hazardous drinking among reindeer-herding Sami in Sweden. A cross-sectional questionnaire study was conducted in 2007, which included the Alcohol Use Disorder Identification Test. A total of 319 reindeer-herding Sami were compared with urban and rural reference populations of 1,393 persons. Data were analyzed with regard to population, gender, age group, education, anxiety, depression, and work-related stress. The Sami population did not report a higher prevalence of hazardous drinking compared with the reference groups; however, subgroups of Sami men with symptoms of depression were revealed as at risk, in contrast to Sami women who were not found to be at risk at all. Limitations of the study are discussed.

  • 39.
    Kaiser, Niclas
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Sjölander, Per
    Southern Lapland Research Department.
    Edin Liljegren, Anette
    Southern Lapland Research Department.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Depression and anxiety in the reindeer-herding Sami population of Sweden2010In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 69, no 4, p. 383-393Article in journal (Refereed)
    Abstract [en]

    Objectives. The objective of this study was to investigate symptoms and predicting factors of depression and anxiety among reindeer-herding Sami in Sweden. Study design. A total of 319 reindeer-herding Sami (168 men, 151 women) were compared with urban and rural reference populations comprising 1,393 persons (662 men, 731 women). Methods. A cross-sectional questionnaire study on mental health, which included the Hospital Anxiety and Depression Scale (HADS). Data were analysed with regard to population, gender, age group, education and work-related stress. Results. The Sami population disclosed higher mean values for both depression and anxiety than the reference groups, with Sami men reporting the highest rates. Work-related stress was associated with anxiety and depression in the Sami group. Conclusions. By comparing Sami men and women with reference groups of men and women living in urban and rural areas in northern Sweden, this study identified that reindeer-herding Sami men require special attention with regard to mental health problems.

  • 40. Kebede, D
    et al.
    Alem, Atalay
    Dept. of Community Health, Addis Ababa University, Addis Ababa, Ethiopia.
    Shibre, Teshome
    Negash, Alemayehu
    Fekadu, A
    Fekadu, Daniel
    Deyessa, Negussie
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Onset and clinical course of schizophrenia in Butajira-Ethiopia--a community-based study.2003In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 38, no 11, p. 625-631Article in journal (Refereed)
    Abstract [en]

    Background:

    There are reports on favourable course and outcome of schizophrenia in lowincome countries. The aim of the present study was to examine onset and clinical course of the illness in a community-based sample in rural Ethiopia based on crosssectional information.

    Method:

    A two-stage survey was carried out in Butajira-Ethiopia, a predominantly rural district. Altogether 68,378 individuals aged 15–49 years were CIDI-interviewed, of whom 2,159 were identified as cases according to the CIDI interview with regard to psychotic or affective disorders. Key informants identified another group of 719 individuals as being probable cases and a total of 2,285 individuals were SCAN-interviewed. The present paper reports on cases with schizophrenia.

    Results:

    There were 321 cases of schizophrenia giving an estimated lifetime prevalence of 4.7/1,000). Of the cases,83.2% (N = 267) were males. Mean age of first onset of psychotic symptoms for males was 23.8 (sd 8.6) compared to 21.0 (sd 7.8) for females (P = 0.037; 95 %CI 0.16–5.47). Over 80% had negative symptoms and over 67% reported continuous course of the illness. Less than 10% had a history of previous treatment with neuroleptic medication. About 7% were vagrants, 9 % had a history of assaultive behaviour,and 3.8% had attempted suicide. The male to female ratio was nearly 5:1.

    Conclusion:

    This large community-based study differs from most previous studies in terms of higher male to female ratio, earlier age of onset in females and the predominance of negative symptoms.

  • 41.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Legal abortion: a painful necessity2001In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 53, no 11, p. 1481-1490Article in journal (Refereed)
    Abstract [en]

    This study was conducted to increase knowledge about the psychosocial background and current living conditions of Swedish women seeking abortion, along with their motives for abortion and their feelings towards pregnancy and abortion. Two hundred and eleven women answered a questionnaire when they consulted the gynaecologist for the first time. The study indicates that legal abortion may be sought by women in many circumstances and is not confined to those in special risk groups. For example, most women in the sample were living in stable relationships with adequate finances. The motives behind a decision to postpone or limit the number of children revealed a wish to have children with the right partner and at the right time in order to combine good parenting with professional career. The study shows that prevailing expectations about lifestyle render abortion a necessity in family planning. One-third of the women had had a previous abortion(s) and 12% had become pregnant in a situation where they had felt pressured or threatened by the man. Two-thirds of the women characterised their initial feelings towards the pregnancy solely in painful words while nearly all the others reported contradictory feelings. Concerning feelings towards the coming abortion, more than half expressed both positive and painful feelings such as anxiety, relief, grief, guilt, anguish, emptiness and responsibility, while one-third expressed only painful feelings. However, almost 70% stated that nothing could change their decision to have an abortion. Thus, this study highlights that contradictory feelings in relation to both pregnancy and the coming abortion are common but are very seldom associated with doubts about the decision to have an abortion.

  • 42.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    The male partner involved in legal abortion1999In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 14, no 10, p. 2669-2675Article in journal (Refereed)
    Abstract [en]

    This study comprises 75 men who have been involved in legal abortion. The men answered a questionnaire concerning living conditions and attitudes about pregnancy and abortion. Most men were found to be in stable relationships with good finances. More than half clearly stated that they wanted the woman to have an abortion while 20 stressed that they submitted themselves to their partner's decision. Only one man wanted the woman to complete the pregnancy. Apart from wanting children within functioning family units, the motivation for abortion revealed that the desire to have children depended on the ability to provide qualitatively good parenting. More than half the men had discussed with their partner what to do in event of pregnancy and half had decided to have an abortion if a pregnancy occurred. More than half expressed ambivalent feelings about the coming abortion, using words such as anxiety, responsibility, guilt, relief and grief. In spite of these contradictory feelings, prevailing expectations concerning lifestyle make abortion an acceptable form of birth control. A deeper understanding of the complexity of legal abortion makes it necessary to accept the role of paradox, which the ambivalence reflects. Obviously, men must constitute a target group in efforts to prevent abortions.

  • 43. Kjellin, Lars
    et al.
    Andersson, Kristina
    Bartholdson, Erik
    Candefjord, Inga-Lill
    Holmstrom, Helge
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Wallsten, Tuula
    Östman, Margareta
    Coercion in psychiatric care: patients' and relatives' experiences from four Swedish psychiatric services2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, no 2, p. 153-159Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore possible regional differences in the use of coercion in psychiatric care as experienced by patients and relatives. At four psychiatric care settings in different parts of Sweden, 138 committed and 144 voluntarily admitted patients were interviewed at admission using the Nordic Admission Interview. At discharge or, if the care episode was still ongoing, after 3 weeks of care, a follow-up patient interview and an interview with 162 relatives of these patients took place. In one of the centers, where involuntarily admitted patients were treated without locking the doors of the wards, the patients reported less coercion at admission than in the other three centers. Regarding the patients' reports of the use of coercive measures, personal treatment and outcome of care, and concerning the relatives' experiences, few differences were found between centers among committed and voluntarily admitted patients, respectively. Coercion in psychiatric care, as reported by patients and relatives, was not always legally based, and many of the patients reported they felt violated during the admission process. Only a minority of patients and relatives reported participation in treatment and care planning, as regulated by law. Still, a majority of both committed and voluntarily admitted patients reported they had been well treated by the personnel at admission as well as during the stay at the ward, and that they had been improved in their mental health after the psychiatric care episode.

  • 44.
    Kullgren, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lynöe, N
    Kohn, R
    Levav, I
    Practices and attitudes among Swedish psychiatrists regarding the ethics of compulsory treatment.1997In: Medicine and law, ISSN 0723-1393, Vol. 16, no 3, p. 499-507Article in journal (Refereed)
  • 45.
    Kullgren, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lynöe, N
    Kohn, R
    Levav, I
    Practices and attitudes among Swedish psychiatrists regarding the ethics of compulsory treatment.1996In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 93, no 5, p. 389-96Article in journal (Refereed)
    Abstract [en]

    Few empirical studies have examined the attitudes and ethical beliefs of psychiatrists. In this study, 328 members of the Swedish Psychiatric Association were randomly selected to respond to a questionnaire containing three clinical vignettes examining involuntary hospitalization, other compulsory interventions, and restraint. The questionnaire also contained 16 controversial statements and items on the abuse of psychiatry. A 60% response rate was obtained. Psychiatrists' responses were influenced not only by the severity of and risks associated with the patient's disorder, but also by family pressure which affected the decision-making process. Female psychiatrists less often suggested the use of physical restraints and the compulsory use of ECT. Sexual misconduct, and also the inadequate treatment of refugees, were the most frequently reported forms of abuse of psychiatry.

  • 46.
    Kullgren, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    An empirical study of borderline personality disorder and psychiatric suicides.1986In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 174, no 6, p. 328-31Article in journal (Refereed)
    Abstract [en]

    Borderline personality disorder (BPD) is closely related to suicidal behavior, and suicide attempts per se are considered a diagnostic criterion. However, there has been no previous study of completed suicides and BPD. The present study is based on a population of 134 consecutive psychiatric suicides from 1961 to 1980 in a catchment area of 250,000 inhabitants. Clinical records were retrospectively diagnosed according to the Diagnostic Interview for Borderlines and DSM-III. There was a progressive increase in proportion of borderline suicides during the time period. The overall proportion of BPD, however, was only 12%, indicating that borderline patients are not seriously overrepresented among patients committing psychiatric suicides. Demographic variables, earlier psychiatric care, and suicidal behavior in the borderline group are described and analyzed.

  • 47. Lagerkvist, Bengt
    et al.
    Maglajlic, R A
    Puratic, V
    Susic, A
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Assessment of community mental health centres in Bosnia and Herzegovina as part of the ongoing mental health reform.2003In: Medicinski arhiv, ISSN 0350-199X, Vol. 57, no 1, p. 31-8Article in journal (Refereed)
    Abstract [en]

    In summary it seems reasonable to state that around 5000 individual service users are visiting the CMHCs in Bosnia and Herzegovina during one week. Approximately 60% of them have mental health problems, around 25% come for non mental medical disorders and around 15% are healthy and come for check ups or certificates. The average CMHC cater for about 65,000 inhabitants with a staff of one psychiatrist, three nurses and 0.7 psychologist and social worker respectively. Most of them have training for tasks within mental health services. The progress of the mental health reform is positive with more CMHCs opened, and basically staffed with trained personnel. They offer a variety of services practiced with a modern strategy. Most personnel has changed their attitudes to mental health itself and the relevant service provision and hence devoted to implement the mental health reform. They would like to have more influence on decision making and present constructive suggestions for future service and policy improvements. The service users are almost all of them very satisfied with the service provided.

  • 48.
    Lalos, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lalos, Othon
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Stendahl, U
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Experiences of the male partner in cervical and endometrial cancer: a prospective interview study1995In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 16, no 3, p. 153-165Article in journal (Refereed)
    Abstract [en]

    This article focuses on social, psychological and sexual experiences of 47 men before their partner was treated for cervical or endometrial cancer and 1 year later. As a complement to the interviews the men completed a symptom check-list. Before initiation of treatment, a great majority of the men were in psychological crisis. The number of psychological symptoms decreased from the first to the last interview. Symptoms with psychosomatic character increased, however, considerably. In the endometrial group, several had intrapsychic problems, while interpersonal problems were more common in the cervical group. Both groups found it difficult to know how to behave and how to communicate with their partner, friends and acquaintances. A majority had nobody to whom they could speak honestly, and most did not obtain basic information about their partner's disease. The experiences of intercourse were much more negative after completed treatment and a majority described impaired sexual desire. Provided that the woman herself desires it, the coping and rehabilitation of the woman, the man and the couple would improve if the male were integrated in the care program from the moment the diagnosis of cancer is made.

  • 49.
    Lalos, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lalos, Othon
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    von Schoultz, Bo
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    The wish to have a child: a pilot-study of infertile couples1985In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 72, no 5, p. 476-481Article in journal (Refereed)
    Abstract [en]

    All women (n = 30) who were to undergo microsurgical treatment for tubal infertility, and their partners (n = 29), were subject to individual interviews just before and 2 years after the tubal surgery. Initially, they answered an open question concerning their wish to have a child and then were asked to choose from a list of 36 alternatives, a maximum of five motives for having a child. The infertile couples' motives were compared with those of three reference groups: one group of 30 who had decided to continue their pregnancy, another group of 101 women who also planned to continue pregnancy and a third group of 459 women applying for legal abortion. All motives on the list were categorized as "philosophical", "social/cultural", "interpersonal" and "intrapsychic" motives. The interpersonal and intrapsychic motives dominated both the infertile women and their partners. A central motive was that a child is an ultimate expression of love between a man and a woman. The motives of the infertile couples, generally, did not differ from those of the reference groups.

  • 50.
    Lalos, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Othon
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    von Schoultz, Bo
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    A psychosocial characterization of infertile couples before surgical treatment of the female1985In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 4, no 2, p. 83-93Article in journal (Refereed)
    Abstract [en]

    Social background and personality characteristics were examined in 30 infertile women with tubal damage and their 29 men. The emotional and social impact of their infertility was investigated using symptom checklists, the Eysenck Personality Inventory and interviews. The infertile couples did not differ with respect to psychosocial background, current life situation, neuroticism or personality characteristics when compared to psychologically normal controls. The infertility had severe emotional and social effects. Grief, depression, guilt, feelings of inferiority and isolation were commonly reported. The women openly admitted more symptoms than their men. Marital relationship was often affected and in particular the effect on sexual life was negative. Relatives and friends could not fulfill a supportive function, and all couples expressed their need for professional support and counselling.

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