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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.
    Andreen, Johan
    et al.
    Nationellt centrum för suicidforskning och prevention av psykisk ohälsa, Karolinska institutet, Sweden.
    Herlofson, Jörgen
    [NO CONNECTION TO ANY AFFILIATION IN XML].
    Einhorn, Stefan
    Karolinska institutet, Centrum för social hållbarhet, Sweden.
    Holm, Herman
    Malmö psykiatri, Sweden.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Nyberg, Ullakarin
    Norra Stockholms psykiatri, Svenska psykiatriska föreningen, Sweden.
    Rosengren, Ludmilla
    Rosengrens läkartjänst, Sweden.
    Åsberg, Marie
    Karolinska institutet, Danderyds sjukhus, Sweden.
    Gör »mötet« till obligatoriskt kompetensområde: För att vårdarbetet ska kunna nå sin fulla potential bör mötesdimensionen införas som nytt kompetensområde i all utbildning och vård2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 41, article id D9YCArticle in journal (Other academic)
  • 9.
    Anne, Ouma
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Sámi traditional medicine and complementary and alternative medicine: a descriptive study of use within the Sámi population of Sweden2023In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 82, no 1, article id 2222908Article in journal (Refereed)
    Abstract [en]

    Traditional medicine has been practised for millennia in the Sámi population, based on a Sámi worldview and cosmology, which includes natural remedies, prayers, drums and yoik singing. During the Christianisation of the Sámi during the seventeenth and eighteenth centuries, these practices were condemned. In recent years, however, a revival of Sámi culture has occurred and so has the practice of Sámi traditional medicine (STM) and the use of complementary alternative medicine (CAM). The aim of this study is to map the prevalence and use of STM and CAM among Sámi in Sweden today. The study population consisted of 3641 Sámi from the whole of Sweden, who had participated in the population-based cross-sectional survey Sámi Health on Equal Terms (SámiHET) in 2021. Our results show that women are more prone to use both STM and CAM than men and that younger persons are more likely to use STM and CAM than elderly persons. STM is more often used in the northern parts of Sápmi compared to the southern parts as well as a lower use of CAM in the north. This might be due to the stronger Sámi identity and easier access to traditional Sámi healers/helpers in the north as well as limited access to CAM services.

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  • 10. 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)
  • 11.
    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.

  • 12. 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.

  • 13.
    Edin-Liljegren, Anette
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Centre for Rural Medicine, Primary Health Care, County Council of Västerbotten, Storuman, Sweden.
    Daerga, Laila
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing. Centre for Rural Medicine, Primary Health Care, County Council of Västerbotten, Storuman, Sweden.
    Sahlén, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing.
    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, E-ISSN 2004-4658, 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.

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  • 14.
    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)
  • 15.
    Ekman, Inger
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Att skada sig själv - ett rationellt val i en problematisk kontext2021In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 98, no 4, p. 717-726Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Självskadande handlingar relateras ofta till psykisk ohälsa vilket medfört att de som skadar sig själva uppfattas vara i behov av psykologisk eller psykiatrisk behandling. Med hänvisning till att ett stort antal ungdomar skadar sig själva finns anledning att ompröva konnotationen mellan självskadande handlingar och psykisk problematik. För att förstå ungdomars självskadande handlingar bör dessa relateras till en sociokulturell kontext med fokus på unga människors handlingsutrymme. Att skada sig själv kan vara en strategi för att hantera de känslor som kan uppstå i problematiska situationer inom familj eller skola. Vi argumenterar för vikten av ett samhälleligt preventivt arbete för att motverka att ungdomar börjar skada sig själva, och menar att konkreta åtgärder i den sociala kontexten även kan stödja dem som redan börjat skada sig.

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  • 16.
    Ekman, Inger
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    On the Risks of Medicalization of Adolescents Self-Injuring Acts2021In: Open Journal of Psychiatry, ISSN 2161-7325, E-ISSN 2161-7333, Vol. 11, no 1, p. 29-46Article in journal (Refereed)
    Abstract [en]

    Although common among community adolescents, self-injuring acts are mainlystudied by psychiatrists and psychologists and rarely by social work researchers.The preponderance of medical research in the field has come to associateself-injuring acts with mental issues. This view has to a large extent beenadopted among professionals as well as among laypeople. When examiningadolescents’ unsolicited internet published narratives, this medicalization ofself-injuring acts was found to have negative consequences for disclosure andhelp-seeking, and hence limit the adolescents’ possibilities to get adequate helpand support. The main objective of this work is to study adolescents’ views onhampering factors for help-seeking for self-injuring acts and the role of medicalisationfor their willingness for disclosure and help-seeking. Disclosure ofself-injuring acts within the social network was described as met with demandsto seek professional mental help. Seeking professional help was accompaniedwith fear of being perceived as crazy or diagnosed as mentally ill. Internet websiteswere described as value free and safe arenas giving opportunity to discloseself-injuring acts without fear of being stigmatized and labelled as mentally ill.An extended involvement of social work researchers and professionals, approachingself-injuring acts not primarily as a sign of mental problems, but asan adolescent way of trying to manage a complicated social context, could enhancefinding adequate support systems. It is also necessary that the medicalprofession contributes to a demedicalization of self-injuring acts.

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  • 17.
    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.

  • 18.
    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.

  • 19.
    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 Tehran2015In: Stigma Research and Action, ISSN 2210-5174, Vol. 5, p. 26-30Article in journal (Refereed)
    Abstract [en]

    There are a limited number of studies on attitudes towards mental illness and mentally ill from Islamic countries even though Islam is the second largest of the religious beliefs in the world. An interesting element in Islamic teaching is the idea that mental illness as well as other ailments might be an effect of the will of Allah. This could imply that persons suffering from mental disorders might be less stigmatized. The aim of this study was to determine the knowledge and attitudes towards mental illness in the city of Tehran, Iran. Eight hundred subjects, randomly chosen from 4 districts of Tehran, responded to a modified version of a questionnaire developed by the World Psychiatric Association to reduce stigma because of schizophrenia. The self-completed questionnaire was delivered by 4 trained psychologists. The mean age of the sample was 37.5 years and 53.3% being males. A majority agreed that mental illness could be treated outside the hospital (70%) and 74% thought that mentally ill “can work in regular jobs”. Almost half agreed that “mentally ill are a public nuisance” and that “mentally ill people are dangerous”. One quarter agreed that they “would be ashamed if people knew someone in the family who was diagnosed with mental illness”. Generally males seemed to be more accepting than women. Generally the level of negative attitudes in Tehran population is at the same level as in other countries and cultures studied. Cultural beliefs and Islamic influence on attitudes towards mental illness and mentally ill need further studies. The result indicates a need for further actions to reduce the negative attitudes towards mentally ill in Tehran, Iran.

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  • 20.
    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)
    Download full text (pdf)
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  • 21.
    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.

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  • 22. 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)
  • 23. 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)
  • 24. 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.

  • 25.
    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.

  • 26.
    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)
  • 27.
    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)
  • 28.
    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)
  • 29.
    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)
  • 30.
    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.

  • 31.
    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)
  • 32.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Lundbystudien 1947-1997. Fynd och psykiatriskt tänkande under 50 år2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 19Article, book review (Other academic)
    Abstract [sv]

    Recension av:

    Lundbystudien 1947–1997. Fynd och psykiatriskt tänkande under 50 år Suppl. 28

    Författare: Per Nettelbladt

    Utgivare: Sydsvenska Medicinhistoriska Sällskapet; 2011

    ISBN: 978-91-979260-2-7

  • 33.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Norrlands universitetssjukhus, Umeå, Sweden.
    Läkarkåren är medansvarig för dagens djupa vårdkris2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 14, article id ELC6Article in journal (Other academic)
  • 34.
    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.))
  • 35.
    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.

  • 36.
    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)
  • 37.
    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)
  • 38.
    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)
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    ”Therapeutic Abortion” on Demand
  • 39.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Välkommet förslag till ny tvångsvårdslagstiftning: [Welcome proposal for a new compulsory care law]2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 3, p. 68-69Article in journal (Other (popular science, discussion, etc.))
  • 40.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Anne, Ouma
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Liu-Helmersson, Jing
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Sámi Traditional Healing in Sweden: An Interview Study2021In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 98, no 5 & 6, p. 813-823Article in journal (Refereed)
    Abstract [en]

    Sámi traditional healing has been practiced in the Sápmi region of northern Norway, Sweden, Finland, and Russia for millennia. This study focuses on Sámi traditional healing in Sweden. Through interviews with five active healers and 11 key informants, we found that traditional healing is currently alive in Sweden but hidden. Healers treat health problems ranging from the physical to the spiritual, including mental issues and life’s difficult situations. Low-cost methods are used: spiritual healing with prayers and the laying on of hands, consultation, and herbal remedies. Healing takes place either face-to-face or over distance. Healers charge no money but accept small gifts. Being a healer is a calling. A general concern is voiced by informants about the diminishing number of healers in Sweden.

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  • 41.
    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)
  • 42.
    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)
    Download full text (pdf)
    fulltext
  • 43.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Ompröva diagnostik och behandlingsupplägg vid ADHD2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 9, article id DDRDArticle in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Vägen till diagnosen ADHD bör kortas ner och behandlingsprocessen leda till individualiserat stöd och behandling. Identifierade kunskapsluckor bör täppas till. Bland annat krävs studier kring risken att utveckla beroende vid behandling med centralstimulantia och effekten av olika icke-farmakologiska insatser vid ADHD.

  • 44.
    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)
  • 45.
    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.

  • 46.
    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.

  • 47.
    Jacobsson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Stoor, Jon Petter A.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Suicide among reindeer herding Sami in Sweden, 1961-20172020In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 79, no 1, article id 1754085Article in journal (Refereed)
    Abstract [en]

    This study analyses suicides amongst reindeer herding Sami in Sweden using information from the database of the National Board of Forensic Medicine. Suicides were identified using registers (39 suicides from 1961-2000) and key informants (11 suicides from 2001-2017). A great majority of cases were males (43 males, 7 females), and 50% occurred in the northernmost region. The mean age was 37.4 years with a peak in the group 20-29 years of age. Shooting was the most common (56%) method, followed by hanging. Blood alcohol concentration measures available from 1993 were above 0.2 g/l in 76% of the cases. There was a maximum incidence of suicides between 1981 and 1990. An accumulation of suicides in the months of May (N = 8) and November (N = 7) was seen. The annual suicide rate was estimated to be between 17.5 and 43.9 per 100 000 population. There was a clear gradient in suicide incidence with the highest being in the southernmost region (Jamtland/Harjedalen) and the lowest in the northernmost county (Norrbotten). For strengthened suicide prevention in this group, future research should address sex differences, the role of alcohol use and the general conditions for reindeer herding.

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  • 48.
    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.

  • 49.
    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.

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    FULLTEXT02
  • 50. 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.

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