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  • 1.
    Andersson, S.
    et al.
    Länssjukhuset, Halmstad.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    The aphasic person's views of the encounter with other people: a grounded theory analysis2002In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 3, p. 285-292Article in journal (Refereed)
    Abstract [en]

    Notes that being affected by aphasia influences the total life experience. The aim of this study was to generate a theoretical model, from a nursing perspective, of what 12 aphasic persons (aged 28-92 yrs old) experience in encounters with other people. Data were collected through interviews which adopted a biophysical, socio-cultural and psychological approach and then analyzed using grounded theory method. Two main categories emerged, namely: interaction and support. Encountered experiences led to (1) a feeling of having ability, (2) a feeling of being an outsider, and (3) a feeling of dejection or uncertainty. The feeling state was dependent on whether the interaction was obstructed or secure and on whether the support resulted in strengthened or impaired self-esteem. Therefore, nurses need to give support that enhances patients self-esteem and which results in them gaining a positive and realistic view of their aphasia, as well as involving those around them in this perspective. This then will give the possibility for the patient to turn the interaction process from an obstructed into a secure one.

  • 2.
    Arnell, Erika
    et al.
    Halmstad University, School of Health and Welfare.
    Wahman, Linda
    Halmstad University, School of Health and Welfare.
    Specialistsjuksköterskors erfarenheter av omvårdnad vid suicidproblematik inom psykiatrisk hälso- och sjukvård2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Specialist nurses in psychiatric health care meet patients with suicide problems on a daily basis. Suicide is seen as a public health problem and is a complex area to work with. Aim: was to describe specialist nurses' experiences of nursing in suicide problems in psychiatric health care. Method: Qualitative design with inductiveapproach. Twelve semistructured interviews were analyzed according to qualitative content analysis. Results: The study revealed three categories "The need for continuous and uniform assessments for patient safety","The importance of collegial collaboration as a basis for participation" and "The importance of competence in creating security". The results described the specialist nurse's experience of sometimes feeling alone in suicide risk assessments and thus emphasized the importance of collegial cooperation. Specialist nurses have an important role in meeting patients with suicide problems and in conveying knowledge to colleagues in other organisations. Conclusion: The time to be there for the patients was highlighted as important and the importance of education and supervision was described as significant efforts in the work with patients with suicide problems. 

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  • 3.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, IngelaHögskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Psykiatrisk omvårdnad: att stödja hälsofrämjande processer2006Collection (editor) (Other (popular science, discussion, etc.))
    Abstract [sv]

    oken, den första i sitt slag, har ett hälsofrämjande förhållningssätt både vad gäller att förhindra att psykisk ohälsa uppstår och att förhålla sig till personer som i någon mening drabbats av psykisk ohälsa. Syftet är att locka fram hälsofrämjande processer, att hitta hälsan i det sjuka. Författarna beskriver den vårdande insatsen, mötet och relationen mellan vårdare och patient/vårdtagare. Boken belyser också betydelsen av att övriga sociala relationer fungerar, såväl inom familjen som i övriga samhällslivet.

    (Beskrivning från förlaget)

  • 4.
    Arvidsson, Jenny
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Theodorsson, Linda
    Halmstad University, School of Social and Health Sciences (HOS).
    Den fysiska aktivitetens betydelse för depression2011Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Depression is a disease where scientists are not in agreement on its origin. Research indicates that depression will be the second most common disease in the world year 2020. Physical activity is important for the public health and benefits the individuals both physically and psychologically. The purpose of this literature study was to illustrate the relation between depression and physical activity. The result is based on 14 articles which relate to the purpose. The result showed that persons who are physically active have less risk of suffering from psychological difficulties such as depression. There is also a connection between how much physical activity that is carried out and the degree of depression. The nurse's role is important to prevent and relieve depression. In consultation with the patient, physical activity can be suggested as a complement to medical treatment. It can be enough with a couple of walks per week to prevent beginning of depression as well as ease symptoms for those who already suffer from depression. If more people exercised on a regular basis the frequency of depression would most likely be reduced. Further research in this area should be carried out as well as the implementation of knowledge that already exists. It is important that the beneficial effects, which physical activity has on depression, reach all relevant persons within health and medical care industries and that it is implemented. In conjunction with additional research this can lead to physical activities being partial replacement to medical treatment.

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  • 5.
    Bengtsson, Dennis
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Landberg, Åsa
    Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Jernbro, Carolina
    Karlstads University, Karlstad, Sweden.
    Increased risk of child maltreatment and mental health problems among adolescents with restrictions regarding choice of future partner: Results from a Swedish school-based survey2022In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 8, p. 1133-1139Article in journal (Refereed)
    Abstract [en]

    Background: Honour-related violence and oppression is a violation of human rights and a public health problem. Oppression can be manifested by not being allowed to choose future partners and can increase the risk of abuse and mental health problems. Aims: The aim of this study was to investigate associations between restrictions regarding choice of future partner (RCP), child maltreatment and mental health problems among adolescents in Sweden. Methods: The study was based on cross-sectional data, including a nationally representative sample of 4741 pupils from grade nine in primary school and second year in high school. Pearson’s chi-square tests and binary logistical regression analyses adjusting for socio-demographic factors were conducted. Results: RCP was significantly associated to child maltreatment, including poly-victimisation, and mental health problems. In the adjusted analysis, an increased risk for all types of maltreatment, poly-victimisation (adjusted odds ratio (aOR) 10.2, confidence interval (CI) 5.6–18.4), self-harm (aOR 1.9, CI 1.1–3.2) and suicide attempt (aOR 2.4, CI 1.3–4.7) were shown in adolescents exposed to RCP compared to non-exposed. Conclusions: There is an increased risk of child maltreatment including poly-victimisation and mental health problems among adolescents exposed to RCP compared to non-exposed. The study emphasizes the matter as a public health problem requiring immediate preventive measures to ensure the rights of children and adolescents. © Author(s) 2021

  • 6.
    Berggren, Anette
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jansson, Eliana
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjöstrand, Charlotta
    Halmstad University, School of Social and Health Sciences (HOS).
    En komplex vardag: Att leva med tvångssyndrom2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Tvångssyndrom är en psykisk sjukdom som ca 2 % av världens befolkning lever med och som visar sig som tvångstankar eller tvångstankar och tvångshandlingar. Den ångest som ligger bakom tvångssyndromet lindras med hjälp av tvångshandlingar. Då sjuksköterskan i sitt yrke kommer att träffa personer med tvångssyndrom är det viktigt med förståelse om hur vardagen ser ut för personer med tvångssyndrom och hur de upplever sitt syndrom.

    I denna litteraturstudie, vars syfte var att öka sjuksköterskans kunskaper kring de komplexa situationer som kan uppstå vid omvårdnaden av personer med tvångssyndrom genom att belysa erfarenheter av den levda vardagen hos personer med tvångssyndrom, har 12 artiklar varav 4 kvalitativa och 8 kvantitativa systematiskt granskats och analyserats.

    Resultatet visar att personer med tvångssyndrom lever med en låg livskvalitet i förhållande till personer utan tvångssyndrom. En försämrad livskvalitet påverkar personens vardagliga liv genom att negativt påverka relationer, arbete och utbildning.

    För att ytterligare öka förståelsen för personer med tvångssyndrom rekommenderas ytterligare kvalitativ forskning om personers upplevelser. Att nå ut till sjuksköterskestudenter och verksamma sjuksköterskor med resultatet av ny forskning är av stor vikt. Temadagar om psykisk ohälsa under utbildningen samt på arbetsplatser kan öka förståelsen inom ämnet.

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    En komplex vardag: Att leva med tvångssyndrom
  • 7.
    Bergman, Stefan
    et al.
    FoU Spenshult, Halmstad, Sweden; The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Lund University, Lund, Sweden.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine. FoU Spenshult, Halmstad, Sweden & Lund University, Lund, Sweden.
    Bergman, Anna-Carin
    Sannarpsgymnasiet, Halmstad, Sweden.
    Brorsson, Sofia
    Health and Welfare, Dalarna University, Falun, Sweden.
    Chronic Widespread Pain in Adolescents Is Highly Associated to Stress and Anxiety2015In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 67, no Suppl. S10, article id 917Article in journal (Refereed)
    Abstract [en]

    Background/Purpose: Chronic widespread pain (CWP), one of the hallmarks of fibromyalgia, is not uncommon in adolescents and it has previously been shown that adolescents with pain often become young adults with pain. CWP often co-varies with anxiety, depression, and stress symptoms in adults, but the knowledge regarding this is small in youth and young adults.

    The aim was to study the associations between CWP, anxiety, depression and stress in adolescents attending first year of high school.

    Methods: A computerized questionnaire to 296 adolescents attending Swedish high school, with validated questions regarding presence and distribution of pain (Epipain mannequin), stress symptoms (ELO question), anxiety and depression (Hospital Anxiety and Depression Scale – HADS), and health related quality of life (HRQL as measured by EQ5D). Pain was considered chronic when persistent for more than three months, and the subgroup CWP was defined according to the 1990 ACR criteria for fibromyalgia. Statistical analyses in SPSS v21 with comparison of means by Student’s t-test and proportions by chi2-test or Fischer’s exact test.

    Results: 257 (87%) out of 296 eligible students, mean (SD) age 16.1 (0.7) and 65.8% girls, responded to the questionnaire.  Prevalence of chronic pain was 20.8% and that of the subgroup CWP was 4.7%, without any gender differences (boys 18.2% vs girls 22.2%; p=0.224, and 3.4% vs 5.4%; p=0.692). High level (4 or 5 on a 5 point scale) of stress symptoms were less common in boys (16.0% vs 28.2%; p=0.015), as was possible or probable anxiety (17.1% vs 44.4%; p<0.001), but not depression (10.3% vs 12.5%; p=0.764). Students with high level of stress reported CWP five times more often than those with less stress (30.4% vs 5.8%; p=0.001). Students with probable anxiety reported CWP ten times more often than students with no anxiety (17.6% vs 1.8%; p=0.001), and CWP was also more common, but not statistically significant, in students with probable depression (20.0% vs 3.1%; p=0.163). Those reporting CWP had significantly lower HRQL (0.58 vs 0.87; p=0.038) than students with no chronic pain.

    Conclusion: The high prevalence of chronic pain and the strong associations between CWP and reports of stress and anxiety in adolescents highlights that a multifactorial background to chronic pain must be considered early in life. An apparent lower score in EQ5D also indicates that the presence of CWP has an marked impact on HRQL also in adolescents.

  • 8.
    Cappelen, Helena
    et al.
    Universiteit Leiden, Leiden, The Netherlands.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare.
    The Effects of an Equine-Assisted Therapeutic Intervention on Well-Being in Persons Diagnosed with Schizophrenia. A Pilot Study2023In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 44, no 2, p. 104-111Article in journal (Refereed)
    Abstract [en]

    The process of personal recovery among persons diagnosed with schizophrenia may be facilitated through innovative health promotion interventions targeting multidimensional aspects of subjective well-being. The current pilot study aims to test the use of self-rated questionnaires as a means of evaluation of the effects of an equine-assisted intervention for persons diagnosed with schizophrenia. Twenty adults diagnosed with schizophrenia were offered a 12-week EAT intervention performed six times once every 14 days by a licenced mental health nurse. Two validated self-rated questionnaires, HSCL-25 and SHIS were used as outcome measurements at baseline and at post-treatment, additionally the self-rated questionnaire PANAS was completed twice a week starting one week before the 12 week - EAT intervention. Only six of the twenty participants managed to complete the validated questionnaires. Despite the low response rate of approximately 30 %, a significant difference was found between pre and post scores for positive affect and well-being. Effect sizes, ranging from small to large for pre-to-post treatment scores indicated less depression and anxiety, more positive affect, less negative affect, and reinforced well-being. Results suggest that EAT interventions may have beneficial effects among persons diagnosed with schizophrenia and that a varied range of research methods is needed to create a solid evidence base for EAT interventions intended for the target group. © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

  • 9.
    Cöster, Maria C.
    et al.
    Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
    Bremander, Ann
    Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Rosengren, Björn E.
    Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
    Magnusson, Håkan
    Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
    Carlsson, Åke
    Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
    Karlsson, Magnus K.
    Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
    Validity, reliability, and responsiveness of the Self-reported Foot and Ankle Score (SEFAS) in forefoot, hindfoot, and ankle disorders2014In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 85, no 2, p. 187-194Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: The self-reported foot and ankle score (SEFAS) is a questionnaire designed to evaluate disorders of the foot and ankle, but it is only validated for arthritis in the ankle. We validated SEFAS in patients with forefoot, midfoot, hindfoot, and ankle disorders.

    PATIENTS AND METHODS: 118 patients with forefoot disorders and 106 patients with hindfoot or ankle disorders completed the SEFAS, the foot and ankle outcome score (FAOS), SF-36, and EQ-5D before surgery. We evaluated construct validity for SEFAS versus FAOS, SF-36, and EQ-5D; floor and ceiling effects; test-retest reliability (ICC); internal consistency; and agreement. Responsiveness was evaluated by effect size (ES) and standardized response mean (SRM) 6 months after surgery. The analyses were done separately in patients with forefoot disorders and hindfoot/ankle disorders.

    RESULTS: Comparing SEFAS to the other scores, convergent validity (when correlating foot-specific questions) and divergent validity (when correlating foot-specific and general questions) were confirmed. SEFAS had no floor and ceiling effects. In patients with forefoot disorders, ICC was 0.92 (CI: 0.85-0.96), Cronbach's α was 0.84, ES was 1.29, and SRM was 1.27. In patients with hindfoot or ankle disorders, ICC was 0.93 (CI: 0.88-0.96), Cronbach's α was 0.86, ES was 1.05, and SRM was 0.99.

    INTERPRETATION: SEFAS has acceptable validity, reliability, and responsiveness in patients with various forefoot, hindfoot, and ankle disorders. SEFAS is therefore an appropriate patient- reported outcome measure (PROM) for these patients, even in national registries.

  • 10.
    Dahlqvist Jönsson, Patrik
    et al.
    Region Halland, Halmstad, Sweden.
    Sandlund, Mikael
    Umeå University, Umeå, Sweden.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The meaning of Shared decision making for persons with long-term mental illness2013In: Breaking barriers 2013, 2013, p. 19-19Conference paper (Refereed)
  • 11.
    Eklund Ortenlöf, Caroline
    et al.
    Halmstad University, School of Health and Welfare.
    Al-Shafie, Bilal
    Halmstad University, School of Health and Welfare.
    Faktorer som påverkar beslutet att söka vård bland personer med PTSD: En litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: More people are exposed to and experience traumatic events in their lives. Therefore, the risk of suffering from posttraumatic stress disorder (PTSD) also increases. Suffering from symptoms of PTSD causes several mental and physical problems, which makes it important for these people to seek treatment. Aim: To identify factors influencing the decision to seek treatment among people with PTSD. Method: This study was conducted as a general literature study with searches in two databases where ten articles that were consistent with the purpose were included in the result.Results: The result revealed that people with PTSD experience a significant number of factors that influence their decision to seek treatment. The four categories were: accessibility to care, previous experiences in care and chance to participate, stigma and knowledge and understanding. Conclusion: In summary, accessibility and stigma were mainly produced as factors that affect people with PTSD to seek treatment. The importance of increased knowledge about the disease and personalized care is identified as positive factors as an individual decision to seek care for PTSD. The results provide valuable information to nurses and future nurses to increase understanding of the care needs of people with PTSD. More research and improved work on the subject is needed to increase knowledge about and accessibility to care for PTSD and reduce the stigma around seeking help.

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  • 12.
    Ekman, Anna
    et al.
    Halmstad University, School of Health and Welfare.
    Kange, Moa
    Halmstad University, School of Health and Welfare.
    ”Vi måste säga att det är fara för hennes liv för hon kommer ju aldrig få någon vård”: En kvalitativ studie om anhörigas upplevelser av delaktighet i vården för närstående personer med diagnosen schizofreni eller schizoaffektivt syndrom2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this bachelor’s thesis was to shed light on how relatives experience their role in contact with psychiatry to a relative with a diagnosis of schizophrenia or schizoaffective syndrome. It also examines what experiences relatives have regarding being included in the process around care interventions. We hope that with this study we can contribute to further sociological knowledge in this subject area to raise the situation of relatives. The thesis is based on a qualitative interview study where eight people were interviewed over the phone and over Zoom. Through a number of articles and a historical review of how psychiatric healthcare in Sweden has developed, the reader gets a deeper understanding of how the role of relatives related to psychiatry has developed and how it looks today. The result is presented by three themes: Relatives' contact with care staff, Present and Future and Improvements regarding relatives' participation. For each theme, the interview results are summarized where differences and similarities are presented and compared with each other. The theoretical framework is based on Melvin Seeman's theory of alienation and Birgitta Andershed’s theory on participation and is used in the analysis to answer the questions. The results of the sociological analysis show that the relatives’ participation in the care of the close relative prevents the relatives' experiences of powerlessness, meaninglessness and social isolation in their everyday life and in their relationship to the care. Participation also contributes to relatives feeling better mentally and that relatives can receive care at an earlier stage.

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  • 13.
    Eriksson, Amanda
    et al.
    Halmstad University, School of Information Technology.
    Blücher, Daniel
    Halmstad University, School of Information Technology.
    Intelligenta beslutstöd och psykisk ohälsa: En kvalitativ studie om etiska utmaningar med Artificiell Intelligens som beslutstöd inom sjukvården för psykisk ohälsa2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Health care has taken interest in the use of AI (Artificial Intelligence) and mental health services are in need of support. Intelligent decision support systems can contribute to reduced workload for health care professionals and better treatment for patients, but the sensitive nature of health care and the possible consequences in the event of neglect or malpractice pose ethical challenges. Treatment of mental illness is complex and needs to be explored in order to identify the potential ethical challenges that can arise. Through an interview study consisting of eight participants, the problem area has been explored amongst both AI researchers and health care professionals, where insights from both contexts have been analysed in order to identify and explore recurring ethical challenges. Through empirical data and a literature study, five ethical challenges have been identified and explored: handle incorrect recommendations, handle moral dilemmas, achieve patient autonomy, the liability dilemma, and generate trust. 

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  • 14.
    Gothred, Lina
    et al.
    Halmstad University, School of Health and Welfare.
    Gullstrand, Lina
    Halmstad University, School of Health and Welfare.
    Läkemedelsassisterad behandling vid heroinberoende: Ur ett omvårdnadsperspektiv2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Heroin addiction has a high mortality and implies high costs to society, and the most common and effective treatment is maintenance treatment (MT). The study's aim was to study MT during a heroin addiction from a nursing perspective. The nursing theory applied was “The Tidal Model” whose philosophy is based on the existence of psychological needs, that nursing can be a way to meet those needs, that humans already have the solution to their problems of life and that nursing is about to develop these solutions. A literature review was made. The result is based on ten quantitative articles and presents three themes: The Meaning of Background Factors, Person-centered Care and Nursing Acceptance. Different background factors affect participation and retention in treatment, for example to have a job or the marital status. To get a positive outcome of the MT it is important with a person-centered care that provides a social support. To increase participation, and therefore the access to care, treatment policy must be lowered and have a higher level of acceptance. In the future we need comprehensive research on nursing during MT and discussions to design the safest care possible.

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  • 15.
    Gouttebarge, Vincent
    et al.
    Academic Medical Center, Amsterdam, The Netherlands & University of Cape Town, Cape Town, South Africa.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Rochcongar, Pierre
    Fédération Française de Football (FFF), Paris, France & France Centre National de Football (FIFA, Medical Centres of Excellence), Clairefontaine, France.
    Rosier, Philippe
    Royal Belgian Football Association, Brussels, Belgium & University Fernando Pessoa, Porto, Portugal.
    Kerkhoffs, Gino
    Academic Medical Center, Amsterdam, The Netherlands.
    Symptoms of common mental disorders among professional football referees: a one-season prospective study across Europe2017In: Physician and sportsmedicine, ISSN 0091-3847, E-ISSN 2326-3660, Vol. 45, no 1, p. 11-16Article in journal (Refereed)
    Abstract [en]

    Objective: The primary aim of this study was to determine the prevalence and one-season incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, eating disorders, adverse alcohol use) among European professional football referees. A secondary aim was to explore the view of European professional football referees on consequences, support and needs related to these symptoms.

    Methods: An observational prospective cohort study with three measurements over a follow-up period of one season (2015-2016) was conducted among central or assistant professional football referees from Belgium, Finland, France, Germany, Norway, Russia, Scotland and Sweden. Using validated questionnaires to assess symptoms of CMD (self-reported and not clinically diagnosed), an electronic questionnaire in English and French was set up and distributed by the eight football federations involved.

    Results: A total of 391 referees (mean age of 33 years old; mean career duration of 7 years) were enrolled, of which 292 completed the follow-up period. Baseline 4-week prevalence rates were 6% for distress, 12% for anxiety/depression, 9% for sleep disturbance, 19% for eating disorders and 17% for adverse alcohol use. The one-season incidence of symptoms of CMD was 10% for distress, 16% for anxiety/depression, 14% for sleep disturbance, 29% for eating disorders and 8% for adverse alcohol use.

    Conclusion: While symptoms of CMD occur among professional football referees and can influence negatively refereeing performances, the development of specific support measures for referees are needed in order to manage properly these symptoms of CMD. © 2016 Informa UK Limited, trading as Taylor & Francis Group

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  • 16.
    Gunnarsson, Sofia
    et al.
    Halmstad University, School of Health and Welfare.
    Sjöstrand, Charlotta
    Halmstad University, School of Health and Welfare.
    Stigmatisering i psykiatrisk omvårdnad: Faktorer som påverkar attityder till patienter med psykisk ohälsa hos specialistsjuksköterskan i psykiatrisk i vård2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stigma, negative attitudes, and discrimination against patients with mental illness are common both in society and globally. A consequence of stigmatization in mental illness is that many patients do not seek care. Negative attitudes hinder recovery and mean that patients with mental illness risk receiving worse treatment for their somatic illnesses. Health care has an important role to play in reducing stigma. The specialist nurse in psychiatric care must promote the recovery of patients with mental illness. Attitudes towards patients with mental illness are described as an influential factor in psychiatric nursing. Aim: The purpose of the study was to highlight which factors influence psychiatric nurses' attitudes towards patients with mental illness. Method: The study was conducted as a systematic literature study based on 11 quantitative articles and data were extracted, synthesized, and summarized. Results: The results were presented in four main categories; the patient's diagnosis, the nurse's personal experiences, the nurse's education, and workplace cultural influences. Conclusion: Specialist nurses in psychiatric care generally have a more positive attitude towards patients with mental illness compared to nurses with basic training. The specialist nurse's personal experiences such as work experience, marital status, and experience of having relatives or friends with mental illness generate more positive attitudes. Education seems to be a significant factor as specialist nurses with education in psychiatric nursing generally have a more positive attitude to patients with mental illness.

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  • 17.
    Hansen, Bodil Winther
    et al.
    University College Copenhagen, Copenhagen, Denmark; Department Of Health Sciences, Lund, Sweden.
    Leufstadius, Christel
    Department Of Health Sciences, Lund, Sweden.
    Pedersen, Helle Andrea
    Region Zealand Psychiatry, Holbak, Denmark.
    Berring, Lene Lauge
    Centre For Relationships And De-escalation, Holbak, Denmark; University Of Southern Denmark, Odense, Denmark.
    Erlandsson, Lena-Karin
    Halmstad University, School of Health and Welfare. Department Of Health Sciences, Lund, Sweden.
    Experiences of Occupational Value When Doing Creative Activities in a Mental Health Context2022In: Occupational Therapy in Mental Health, ISSN 0164-212X, E-ISSN 1541-3101, Vol. 38, no 4, p. 383-402Article in journal (Refereed)
    Abstract [en]

    Everything a person does generates a unique experience of occupational value, and occupational values can in turn generate meaning in life. Doing creative activities positively influences subjective health and well-being. This article provides information about how and to what extent people diagnosed with mental illness experienced occupational value when participating in an intervention with creative activities. Thirty-three participants provided data within a mixed-methods design. Data were analyzed by quantitative non-parametric statistical methods and qualitative directed content analysis. Interventions with creative activities enable a high degree of experienced occupation value and are associated with all dimensions in the occupational value triad. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

  • 18.
    Hansson, Lars
    et al.
    Lunds Universitet.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svensson, Bengt
    Lunds Universitet.
    Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness?2011In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854Article in journal (Refereed)
    Abstract [en]

    AIMS: Studies investigating mental health professionals' attitudes towards people with mental illness are scarce and there is a lack of comparative studies including both patients' and mental health professionals' attitudes. The aim of the present study was to investigate mental health staff's attitudes towards people with mental illness and compare these with the attitudes of patients in contact with mental health services. A further aim was to relate staff attitudes to demographic and work characteristics.

    METHODS: A cross-sectional study was performed including 140 staff and 141 patients. The study included a random sample of outpatients in contact with mental health services in the southern part of Sweden and staff working in these services. Attitudes were investigated using a questionnaire covering beliefs of devaluation and discrimination of people with a mental illness.

    RESULTS: Negative attitudes were prevalent among staff. Most negative attitudes concerned whether an employer would accept an application for work, willingness to date a person who had been hospitalized, and hiring a patient to take care of children. Staff treating patients with a psychosis or working in inpatient settings had the most negative attitudes. Patient attitudes were overall similar to staff attitudes and there were significant differences in only three out of 12 dimensions. Patients' most negative attitudes were in the same area as the staff's.

    CONCLUSIONS: This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff-patient relationship.

  • 19.
    Hilmersson, Ilona
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Rundqvist, Minda
    Halmstad University, School of Social and Health Sciences (HOS).
    Case Management: Sjuksköterskans uppfattning om arbetsmodellens effekt för patienter med missbruk och samtidig psykisk störning.2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this pilot study was to describe how nurses who work as Case Managers perceive the effect of this approach for medical treatment, social status, substance abuse, quality of health care and coordination for patients with substance abuse and concurrent psychiatric disorder. The method was quantitative and was conducted with a web survey. The results showed that the respondents believe that case management had a positive impact on patients' medical care and social situation. It also led to a better contact with the patient, and improved assessment of the patient's complex situation. Overall, the answers also revealed a generally positive perception of the care quality, the coordination and used methods. As for the abuse, some respondents answered that Case Management had affected the abuse in a positive way, and others that it had not been affected at all. In a full scale study it would have been interesting to make the questionnaire more nuanced with more response options, and also have the background variables to make comparisons. The pilot study indicate that case management is an approach that can facilitate nursing care for patients with complex problems and need of care and support, and also be a method to help to coordinate the efforts of various health care providers. The nurse can through Case Management support patients with substance abuse and mental disorders in different areas of health.

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  • 20. Holmqvist, Gärd
    et al.
    Roxberg, Åsa
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). VID, Specialized University, Bergen, Norway.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundqvist-Persson, Cristina
    Skaraborg Institute for Research and Development in Skövde, Skövde, Sweden.
    Expressions of vitality affects and basic affects during art therapy and their meaning for inner change2019In: International Journal of Art Therapy, ISSN 1745-4832, Vol. 24, no 1, p. 30-39Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the occurrence of vitality affects and basic affects and to shed light on their importance in terms of patients’ inner change through art therapy. In an earlier study, where 17 women were interviewed about inner change through art therapy, a secondary deductive content analysis of images and statements was performed exploring the presence of vitality affects and basic affects. Nine of the 17 interviews contained clear descriptions of vitality affects and basic affects in the intersubjective communication between the patient and the therapist; these affects were also mirrored in the patients’ painted images. Three cases are used to illustrate the result and how affects are related to inner change. These three cases differ from each other in that they describe vitality affects either; arising from the art therapist’s empathetic verbal or non-verbal response, from a particular experience in nature, or from the interpreted symbolic language of the image. The common denominator identified as uniting the three cases was the intersubjective communication with the therapist. This study indicates that image making in art therapy gives rise to vitality affects and basic affects that contribute to inner change. It also indicates the importance of having trust in both the method and the art therapist. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

  • 21.
    Hörberg, Ulrica
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Brunt, David
    Växjö University.
    Axelsson, Åsa
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Clients' perceptions of client-nurse relationships in local authority psychiatric services: a qualitative study2004In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 13, no 1, p. 9-17Article in journal (Refereed)
    Abstract [en]

    The Mental Health Care reform in Sweden aimed, among other things, to improve the possibilities for persons with mental illnesses to experience companionship and participation in society. The aim of the study was to describe how persons suffering from mental illness perceive their relationships with nursing staff in local authority psychiatric services. Data were collected through semi-structured recorded interviews with 17 strategically chosen clients. A qualitative approach inspired by phenomenography was used to analyse the data. The analysis resulted in four main categories and 13 subcategories. The main categories were: security, companionship, confirmation and development.

  • 22.
    Jormfeldt, Henrika
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Attitudes towards health among patients and staff in mental health services: a comparison of ratings of importance of different items of health2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 2, p. 225-231Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    In mental health services, the concept of health is often perceived, from a biomedical perspective, as the absence of disease, involving several negative consequences together with a lack of systematic health-promoting activities. The subjective experiences of health among patients in mental health services are crucial to reinforce the experience of health throughout different phases of life. Positive dimensions of health include interaction between the individual and the environment, subjective experience of individual power as well as possibilities to influence important aspects of the life situation. The aim of the study was to describe and compare attitudes to health among patients and staff in mental health services in terms of the importance of health as measured by the attitude version of the Health Questionnaire.

    METHODS:

    A cross-sectional study including a randomly selected sample of 141 outpatients in contact with the mental health services and 140 mental health staff was performed.

    RESULTS:

    Patients and staff share most attitudes towards health, which indicates that health is a concept that applies to human beings irrespective of mental disease in the context of mental health services.

    CONCLUSIONS:

    The possibility to be able to define, measure, and compare positive dimensions of health may be important in the attempts to divert the focus towards one that promotes health and resources in mental health services and away from one on illness and deficits.

  • 23.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Traditionellt sjukdomsfokus och nya psykosociala riktlinjer – var finns psykiatrisjuksköterskan?2012In: Psyche : psykiatrisk vårdtidskrift, ISSN 0283-3468, no 1, p. 18-21Article in journal (Other (popular science, discussion, etc.))
  • 24.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Carlsson, Ing-Marie
    Equine-assisted therapeutic interventions among individuals diagnosed with schizophrenia2018In: Programme and Abstract book: Horatio European Congress in the Faroe Islands 2018, 2018, p. 45-45Conference paper (Refereed)
    Abstract [en]

    Persons diagnosed with schizophrenia are not sufficiently offered health promotion interventions, notwithstanding their increased risk of bodily ill health. Physical activity is found to improve health and decrease psychiatric symptoms although, there is a challenge to motivate and increase physical activity in people with schizophrenia and innovative evidence-based treatment interventions are needed. The aim was to systematically review studies concerning equine assisted interventions among individuals diagnosed with schizophrenia. The findings of the six included articles indicate that therapeutic equine assisted interventions could be beneficial for individuals with severe mental illness such as schizophrenia or schizophrenia like disorders.

  • 25.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Blomqvist, Marjut
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Methodological Issues in Qualitative Studies Involving People with Severe and Persistent Mental Illness2019In: Welcome to the Conference "Developing Dialogue": Programme and Abstract book, 2019, p. 44-45Conference paper (Refereed)
  • 26.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hansson, Lars
    Institutionen för hälsa, vård och samhälle, Lunds universitet, Department of Health Sciences, Lund University, Lund, Sweden.
    Svensson, Bengt
    Institutionen för hälsa, vård och samhälle, Lunds universitet, Department of Health Sciences, Lund University, Lund, Sweden.
    Differences in self-reported importance of elements of health and subjectively experienced health among outpatients in community mental health services2011In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 25, no 5, p. e19-e26Article in journal (Refereed)
    Abstract [en]

    Positive dimensions of mental health are strong protective factors against physical and mental illness in general population. A cross-sectional study including a randomly selected sample of 141 outpatients was performed to explore differences in patients' self-reported importance of elements of health and subjective experiences of health related to sociodemographic background variables. The examination of differences in self-reported importance of elements of health showed differences regarding gender, and the analyses of subjectively experienced health showed differences regarding age and diagnosis. Clinical interventions aiming at strengthening positive dimensions of health are required in community mental health services to meet the patients' individual needs of enhanced health.

  • 27.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perspektiv på hälsa och ohälsa i psykiatrisk omvårdnad2010In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur , 2010, p. 63-85Chapter in book (Other (popular science, discussion, etc.))
  • 28.
    Kalén, Anton
    et al.
    University Of Vigo, Vigo, Spain; University of Skövde, Skövde, Sweden.
    Bisagno, Elisa
    University Of Modena And Reggio Emilia, Modena, Italy.
    Musculus, Lisa
    German Sport University Cologne, Cologne, Germany.
    Raab, Markus
    German Sport University Cologne, Cologne, Germany; London South Bank University, London, United Kingdom.
    Pérez-Ferreirós, Alexandra
    University Of Vigo, Vigo, Spain; University of Santiago de Compostela, Santiago de Compostela, Spain.
    Williams, A. Mark
    University Of Utah, Salt Lake City, United States.
    Araújo, Duarte
    University of Lisbon, Lsibon, Portugal.
    Lindwall, Magnus
    University Of Gothenburg, Gothenburg, Sweden; The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare. University of Agder, Kristiansand, Norway.
    The Role of Domain-Specific and Domain-General Cognitive Functionsand Skills in Sports Performance: A Meta-Analysis2021In: Psychological bulletin, ISSN 0033-2909, E-ISSN 1939-1455, Vol. 147, no 12, p. 1290-1308Article in journal (Refereed)
    Abstract [en]

    Cognition plays a key role in sports performance. This meta-analytic review synthesizes research that examined the relationship between cognitive functions, skills, and sports performance. We identified literature by searching Cochrane Library, APA PsycINFO, PubMed, and Web of Science. We included studies conducted on competitive athletes, assessed cognitive prerequisites, and included performance measures related to the sport. Of the 9,433 screened records, 136 reports were included, containing 142 studies, 1,227 effect sizes, and 8,860 participants. Only 11 studies used a prospective study design. The risk of bias was assessed using the Risk of Bias Assessment Tool for Nonrandomized Studies. The multilevel meta-analysis showed a medium effect size for the overall difference in cognitive functions and skills, with higher skilled athletes scoring better than lower skilled athletes (Hedges' g = 0.59, 95% CI [0.49, 0.69]). The moderator analysis showed larger effect size for tests of cognitive decision-making skills (g = 0.77, 95% CI [0.6, 0.94]) compared to basic (g = 0.39, 95% CI [0.21, 0.56]) and higher cognitive functions (g = 0.44, 95% CI [0.26, 0.62]), as well as larger effect for sport-specific task stimuli compared to general ones. We report that higher skilled athletes perform better on cognitive function tests than lower skilled athletes. There was insufficient evidence to determine whether cognitive functions and skills can predict future sport performance. We found no evidence to support claims that tests of general cognitive functions, such as executive functioning, should be used by practitioners for talent identification or player selection. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

  • 29.
    Khemiri, Lotfi
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Kuja-Halkola, Ralf
    Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Karolinska Institutet, Stockholm, Sweden; Örebro University, Orebro, Sweden.
    Butwicka, Agnieszka
    Karolinska Institutet, Stockholm, Sweden; University Of Oslo, Oslo, Norway; Akershus University Hospital, Lorenskog, Norway; Medical University Of Lodz, Lodz, Poland.
    Tideman, Magnus
    Halmstad University, School of Health and Welfare. Marie Cederschiöld University, Stockholm, Sweden.
    D'Onofrio, Brian M.
    Karolinska Institutet, Stockholm, Sweden; Indiana University, Bloomington, United States.
    Latvala, Antti
    Karolinska Institutet, Stockholm, Sweden; Institute Of Criminology And Legal Policy, Helsinki, Finland.
    Lichtenstein, Paul
    Karolinska Institutet, Stockholm, Sweden.
    Parental substance use disorder and risk of intellectual disability in offspring in Sweden: a national register study2023In: eClinicalMedicine, E-ISSN 2589-5370, Vol. 63, article id 102170Article in journal (Refereed)
    Abstract [en]

    Background: Intellectual disability (ID) is a disorder with unknown aetiology in many cases. Maternal alcohol use is a known risk factor for ID, but less is known about the importance of maternal and paternal substance use disorder (SUD) and risk of ID in offspring. Methods: Data from multiple nationwide registers were used to create a cohort of children born from January 01, 1978 to December 31, 2002. All participants were born in Sweden, had available parental identification information and did not emigrate or die before age 12 (n = 1,940,820). Logistic regression modelling was performed with exposure defined as having a parent who received any SUD diagnosis, including alcohol use disorder (AUD) and drug use disorder (DUD). The outcome was registration of diagnosis of any form of ID. First, we analysed the risk of ID if parental SUD was registered prior to childbirth with stepwise adjustment of multiple covariates. Second, the effect of timing of SUD diagnosis in relation to childbirth was analysed. Findings: Of 37,410 offspring with parental SUD registered prior to birth, 3.0% (n = 1110) had any form of ID compared to 1.2% (n = 23,168) of those 1,903,410 individuals without parental SUD prior birth. Parental SUD prior birth was associated with an increased risk of any form of ID (Odds Ratio [OR]: 2.3 [2.2–2.5]), with ORs similar for maternal (OR: 2.3 [2.1–2.5]) and paternal SUD (OR: 2.3 [2.1–2.5]). These ORs were reduced but remained statistically significant after adjusting for parental education, migration, psychiatric comorbidity, and co-parent SUD (OR parental SUD: 1.6 [1.5–1.8]; OR maternal SUD: 1.4 [1.2–1.5]; OR paternal SUD: 1.6 [1.5–1.7]). Parental SUD was associated with increased risk of ID in offspring irrespective of timing of diagnosis, but if mothers or fathers were diagnosed with AUD during pregnancy (OR maternal AUD: 5.0 [3.1–8.2]; OR paternal AUD: 2.8 [2.2–3.6]), the risk was significantly greater than if the AUD diagnosis was first registered after childbirth (OR maternal AUD: 1.9 [1.8–2.0]; OR paternal AUD: 1.6 [1.6–1.7]). Interpretation: Both paternal and maternal SUD were associated with an increased risk of ID in offspring, with greatest risk observed when AUD was diagnosed during pregnancy. Possible mechanisms may involve shared genetic and environmental factors, including toxic effects from alcohol intake. These findings have clinical implications in suggesting that parental SUD in either parent represents a possibly modifiable risk factor to consider when developing prevention, diagnostics and treatment programs for children with ID. Funding: Stockholm County Council, the Research Council of the Swedish Alcohol Retailing Monopoly, Fredrik and Ingrid Thurings stiftelse, Academy of Finland, the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare, Nordforsk by the Nordic Council of Ministers and the Polish Medical Research Agency. © 2023 The Authors

  • 30.
    Kilic, Ozgur
    et al.
    Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, Netherlands.
    Aoki, Haruhito
    St. Marianna University School of Medicine, Kawasaki, Japan.
    Haagensen, Rasmus
    4Player, København, Denmark.
    Jensen, Claus
    Department of Sport Management, University College Nordjylland, Aalborg, Denmark.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Kerkhoffs, Gino M. M. J.
    Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, Netherlands & Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, Netherlands & Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center/VU University Medical Center, Amsterdam, Netherlands.
    Gouttebarge, Vincent
    Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, Netherlands & Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, Netherlands & Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa & World Players’ Union (FIFPro), Hoofddorp, Netherlands.
    Symptoms of common mental disorders and related stressors in Danish professional football and handball2017In: European Journal of Sport Science, ISSN 1746-1391, E-ISSN 1536-7290, Vol. 17, no 10, p. 1328-1334Article in journal (Refereed)
    Abstract [en]

    The aim of the study was twofold, namely (i) to determine the prevalence of symptoms of common mental disorders (CMDs) among current and retired professional football and handball players and (ii) to explore the relationship of psychosocial stressors with the outcome measures under study. A total of 1155 players were enrolled in an observational study based on a cross-sectional design. Questionnaires based on validated scales were set up and distributed among current and retired professional football and handball players by the Danish football and handball players’ union. In professional football, the highest prevalence (4 weeks) of symptoms of CMDs was 18% and 19% for anxiety/depression among current and retired players, respectively. In professional handball, the highest prevalence (4 weeks) of symptoms of CMDs was 26% and 16% for anxiety/depression among current and retired players, respectively. For both the current and retired professional football and handball players, a higher number of severe injuries and recent adverse life events (LE) were related to the presence of symptoms of CMD. Players exposed to severe injuries and/or recent adverse LE were 20–50% times more likely to report symptoms of CMD. The results suggest that it is possible to recognize the population of professional athletes that are more likely to develop symptoms of CMD. This could create the opportunity to intervene preventively on athletes that suffered from severe injury and/or recent adverse LE that could lead to a faster and safer recovery and psychological readiness to return to play. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

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  • 31.
    Kilic, Ö.
    et al.
    Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Kerkhoffs, G. M. M. J.
    Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
    Rosier, P.
    Royal Belgian Football Association, Brussels, Belgium.
    Gouttebarge, V.
    Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
    Exposure to physical and psychosocial stressors in relation to symptoms of common mental disorders among European professional football referees: A prospective cohort study2018In: BMJ Open Sport and Exercise Medicine, E-ISSN 2055-7647, Vol. 4, no 1, article id e000306Article in journal (Refereed)
    Abstract [en]

    Objectives The study aim was to explore the association of physical and psychosocial stressors (severe injuries, surgeries, recent life events, social support) with one-season onset of symptoms of common mental disorders (CMDs) among European professional football referees. Methods An observational prospective cohort study over a follow-up period of one season (2015-2016) was conducted among professional football referees from Belgium, Finland, France, Germany, Norway, Russia, Scotland and Sweden. Based on physical and psychosocial stressors as well as symptoms of CMD, an electronic questionnaire in English and French was set up and distributed by eight football federations involved. Results The prevalence of symptoms of CMD ranged from 5.9% for distress to 19.2% for eating disorders. A higher number of severe injuries and a lower degree of satisfaction about social support were significantly related to the occurrence of symptoms of CMD with an OR of 2.63 and an OR of 1.10, respectively. Conclusion A higher number of severe injuries and a lower degree on satisfaction about social support were found to be significantly associated with the onset of symptoms of CMD among European professional football referees. Referees suffering from severe injuries were nearly three times more likely to report symptoms of anxiety and depression. Referees who reported a low satisfaction of social support were significantly more likely to report symptoms of eating disorder. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.

  • 32.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare. Spenshult Research and Development Centre, Halmstad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Johansson, Pia
    Halmstad University, School of Health and Welfare.
    Jarbin, Håkan
    Faculty of Medicine, Lund University, Lund, Sweden; Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    SLEEP: intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 1, article id e047509Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION AND OBJECTIVES: Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children's and parents' experiences of a sleep intervention with weighted blankets.

    METHODS AND ANALYSIS: This study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6-13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention.

    ETHICS AND DISSEMINATION: Ethical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019--2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers.

    TRIAL REGISTRATION NUMBER: NCT04180189. © Author(s) (or their employer(s)) 2022.

  • 33.
    Larsson, Stefan
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Östberg, Anna
    Halmstad University, School of Social and Health Sciences (HOS).
    Långvarig sjukdom förändrar den levda kroppens tanke: Hur sjuksköterskan kan identifiera och förebygga depression hos människor som behandlas med dialys2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Mental illness is increasing in society, 20% of Sweden's population is at risk to suffer some from depression at some point in their lives. 600 people each year suffer from chronic kidney failure, which can lead to the need for dialysis treatment. To live with a lifelong disease and suffer from mental illness at the same time exposes the individual for a great suffering. By responding to the patients with empathy and compassion the nurse creates good conditions for the relationship, to be able to be characterized by trust and honesty. The purpose of this literature study was to elucidate how the nurse can identify and prevent depression for people treated with dialysis. The results show that depression is common among dialysis patients. For these people, depression can lead to sleeping problems, nutritional problems, feelings of loss, and social isolation. Identification of depression can be done through the use of evaluation forms; this can also be used as a measure to prevent depression. More qualitative research on the subject would be a good method to increase the understanding of the situation these patients are in. Raising awareness also increases the understanding of depression and what it means to live with a lifelong disease, and the complex situation it means.

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  • 34.
    Latvala, Antti
    et al.
    Institute Of Criminology And Legal Policy, Helsinki, Finland; Karolinska Institutet, Stockholm, Sweden.
    Tideman, Magnus
    Halmstad University, School of Health and Welfare.
    Sondenaa, Erik
    St. Olavs Hospital, Trondheim, Norway.
    Larsson, Henrik
    Karolinska Institutet, Stockholm, Sweden; Örebro University, Örebro, Sweden.
    Butwicka, Agnieszka
    Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Sweden; Medical University Of Warsaw, Warsaw, Poland; Medical University Of Lodz, Lodz, Poland.
    Fazel, Seena
    University Of Oxford, Oxford, United Kingdom.
    Lichtenstein, Paul
    Karolinska Institutet, Stockholm, Sweden.
    Association of intellectual disability with violent and sexual crime and victimization: A population-based cohort study2023In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 53, no 9, p. 3817-3825Article in journal (Refereed)
    Abstract [en]

    Background Intellectual disability (ID) is associated with violent and sexual offending and victimization, but the importance of neuropsychiatric comorbidity and severity of disability remains unclear. Methods In a register-based cohort study of people born in Sweden 1980-1991 (n = 1 232 564), we investigated associations of mild and moderate/severe ID with any, violent and sexual crimes, and with assault victimization, stratified by comorbid autism and attention deficit hyperactivity disorder (ADHD). We defined ID by attendance at a special school or registered diagnosis and obtained data on criminal convictions and injuries or deaths due to assaults from nationwide registers until end of 2013. Results Compared to people without ID, autism or ADHD, men and women with mild or moderate/severe ID and comorbid ADHD had elevated risks of violent crimes [range of hazard ratios (HRs) 4.4-10.4] and assault victimization (HRs 2.0-7.7). Women with mild ID without comorbidities or with comorbid autism also had elevated risks of violent crimes and victimization (HRs 1.8-4.6) compared to women without ID, autism or ADHD. The relative risks of sexual offending and victimization were elevated in men and women with ID without comorbidities (HRs 2.6-12.7). The highest risks for sexual offending in men (HRs 9.4-11.0) and for sexual assault victimization in women (HRs 11.0-17.1) related to ID and comorbid ADHD. Conclusions The elevated risk of violent offending and assault victimization in people with ID is largely explained by comorbid ADHD, whereas ID is independently associated with sexual crimes and victimization, even though absolute risks are low. Copyright © The Author(s), 2022. Published by Cambridge University Press.

  • 35.
    Lichtenstein, Paul
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Tideman, Magnus
    Halmstad University, School of Health and Welfare.
    Sullivan, Patrick F.
    Karolinska Institutet, Stockholm, Sweden; University of North Carolina, Chapel Hill, United States.
    Serlachius, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Karolinska Institutet, Stockholm, Sweden; Örebro University, Örebro, Sweden.
    Kuja-Halkola, Ralf
    Karolinska Institutet, Stockholm, Sweden.
    Butwicka, Agnieszka
    Karolinska Institutet, Stockholm, Sweden; Region Stockholm, Stockholm, Sweden; Medical University Of Warsaw, Warsaw, Poland; Medical University Of Lodz, Lodz, Poland.
    Familial risk and heritability of intellectual disability: a population-based cohort study in Sweden2022In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 63, no 9, p. 1092-1102Article in journal (Refereed)
    Abstract [en]

    Background: Intellectual disability (ID) aggregates in families, but factors affecting individual risk and heritability estimates remain unknown. Methods: A population-based family cohort study of 4,165,785 individuals born 1973–2013 in Sweden, including 37,787 ID individuals and their relatives. The relative risks (RR) of ID with 95% confidence intervals (95% CI) were obtained from stratified Cox proportional-hazards models. Relatives of ID individuals were compared to relatives of unaffected individuals. Structural equation modeling was used to estimate heritability. Results: Relatives of ID individuals were at increased risk of ID compared to individuals with unaffected relatives. The RR of ID among relatives increased proportionally to the degree of genetic relatedness with ID probands; 256.70(95% CI 161.30–408.53) for monozygotic twins, 16.47(13.32–20.38) for parents, 14.88(12.19–18.16) for children, 7.04(4.67–10.61) for dizygotic twins, 8.38(7.97–8.83) for full siblings, 4.56(4.02–5.16) for maternal, 2.90(2.49–3.37) for paternal half-siblings, 3.03(2.61–3.50) for nephews/nieces, 2.84(2.45–3.29) for uncles/aunts, and 2.04(1.91–2.20) for cousins. Lower RRs were observed for siblings of probands with chromosomal abnormalities (RR 5.53, 4.74–6.46) and more severe ID (mild RR 9.15, 8.55–9.78, moderate RR 8.13, 7.28–9.08, severe RR 6.80, 5.74–8.07, and profound RR 5.88, 4.52–7.65). Male sex of relative and maternal line of relationship with proband was related to higher risk (RR 1.33, 1.25–1.41 for brothers vs. sisters and RR 1.49, 1.34–1.68 for maternal vs. paternal half-siblings). ID was substantially heritable with 0.95(95% CI 0.93–0.98) of the variance in liability attributed to genetic influences. Conclusions: The risk estimates will benefit researchers, clinicians, families in understanding the risk of ID in the family and the whole population. The higher risk of ID related to male sex and maternal linage will be of value for planning and interpreting etiological studies in ID. © 2021 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health

  • 36.
    Liu, Shengxin
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Kuja-Halkola, Ralf
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Larsson, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Ludvigsson, Jonas F.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
    Svensson, Ann-Marie
    Swedish National Diabetes Register, Centre of Registers, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Gudbjörnsdottir, Soffia
    Swedish National Diabetes Register, Centre of Registers, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Tideman, Magnus
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Serlachius, Eva
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Service, Region Stockholm, Stockholm, Sweden.
    Butwicka, Agnieszka
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Service, Region Stockholm, Stockholm, Sweden; Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland.
    Neurodevelopmental Disorders, Glycemic Control, and Diabetic Complications in Type 1 Diabetes: a Nationwide Cohort Study2021In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 106, no 11, p. e4459-e4470Article in journal (Refereed)
    Abstract [en]

    Context: Neurodevelopmental disorders are more prevalent in childhood-onset type 1 diabetes than in the general population, and the symptoms may limit the individual’s ability for diabetes management.

    Objective: This study investigated whether comorbid neurodevelopmental disorders are associated with long-term glycemic control and risk of diabetic complications.

    Methods: This population-based cohort study used longitudinally collected data from Swedish registers. We identified 11 326 individuals born during 1973-2013, diagnosed with type 1 diabetes during 1990-2013 (median onset age: 9.6 years). Among them, 764 had a comorbid neurodevelopmental disorder, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, and intellectual disability. We used multinomial logistic regression to calculate odds ratios (ORs) of having poor glycemic control (assessed by glycated hemoglobin [HbA1c]) and Cox regression to estimate hazard ratios (HRs) of nephropathy and retinopathy.

    Results: The median follow-up was 7.5 years (interquartile range [IQR] 3.9, 11.2). Having any neurodevelopmental disorder (ORadjusted 1.51 [95% CI 1.13, 2.03]), or ADHD (ORadjusted 2.31 [95% CI 1.54, 3.45]) was associated with poor glycemic control (mean HbA1c > 8.5%). Increased risk of diabetic complications was observed in patients with comorbid neurodevelopmental disorders (HRadjusted 1.72 [95% CI 1.21, 2.44] for nephropathy, HRadjusted 1.18 [95% CI 1.00, 1.40] for retinopathy) and patients with ADHD (HRadjusted 1.90 [95% CI 1.20, 3.00] for nephropathy, HRadjusted 1.33 [95% CI 1.07, 1.66] for retinopathy). Patients with intellectual disability have a particularly higher risk of nephropathy (HRadjusted 2.64 [95% CI 1.30, 5.37]).

    Conclusion: Comorbid neurodevelopmental disorders, primarily ADHD and intellectual disability, were associated with poor glycemic control and a higher risk of diabetic complications in childhood-onset type 1 diabetes. © The Author(s) 2021.

  • 37.
    Lydell, Marie
    et al.
    Halmstad University, School of Health and Welfare.
    Kristén, Lars
    Halmstad University, School of Health and Welfare.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare.
    Health promotion partnership to promote physical activity in Swedish children with ASD and ADHD2022In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 37, no 6, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) have a higher risk of inactivity, and efforts to promote physical activity among this population have been limited. Physical activity on prescription (PAP) may be a suitable tool for motivating participation in physical activity among children with these diagnoses. However, PAP calls for synergy and partnership between health care and other sectors of the community. The aim of this study was to describe a health promotion partnership for physical activity targeting children with ASD or ADHD. Data were obtained through individual interviews with professionals at CAP (n = 11) and three focus-group interviews with coaches from local sports clubs. We used the Bergen Model of Collaborative Functioning as the theoretical framework and used qualitative content analysis as the method of analysis to study partnerships between professionals from the Child and Adolescent Psychiatry outpatient clinic (CAP) and coaches from local sport clubs. The findings demonstrate that the partnerships included both positive and negative processes. Although the two partners shared values regarding the project, such as working for a good cause for the children and seeing the potential in the collaboration, there were doubts about sharing common resources and uncertainties about the sustainability of the PAP project. Challenges remain and further research is needed into developing, monitoring and evaluating health promotion partnerships when promoting physical activity for all. © The Author(s) 2022. Published by Oxford University Press.

  • 38.
    Lönn, Maria
    et al.
    Halmstad University, School of Health and Welfare. Psychiatry Region Halland, Halmstad, Sweden.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Jarbin, Håkan
    Lund University, Lund, Sweden; Psychiatry Region Halland, Halmstad, Sweden.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare.
    Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties2023In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 2023, p. 1-12, article id 1945290Article in journal (Refereed)
    Abstract [en]

    Introduction. Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children’s individual needs in connection with sleep and daytime functioning. Aim. To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods. An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results. Children’s experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions. Using weighted blankets promoted children’s management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves. Copyright © 2023 Maria Lönn et al.

  • 39.
    Lönn, Maria
    et al.
    Halmstad University, School of Health and Welfare. Region Halland, Halmstad, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Jarbin, Håkan
    Region Halland, Halmstad, Sweden; Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare.
    The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder—A randomized controlled crossover trial2023In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, article id e13990Article in journal (Refereed)
    Abstract [en]

    Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. −2.79 min, p = 0.015, Cohen's d = −0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11–14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions. © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

  • 40.
    Malmberg, Malin
    et al.
    Halmstad University, School of Health and Welfare.
    Wargren, Mattias
    Halmstad University, School of Health and Welfare.
    Specialistsjuksköterskors erfarenheter av kommunikation inom professionen mellan psykiatrisk öppen- och slutenvård2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Specialist nurses have a central role in healthcare and communication within the profession is of the utmost importance for both patient safety and the efficiency of the organization. Communication and nurses' teamwork strengthen each other and together the conditions are created for good and safe care. Patients are often brought up to date in both forms of care, which requires good communication between the units. Aim: The purpose of the study was to describe specialist nurses' experiences of communication within the profession between psychiatric outpatient and inpatient care. Method: An inductive interview study involving twelve specialist nurses was conducted. The material was analyzed with qualitative content analysis and resulted in four categories. Results and conclusion: Contact routes with different functions were a main category that emerged and describes the specialist nurses' experiences of how the current communication takes place. The results show that the specialist nurses call for a personal contact between nurses. The category Experiences of "us and them" contains results on the specialist nurses' description of the relational interaction. The results indicate that the specialist nurses lack personal knowledge of their colleagues, which negatively affects the collaboration. Ther esults under the category Perceived obstacles show that the specialist nurses have experience of not fully understanding each other's conditions. The category Need for more contact areas concerns the desire for expanded meeting places and hospitation, which can be seen as the central message in the results of this study.

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  • 41.
    Meesters, Jorit
    et al.
    Epi-centre Skåne, Skåne University Hospital, Lund, Sweden & Department of Orthopaedics, Rehabilitation and Physical Therapy, LUMC, Leiden, Netherlands.
    Bremander, Ann
    Research and Development Center, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Petersson, Ingemar
    Epi-centre Skåne, Skåne University Hospital, Lund, Sweden & Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Bergman, Stefan
    Research and Development Center, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Englund, Martin
    Epi-centre Skåne, Skåne University Hospital, Lund, Sweden; Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden & Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, United States.
    Depression is More Common in Patients with Ankylosing Spondylitis as Compared to the General Population Seeking Health-Care2013In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, no Suppl. 3, p. A556-A556Article in journal (Refereed)
    Abstract [en]

    Background: Ankylosing spondylitis (AS) affects physical function and health related quality of life. Depression has been reported to be frequent in AS patients. However, available epidemiological data are limited and estimates of the potentially increase in risk are lacking.

    Objectives: To compare the rate of doctor-diagnosed depression in a well-defined cohort of AS patients to the general health-care seeking population.

    Methods: The Skåne Health Care Register comprises data from each single health care consultation in the Skåne County, Sweden (population 1.2 million). Data include information about date of consultation and all ICD-10 diagnoses. Linking this register to the Swedish population register adds data regarding death and residency. We studied all patients who were registered with an AS diagnosis (ICD-10 code M45) at least once during 4 calendar years (2004 to 2007). To obtain depression rates we calculated the person-time from the day after the first occurrence of the AS diagnosis within the study period until the day of diagnosis of depression (F32 or F33) or another censoring event (death/relocation). We then obtained standardized depression-rate ratios by dividing the observed depression rate in AS patients by the expected rate based on the corresponding age- and sex specific rates of doctor-diagnosed depression in the general population of the county seeking care (reference population). A ratio >1 equals a higher rate of depression among AS patients than in the reference population of corresponding age and sex distribution.

    Results: We identified 935 AS patients, 67.2% men, mean age (SD) 52.3 (14.8) years. The reference population consisted of 761,210 subjects. During the 4-year observation period 10% (n=94) of the AS cohort had a doctor-diagnosed depression compared to 7% (n=66) to be expected based on data from the reference population. The standardized depression-rate ratio in men (1.41, 95% CI 1.04–1.87) and women with AS (1.43, 95% CI 1.05–1.91) were both significantly elevated in the same order of magnitude (Table).

    Conclusions: The rate of doctor-diagnosed depression was increased by about 40% in both male and female AS patients compared to the general population seeking care. Future challenges are to identify and treat the AS patients who suffer from depression as early as possible.

  • 42.
    Melin, Karin
    et al.
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Department of Child and Adolescent Psychiatry, CAP Specialized unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Skarphedinsson, Gudmundur
    University of Iceland, Reykjavik, Iceland.
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Storm Mowatt Haugland, Bente
    Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
    Ivarsson, Tord
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
    A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD2018In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 27, no 10, p. 1373-1381Article in journal (Refereed)
    Abstract [en]

    This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment. Treatment response was defined as CY-BOCS total score ≤ 15, and remission was defined as CY-BOCS total score ≤ 10. Analyzing the outcomes with linear mixed-effects models (LME) showed a decrease in OCD symptom load from 23 to 6.9 at the 3-year follow-up. Moreover, two of three (66.1%) participants were in remission, and another 19.2% had responded to treatment at the 3-year follow-up. Thus, 85.3% of participants responded to treatment. Moreover, during the follow-up period, participants' psychosocial functioning had significantly improved, and depressive symptoms had significantly decreased. The results suggest that evidence-based treatment for pediatric OCD, following expert consensus guidelines, has long-term positive effects for most children and adolescents diagnosed with OCD. The results also indicate that improvements are maintained over a 3-year period, at least, and that improvement is also found with regard to psychosocial functioning and depressive symptoms. © 2018 Springer International Publishing AG

  • 43.
    Melin, Karin
    et al.
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Skarphedinsson, Gudmundur
    Faculty of Psychology, University of Iceland, Reykjavik, Iceland.
    Thomsen, Per Hove
    Aarhus University Hospital, Aarhus, Denmark.
    Weidle, Bernhard
    Norwegian University of Science and Technology, Trondheim, Norway & St. Olav's University Hospital, Trondheim, Norway.
    Torp, Nor Christian
    Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway.
    Valderhaug, Robert
    Norwegian University of Science and Technology, Trondheim, Norway & Hospital of Aalesund, Aalesund, Norway.
    Højgaard, David R. M. A.
    Aarhus University Hospital, Aarhus, Denmark.
    Hybel, Katja A.
    Aarhus University Hospital, Aarhus, Denmark.
    Nissen, Judith Becker
    Aarhus University Hospital, Aarhus, Denmark.
    Jensen, Sanne
    Aarhus University Hospital, Aarhus, Denmark.
    Dahl, Kitty
    Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Haugland, Bente Storm
    Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
    Ivarsson, Tord
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Norwegian University of Science and Technology, Trondheim, Norway.
    Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS2020In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 59, no 2, p. 244-253Article in journal (Refereed)
    Abstract [en]

    Objective: This study evaluated the long-term outcomes of a stepped care treatment for pediatric obsessive-compulsive disorder (OCD) and investigated whether response to first-step cognitive-behavioral therapy (CBT) is an important indicator of 3-year outcomes. Method: This study is a part of the Nordic Long-term OCD Treatment Study (NordLOTS), in which 269 children and adolescents were treated with CBT. Nonresponders to CBT were randomized to extended treatment with continued CBT or pharmacotherapy with sertraline. Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) scores no higher than 15 and no higher than 10 were defined as treatment response and remission, respectively. Participants were assessed 2 and 3 years after first-step CBT. Linear mixed-effects models were used to analyze the outcomes. Results: Intent-to-treat analyses showed a significant decrease in CY-BOCS total score from baseline (24.6) to 3-year follow-up (5.0; p =. 001), with a mean decrease of 5.9 from after treatment to 3-year follow-up. Three years after treatment, 90% (n = 242) of participants were rated as responders and 73% were in clinical remission. The duration of treatment did not influence the symptom level at 3-year follow-up (p =. 998) and no significant difference was found (p =. 169) between the extended treatment conditions. Conclusion: The results suggest that evidence-based treatment for pediatric OCD has long-term positive effects, whether a first step of manual-based CBT or extended treatment with CBT or sertraline. The improvements were maintained, and the symptoms decreased further during follow-up and were, after 3 years, similarly independent of treatment duration and form of extended treatment. Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119. © 2019 American Academy of Child and Adolescent Psychiatry

  • 44.
    Milos Nymberg, Veronica
    et al.
    Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Primary Care Skåne, Region Skåne, Sweden.
    Nymberg, Peter
    Halmstad University, School of Health and Welfare.
    Pikkemaat, Miriam
    Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Primary Care Skåne, Region Skåne, Sweden.
    Calling, Susanna
    Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Primary Care Skåne, Region Skåne, Sweden.
    Stenman, Emelie
    Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
    Grundberg, Anton
    Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
    Smith, J. Gustav
    Lund University, Lund, Sweden; Skåne University Hospital, Lund, Sweden; University of Gothenburg, Gothenburg, Sweden.
    Sundquist, Kristina
    Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Primary Care Skåne, Region Skåne, Sweden.
    Lifestyle and cardiovascular risk factors in a Swedish primary care population with self-reported psychiatric symptoms2024In: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 37, article id 102547Article in journal (Refereed)
    Abstract [en]

    Objective

    Individuals with psychiatric illness suffer from poorer physical health compared with the general population and have a higher risk of developing cardiovascular and metabolic diseases. This cross-sectional study aims to describe the prevalence of lifestyle and cardiovascular risk factors and the association with self-reported psychiatric symptoms in a population of 40-year-old individuals screened with targeted Health Dialogues in southern Sweden.

    Methods

    All 40-year-old individuals registered at 99 primary healthcare centers in southern Sweden were invited to participate. Self-reported lifestyle habits on a web questionnaire, anthropometric measurements, blood pressure, and blood tests were collected. The Health Dialogue resulted in a risk level assessment for different lifestyle habits and a meeting with a trained coach.

    Results

    A total of 1831 individuals completed a Health Dialogue between 1st January 2021 and 30th June 2022. There were more individuals with high-risk levels for several lifestyle habits in the group with self-reported psychiatric illness compared with the rest of the study population. The analysis showed that physical inactivity, unhealthy diet, high-risk alcohol intake, tobacco use, psychosocial strain, higher BMI, and waist-hip ratio were associated with increased levels of psychiatric symptoms after adjustment for sex and socioeconomic factors.

    Conclusion

    Unhealthy lifestyle habits were associated with self-reported psychiatric symptoms in 40-year-old individuals assessed with targeted Health Dialogues in a primary care context. Organized screening might contribute to early detection of modifiable risk factors for cardiovascular disease. Individuals with psychiatric symptoms should be prioritized for screening of unhealthy lifestyle behaviors. © 2023 The Author(s)

  • 45.
    Milos Nymberg, Veronica
    et al.
    Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Pikkemaat, Miriam
    Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Calling, Susanna
    Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Nymberg, Peter
    Halmstad University, School of Health and Welfare. Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    HEAD-MIP–(HEAlth Dialogues for patients with Mental Illness in Primary care)—a feasibility study2023In: Pilot and Feasibility Studies, E-ISSN 2055-5784, Vol. 9, article id 167Article in journal (Refereed)
    Abstract [en]

    Background: Patients with mental illness have an increased risk of cardiovascular morbidity and mortality compared to the rest of the population, which is partly related to unhealthy lifestyle habits. To individualise lifestyle counselling in primary care, the Swedish-developed Health Dialogue (HD) can be used as an educative tool at recurrent measurement points with the goal to improve non-healthy lifestyle habits. HD has not been aimed specifically at patients with mental illness, and the effect of a systematic approach with repeated HDs in patients with mental illness in primary care has not been previously studied. The aim of this pilot study was to assess the feasibility of the study design for a larger-scale cohort study using repeated HDs focused on the improvement of lifestyle habits in patients seeking primary care due to anxiety, depression, sleeping problems or stress-related symptoms. Methods: Patients were recruited after a visit to a Primary Health Care Center due to mental illness between October 2019 until November 2021 and received a Health Dialogue, including an assessment of cardiovascular risk factors through a Health Curve. Specific feasibility objectives measured were dropout rate, time to follow-up, and risk improvement rate for different lifestyle changes. Results: A total of 64 patients were recruited and 29 (45%) attended a second HD, with a mean follow-up time of 15 months. All participants had at least one elevated cardiovascular risk level on the Health Curve for the assessed lifestyles. Risk level improvement rate was good except for tobacco use. Conclusion: Despite a higher dropout rate than expected, we suggest that the proposed methodology for a full cohort study within general practice of patients with mental illness in primary care is both acceptable to practice and feasible. © 2023, BioMed Central Ltd., part of Springer Nature.

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  • 46.
    Nilsson, Anna Maria
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Waern, Margda
    University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; .
    Ehnvall, Anna
    University of Gothenburg, Gothenburg, Sweden; Psychiatric Outpatient Clinic, Varberg, Sweden.
    Skärsäter, Ingela
    Halmstad University.
    The Meaning of Mental Imagery in Acute Suicidal Episodes: A Qualitative Exploration of Lived Experiences2023In: Omega, ISSN 0030-2228, E-ISSN 1541-3764Article in journal (Refereed)
    Abstract [en]

    Clinical assessment of suicidal ideation focuses on cognitions in the form of verbal thoughts. However, cognitions also take the shape of mental imagery. The aim of this qualitative study was to explore the meaning of mental imagery in acute suicidal episodes (ASEs). Eight persons with severe previous ASEs participated in repeated in-depth interviews and in the semi-structured Suicidal Cognitions Interview. Textual data from both sources underwent content analysis. All participants experienced suicide-related imagery during ASEs. Analysis resulted in two themes. (1) Suicide-approaching imagery: intrusive looming images that contributed to loss of control, flashforwards that clarified the suicidal solution, or desirable but unattainable images. (2) Suicide preventive imagery: death-alienating, life-affirming, or potentially helpful images. The meaning of mental imagery in ASEs is suggested to be understood in relation to the context of the individual ASE. A narrative approach is encouraged, as is an increased clinical focus on mental imagery in general. © The Author(s) 2023.

  • 47.
    Nilsson, Anna-Maria
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare.
    Ehnvall, Anna
    University of Gothenburg, Gothenburg, Sweden; Psychiatric Outpatient Clinic, Varberg, Sweden.
    Beskow, Jan
    University of Gothenburg, Gothenburg, Sweden.
    Waern, Margda
    University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Mölndal, Sweden.
    Application of an accident approach to the study of acute suicidal episodes through repeated in-depth interviews2023In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, Vol. 47, no 1, p. 75-83Article in journal (Refereed)
    Abstract [en]

    We modified an accident analysis model for the study of acute suicidal episodes (ASEs). Our aim was to use this model (SCREAM, Suicidal Cognitions’ Reliability and Error Analysis Method) as a lens to understand the worst-ever ASEs of nine patients who took part in repeated in-depth interviews. Guided by the theory of SCREAM including four predetermined categories, nine themes were identified. ASEs were triggered by interactions with the interpersonal and physical environment and spiraled into a state of lost control. Timing and the availability of promoters and barriers in the environment were salient features. Findings may aid person-centered safety planning. © 2022 The Author(s).

  • 48.
    Nilsson, Sanne
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Zidar, Sofia
    Halmstad University, School of Social and Health Sciences (HOS).
    Mot min egen vilja: Individens upplevelse av sluten psykiatrisk tvångsvård2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Coercion is a reality in psychiatric inpatient care and how it affects the individual’s autonomy is an important source of knowledge for nursing staff. During the 1990´s, important changes were conducted within the area of psychiatry with creation of “Psykiatrireformen”, “Lag om psykiatrisk tvångsvård” and “Lag om rättspsykiatrisk vård”, aiming to improve care and treatment of individual´s with psychiatric diseases. Coercive measures that occurs within psychiatric care consists of mechanical restraint, seclusion, detention in a psychiatric unit and similar confinement measures. The aim was to describe the experiences of individuals who have undergone coercion within psychiatric inpatient care. The method was a literature study of qualitative design with an inductive approach.  The result’s four carrying themes are: The individual and autonomy, The Individual, the semblance of coercion and surroundings, The individual and relationships and The individual during coercion. Conclusions of this literature study consist to a part of the importance of information. In addition, a caring relationship is of the most importance and the content in the experience of coercion is differentiating.  Coercion is alwayspresent in nursing situations where the threat of this exists. Implication for thenurse basic education consists in providing greater understanding for the individual’sexperiences of psychiatric inpatient coercion and providing tools inencountering. Future research should concentrate at the individual’sexperiences of coercion in psychiatric inpatient care, aiming to increase thequality of the care that is provided.       

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    Mot min egen vilja - Individens upplevelse av sluten psykiatrisk tvångsvård
  • 49.
    Nilsson, Sverker
    et al.
    Department of Primary Health Care, Falkenberg.
    Baigi, Amir
    Research and Development Unit, Primary Hearth Care Halland, Falkenberg.
    Marklund, Bertil
    Research and Development Unit, Primary Hearth Care Halland, Falkenberg.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS). Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The prevalence of the use of androgenic anabolic steroids by adolescents in a county of Sweden2001In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 11, no 2, p. 195-197Article in journal (Refereed)
    Abstract [en]

    Background

    The prevalence of the use of androgenic anabolic steroids has been poorly studied in Europe. This study was undertaken to examine the prevalence of the misuse - the non-medical use - of androgenic anabolic steroids among adolescents in a county of Sweden.

    Methods

    The total population of 16 and 17 year old male and female adolescents in a county on the south-west coast of Sweden was studied. The investigation was done by an anonymous multiple-choice questionnaire. The questionnaire was completed by 5,827 pupils and statistically analysed. The participation rate was 95%.

    Results

    Among male adolescents 16 acid 17 years old, 3.6% and 2.8% had misused androgenic anabolic steroids, respectively, These male adolescents had also misused alcohol, growth hormones and narcotic drugs more than the steroid hormone non-users. Among female adolescents there was no recorded misuse of these drugs (0.0%),

    Conclusions

    The misuse of androgenic anabolic steroids is a reality in both small and large municipalities in Sweden. The prevalence figures are higher among 16 year old compared to 17 year old male adolescents. There is an association between this drug misuse and other substance misuse such as narcotic drugs, Female adolescents do not misuse steroid hormones. The findings indicate the need for preventive work among male adolescents in order to induce adolescents not to start misusing androgenic anabolic steroids.

  • 50.
    Oevreboe, Tom Henning
    et al.
    Norwegian School of Sport Sciences, Oslo, Norway.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare. University of Agder, Kristiansand, Norway.
    Sundgot-Borgen, Jorunn
    Norwegian School of Sport Sciences, Oslo, Norway.
    Knudsen, Ann Kristin Skrindo
    Norwegian Institute of Public Health, Oslo, Norway.
    Reneflot, Anne
    Norwegian Institute of Public Health, Oslo, Norway.
    Pensgaard, Anne Marte
    Norwegian School of Sport Sciences, Oslo, Norway.
    Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes2023In: BMJ Open Sport and Exercise Medicine, E-ISSN 2055-7647, Vol. 9, no 3, article id e001538Article in journal (Refereed)
    Abstract [en]

    Objectives: To, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with 'at-risk scores' on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between 'at-risk scores' and diagnosed mental disorders.

    Methods: A two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with 'at-risk scores' using the fifth version of the Composite International Diagnostic Interview.

    Results: Two hundred and eighty athletes (74.1%) had an 'at-risk score,' and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews.

    Conclusions: Using self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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