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Thorell, Lars-Håkan
Publications (10 of 28) Show all publications
Lowén, M. B. O., Mayer, E., Tillisch, K., Labus, J., Naliboff, B., Lundberg, P., . . . Walter, S. (2015). Deficient habituation to repeated rectal distensions in irritable bowel syndrome patients with visceral hypersensitivity. Neurogastroenterology and Motility, 27(5), 646-655
Open this publication in new window or tab >>Deficient habituation to repeated rectal distensions in irritable bowel syndrome patients with visceral hypersensitivity
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2015 (English)In: Neurogastroenterology and Motility, ISSN 1350-1925, E-ISSN 1365-2982, Vol. 27, no 5, p. 646-655Article in journal (Refereed) Published
Abstract [en]

Background Irritable bowel syndrome (IBS) patients show evidence of altered central processing of visceral signals. One of the proposed alterations in sensory processing is an altered engagement of endogenous pain modulation mechanisms. The aim was to test the hypothesis that IBS patients with (IBS-S) and without visceral hypersensitivity (IBS-N) differ in their ability to engage endogenous pain modulation mechanism during habituation to repeated visceral stimuli.

Methods Brain blood oxygen level dependent (BOLD) response was measured during repeated rectal distension and its anticipation in 33 IBS patients with and without visceral hypersensitivity and 18 healthy controls (HCs). BOLD response to early and late phase of the distension series was compared within and between groups.

Key Results While BOLD response was similar during the early phase of the experiment, IBS-S showed greater BOLD response than IBS-N and HCs during the late phase of the distension series. IBS-S showed increasing BOLD response both to the anticipation and delivery of low intensity rectal distensions in brain regions including insula, anterior and mid cingulate cortex. IBS-N showed decreasing BOLD response to repeated rectal distensions in brain regions including insula, prefrontal cortex and amygdala.

Conclusions & Inferences These findings are consistent with compromised ability of IBS-S to respond to repeated delivery of rectal stimuli, both in terms of sensitization of sensory pathways and habituation of emotional arousal. The fact that both IBS subgroups met Rome criteria, and did not differ in terms of reported symptom severity demonstrates that similar symptom patterns can result from different underlying neurobiological mechanisms.

Keywords
irritable bowel syndrome, brain-gut interaction, fMRI, visceral sensitivity
National Category
Gastroenterology and Hepatology Neurosciences
Identifiers
urn:nbn:se:liu:diva-122143 (URN)10.1111/nmo.12537 (DOI)000364742000007 ()25777251 (PubMedID)
Note

Funding agencies: County Council of Ostergotland, Sweden; National Institute of Health [DK 64531]

Available from: 2015-10-20 Created: 2015-10-20 Last updated: 2018-01-11Bibliographically approved
Thorell, L.-H., Wolfersdorf, M., Straub, R., Steyer, J., Hodgkinson, S., Kaschka, W., . . . Wahlin, K. (2014). A paradox in suicide statistics in estimating specificity of tests for suicide - reply to Mushquash and co-workers and Culver [Letter to the editor]. Journal of Psychiatric Research, 54, 142-143
Open this publication in new window or tab >>A paradox in suicide statistics in estimating specificity of tests for suicide - reply to Mushquash and co-workers and Culver
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2014 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 54, p. 142-143Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2014
National Category
Clinical Medicine Mathematics
Identifiers
urn:nbn:se:liu:diva-109128 (URN)10.1016/j.jpsychires.2014.03.015 (DOI)000337649300020 ()24725653 (PubMedID)
Available from: 2014-08-13 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved
Thorell, L.-H., Wolfersdorf, M., Straub, R., Steyer, J., Hodgkinson, S., Kaschka, W. P. & Jandl, M. (2013). Electrodermal hyporeactivity as a trait marker for suicidal propensity in uni- and bipolar depression. Journal of Psychiatric Research, 47(12), 1925-1931
Open this publication in new window or tab >>Electrodermal hyporeactivity as a trait marker for suicidal propensity in uni- and bipolar depression
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2013 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 47, no 12, p. 1925-1931Article in journal (Refereed) Published
Abstract [en]

Background: A meta-analysis of studies investigating electrodermal activity in depressed patients, suggested that electrodermal hyporeactivity is sensitive and specific for suicide. less thanbrgreater than less thanbrgreater thanAims: To confirm this finding and to study electrodermal hyporeactivity relative to type and severity of depression, trait anxiety, its stability and independence of depressive state. Method: Depressed inpatients (n = 783) were tested for habituation of electrodermal responses and clinically assessed using the Beck Depression Inventory (BDI) and the STAI-Trait scale for trait anxiety. less thanbrgreater than less thanbrgreater thanResults: The high sensitivity and raw specificity of electrodermal hyporeactivity for suicide were confirmed. Its prevalence was highest in bipolar disorders and was independent of severity of depression, trait anxiety, gender and age. Hyporeactivity was stable, while reactivity changed into hyporeactivity in a later depressive episode. less thanbrgreater than less thanbrgreater thanConclusions: The findings support the hypothesis that electrodermal hyporeactivity is a trait marker for suicidal propensity in depression.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Suicidal behaviour, Depression, Electrodermal hyporeactivity, Sensitivity, Specificity, Stability
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-102494 (URN)10.1016/j.jpsychires.2013.08.017 (DOI)000327110300013 ()
Note

Funding Agencies|Deutsche Forschungsgemeinschaft|DFG Sonderforschungsbereich 129|

Available from: 2013-12-13 Created: 2013-12-12 Last updated: 2017-12-06
Spetz, A.-C., Thorell, L.-H., Theodorsson, E. & Hammar, M. (2012). Hot flushes in healthy aging men differ from those in men with prostate cancer and in menopausal women. Gynecological Endocrinology, 28(1), 72-75
Open this publication in new window or tab >>Hot flushes in healthy aging men differ from those in men with prostate cancer and in menopausal women
2012 (English)In: Gynecological Endocrinology, ISSN 0951-3590, E-ISSN 1473-0766, Vol. 28, no 1, p. 72-75Article in journal (Refereed) Published
Abstract [en]

Calcitonin gene-related peptide (CGRP) seems to be involved in hot flushes in women and in castrated men. Therefore, we studied whether the plasma concentrations of CGRP changed during flushes in a group of healthy aging men. Twelve men (49-71 years) with no history of current or former prostate cancer or hormonal treatment reporting greater than= 20 flushes/week were investigated. Blood samples were drawn during and between flushes for analysis of CGRP and also androgen concentrations, that is, testosterone and bioavailable testosterone were analysed. Skin temperature and skin conductance were monitored. Thirty-five flushes were reported by 10 men. The plasma concentrations of CGRP did not increase during flushes. No significant change in skin temperature or conductance was found. CGRP is probably not involved in the mechanisms of flushes in healthy aging men. Therefore, flushes in aging healthy men seem to be different from flushes in men and women deprived of sex steroids where CGRP increases during flushes.

Place, publisher, year, edition, pages
Informa Healthcare, 2012
Keywords
Calcitonin gene-related peptide; climacteric; hot flashes; men
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-73729 (URN)10.3109/09513590.2011.588744 (DOI)000298003400017 ()
Available from: 2012-01-12 Created: 2012-01-12 Last updated: 2017-12-08
Ekbladh, E., Thorell, L.-H. & Haglund, L. (2010). Perceptions of the work environment among people with experience of long term sick leave. WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, 35(2), 125-136
Open this publication in new window or tab >>Perceptions of the work environment among people with experience of long term sick leave
2010 (English)In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 35, no 2, p. 125-136Article in journal (Refereed) Published
Abstract [en]

Purpose: The aims were to describe and analyze how people with experience of long term sick leave perceive that factors in their work environment support or interfere with work performance, satisfaction, and well-being. Method: The 53 participants were interviewed with the Work Environment Impact Scale (WEIS). The WEIS ratings and belonging notes were analyzed by descriptive statistics and qualitative analysis respectively. Differences in WEIS ratings between; women and men; participants with somatic and mental diseases; and participants working and on full-time sick leave were tested. Results: The most supportive factors concerned social interactions at work, and the value and meaning of work. The factors perceived as most interfering concerned work demands and rewards. The social relations at work were perceived as more supportive by the working group than by those on full-time sick leave. The participants with somatic diseases perceived physical work factors as more interfering than did participants with mental diseases, who in turn perceived the value and meaning of work as more interfering. Conclusion: Knowledge about the interaction between the worker and the work environment could reveal useful information about the complex phenomenon of reducing sick leave. The WEIS seems useful in providing information about how alterations and accommodations in the work environment could support individual workers.

Keywords
Psychosocial, assessment, WEIS, well-being, RTW, occupational therapy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54491 (URN)10.3233/WOR-2010-0964 (DOI)000275284100003 ()
Note
Original Publication: Elin Ekbladh, Lars-Håkan Thorell and Lena Haglund, Perceptions of the work environment among people with experience of long term sick leave, 2010, WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, (35), 2, 125-136. http://dx.doi.org/10.3233/WOR-2010-0964 Copyright: IOS Press http://www.iospress.nl/ Available from: 2010-03-19 Created: 2010-03-19 Last updated: 2010-12-06
Ekbladh, E., Thorell, L.-H. & Haglund, L. (2010). Return to work: the predictive value of the Worker Role Interview (WRI) over two years. Work: A journal of Prevention, Assesment and rehabilitation, 35(2), 163-172
Open this publication in new window or tab >>Return to work: the predictive value of the Worker Role Interview (WRI) over two years
2010 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 35, no 2, p. 163-172Article in journal (Refereed) Published
Abstract [en]

Worker Role Interview (WRI) is an assessment tool designed to identify psychosocial and environmental factors which influence a persons ability to return to work. The purpose of this study was to investigate if the Worker Role Interview (WRI) can predict return to work over a period of two years. Fifty three long-term sick-listed people were interviewed and rated with the WRI. Differences in ratings and the ability of WRI to correctly predict whether these people would fall into the working or non-working groups at 6, 12 and 24 month follow-ups were tested by Mann-Whitney test and logistic regression respectively. Eight of 17 items in WRI were rated differently between the groups at one or more of the follow-ups. The regression models based on the WRI ratings had an overall correct prediction rate ranging from 81% to 96%. Expectation of job success which concerns the persons belief in abilities in relation to return to work emerged as an important predictive factor for return to work in all statistical analyses. The WRI assessment contains items that could predict return to work. This implies that the WRI could be a useful tool in vocational rehabilitation for identifying individual rehabilitation needs.

Keywords
assessment, motivation, psychosocial, RTW, sick-leave, work ability, vocational rehabilitation, occupational therapy, Model of Human Occupation, Bedömningsinstrument, arbetsförmåga, arbetsterapi, sjukfrånvaro, Model of Human Occupation
National Category
Medical and Health Sciences Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-13272 (URN)10.3233/WOR-2010-0968 (DOI)000275284100007 ()
Available from: 2008-05-07 Created: 2008-05-07 Last updated: 2017-12-13
Thorell, L.-H. (2009). Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory. ACTA PSYCHIATRICA SCANDINAVICA, 119(5), 338-349
Open this publication in new window or tab >>Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory
2009 (English)In: ACTA PSYCHIATRICA SCANDINAVICA, ISSN 0001-690X, Vol. 119, no 5, p. 338-349Article, review/survey (Refereed) Published
Abstract [en]

Studies from three independent laboratories report varying relationships between electrodermal hyporeactivity and suicidal behavior in depressed patients. The aims of this study were to explain that variation, to assess the discriminative validity of electrodermal hyporeactivity for suicide and suicide attempts and to suggest a tentative explanation model.

A meta-analysis was performed of 279 depressed patients and 59 healthy subjects.

The sensitivity was 96.6% and specificity 92.9% of electrodermal hyporeactivity for suicide and 83.3% and 92.7%, respectively, for suicide and/or violent attempts. The shares of hyporeactives were strongly significantly and greatly larger in high than in low suicidal propensity groups, P-value ranging from 4.7 x 10(-8) to 1.1 x 10(-14).

The high discriminative validity and the emerging links over a proposed interest-limiting precognitive set to cognitive theory of suicide encourage clinical application of tests of electrodermal reactivity. The study offers a series of testable hypotheses constituting a new platform for suicidological research in depression.

Keywords
electrodermal response, suicide, depression, validity, cognition
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-18040 (URN)10.1111/j.1600-0447.2009.01364.x (DOI)000264954100002 ()
Available from: 2009-05-04 Created: 2009-05-04 Last updated: 2017-01-16
Åström, J. & Thorell, L.-H. (2008). Graphometric variables of one's signature: II. Correlations with measures of perception, cognitive function, and personality. Perceptual and Motor Skills, 107(1), 197-221
Open this publication in new window or tab >>Graphometric variables of one's signature: II. Correlations with measures of perception, cognitive function, and personality
2008 (English)In: Perceptual and Motor Skills, ISSN 0031-5125, E-ISSN 1558-688X, Vol. 107, no 1, p. 197-221Article in journal (Refereed) Published
Abstract [en]

This study focused on interrelations between graphometric variables of the signature and measures of perception, cognitive function, and personality. Signatures from a sample of psychiatric and somatic outpatients (N=205) were analyzed into 23 graphometric variables and correlated with tests of IQ, cognitive and perceptual function, and personality. The results of a factor analysis of the graphometric, perceptual, and cognitive variables were very much like results from previous studies. Relationships with the graphometric variables can be described in five categories of intelligence, psychomotility, flexibility and speed of closure, and personality. Graphometric signs of Extraversion and Neuroticism were identified, and the two capitals in the signature indicated different psychological meanings. Measurements of the signature offered important personality information. © Perceptual and Motor Skills 2008.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-43502 (URN)10.2466/PMS.107.1.197-221 (DOI)73988 (Local ID)73988 (Archive number)73988 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Börelius, L., Foldemo, A., Holmberg, T., Schöld, A.-K., Thorell, L.-H., Ylikivelä, R. & Nettelbladt, P. (2008). Mental unhealth among young adults in primary health care. In: European Psychiatry - the journal of the association of european psychiatrists,2008 (pp. 248-248).
Open this publication in new window or tab >>Mental unhealth among young adults in primary health care
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2008 (English)In: European Psychiatry - the journal of the association of european psychiatrists,2008, 2008, p. 248-248Conference paper, Published paper (Other academic)
Abstract [en]

    

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-42421 (URN)63959 (Local ID)63959 (Archive number)63959 (OAI)
Note
Nr P0190Available from: 2009-10-10 Created: 2009-10-10
Walter, S. A., Bodemar, G., Hallböök, O. & Thorell, L.-H. (2008). Sympathetic (electrodermal) activity during repeated maximal rectal distensions in patients with irritable bowel syndrome and constipation. Neurogastroenterology and Motility, 20(1), 43-52
Open this publication in new window or tab >>Sympathetic (electrodermal) activity during repeated maximal rectal distensions in patients with irritable bowel syndrome and constipation
2008 (English)In: Neurogastroenterology and Motility, ISSN 1350-1925, E-ISSN 1365-2982, Vol. 20, no 1, p. 43-52Article in journal (Refereed) Published
Abstract [en]

Irritable bowel syndrome (IBS) is associated with visceral hypersensitivity, stress and autonomic dysfunction. Sympathetic activity during repeated events indicates excitatory or inhibitory mechanisms such as sensitization or habituation. We investigated skin conductance (SC) during repetitive rectal distensions at maximal tolerable pressure in patients with IBS and chronic constipation. Twenty-seven IBS patients, 13 constipation patients and 18 controls underwent two sets of isobaric rectal distensions. First, maximal tolerable distension was determined and then it was repeated five times. Skin conductance was measured continuously. Subjective symptom assessment remained steady in all groups. The baseline values of SC were higher in IBS patients than in patients with constipation and significantly lower in constipation patients than in controls. The maximal SC response to repetitive maximal distensions was higher in IBS patients compared with constipation patients. The amplitude of the initial SC response decreased successively with increased number of distensions in patients with IBS and constipation but not in controls. Irritable bowel syndrome and constipation patients habituated to maximal repetitive rectal distensions with decreasing sympathetic activity. Irritable bowel syndrome patients had higher sympathetic reactivity and baseline activity than constipation patients. A lower basal SC in constipation patients compared with controls suggests an inhibition of the sympathetic drive in constipation patients.

Keywords
constipation, irritable bowel syndrome, rectal distensions, skin conductance, sympathetic, visceral hypersensitivity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14183 (URN)10.1111/j.1365-2982.2007.00998.x (DOI)
Available from: 2006-12-07 Created: 2006-12-07 Last updated: 2017-12-13Bibliographically approved
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