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  • 1.
    Brus, Ole
    et al.
    Orebro Univ, Sweden.
    Cao, Yang
    Orebro Univ, Sweden; Karolinska Inst, Sweden.
    Hammar, Asa
    Univ Bergen, Norway; Haukeland Hosp, Norway.
    Landen, Mikael
    Gothenburg Univ, Sweden; Karolinska Inst, Sweden.
    Lundberg, Johan
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Nordanskog, Pia
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Nordenskjold, Axel
    Orebro Univ, Sweden.
    Lithium for suicide and readmission prevention after electroconvulsive therapy for unipolar depression: population-based register study2019In: BJPsych Open, E-ISSN 2056-4724, Vol. 5, no 3, article id e46Article in journal (Refereed)
    Abstract [en]

    Background Electroconvulsive therapy (ECT) is effective for unipolar depression but relapse and suicide are significant challenges. Lithium could potentially lower these risks, but is used only in a minority of patients. Aims This study quantifies the effect of lithium on risk of suicide and readmission and identifies factors that are associate with readmission and suicide. Method This population-based register study used data from the Swedish National Quality Register for ECT and other Swedish national registers. Patients who have received ECT for unipolar depression as in-patients between 2011 and 2016 were followed until death, readmission to hospital or the termination of the study at the end of 2016. Cox regression was used to estimate hazard ratios (HR) of readmission and suicide in adjusted models. Results Out of 7350 patients, 56 died by suicide and 4203 were readmitted. Lithium was prescribed to 638 (9%) patients. Mean follow-up was 1.4 years. Lithium was significantly associated with lower risk of suicide (P = 0.014) and readmission (HR 0.84 95% CI 0.75-0.93). The number needed to be treated with lithium to prevent one readmission was 16. In addition, the following factors were statistically associated with suicide: male gender, being a widow, substance use disorder and a history of suicide attempts. Readmission was associated with young age, being divorced or unemployed, comorbid anxiety disorder, nonpsychotic depression, more severe symptoms before ECT, no improvement with ECT, not receiving continuation ECT or antidepressants, usage of antipsychotics, anxiolytics or benzodiazepines, severity of medication resistance and number of previous admissions. Conclusions More patients could benefit from lithium treatment.

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  • 2.
    Böhme, Rebecca
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Hauser, Steven
    Univ Virginia, VA 22904 USA.
    Gerling, Gregory J.
    Univ Virginia, VA 22904 USA.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Olausson, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Distinction of self-produced touch and social touch at cortical and spinal cord levels2019In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 116, no 6, p. 2290-2299Article in journal (Refereed)
    Abstract [en]

    Differentiation between self-produced tactile stimuli and touch by others is necessary for social interactions and for a coherent concept of "self." The mechanisms underlying this distinction are unknown. Here, we investigated the distinction between self-and other-produced light touch in healthy volunteers using three different approaches: fMRI, behavioral testing, and somatosensory-evoked potentials (SEPs) at spinal and cortical levels. Using fMRI, we found self-other differentiation in somatosensory and sociocognitive areas. Other-touch was related to activation in several areas, including somatosensory cortex, insula, superior temporal gyrus, supramarginal gyrus, striatum, amygdala, cerebellum, and prefrontal cortex. During self-touch, we instead found deactivation in insula, anterior cingulate cortex, superior temporal gyrus, amygdala, parahippocampal gyrus, and prefrontal areas. Deactivation extended into brain areas encoding low-level sensory representations, including thalamus and brainstem. These findings were replicated in a second cohort. During self-touch, the sensorimotor cortex was functionally connected to the insula, and the threshold for detection of an additional tactile stimulus was elevated. Differential encoding of self-vs. other-touch during fMRI correlated with the individual self-concept strength. In SEP, cortical amplitudes were reduced during self-touch, while latencies at cortical and spinal levels were faster for other-touch. We thus demonstrated a robust self-other distinction in brain areas related to somatosensory, social cognitive, and interoceptive processing. Signs of this distinction were evident at the spinal cord. Our results provide a framework for future studies in autism, schizophrenia, and emotionally unstable personality disorder, conditions where symptoms include social touch avoidance and poor self-vs.-other discrimination.

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  • 3.
    Carvalho, Andre F.
    et al.
    Ctr Addict and Mental Hlth, Canada; Univ Toronto, Canada.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Perez, Augusto
    Corp Nuevos Rumbos, Colombia.
    Probst, Charlotte
    Ctr Addict and Mental Hlth, Canada.
    Rehm, Jurgen
    Ctr Addict and Mental Hlth, Canada; Univ Toronto, Canada; Univ Toronto, Canada; Univ Toronto, Canada; Ctr Addict and Mental Hlth, Canada; Tech Univ Dresden, Germany; Tech Univ Dresden, Germany; Sechenov First Moscow State Med Univ, Russia.
    Alcohol use disorders2019In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 394, no 10200, p. 781-792Article, review/survey (Refereed)
    Abstract [en]

    Alcohol use disorders consist of disorders characterised by compulsive heavy alcohol use and loss of control over alcohol intake. Alcohol use disorders are some of the most prevalent mental disorders globally, especially in high-income and upper-middle-income countries; and are associated with high mortality and burden of disease, mainly due to medical consequences, such as liver cirrhosis or injury. Despite their high prevalence, alcohol use disorders are undertreated partly because of the high stigma associated with them, but also because of insufficient systematic screening in primary health care, although effective and cost-effective psychosocial and pharmacological interventions do exist. Primary health care should be responsible for most treatment, with routine screening for alcohol use, and the provision of a staggered treatment response, from brief advice to pharmacological treatment. Clinical interventions for these disorders should be embedded in a supportive environment, which can be bolstered by the creation of alcohol control policies aimed at reducing the overall level of consumption.

  • 4.
    Domi, Esi
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Univ Camerino, Italy.
    Caputi, Francesca Felicia
    Alma Mater Studiorum Univ Bologna, Italy.
    Romualdi, Patrizia
    Alma Mater Studiorum Univ Bologna, Italy.
    Domi, Ana
    Univ Camerino, Italy.
    Scuppa, Giulia
    Univ Camerino, Italy.
    Candeletti, Sanzio
    Alma Mater Studiorum Univ Bologna, Italy.
    Atkins, Alison Lynn
    Linköping University, Department of Clinical and Experimental Medicine, Divison of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Demopulos, Gregory
    Omeros Corp, WA 98101 USA.
    Gaitanaris, George
    Omeros Corp, WA 98101 USA.
    Ciccocioppo, Roberto
    Univ Camerino, Italy.
    Ubaldi, Massimo
    Univ Camerino, Italy.
    Activation of PPAR gamma Attenuates the Expression of Physical and Affective Nicotine Withdrawal Symptoms through Mechanisms Involving Amygdala and Hippocampus Neurotransmission2019In: Journal of Neuroscience, ISSN 0270-6474, E-ISSN 1529-2401, Vol. 39, no 49, p. 9864-9875Article in journal (Refereed)
    Abstract [en]

    An isoform of peroxisome proliferator-activated receptors (PPARs), PPAR gamma, is the receptor for the thiazolidinedione class of antidiabetic medications including pioglitazone. Neuroanatomical data indicate PPAR gamma localization in brain areas involved in drug addiction. Preclinical and clinical data have shown that pioglitazone reduces alcohol and opioid self-administration, relapse to drug seeking, and plays a role in emotional responses. Here, we investigated the behavioral effect of PPAR gamma manipulation on nicotine withdrawal in male Wistar rats and in male mice with neuron-specific PPAR gamma deletion (PPAR gamma(()(+/+)())) and their littermate wild-type (PPAR gamma((-/-))) controls. Real-time quantitative RT-PCR and RNAscope in situ hybridization assays were used for assessing the levels of expression and cell-type localization of PPAR gamma function, Memory, Mortality, Older subjects, Structural brain abnormalities during nicotine withdrawal. Brain site-specific microinjections of the PPAR gamma agonist pioglitazone were performed to explore the role of this system on nicotine withdrawal at a neurocircuitry level. Results showed that activation of PPAR gamma by pioglitazone abolished the expression of somatic and affective nicotine withdrawal signs in rats and in (PPAR gamma(()(+/+)())) mice. This effect was blocked by the PPAR gamma antagonist GW9662. During early withdrawal and protracted abstinence, the expression of PPAR gamma increased in GABAergic and glutamatergic cells of the amygdala and hippocampus, respectively. Hippocampal microinjections of pioglitazone reduced the expression of the physical signs of withdrawal, whereas excessive anxiety associated with protracted abstinence was prevented by pioglitazone microinjection into the amygdala. Our results demonstrate the implication of the neuronal PPAR gamma in nicotine withdrawal and indicates that activation of PPAR gamma may offer an interesting strategy for smoking cessation.

  • 5.
    Filipcic, Igor
    et al.
    Psychiat Hosp Sveti Ivan, Croatia; Josip Juraj Strossmayer Univ Osijek, Croatia; Univ Zagreb, Croatia.
    Filipcic, Ivona Simunovic
    Univ Hosp Ctr Zagreb, Croatia.
    Milovac, Zeljko
    Psychiat Hosp Sveti Ivan, Croatia.
    Sucic, Strahimir
    Psychiat Hosp Sveti Ivan, Croatia.
    Gajsak, Tomislav
    Psychiat Hosp Sveti Ivan, Croatia.
    Ivezic, Ena
    Psychiat Hosp Sveti Ivan, Croatia; Josip Juraj Strossmayer Univ Osijek, Croatia.
    Basic, Silvio
    Josip Juraj Strossmayer Univ Osijek, Croatia; Dubrava Univ Hosp, Croatia.
    Bajic, Zarko
    Psychiat Hosp Sveti Ivan, Croatia.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Efficacy of repetitive transcranial magnetic stimulation using a figure-8-coil or an H1-Coil in treatment of major depressive disorder; A randomized clinical trial2019In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 114, p. 113-119Article in journal (Refereed)
    Abstract [en]

    Repetitive transcranial magnetic stimulation (rTMS) is an evidence-based treatment option for major depressive disorder (MDD). However, comparisons of efficacy between the two FDA-approved protocols of rTMS modalities are lacking. The aim of this industry-independent, randomized-controlled, single-blind trial was to evaluate clinical outcome of the two FDA-approved rTMS protocols delivered by H1-coil and the figure-8-coil, in MDD patients. A total of 228 MDD patients were randomized to 20 sessions of H1-coil or 8-coil as an adjunct to standard-of-care pharmacotherapy, or standard-of-care pharmacotherapy alone. Baseline MDD symptom severity was almost the same in the three groups. Hamilton depression rating scale (HAM-D17) mean score was 17 (5.3) in H1-coil, 17 (5.4) in 8-coil, and 19 (6.1) in control group. The primary outcome was the proportion of patients achieving remission defined as HAM-D17 score amp;lt;= 7 at end-of-treatment at week-4. In the intention-to-treat analysis odds ratio for remission was 1.74 (CI95% 0.79-3.83) in H1-coil compared to the 8-coil group. The difference between two rTMS protocols was not significant. Remission rate was significantly greater in both HF-rTMS groups compared to the control: 60% (CI95% 48-71%), 43% (C195% 31-55%) and 11% (CI95% 5-20%) respectively. The response was significantly better in H1-coil, than in 8-coil group OR = 2.33; CI95% 1.04-5.21 (P = 0.040). The HAM-D17 was lowered by 59% in the H1-coil, 41% in the 8-coil (P = 0.048), and 17% in the control group (P amp;lt; 0.001 vs H1-coil; P = 0.003 vs 8-coil). Safety, tolerability, and the changes in quality of life were comparable. We confirmed the safety and efficacy of both FDA-approved protocols as adjunctive treatments of MDD. Better response rate and greater reduction of depression severity were observed in the H1-coil group, but without a significant difference in the remission rate between the two rTMS modalities.

  • 6.
    Fredlund, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Adolescents Selling Sex and Sex as Self-Injury2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    There are today only a few population-based studies in the world investigating the prevalence of and associated risk-factors with adolescents selling sex and so far no earlier population-based study has been found investigating adolescents motives for selling sex. Further, to use sex in means of self-injury (SASI) is a behaviour that has been highlighted in Sweden the last years but it is a new field of research and a behaviour in need of conceptualization.

    The aim of this thesis was to investigate the prevalence of, associated risk factors with, motives for and manifestations of adolescents selling sex and the use of sex as self-injury (SASI). For the thesis, two nationally representative cross-sectional population surveys with third year students at Swedish high schools were collected in 2009 (n = 3498, mean age 18.3 +/- 0.6 years, response rate 60.4%) and in 2014 (n = 5839, mean age 18.0 +/- 0.6 years, response rate 59.7%). Further, the motives and manifestations of SASI were investigated in an anonymous self-selected, open-ended questionnaire published on websites of non-governmental organizations offering help and support to women and adolescents (n = 199, mean age 27.9 +/- 9.3 years). Quantitative and qualitative methods were used for data analyses.

    In the 2009 population-based survey, 1.5% (n = 51) of the adolescents reported having sold sex on at least one occasion, but in 2014 the prevalence was slightly lower at 0.9% (n = 51). SASI was reported by 3.2% of girls (n = 100) and 0.8% of boys (n = 20). Both selling sex and SASI were associated with various adverse factors such as experience of sexual abuse, emotional and physical abuse, poor mental health and self-injury. Adolescents selling sex had sought help and support for different problems and worries to a greater extent compared to peers. Contact with healthcare for various psychiatric problems such as suicide attempts, depression and eating disorders was common for adolescents using SASI. Further analysis showed that adolescents selling sex are a heterogeneous group in regard to underlying motives for selling sex, which included emotional and material reasons as well as pleasure. Depending on their underlying motives, adolescents selling sex were found to differ in regard to compensation received, age of the buyer, means of contact with the buyer, sexual orientation, experience of sexual abuse and the use of SASI. By using data from an open-ended questionnaire, SASI was described as deliberate or self-inflicted sexual situations that could include psychological and physical harm. SASI was used as a way to regulate negative feelings, such as anxiety, or to get positive or negative confirmation and the behaviour could be hard to stop.

    In conclusion, selling sex and SASI occurs among Swedish adolescents and the behaviours are associated with sexual, physical and emotional abuse and poor mental health, including trauma symptoms. In regard of the motives and manifestations of SASI, the behaviour could be compared to direct self-injurious behaviours. Data from this thesis suggest that more attention should be paid in healthcare to recognizing adolescents selling sex and SASI in order to prevent further traumatization and victimization.

    List of papers
    1. Adolescents selling sex: Exposure to abuse, mental health, self-harm behaviour and the need for help and support - a study of a Swedish national sample
    Open this publication in new window or tab >>Adolescents selling sex: Exposure to abuse, mental health, self-harm behaviour and the need for help and support - a study of a Swedish national sample
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    2013 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 67, no 2, p. 81-88Article in journal (Refereed) Published
    Abstract [en]

    Selling sex is not uncommon among adolescents and we need to increase our knowledge of how this affects them. The aim of this study was to investigate adolescents who sell sex regarding sexual, mental and physical abuse, mental health as estimated by using the Hopkins Symptom Check List-25 (HSCL-25), self-harm behaviour and the adolescents' experience of receiving help and support. The study was carried out on a national representative sample of adolescents (mean age 18.3 years) in Swedish high schools in the final year of their 3-year programme. The study had 3498 participants and a response rate of 60.4%. Of the adolescents, 1.5% stated that they had sold sexual services. The selling of sex was associated with a history of sexual, mental and physical abuse. Poorer mental health and a higher degree of self-harm behaviour were reported among the adolescents who had sold sex. Help and support was sought to a greater extent by adolescents who had sold sex but these adolescents were not as satisfied with this help and support as the other adolescents. Adolescents that sell sex are a group especially exposed to sexual, mental and physical abuse. They have poorer metnal health and engage in more self-harm behaviour than other adolescents. They are in need of more help and support than other adolescents ant it is reasonable to assert that more resources, research and attention should be directed to this group to provide better help and support in the future.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2013
    Keywords
    adolescents, child abuse, help and support, mental health, self-harm behaviour, selling sex
    National Category
    Other Medical Sciences
    Identifiers
    urn:nbn:se:liu:diva-91850 (URN)10.3109/08039488.2012.679968 (DOI)000316956800001 ()
    Available from: 2013-05-03 Created: 2013-05-03 Last updated: 2021-05-18Bibliographically approved
    2. Adolescents motives for selling sex in a welfare state - A Swedish national study
    Open this publication in new window or tab >>Adolescents motives for selling sex in a welfare state - A Swedish national study
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    2018 (English)In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 81, p. 286-295Article in journal (Refereed) Published
    Abstract [en]

    In addition to money or other compensation, other motives for selling sex may be important in a welfare country such as Sweden. The aim of this study was to carry out an exploratory investigation of adolescents motives for selling sex in a population-based survey in Sweden. A total of 5839 adolescents from the third year of Swedish high school, mean age 18.0 years, participated in the study. The response rate was 59.7% and 51 students (0.9%) reported having sold sex. Exploratory factor analysis and hierarchical cluster analysis were used to identify groups of adolescents according to underlying motives for selling sex. Further analyses were carried out for characteristics of selling sex and risk factors. Three groups of adolescents were categorized according to their motives for selling sex: Adolescents reporting; 1) Emotional reasons, being at a greater risk of sexual abuse, using sex as a means of self-injury and having a non-heterosexual orientation. 2) Material but no Emotional reasons, who more often receive money as compensation and selling sex to a person over 25 years of age, and 3) Pleasure or no underlying motive for selling sex reported, who were mostly heterosexual males selling sex to a person under 25 years of age, the buyer was not known from the Internet, the reward was seldom money and this group was less exposed to penetrative sexual abuse or using sex as a means of self-injury. In conclusion, adolescents selling sex are a heterogeneous group in regard to underlying motives.

    Place, publisher, year, edition, pages
    PERGAMON-ELSEVIER SCIENCE LTD, 2018
    Keywords
    Selling sex; Adolescent; Child sexual exploitation; Motives; Prostitution
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-149697 (URN)10.1016/j.chiabu.2018.04.030 (DOI)000436375800026 ()29775872 (PubMedID)
    Note

    Funding Agencies|Ministry of Health and Social Affairs/the Childrens Welfare Foundation Sweden; County of Stockholm, Sweden

    Available from: 2018-07-24 Created: 2018-07-24 Last updated: 2021-05-18
    3. Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health
    Open this publication in new window or tab >>Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health
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    2017 (English)In: Child and Adolescent Psychiatry and Mental Health, E-ISSN 1753-2000, Vol. 11, no 1Article in journal (Refereed) Published
    Abstract [en]

    Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct self-injury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury.

    Place, publisher, year, edition, pages
    BioMed Central, 2017
    National Category
    Neurosciences Rheumatology and Autoimmunity Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-134927 (URN)10.1186/s13034-017-0146-7 (DOI)000395328600001 ()
    Available from: 2017-03-02 Created: 2017-03-02 Last updated: 2024-01-17Bibliographically approved
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  • 7.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsson, Therese
    Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Andersson, Caroline
    Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    The use of MOHO intervention methods for enabling occupational change in mental health.2019Conference paper (Refereed)
    Abstract [en]

    The presented MOHO intervention methods; strategies and interventions, for facilitating change has not been investigated in practice in Sweden. MOHO is often seen as an assessment model. Many assessments have been translated and tested for scientific standard in Sweden but the intervention part has not been noticed in the same way. The aim of the presented survey was to investigate the use of the methods for facilitating change with MOHO in a Swedish context. Ten OT in the area of mental health were invited to partaken in the survey. In their daily work they reported on a questionnaire which methods they used if they were applying MOHO in the treatment sessions together with the client. Regarding therapeutic strategies in total 78 treatment sessions were reported. After following a treatment planning process including different MOHO assessments depending on the client ́s needs, it was stated that the main areas of concern for the clients were volition or habit or performance capacity to almost the same extent for all three elements. The result show that two of the strategies; “Validation” and “Identifying” was use most frequently. “Providing Physical Support” and “Negotiating” was used very sparingly. The most surprising result was that ”Structuring” was rated as number 6of the 9 strategies. When OT describe what they are doing, structuring daily occupations very often is mention as a regular intervention. The interventions are currently being tested, the results will be presented in September.

  • 8.
    Heilig, Markus
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Augier, Eric
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Pfarr, Simone
    Cent Inst Mental Hlth, Germany.
    Sommer, Wolfgang H.
    Cent Inst Mental Hlth, Germany; Cent Inst Mental Hlth, Germany.
    Developing neuroscience-based treatments for alcohol addiction: A matter of choice?2019In: Translational Psychiatry, E-ISSN 2158-3188, Vol. 9, article id 255Article, review/survey (Refereed)
    Abstract [en]

    Excessive alcohol use is the cause of an ongoing public health crisis, and accounts for -5% of global disease burden. A minority of people with recreational alcohol use develop alcohol addiction (hereafter equated with "alcohol dependence" or simply "alcoholism"), a condition characterized by a systematically biased choice preference for alcohol at the expense of healthy rewards, and continued use despite adverse consequences ("compulsivity"). Alcoholism is arguably the most pressing area of unmet medical needs in psychiatry, with only a small fraction of patients receiving effective, evidence-based treatments. Medications currently approved for the treatment of alcoholism have small effect sizes, and their clinical uptake is negligible. No mechanistically new medications have been approved since 2004, and promising preclinical results have failed to translate into novel treatments. This has contributed to a reemerging debate whether and to what extent alcohol addiction represents a medical condition, or reflects maladaptive choices without an underlying brain pathology. Here, we review this landscape, and discuss the challenges, lessons learned, and opportunities to retool drug development in this important therapeutic area.

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  • 9.
    Holmqvist Larsson, Mattias
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Rupture and Repair in the Working Alliance: Relation to Psychotherapy Outcome and Within-Session Interaction2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Ruptures and repairs are processes related to shifts in the collaborative relationship Cthe working allianceJ between patient and therapist in psychotherapy. Ta study ruptures and repairs is one way ta disentangle mechanisms that might underlie the association between the working alliance and psychotherapy outcome. The overarching aim af this thesis was ta analyze the clinical relevance af the rupture and repair concepts at different process levels. The same three alliance patterns were investigated in the three empirical studies: the rupture pattern, the repair pattern, and the no-rupture/stable pattern. The analyses af the alliance patterns moved fromwhole treatments ta session segments. In Study I ruptures were found ta be associated with worse outcomes than treatments without ruptures. Repairs were, in longer therapies, shown ta be related ta better outcomes than norupture treatments. In Study Il it was found that the three alliance patterns could be discerned within sessions. Ruptures and repairs within sessions were found ta be associated with patient-ratings af the working alliance. In Study 111 the alliance patterns were found ta be related ta different  interaction patterns within sessions. In these analyses, importont patient contributions ta repairs af ruptures were found.

    List of papers
    1. Alliance ruptures and repairs in psychotherapy in primary care
    Open this publication in new window or tab >>Alliance ruptures and repairs in psychotherapy in primary care
    2018 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 28, no 1, p. 123-136Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: The association between alliance level and outcome in psychotherapy has been extensively studied. One way to expand this knowledge is to study alliance patterns. The main aims of this study were to examine how frequent alliance patterns with ruptures or rupture-repair episodes were in a naturalistic sample of psychotherapies in primary care, and if three alliance patterns (a Rupture pattern, a Repair pattern, and a No Rupture pattern) were differentially associated with treatment outcome.

    METHOD: The psychotherapies (N = 605) included a wide range of different treatment orientations and patient diagnoses. Alliance patterns were studied at session-to-session level, using patient-rated alliance scores. Outcome data were analyzed using longitudinal multilevel modeling with a slopes-as-outcomes model.

    RESULTS: The Repair pattern accounted for 14.7% (n = 89) of the treatments, 10.7% (n = 65) exhibited a Rupture pattern, and 74.5% (n = 451) contained no ruptures. The Rupture pattern was associated with inferior treatment outcomes. The Repair pattern was, in longer treatments, associated with better outcomes than the No Rupture pattern.

    CONCLUSIONS: The results support theory about the importance of ruptures in the therapeutic alliance and suggest that identification of alliance ruptures is important in alliance-outcome research, for feedback purposes in clinical practice, and in training of therapists.

    Place, publisher, year, edition, pages
    Routledge, 2018
    Keywords
    alliance, alliance patterns, alliance ruptures, longitudinal multilevel modeling, naturalistic process and outcome research
    National Category
    Applied Psychology
    Identifiers
    urn:nbn:se:liu:diva-143855 (URN)10.1080/10503307.2016.1174345 (DOI)000418942800011 ()27139816 (PubMedID)2-s2.0-84965032354 (Scopus ID)
    Available from: 2017-12-21 Created: 2017-12-21 Last updated: 2019-06-27Bibliographically approved
    2. The Alliance and Rupture Observation Scale (AROS): Development and validation of an alliance and rupture measure for repeated observations within psychotherapy sessions
    Open this publication in new window or tab >>The Alliance and Rupture Observation Scale (AROS): Development and validation of an alliance and rupture measure for repeated observations within psychotherapy sessions
    Show others...
    2019 (English)In: Journal of Clinical Psychology, ISSN 0021-9762, E-ISSN 1097-4679, Vol. 75, no 3, p. 404-417Article in journal (Refereed) Published
    Abstract [en]

    Objective: The aim of this study was to test a new observer-rated instrument, the Alliance and Rupture Observation Scale (AROS). It was designed for repeated measurements of the alliance within sessions and to detect alliance ruptures.

    Method: Videotaped therapy sessions with depressed adults were analyzed. Reliability was mainly assessed as inter-rater reliability. Convergent, predictive, and discriminant validity of the AROS was assessed by comparing the instrument with both observer-rated and patient-rated measures.

    Results: The AROS exhibited excellent inter-rater reliability. Alliance levels measured with the AROS predicted patients’ ratings of the alliance in the same session and were highly correlated with another observer-rated alliance measure. Alliance patterns (rupture; repair; and no-rupture) based on AROS scores were significantly correlated with patients’ ratings of the alliance.

    Conclusions: Preliminary support for convergent and predictive validity was found. It is yet to be determined whether AROS scores are related to psychotherapy outcomes.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2019
    Keywords
    alliance ruptures and repairs, measurement, observer-based alliance measure, psychotherapy process, test development, therapeutic alliance, therapeutic relationship
    National Category
    Psychology
    Identifiers
    urn:nbn:se:liu:diva-154932 (URN)10.1002/jclp.22704 (DOI)000459626300006 ()30431649 (PubMedID)2-s2.0-85056660476 (Scopus ID)
    Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-06-27Bibliographically approved
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  • 10.
    Josefsson, Ann
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Vikström, Josefin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Bladh, Marie
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Major depressive disorder in women and risk for future generations: population-based three-generation study2019In: BJPsych Open, E-ISSN 2056-4724, Vol. 5, no 1, article id e8Article in journal (Refereed)
    Abstract [en]

    Background The well-known adverse consequences of maternal depression prompts consideration of the importance of learning more about intergenerational transmission in order to identify individuals at risk of developing depressive disorders. Aims To follow two generations of women with major depressive disorder (MDD) and to examine the risk of MDD in the third-generation children. Method A register-based, retrospective cohort study of all women born in Sweden between 1973 and 1982 who had given birth during the study period, their mothers and their children. All generations were followed until 2013. Data was stratified into two cohorts: women born between 1973 and 1977 and those born between 1978 and 1982. Results Second-generation women were twice as likely to be diagnosed with MDD if their mothers had been diagnosed with MDD. If both previous generations had been diagnosed with depression the likelihood of the third-generation child being diagnosed with MDD was markedly increased (odds ratio (OR) = 5.07, 95% CI 4.06-6.34 and OR = 7.20, 95% CI 4.41-11.77 in cohort 1 and cohort 2, respectively). Conclusions There is a strong intergenerational impact in the transmission of MDD. The risk of MDD is especially high in individuals with MDD in both previous maternal generations.

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  • 11.
    Ludvigsson, Mikael
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Marcusson, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Milberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping.
    Morbidity and mortality in very old individuals with subsyndromal depression: an 8-year prospective study2019In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 31, no 11, p. 1569-1579, article id PII S1041610219001480Article in journal (Refereed)
    Abstract [en]

    Objectives: Both morbidity and mortality are elevated for individuals with subsyndromal depression (SSD) compared to non-depression (ND) in those of younger ages, but scientific studies are scarce for very old individuals. The aim of this study was therefore to compare the morbidity and mortality in very old individuals with SSD and ND. Design and setting: An 8-year prospective population-based study was undertaken on 85-year-old individuals in Sweden. Measurements: Data were collected from postal questionnaires and clinical assessments at baseline, after 1, 5, and 8 years. Depressive symptoms were measured with Geriatric Depression Scale and the results were classified into ND, SSD, and syndromal depression. Mortality was investigated using multivariable cox regressions, and variables of morbidity were investigated using linear mixed models. Results: Compared to ND, in people with SSD, mortality was elevated in the univariate regression, but this association vanished when controlling for relevant covariates. Morbidity was elevated with regard to basic activities of daily living (ADLs), instrumental ADLs, loneliness, self-perceived health, and depressive symptoms for individuals with SSD compared to ND, whereas cognitive speed, executive functions, and global cognitive function were not significantly impaired when adjusting for covariates. Conclusions: SSD among very old individuals is longitudinally associated with elevated morbidity but not mortality, when controlling for relevant covariates. Considering the high prevalence of SSD and the demographic development of increasing numbers of very old people, the findings highlight the need to develop clinical and societal strategies to prevent SSD and associated negative outcomes.

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  • 12.
    Mayo, Leah
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    In the face of stress: Interpreting individual differences in stress-induced facial expressions2019In: NEUROBIOLOGY OF STRESS, ISSN 2352-2895, Vol. 10, article id 100166Article, review/survey (Refereed)
    Abstract [en]

    Stress is an inevitable part of life that can profoundly impact social and emotional functioning, contributing to the development of psychiatric disease. One key component of emotion and social processing is facial expressions, which humans can readily detect and react to even without conscious awareness. Facial expressions have been the focus of philosophic and scientific interest for centuries. Historically, facial expressions have been relegated to peripheral indices of fixed emotion states. More recently, affective neuroscience has undergone a conceptual revolution, resulting in novel interpretations of these muscle movements. Here, we review the role of facial expressions according to the leading affective neuroscience theories, including constructed emotion and social-motivation accounts. We specifically highlight recent data (Mayo et al, 2018) demonstrating the way in which stress shapes facial expressions and how this is influenced by individual factors. In particular, we focus on the consequence of genetic variation within the endocannabinoid system, a neuromodulatory system implicated in stress and emotion, and its impact on stress-induced facial muscle activity. In a re-analysis of this dataset, we highlight how gender may also influence these processes, conceptualized as variation in the "fight-or-flight" or "tend-and-befriend" behavioral responses to stress. We speculate on how these interpretations may contribute to a broader understanding of facial expressions, discuss the potential use of facial expressions as a trans-diagnostic marker of psychiatric disease, and suggest future work necessary to resolve outstanding questions.

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  • 13.
    Nelson, Britta S.
    et al.
    Univ Georgia, GA 30602 USA.
    Fulenwider, Hannah D.
    Univ Georgia, GA 30602 USA.
    Nennig, Sadie E.
    Univ Georgia, GA 30602 USA.
    Smith, Britessia M.
    Univ Georgia, GA 30602 USA.
    Sequeira, Michelle K.
    Univ Georgia, GA 30602 USA.
    Chimberoff, Scott H.
    Univ Georgia, GA 30602 USA.
    Richie, Christopher T.
    NIDA, MD 20892 USA.
    Cheng, Kejun
    NIAAA, MD USA; NIDA, MD 20892 USA; US FDA, MD USA.
    Rice, Kenner C.
    NIAAA, MD USA; NIDA, MD 20892 USA.
    Harvey, Brandon K.
    NIDA, MD 20892 USA.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Schank, Jesse R.
    Univ Georgia, GA 30602 USA.
    Escalated Alcohol Self-Administration and Sensitivity to Yohimbine-lnduced Reinstatement in Alcohol Preferring Rats: Potential Role of Neurokinin-1 Receptors in the Amygdala2019In: Neuroscience, ISSN 0306-4522, E-ISSN 1873-7544, Vol. 413, p. 77-85Article in journal (Refereed)
    Abstract [en]

    Genetic factors significantly contribute to the risk for developing alcoholism. To study these factors and other associated phenotypes, rodent lines have been developed using selective breeding for high alcohol preference. One of these models, the alcohol preferring (P) rat, has been used in hundreds of preclinical studies over the last few decades. However, very few studies have examined relapse-like behavior in this rat strain. In this study, we used operant self-administration and yohimbine-induced reinstatement models to examine relapse-like behavior in P rats. Our previous work has demonstrated that P rats show increased expression of the neurokinin-1 receptor (NK1R) in the central nucleus of the amygdala (CeA), and this functionally contributes to escalated alcohol consumption in this strain. We hypothesized that P rats would show increased sensitivity to yohimbine-induced reinstatement that is also mediated by NK1R in the CeA. Using Fos staining, site-specific infusion of NK1R antagonist, and viral vector overexpression, we examined the influence of NK1R on the sensitivity to yohimbine-induced reinstatement of alcohol seeking. We found that P rats displayed increased sensitivity to yohimbine-induced reinstatement as well as increased neuronal activation in the CeA after yohimbine injection compared to the control Wistar strain. Intra-CeA infusion of NK1R antagonist attenuates yohimbine-induced reinstatement in P rats. Conversely, upregulation of NK1R within the CeA of Wistar rats increases alcohol consumption and sensitivity to yohimbine-induced reinstatement. These findings suggest that NK1R upregulation in the CeA contributes to multiple alcohol-related phenotypes in the P rat, including alcohol consumption and sensitivity to relapse. (C) 2019 IBRO. Published by Elsevier Ltd. All rights reserved.

  • 14.
    Perini, Irene
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Hamilton, Paul J.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Kämpe, Robin
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Mayo, Leah M.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Zetterqvist, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Brain-based Classification of Negative Social Bias in Adolescents With Nonsuicidal Self-injury: Findings From Simulated Online Social Interaction.2019In: eClinicalMedicine, E-ISSN 2589-5370, Vol. 13, p. 81-90Article in journal (Refereed)
    Abstract [en]

    Background: Interpersonal stress and perceived rejection have been clinically observed as common triggers of nonsuicidal self-injury (NSSI), with self-injury behavior regulating both affective and social experiences. We investigated whether the subjective interpretation of social interaction in a simulated online environment might be biased in the NSSI group, and the brain mechanisms underlying the experience.

    Methods: Thirty female adolescent patients with NSSI and thirty female age-matched controls were investigated in this case-control study. In our novel task that simulates interaction on current social media platforms, participants indicated whether they liked or disliked pictures of other players during a functional magnetic resonance imaging (fMRI) scan. Participants also viewed positive and negative feedback directed toward them by others. The task also assessed the subjective effects of the social interaction. Finally, subjects underwent a separate facial electromyography session, which measured facial expressions processing.

    Outcomes: Behaviorally, the NSSI group showed a negative bias in processing social feedback from others. A multi-voxel pattern analysis (MVPA) identified brain regions that robustly classified NSSI subjects and controls. Regions in which mutual activity contributed to the classification included dorsomedial prefrontal cortex and subgenual anterior cingulate cortex, a region implicated in mood control. In the NSSI group, multi-voxel classification scores correlated with behavioral sensitivity to negative feedback from others. Results remained significant after controlling for medication, symptoms of depression, and symptoms of borderline personality disorder.

    Interpretation: This study identified behavioral and neural signatures of adolescents with NSSI during social interaction in a simulated social media environment. These findings highlight the importance of understanding social information processing in this clinical population and can potentially advance treatment approaches.

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  • 15.
    Persson, Emil
    et al.
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
    Asutay, Erkin
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Löfberg, Andreas
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Pedersen, Nancy
    Karolinska Inst, Sweden.
    Västfjäll, Daniel
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Decis Res, OR USA.
    Tinghög, Gustav
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
    Variation in the mu-Opioid Receptor Gene (OPRM1) Does Not Moderate Social-Rejection Sensitivity in Humans2019In: Psychological Science, ISSN 0956-7976, E-ISSN 1467-9280, Vol. 30, no 7, p. 1050-1062Article in journal (Refereed)
    Abstract [en]

    Given previous findings from animal studies and small-scale studies in humans, variation in the mu-opioid receptor gene (OPRM1) has been proposed as a strong biological candidate for moderating sensitivity to social rejection. Using a substantially larger sample (N = 490) than previous studies, a prospective genotyping strategy, and preregistered analysis plans, we tested the hypotheses that OPRM1 variation measured by the functional A118G polymorphism (rs1799971) moderates (a) dispositional sensitivity to rejection and feelings of distress following social exclusion and (b) decision making involving social cognition. In three experimental tasks commonly used to assess altruism, reciprocity, and trust in humans, we found no evidence in favor of the hypotheses; nine main tests were preregistered, and all of them yielded small and statistically insignificant estimates. In secondary analyses, we used Bayesian inference and estimation to quantify support for our findings. Taken together, our results strongly suggest that the link between OPRM1 A118G variation and social-rejection sensitivity is weaker than previously thought.

  • 16.
    Popiolek, K.
    et al.
    Orebro Univ, Sweden.
    Beierot, S.
    Orebro Univ, Sweden.
    Brus, O.
    Orebro Univ, Sweden.
    Hammer, A.
    Univ Bergen, Norway; Haukeland Hosp, Norway.
    Leaden, M.
    Gothenburg Univ, Sweden; Karolinska Inst, Sweden.
    Lundberg, J.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Nordanskog, Pia
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Nordenskjold, A.
    Orebro Univ, Sweden.
    Electroconvulsive therapy in bipolar depression - effectiveness and prognostic factors2019In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 140, no 3, p. 196-204Article in journal (Refereed)
    Abstract [en]

    Objective Electroconvulsive therapy (ECT) is used in patients with severe forms of bipolar depression. ECT is effective but not all patients respond. The aim of this study was to determine prognostic factors for response to ECT in patients hospitalized for bipolar depression. Methods Data were obtained from several national Swedish registers. All patients with bipolar depression treated with ECT in any hospital in Sweden between 2011 and 2016 for whom information about ECT response was available were included (n = 1251). Response was defined as a score on the Clinical Global Impression - Improvement scale of one or two. Univariate and multivariate logistic regression were conducted to investigate associations between socio-demographic and clinical factors and response. Results Response was achieved in 80.2% patients. Older age was associated with higher response rate to ECT. Patients with comorbid obsessive-compulsive disorder or personality disorder, and patients previously treated with lamotrigine had lower response rate. Conclusion Electroconvulsive therapy for bipolar depression was associated with very high response rates. The strongest prognostic factors were higher age, absence of comorbid obsessive-compulsive disorder or personality disorder, and less prior pharmacologic treatment.

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  • 17.
    Ray, Lara A.
    et al.
    Univ Calif Los Angeles, CA 90095 USA.
    Grodin, Erica N.
    Univ Calif Los Angeles, CA 90095 USA.
    Leggio, Lorenzo
    NIDA, MD USA; Brown Univ, RI 02912 USA.
    Bechtholt, Anita J.
    NIAAA, MD USA.
    Becker, Howard
    Med Univ South Carolina, SC 29425 USA; Ralph H Johnson VA Med Ctr, SC USA.
    Ewing, Sarah W. Feldstein
    Oregon Hlth and Sci Univ, OR 97201 USA.
    Jentsch, James David
    SUNY Binghamton, NY USA.
    King, Andrea C.
    Univ Chicago, IL 60637 USA.
    Mason, Barbara J.
    Scripps Res Inst, CA USA.
    OMalley, Stephanie
    Yale Sch Med, CT USA.
    MacKillop, James
    McMaster Univ, Canada; St Josephs Healthcare Hamilton, Canada.
    Heilig, Markus
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Koob, George F.
    NIDA, MD USA.
    The future of translational research on alcohol use disorder2021In: Addiction Biology, ISSN 1355-6215, E-ISSN 1369-1600, Vol. 26, no 2, article id e12903Article, review/survey (Refereed)
    Abstract [en]

    In March 2019, a scientific meeting was held at the University of California, Los Angeles (UCLA) Luskin Center to discuss approaches to expedite the translation of neurobiological insights to advances in the treatment of alcohol use disorder (AUD). A guiding theme that emerged was that while translational research in AUD is clearly a challenge, it is also a field ripe with opportunities. Herein, we seek to summarize and disseminate the recommendations for the future of translational AUD research using four sections. First, we briefly review the current landscape of AUD treatment including the available evidence-based treatments and their uptake in clinical settings. Second, we discuss AUD treatment development efforts from a translational science viewpoint. We review current hurdles to treatment development as well as opportunities for mechanism-informed treatment. Third, we consider models of translational science and public health impact. Together, these critical insights serve as the bases for a series of recommendations and future directions. Towards the goal of improving clinical care and population health for AUD, scientists are tasked with bolstering the clinical applicability of their research findings so as to expedite the translation of knowledge into patient care.

  • 18.
    Ree, Anbjorn
    et al.
    Univ Oslo, Norway.
    Morrison, India
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Olausson, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Sailer, Uta
    Univ Oslo, Norway.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Mayo, Leah
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Using Facial Electromyography to Assess Facial Muscle Reactions to Experienced and Observed Affective Touch in Humans2019In: Journal of Visualized Experiments, E-ISSN 1940-087X, no 145, article id e59228Article in journal (Refereed)
    Abstract [en]

    Affective

  • 19.
    Rehm, Juergen
    et al.
    CAMH, Canada; Univ Toronto, Canada; Univ Toronto, Canada; Univ Toronto, Canada; Tech Univ Dresden, Germany; IM Sechenov First Moscow State Med Univ, Russia.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Gual, Antoni
    Hosp Clin Barcelona, Spain; IDIBAPS Inst Recerca Biomed Agusti Pi and Sunyer, Spain; Inst Carlos III, Spain.
    Comments: ICD-11 for Alcohol Use Disorders: Not a Convincing Answer to the Challenges2019In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 43, no 11, p. 2296-2300Article in journal (Other academic)
    Abstract [en]

    n/a

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  • 20.
    Rönnqvist, Ida
    et al.
    Orebro Univ, Sweden.
    Brus, Ole
    Orebro Univ, Sweden.
    Hammar, Asa
    Univ Bergen, Norway; Haukeland Hosp, Norway.
    Landen, Mikael
    Karolinska Inst, Sweden; Gothenburg Univ, Sweden.
    Lundberg, Johan
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Nordanskog, Pia
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Nordenskjold, Axel
    Orebro Univ, Sweden.
    Rehospitalization of Postpartum Depression and Psychosis After Electroconvulsive Therapy A Population-Based Study With a Matched Control Group2019In: Journal of ECT, ISSN 1095-0680, E-ISSN 1533-4112, Vol. 35, no 4, p. 264-271Article in journal (Refereed)
    Abstract [en]

    Objectives Electroconvulsive therapy (ECT) is used in some cases of postpartum depression (PPD) and postpartum psychosis (PPP). The risk of relapse for PPD and PPP after ECT is unknown. This study compared the relapse rate after ECT between women who had been treated for PPD and/or PPP and women who had been treated for depression and/or psychosis outside the postpartum period. Methods The Swedish National Quality Register for ECT and the Swedish National Patient Register were used to identify women with PPD and/or PPP who had been treated with ECT within 6 months after delivery. For each case, a control (treated with ECT but not postpartum) patient was also selected. A Kaplan-Meier estimator was used to calculate the relapse rate (defined as rehospitalization or suicide) after ECT. Cox regression was used to identify variables associated with relapse. Results A total of 180 patients were included in each group. The proportions of patients who suffered relapse after 6 months, 1 year, and 2 years were 28%, 31%, and 40% for the postpartum group and 39%, 50%, and 55% for the nonpostpartum group. Treatment with benzodiazepines, several previous psychiatric admissions, and the absence of improvement after ECT were associated with relapse. Conclusions The risk of relapse after ECT is lower for patients with PPD and/or PPP than for patients outside the postpartum period, but the risk is nonetheless substantial in both groups.

  • 21.
    Schwandt, Melanie L.
    et al.
    NIAAA, MD 20892 USA.
    Diazgranados, Nancy
    NIAAA, MD 20892 USA.
    Umhau, John C.
    US FDA, DC 20204 USA.
    Kwako, Laura E.
    NIAAA, MD USA.
    George, David T.
    NIAAA, MD 20892 USA.
    Heilig, Markus
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    PPAR gamma activation by pioglitazone does not suppress cravings for alcohol, and is associated with a risk of myopathy in treatment seeking alcohol dependent patients: a randomized controlled proof of principle study2020In: Psychopharmacology, ISSN 0033-3158, E-ISSN 1432-2072, Vol. 237, p. 2367-2380Article in journal (Refereed)
    Abstract [en]

    Rationale Proinflammatory processes have been implicated in alcohol addiction, craving, and relapse, while studies in experimental animals have suggested that activation of peroxisome proliferator-activated receptor gamma (PPAR gamma) inhibits proinflammatory signaling. Accordingly, it is hypothesized that medications with PPAR gamma activity may have therapeutic potential in alcohol dependence. Objectives We conducted a double-blind, placebo-controlled mechanistic proof of principle study in alcohol-dependent inpatients to investigate the effect of pioglitazone on alcohol craving. Methods Participants were treated for withdrawal, if needed, and then randomized to pioglitazone (target dose 45 mg/day) or placebo. Once at target dose, they completed two experimental manipulations: guided imagery, which used personalized auditory scripts to induce alcohol cravings, and a low-dose challenge with i.v. lipopolysaccharide (LPS; 0.8 ng/kg) or placebo, on two separate sessions, in counterbalanced order. Behavioral and endocrine responses as well as CSF levels of proinflammatory cytokines were evaluated. Results The study was prematurely terminated after randomization of 16 subjects, following an independent review that established a high risk of myopathy in the active treatment group. Analysis of those who completed the study indicated that pioglitazone was associated with elevated, rather than suppressed alcohol cravings in response to alcohol-associated stimuli. LPS did not induce cravings for alcohol and thus did not lend itself to evaluating pioglitazone effects; however, pioglitazone increased the neuroendocrine stress response to LPS. CSF levels of IL-6, TNF-alpha, or MCP-1 were unaffected by pioglitazone treatment. Conclusions Both safety and efficacy biomarker data suggest that pioglitazone lacks potential as a medication for the treatment of alcohol dependence.

  • 22.
    Spagnolo, Primavera A.
    et al.
    NINDS, MD 20892 USA.
    Kimes, Alane
    NIDA, MD 20892 USA.
    Schwandt, Melanie L.
    NIAAA, MD 20892 USA.
    Shokri-Kojori, Ehsan
    NIAAA, MD 20892 USA.
    Thada, Shantalaxmi
    NIDA, MD 20892 USA.
    Phillips, Karran A.
    NIDA, MD 20892 USA.
    Diazgranados, Nancy
    NIAAA, MD 20892 USA.
    Preston, Kenzie L.
    NIDA, MD 20892 USA; NIDA, MD 20892 USA.
    Herscovitch, Peter
    NIDA, MD 20892 USA.
    Tomasi, Dardo
    NIAAA, MD 20892 USA.
    Ramchandani, Vijay A.
    NIAAA, MD 20892 USA.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Striatal Dopamine Release in Response to Morphine: A [C-11]Raclopride Positron Emission Tomography Study in Healthy Men2019In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 86, no 5, p. 356-364Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Preclinical and human positron emission tomography studies have produced inconsistent results regarding the effects of opioids on mesolimbic dopamine (DA). Here, we quantify striatal DA release (measured by [C-11]raclopride displacement) in response to an intravenous infusion of morphine, and its relationship with morphine-induced subjective effects, in healthy, nondependent opioid-experienced participants. METHODS: Fifteen healthy male participants were initially included. Sessions were on separate days. On session 1, participants received intravenous morphine (10 mg/70 kg) in the clinic to ensure tolerability. Participants without adverse reactions (n = 10) then received intravenous morphine and placebo (saline) sessions, in counterbalanced order, while undergoing [C-11]raclopride positron emission tomography scans. Subjective and physiological responses were assessed. Region-of-interest and voxelwise image analyses were used to assess changes in [C-11]raclopride nondisplaceable binding potential. RESULTS: Morphine produced marked subjective and physiological effects and induced a significant decrease in [C-11]raclopride nondisplaceable binding potential, particularly in the nucleus accumbens and globus pallidus, where the change in [C-11]raclopride nondisplaceable binding potential was approximately 9%. However, the subjective effects of morphine did not show a simple pattern of correlation with DA release. CONCLUSIONS: This is, to our knowledge, the first study providing in vivo human evidence that DA transmission in the ventral striatum is affected by morphine. Further studies are required to fully delineate the DA contribution to the reinforcing effects of opioids.

  • 23.
    Spagnolo, Primavera A.
    et al.
    Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
    Wang, Han
    Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Department of Neurology, Peking Union Medical College Hospital, Beijing, China.
    Srivanitchapoom, Prachaya
    Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
    Schwandt, Melanie
    Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Hallett, Mark
    Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
    Lack of Target Engagement Following Low-Frequency Deep Transcranial Magnetic Stimulation of the Anterior Insula2019In: Neuromodulation, ISSN 1094-7159, E-ISSN 1525-1403, Vol. 22, no 8, p. 877-883Article in journal (Refereed)
    Abstract [en]

    To evaluate the safety and efficacy of low-frequency, inhibitory, deep rTMS with a novel H-coil specifically designed to stimulate the insula.

  • 24.
    Zallar, L J
    et al.
    Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research and National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Bethesda, MD, USA; Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Tunstall, B J
    Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Richie, C T
    Genetic Engineering and Viral Vector Core, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Zhang, Y J
    Genetic Engineering and Viral Vector Core, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, Rockville, MD, USA.
    You, Z B
    Neuropsychopharmacology Section, Molecular Targets and Medications Discover Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Gardner, E L
    Neuropsychopharmacology Section, Molecular Targets and Medications Discover Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Pickel, J
    Transgenic Core Facility, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA.
    Koob, G F
    Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Vendruscolo, L F
    Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
    Harvey, B K
    Molecular Mechanisms of Cellular Stress and Inflammation Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA.
    Leggio, L-
    Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research and National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Bethesda, MD, USA. lorenzo.leggio@nih.gov; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
    Development and initial characterization of a novel ghrelin receptor CRISPR/Cas9 knockout wistar rat model2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 43, no 2, p. 344-354Article in journal (Refereed)
    Abstract [en]

    Ghrelin, a stomach-derived hormone implicated in numerous behaviors including feeding, reward, stress, and addictive behaviors, acts by binding to the growth hormone secretagogue receptor (GHSR). Here, we present the development, verification, and initial characterization of a novel GHSR knockout (KO) Wistar rat model created with CRISPR genome editing.

1 - 24 of 24
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