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  • 1.
    Aalto, Anne
    et al.
    Linköping University, Department of Medicine and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Dahlqvist Leinhard, Olof
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Jaworski, M
    Gustavsson, M
    Tisell, Anders
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurosurgery UHL. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Department of Medicine and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Smedby, Örjan
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Effects of Betainterferon treatment in Multiple Sclerosis Studied by Quantitative 1H MRS2009Conference paper (Other academic)
  • 2.
    Aardal-Eriksson, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion.
    Holm, AC
    Eriksson, TE
    Lundin, T
    Linkoping Univ, Fac Hlth Sci, Dept Biomed & Surg, Ctr Clin Chem, S-58185 Linkoping, Sweden.
    Thorell, Lars-Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Salivary cortisol and posttraumatic stress reactions methodological and applied studies before and after trauma2002In: International Journal of Psychophysiology, ISSN 0167-8760, E-ISSN 1872-7697, Vol. 45, no 1-2, p. 89-89Conference paper (Other academic)
  • 3.
    Annerbrink, K.
    et al.
    University of Gothenburg.
    Hansson, C.
    University of Gothenburg.
    Allgulander, C.
    Karolinska Institute.
    Andersch, S.
    Sahlgrens University Hospital.
    Sjödin, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Holm, G.
    Sahlgrens University Hospital.
    Dickson, S.
    University of Gothenburg.
    Eriksson, E.
    Gothenburg University Hospital.
    A possible association between panic disorder and the ghrelin gene in EUROPEAN NEUROPSYCHOPHARMACOLOGY, vol 21, issue , pp S238-S2382011In: EUROPEAN NEUROPSYCHOPHARMACOLOGY, Elsevier , 2011, Vol. 21, p. S238-S238Conference paper (Refereed)
    Abstract [en]

    n/a

  • 4.
    Annerbrink, Kristina
    et al.
    University of Gothenburg.
    Westberg, Lars
    University of Gothenburg.
    Olsson, Marie
    Sahlgrens University Hospital.
    Allgulander, Christer
    Karolinska Institute.
    Andersch, Sven
    University of Gothenburg.
    Sjödin, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Holm, Goran
    Sahlgrens University Hospital.
    Eriksson, Elias
    University of Gothenburg.
    Association between the catechol-O-methyltransferase Val158Met polymorphism and panic disorder: A replication2010In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 178, no 1, p. 196-198Article in journal (Refereed)
    Abstract [en]

    The association between the catechol-O-methyltransferase Val158Met polymorphism and panic disorder was studied in a Swedish sample of 211 patients and 452 controls. We found a significant excess of the Val allele in both male and female patients, the latter but not the former finding being in line with previous studies.

  • 5.
    Annerbrink, Kristina
    et al.
    University of Gothenburg.
    Westberg, Lars
    University of Gothenburg.
    Olsson, Marie
    Apoteket AB.
    Andersch, Sven
    University of Gothenburg.
    Sjödin, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Holm, Goran
    Sahlgrens University Hospital.
    Allgulander, Christer
    Karolinska Institute.
    Eriksson, Elias
    University of Gothenburg.
    Panic disorder is associated with the Val308Iso polymorphism in the hypocretin receptor gene2011In: PSYCHIATRIC GENETICS, ISSN 0955-8829, Vol. 21, no 2, p. 85-89Article in journal (Refereed)
    Abstract [en]

    Background Orexin A and B are neuropeptides influencing, for example, arousal and respiration. Although panic disorder is characterized by both enhanced proneness for arousal and by respiratory abnormalities, the possible influence of orexin-related genes on the risk of developing this disorder has not been studied until now. Methods We have analyzed the Ile408Val polymorphism in the hypocretin receptor 1 (HCRTR1) gene and the Val308Iso (G1246A) polymorphism in the hypocretin receptor 2 (HCRTR2) gene in a sample of 215 panic disorder patients and 454 controls. Results Although the polymorphism in the HCRTR1 did not differ between groups, the Iso allele of the HCRTR2 polymorphism was significantly more frequent in patients than in controls. After the population was divided according to sex, the association between the Iso allele of the Val308Iso polymorphism and panic disorder was observed only in female patients. Conclusion Our results suggest that the HCRTR2 polymorphism may be of importance for the pathophysiology of panic disorder. The results should be regarded as preliminary until replicated in an independent sample. This indicates that further research on the possible role of orexin in panic disorder may prove rewarding.

  • 6. Atlas, Ann
    et al.
    Gisslen, Magnus
    Nordin, Conny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Lindstrom, Leif
    Schwieler, Lilly
    Acute psychotic symptoms in HIV-1 infected patients are associated with increased levels of kynurenic acid in cerebrospinal fluid2007In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 21, no 1, p. 86-91Article in journal (Refereed)
    Abstract [en]

    Human immunodeficiency virus type 1 (HIV-1) infection is associated with psychiatric complications including cognitive impairment, affective disorders, and psychosis. Previous studies have revealed a disturbed kynurenine metabolism in these patients leading to increased levels of neuroactive compounds acting at glutamatergic neurotransmission. Kynurenic acid (KYNA), one of these metabolites is a glutamate-receptor antagonist, preferentially blocking the glycine site of the N-methyl-D-aspartate (NNIDA) receptor. Increased levels of brain KYNA have been suggested to induce a NNIDA receptor hypofunction that is associated with psychotic symptoms. In the present study, we analyze the concentration of KYNA in the cerebrospinal fluid (CSF) from HIV-1 infected patients (n = 22), including HIV-1 infected patients with psychotic symptoms (n = 8) and HIV-1 infected patients without psychiatric symptoms (n = 14). We found that HIV-1 infected patients had significantly higher median concentration of CSF KYNA (3.02 nM) compared to healthy controls (1.17 nM). Furthermore, CSF KYNA levels were significantly elevated in HIV-1 infected patients with psychotic symptoms (4.54 nM) compared to patients with HIV-1 without psychiatric symptoms (2.28 nNI). Present results indicate that increased levels of CSF KYNA may be associated with development of psychotic symptoms in HIV-1 infected patients. (c) 2006 Elsevier Inc. All rights reserved.

  • 7.
    Bjorck, RV
    et al.
    Huddinge Univ Hosp, Dept Psychiat, S-14186 Huddinge, Sweden Linkoping Univ Hosp, Div Psychiat, S-58185 Linkoping, Sweden.
    Nordin, Conny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Eye dominance and perinatal complications in schizophrenia2000In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 41, no 1, p. A309-Conference paper (Other academic)
  • 8.
    Bjorck, RV
    et al.
    Linkoping Univ Hosp, S-58185 Linkoping, Sweden Karolinska Inst, Dept Clin Neurosci, Sect Psychiat, Stockholm, Sweden.
    Nordin, Conny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Left eyedness is associated with a disproportionate birth weight/birth length ratio in schizophrenia2002In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 17, p. 186S-186SConference paper (Other academic)
  • 9.
    Bogren, Lennart
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Bogren, Inga-Britt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    The defence mechanism test in panic disorder and generalized anxiety2000In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 54, p. 15-15Conference paper (Other academic)
  • 10.
    Bogren, Lennart
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Bogren, Inga-Britt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    The Defence Mechanism Test in panic disorder, generalized anxiety disorder and schizophrenia2000In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 15, p. 319S-320SConference paper (Other academic)
  • 11.
    Brändström, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Personality and its complexity: An investigation of the Swedish version of the Temperament and Character Inventory2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In former days the descriptions of personality were based on typologies, reflecting the view that people do not change over time and so have a stable, life-long personality type. Later on exclusive categories were created, but during recent times the understanding of personality has changed due to more dimensional and dynamic thinking.

    Cloninger’s personality theory integrates concepts and research findings from neuroanatomy, neurophysiology of behavior and learning, and from developmental, social and clinical psychology. It is postulated that the behavioural systems of temperament and character are related to two major neural systems for the adaptation of experiences on various levels. The continuous interaction between temperament and character affects the personality development in both directions; temperament impacts upon character and vice versa during life.

    The development of the TCI was founded on the development of the biosocial theory of personality, which in turn stimulated the further development of the theory. Unfortunately this theory-based approach is not commonly used in the development of personality measurements. The development of a personality questionnaire on the basis of the theory must be viewed as a significant challenge, and this prompted my interest in dealing with and learning more about this personality assessment method.

    The objectives of this thesis were a critical evaluation of Cloninger’s theory; a test of its applicability in psychiatric science; and an attempt to contribute to its development.

    The main findings of our investigations can be described as follows:

    The adaptation of the Swedish version of the Temperament and Character Inventory (TCI) was successful and the seven factor structure of Cloninger’s biopsychological theory of personality theory was mainly confirmed by the Swedish normative data and by cross-cultural comparisons between data from Germany, Sweden and the U.S.A.

    The results concerning internal consistency and factor structure further underline that the adult version of the TCI is unsuitable for use in adolescents before age of 17 years. For the adolescents the junior TCI is recommended.

    Furthermore temperament dimensions seem to be more stable over time compared to the character dimensions. The gender and age differences found suggest that both have to be taken into account in research and clinical application.

    The results from our studies suggested that the Temperament and Character Inventory (TCI) has to be evaluated as a useful tool within the process of validation of diagnosis of a Personality Disorder (PD), especially in clinical practice where it is often difficult to recognise all a patient’s personality disturbances during a short time. Use of the TCI is likely to improve understanding, classification, and subsequently the interpretations in clinical settings.

     

    List of papers
    1. Swedish normative data on personality using the Temperament and Character Inventory
    Open this publication in new window or tab >>Swedish normative data on personality using the Temperament and Character Inventory
    Show others...
    1998 (English)In: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 39, no 3, p. 122-128Article in journal (Refereed) Published
    Abstract [en]

    The Temperament and Character Inventory (TCI) is a self-report personality questionnaire based on Cloninger's psychobiological model of personality, which accounts for both normal and abnormal variation in the two major components of personality, temperament and character. Normative data for the Swedish TCI based on a representative Swedish sample of 1,300 adults are presented, and the psychometric properties of the questionnaire are discussed. The structure of the Swedish version replicates the American version well for the means, distribution of scores, and relationships within the between scales and subscales. Further, the Swedish inventory had a reliable factor structure and test-retest performance. The results of this study confirm the theory of temperament and character as a seven-factor model of personality.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-17831 (URN)10.1016/S0010-440X(98)90070-0 (DOI)9606577 (PubMedID)
    Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
    2. The Swedish Version of the Temperament and Character Inventory (TCI): A Cross-Validation of Age and Gender Influences
    Open this publication in new window or tab >>The Swedish Version of the Temperament and Character Inventory (TCI): A Cross-Validation of Age and Gender Influences
    2008 (English)In: European Journal of Psychological Assessment, ISSN 1015-5759, E-ISSN 2151-2426, Vol. 24, no 1, p. 14-21Article in journal (Refereed) Published
    Abstract [en]

    In order to establish new norms of the Swedish version of the Temperament and Character Inventory (TCI), data from 2,209 Swedish individuals (age between 13 and 80) was analyzed. The second aim was to evaluate the impact of age and gender on the questionnaire scores. The third aim was to investigate whether the TCI can be meaningfully applied to adolescents in personality assessment as a basis for further research and clinical studies. Age and gender showed independent effects on personality dimensions, which implies that age and gender specific norms have to be established for the TCI. Furthermore, the results in terms of inconsistencies in the correlational and factorial structure, as well as low internal consistency scores in the younger age groups, suggest that the adult version of the TCI should not be applied below the age of 17; for these age groups we recommend the use of the junior TCI (JTCI). The inventory is under further development and several items are in need of revision in order to create less complicated formulations, enabling an improvement in the psychometrics.

    Keywords
    Temperament and Character Inventory (TCI), age cohort, Swedish normative data, personality, gender
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-17832 (URN)10.1027/1015-5759.24.1.14 (DOI)
    Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
    3. Assessing personality: The Temperament and Character Inventory in a cross-cultural comparison between Germany, Sweden, and the U.S.A.
    Open this publication in new window or tab >>Assessing personality: The Temperament and Character Inventory in a cross-cultural comparison between Germany, Sweden, and the U.S.A.
    1999 (English)In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 84, p. 1315-1330Article in journal (Refereed) Published
    Abstract [en]

    In this study the American, Swedish, and German versions of the Temperament and Character Inventory were compared based on samples of 330 healthy volunteers each, which had been carefully matched for age and sex. The analyses indicate a high agreement for scores on the temperament and character dimensions and subscales across the samples. Exceptions include minor differences that appear to be due to cultural variations, differences in sampling methods, and of some minor difficulties with two subscales (Exploratory Excitability and Self-acceptance) as well as defining the Persistence factor as an independent dimension of Temperament. The subscales yielded similar internal consistencies, correlational structure, factor structures, and high factor congruence coefficients. The results indicate a cross-cultural transferability of the Temperament and Character dimensions of the inventory. Also, the validity and stability of the seven-factor model of personality, as suggested by Cloninger, is supported.

    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-17833 (URN)
    Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
    4. Distributions by age and sex of the dimensions of Temperament and Character Inventory in a cross-cultural perspective among Sweden, Germany, and the USA
    Open this publication in new window or tab >>Distributions by age and sex of the dimensions of Temperament and Character Inventory in a cross-cultural perspective among Sweden, Germany, and the USA
    2001 (English)In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 89, p. 747-758Article in journal (Refereed) Published
    Abstract [en]

    Distribution by age and sex of the dimensions of the Temperament and Character Inventory were assessed cross-culturally for samples in Sweden, German, and USA. The Temperament and Character Inventory is a 240-item (Sweden, 238-item), self-administered, true-false format, paper-and-pencil test developed by Cloninger and his co-workers based on his unified biosocial theory of personality. The inventory measures the Temperament dimensions Novelty Seeking, Harm Avoidance, Reward Dependence, and Persistence as well as the Character dimensions, Self-directedness, Cooperativeness, and Self-transcendence. The samples consisted of 300 German subjects, 300 Swedish subjects, and 300 U.S. subjects matched by age cohort and sex. Stability of the personality dimensions was evaluated across samples as were their age and sex distributions. We found significant affects of age, sex, and culture in univariate and multivariate comparisons on the personality dimensions. However, several significant differences in the personality dimensions for both European samples appear to be similar compared with those of the U.S. sample. We have to conclude that sex- and age-specific norms for the dimensions of the Temperament and Character Inventory are necessary given the established significant differences.

    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-17834 (URN)
    Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
    5. Further development of the Temperament and Character Inventory
    Open this publication in new window or tab >>Further development of the Temperament and Character Inventory
    2001 (English)In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 93, p. 995-1002Article in journal (Refereed) Published
    Abstract [en]

    The Temperament and Character Inventory is an internationally used personality questionnaire based on Cloninger’s psychobiological theory of personality. Given some limitations of Version 9 a revised version was developed. The structural equivalence of the two versions was demonstrated from a cross-cultural perspective with 309 and 173 healthy volunteers from Sweden and Germany, respectively, who completed both versions in one session. In testing for the replicability of the factors across both samples as well as across both versions, an orthogonal Procrustes rotation method was used. The reliability coefficients for the revision were higher than the former version for both samples. The factor structures of the inventory remain highly equivalent across cultures and across versions. The results indicate a cross-cultural transferability of the Temperament and Character dimensions of the inventory. The stability and the validity of the 7-factor model of personality, as suggested by Cloninger, are supported. The Temperament and Character Inventory-Revised represents an important and useful method for the assessment of personality.

    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-17837 (URN)
    Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
    6. Personality disorder diagnosis by means of the Temperament and Character Inventory
    Open this publication in new window or tab >>Personality disorder diagnosis by means of the Temperament and Character Inventory
    2009 (English)In: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 50, no 4, p. 347-352Article in journal (Refereed) Published
    Abstract [en]

    Personality disorders (PDs) criteria are still in development. Cloninger's biosocial theory of personality contributed to this discussion. The aim of the study was to explore the relationships between extreme expressions on temperament and an immature character according to Cloninger's assumptions. Eight hundred healthy volunteers and 200 psychiatric inpatients were consecutively recruited each from Sweden and Germany, and were asked to complete the Temperament and Character Inventory, which measures 4 temperament and 3 character dimensions. Patients differed from controls on temperament and character dimensions. The combination of low and very low character scores with extreme scores in either novelty seeking, harm avoidance, or reward dependence was found more often among patients with PD compared with patients without PD and controls; this is more pronounced with an increasing number of extreme temperament scores. The Temperament and Character Inventory represents a useful tool in the diagnostic process of personality disorders.

    Place, publisher, year, edition, pages
    Maryland Heights, United States: Saunders Elsevier, 2009
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-17838 (URN)10.1016/j.comppsych.2008.09.002 (DOI)000266820100008 ()
    Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
  • 12.
    Brändström, Sven
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Richter, Jörg
    Clinical of Psychiatry and Psychotherapy, Rostock University, Germany.
    Nylander, Per-Olof
    Linköping University, Department of Neuroscience and Locomotion.
    Further development of the Temperament and Character Inventory2001In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 93, p. 995-1002Article in journal (Refereed)
    Abstract [en]

    The Temperament and Character Inventory is an internationally used personality questionnaire based on Cloninger’s psychobiological theory of personality. Given some limitations of Version 9 a revised version was developed. The structural equivalence of the two versions was demonstrated from a cross-cultural perspective with 309 and 173 healthy volunteers from Sweden and Germany, respectively, who completed both versions in one session. In testing for the replicability of the factors across both samples as well as across both versions, an orthogonal Procrustes rotation method was used. The reliability coefficients for the revision were higher than the former version for both samples. The factor structures of the inventory remain highly equivalent across cultures and across versions. The results indicate a cross-cultural transferability of the Temperament and Character dimensions of the inventory. The stability and the validity of the 7-factor model of personality, as suggested by Cloninger, are supported. The Temperament and Character Inventory-Revised represents an important and useful method for the assessment of personality.

  • 13.
    Brändström, Sven
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Sigvardsson, Sören
    Department of Social Medicine, Umeå University, Sweden.
    Nylander, Per-Olof
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Richter, Jörg
    Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
    The Swedish Version of the Temperament and Character Inventory (TCI): A Cross-Validation of Age and Gender Influences2008In: European Journal of Psychological Assessment, ISSN 1015-5759, E-ISSN 2151-2426, Vol. 24, no 1, p. 14-21Article in journal (Refereed)
    Abstract [en]

    In order to establish new norms of the Swedish version of the Temperament and Character Inventory (TCI), data from 2,209 Swedish individuals (age between 13 and 80) was analyzed. The second aim was to evaluate the impact of age and gender on the questionnaire scores. The third aim was to investigate whether the TCI can be meaningfully applied to adolescents in personality assessment as a basis for further research and clinical studies. Age and gender showed independent effects on personality dimensions, which implies that age and gender specific norms have to be established for the TCI. Furthermore, the results in terms of inconsistencies in the correlational and factorial structure, as well as low internal consistency scores in the younger age groups, suggest that the adult version of the TCI should not be applied below the age of 17; for these age groups we recommend the use of the junior TCI (JTCI). The inventory is under further development and several items are in need of revision in order to create less complicated formulations, enabling an improvement in the psychometrics.

  • 14.
    Brändström, Sven
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry .
    Nylander, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry .
    Przybeck, T
    Linkoping Univ, Linkoping, Sweden Washington Univ, St Louis, MO 63130 USA Univ Rostock, D-2500 Rostock 1, Germany.
    Richter, J
    The temperament and character inventory (TCI) - A cross-cultural tool.2000In: International Journal of Psychology, ISSN 0020-7594, E-ISSN 1464-066X, Vol. 35, no 3-4, p. 440-440Conference paper (Other academic)
  • 15.
    Brändström, Sven
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Richter, Jörg
    Department of Psychiatry and Phsycotherapy, Rostock Univeristy, Germany.
    Przybeck, Tom
    Centre for Psychobioloty of Personality, Washington University, St Louis, USA.
    Distributions by age and sex of the dimensions of Temperament and Character Inventory in a cross-cultural perspective among Sweden, Germany, and the USA2001In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 89, p. 747-758Article in journal (Refereed)
    Abstract [en]

    Distribution by age and sex of the dimensions of the Temperament and Character Inventory were assessed cross-culturally for samples in Sweden, German, and USA. The Temperament and Character Inventory is a 240-item (Sweden, 238-item), self-administered, true-false format, paper-and-pencil test developed by Cloninger and his co-workers based on his unified biosocial theory of personality. The inventory measures the Temperament dimensions Novelty Seeking, Harm Avoidance, Reward Dependence, and Persistence as well as the Character dimensions, Self-directedness, Cooperativeness, and Self-transcendence. The samples consisted of 300 German subjects, 300 Swedish subjects, and 300 U.S. subjects matched by age cohort and sex. Stability of the personality dimensions was evaluated across samples as were their age and sex distributions. We found significant affects of age, sex, and culture in univariate and multivariate comparisons on the personality dimensions. However, several significant differences in the personality dimensions for both European samples appear to be similar compared with those of the U.S. sample. We have to conclude that sex- and age-specific norms for the dimensions of the Temperament and Character Inventory are necessary given the established significant differences.

  • 16. Börelius, Lisbeth
    et al.
    Foldemo, Anniqa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Holmberg, Tommy
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Schöld, Anna-Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Thorell, Lars-Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Ylikivelä, Rita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Nettelbladt, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Mental unhealth among young adults in primary health care2008In: European Psychiatry - the journal of the association of european psychiatrists,2008, 2008, p. 248-248Conference paper (Other academic)
    Abstract [en]

        

  • 17.
    Carlbring, Per
    et al.
    Umea University.
    Maurin, Linda
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Torngren, Charlotta
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Linna, Emma
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Eriksson, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Sparthan, Elisabeth
    Svenska KBT Institute.
    Straat, Marcus
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Marquez von Hage, Christian
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Bergman-Nordgren, Lise
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Individually-tailored, Internet-based treatment for anxiety disorders: A randomized controlled trial2011In: BEHAVIOUR RESEARCH AND THERAPY, ISSN 0005-7967, Vol. 49, no 1, p. 18-24Article in journal (Refereed)
    Abstract [en]

    Previous studies on Internet-based treatment with minimal to moderate therapist guidance have shown promising results for a number of specific diagnoses. The aim of this study was to test a new approach to Internet treatment that involves tailoring the treatment according to the patients unique characteristics and comorbidities. A total of 54 participants, regardless of specific anxiety diagnosis, were included after an in-person, semi-structured diagnostic interview and randomized to a 10 week treatment program or to a control group. Treatment consisted of a number of individually-prescribed modules in conjunction with online therapist guidance. Significant results were found for all dependent measures both immediately following treatment and at 1 and 2 year intervals. Mean between-group effect size including measures of anxiety, depression and quality of life was Cohens d = 0.69 at post-treatment, while the mean within-group effect size was d = 1.15 at post-treatment and d = 1.13 and d = 1.04 at 1 and 2 year follow-up respectively. The tentative conclusion drawn from these results is that tailoring the Internet-based therapy can be a feasible approach in the treatment of anxiety in a homogeneous population.

  • 18. Carlsson, A
    et al.
    Forsgren, L
    Umea Univ, Umea Ctr Mol Med, Umea, Sweden Umea Univ, Dept Neurol, S-90187 Umea, Sweden Umea Univ, Dept Med Biosci Clin Genet, Umea, Sweden Linkoping Univ, Dept Neurosci & Locomot, Linkoping, Sweden Kalmar Hosp, Dept Psychiat, Kalmar, Sweden.
    Nylander, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry .
    Hellman, U
    Umea Univ, Umea Ctr Mol Med, Umea, Sweden Umea Univ, Dept Neurol, S-90187 Umea, Sweden Umea Univ, Dept Med Biosci Clin Genet, Umea, Sweden Linkoping Univ, Dept Neurosci & Locomot, Linkoping, Sweden Kalmar Hosp, Dept Psychiat, Kalmar, Sweden.
    Forsman-Semb, K
    Umea Univ, Umea Ctr Mol Med, Umea, Sweden Umea Univ, Dept Neurol, S-90187 Umea, Sweden Umea Univ, Dept Med Biosci Clin Genet, Umea, Sweden Linkoping Univ, Dept Neurosci & Locomot, Linkoping, Sweden Kalmar Hosp, Dept Psychiat, Kalmar, Sweden.
    Holmgren, G
    Umea Univ, Umea Ctr Mol Med, Umea, Sweden Umea Univ, Dept Neurol, S-90187 Umea, Sweden Umea Univ, Dept Med Biosci Clin Genet, Umea, Sweden Linkoping Univ, Dept Neurosci & Locomot, Linkoping, Sweden Kalmar Hosp, Dept Psychiat, Kalmar, Sweden.
    Holmberg, D
    Umea Univ, Umea Ctr Mol Med, Umea, Sweden Umea Univ, Dept Neurol, S-90187 Umea, Sweden Umea Univ, Dept Med Biosci Clin Genet, Umea, Sweden Linkoping Univ, Dept Neurosci & Locomot, Linkoping, Sweden Kalmar Hosp, Dept Psychiat, Kalmar, Sweden.
    Holmberg, M
    Identification of a susceptibility locus for migraine with and without aura on 6p12.2-p21.12002In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 59, no 11, p. 1804-1807Article in journal (Refereed)
    Abstract [en]

    Migraine is the most common type of chronic episodic headache. To find novel susceptibility genes for familial migraine with and without aura, a genomewide screen was performed in a large family from northern Sweden. Evidence of linkage was obtained on chromosome 6p12.2-p21.1, with a maximum two-point lod score of 5.41 for marker D6S452. The patients with migraine shared a common haplotype of 10 Mb between markers D6S1650 and D6S1960.

  • 19.
    Carlsson, Björn
    et al.
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Olsson, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences.
    Reis, Margareta
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Wålinder, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Nordin, Conny
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Lundmark, Jöns
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Scordo, M. G.
    Dahl, M-L.
    Bengtsson, Finn
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Ahlner, Johan
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Enantioselective Analysis of Citalopram and Metabolites in Adolescents2001In: Therapeutic drug monitoring, ISSN 0163-4356, Vol. 23, no 6, p. 658-664Article in journal (Refereed)
    Abstract [en]

    Studies of the antidepressant effect and pharmacokinetics of citalopram have been performed in adults, but the effects on children and adolescents have only been studied to a minor extent despite its increasing use in these age groups. The aim of this study was to investigate a group of adolescents treated for depression, with respect to the steady-state plasma concentrations of the enantiomers of citalopram and its demethylated metabolites desmethylcitalopram and didesmethylcitalopram. Moreover, the authors studied the genotypes for the polymorphic cytochrome P450 enzymes CYP2D6 and CYP2C19 in relation to the different enantiomers. The S/R ratios of citalopram and desmethylcitalopram found in this study of 19 adolescents were similar to studies involving older patients. The concentrations of the R-(-)- and S-(+)-enantiomers of citalopram and desmethylcitalopram were also in agreement with values from earlier studies, the R-(-)-enantiomer (distomer) being the major enantiomer. The results indicate that the use of oral contraceptives may have some influence on the metabolism of citalopram. This might be because of an interaction of the contraceptive hormones with the CYP2C19 enzyme.

  • 20.
    Dahlqvist Leinhard, Olof
    et al.
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Jarowski, J
    Gustavsson, M
    Tisell, Anders
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL.
    Gladigau, D
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurosurgery UHL.
    Lundberg, Peter
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Department of Medicine and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Betainterferon treatment: Absolute quantification of white matter metabolites in patients with multiple sclerosis2008Conference paper (Other academic)
  • 21.
    Dobrov, Eugen
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Thorell, Lars-Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    "Reasons For Living" - Translation, psychometric evaluation and relationships to suicidal behaviour in a Swedish random sample2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 58, no 4, p. 277-285Article in journal (Refereed)
    Abstract [en]

    The protective role of positive beliefs and expectations against suicide has been studied using the Reasons For Living inventory (RFL). The RFL has shown to be useful in research and suggested for use in clinical practice. A Swedish translation of the RFL was examined for psychometric properties, reliability, latent structure and convergent validity in a Swedish general population. The RFL was distributed with the Suicide Behaviors Questionnaire (SBQ) to 1366 randomly selected subjects aged 20-65 years in the county of Östergötland. The results were based on 506 complete replies. The Cronbach a of the total RFL was 0.92, ranging from 0.72 to 0.93 in the six scales of RFL. The intercorrelations between the scales were weak and the scale to total RFL score moderate to high. The factor structure and item loadings of the inventory showed great similarities with the American one with exception for the scales Responsibility to Family and Child-related Concerns, which formed one common factor. The convergent validity was supported by significant relationships to the items of the SBQ. It is concluded that the Swedish translation of the RFL inventory in a Swedish general sample possesses great similarities to the American original RFL. Thus, it is suggested as an instrument for research and clinical usage in Sweden. © 2004 Taylor & Francis.

  • 22.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    The Worker Role Interview: Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation2004In: Journal of Occupational Rehabilitation, ISSN 1053-0487, Vol. 14, no 2, p. 131-141Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate the predictive validity of the Worker Role Interview (WRI) for return to work at a 2-year follow-up of clients who attended an insurance medicine investigation center. The WRI identifies psychosocial and environmental factors that influence a person's abilities to return to work. Forty-eight of 202 consecutively selected clients constituted the study group. The Mann–Whitney U test was used to test the statistically significant differences in WRI ratings between those who were working (n=6) and those who were not (n=42) 2 years after their investigations. Five of the 17 items in WRI had a tentative predictive validity of return to work. The content area personal causation in WRI, had the best predictive validity. The results emphasize the importance of considering the unique individual's beliefs and expectations of his/her effectiveness at work when assessing clients' work ability and planning for further rehabilitation.

  • 23.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Perceptions of the work environment among people with experience of long term sick leave2010In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 35, no 2, p. 125-136Article in journal (Refereed)
    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.

  • 24.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Return to work: the predictive value of the Worker Role Interview (WRI) over two years2010In: 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)
    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.

  • 25.
    Engström, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Faculty of Health Sciences.
    Flensner, Gullvi
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurosurgery UHL.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Fatigue and cognitive effort in multiple sclerosis: an fMRI study2011Conference paper (Other academic)
    Abstract [en]

    Despite recent advances in therapy and diagnosis, fatigue remains a mayor challenge in multiple sclerosis (MS).  To further the understanding of the neural underpinnings of fatigue, we undertook a study using functional magnetic resonance imaging (fMRI) to investigate neural networks that may be affected by MS-related fatigue. Twelve MS patients and 12 age- and sex matched controls were administered the Fatigue Impact Scale (FIS) to assess clinically significant fatigue, and underwent a neuropsychological examination. The participants performed a working memory task (Daneman’s  ‘Reading Span’ task) while being monitored by means of a 1.5 T Philips Achieva MR scanner. We have previously shown that this task triggers an executive network comprising frontal and parietal areas typically involved in working memory. In addition, the task engages a core network involving the anterior insula and the anterior cingulate cortex.  This latter network may be implicated in allocation of mental resources and monitoring of the present state of the individual. There were two main findings. MS participants evidenced less activation than controls in the anterior cingulate and the left parietal cortex (Brodmann area 7) and more activation in left hemisphere language areas as well as the anterior insula. The second main finding was that clinical ratings of fatigue were strongly correlated with activity in wide areas of the core network, as well as posterior language areas. We take this finding to indicate that fatigue is related to compensatory involvement of the core network, and that excess activity in the core network possibly could be used as an objective marker of fatigue in MS.

  • 26.
    Engström, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Faculty of Health Sciences.
    Flensner, Gullvi
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurosurgery UHL.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences.
    Aberrant brain activation in the core control network for cognitive function in MS2011Conference paper (Other academic)
    Abstract [en]

    Purpose: The purpose of this study was to investigate if patients with multiple sclerosis (MS) and fatigue have aberrant brain activation in the anterior insular cortex (AIC) and the anterior cingulate cortex (ACC), which are regions in the brain that are suggested to be a core network for cognitive control (Cole and Schneider, 2007; Sridharan et al., 2008).

     Materials and Methods: Twelve patients with MS and eleven healthy controls were examined with functional Magnetic Resonance Imaging (fMRI) while performing a complex working memory task. The task was to indicate if words presented in video goggles had appeared in previously presented sentences. Axial blood oxygen level dependent (BOLD) images were analyzed with SPM8 software. Images were realigned for movement correction, normalised to standard brain template, and smoothed with 8mm Gaussian kernel. We used a parametric contrast that tapped brain activation as a function of difficulty level of the task, i.e. words presented after 1, 2, 3, or 4 consecutive sentences.

    Results: Healthy controls elicited more activation in the left superior parietal lobe (p<0.001 family wise error (FWE) corrected for multiple comparisons), the right caudate head (p=0.002), and ACC (p=0.004) compared to MS patients. The MS patients had more activity in the left and right inferior parietal lobe (p=0.001 and p=0.029, respectively). In addition, in a region of interest analysis the MS patients had more activation in the left dorsal and ventral AIC (p=0.011 and p=0.009, respectively). The figure shows brain activation at working memory across both healthy controls and MS.

     Conclusion: MS patients elicited, as predicted, aberrant activation in the AIC-ACC network in that they had activation depletion in ACC and increased activity in the left AIC. It has recently been proposed that the AIC engenders awareness and the ACC engenders volitional action (Craig, 2009). The abnormal activation in this region could therefore explain the frequent symptoms of fatigue and cognitive impairment in MS.

     Clinical Relevance statement: Cognitive impairment occurs in 40-70% of individuals with MS and the patophysiology is unknown. Increased knowledge might contribute to novel strategies for symptomatic treatment.

  • 27.
    Engström, Maria
    et al.
    Linköping University, Department of Medicine and Health Sciences, Radiology. Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Faculty of Health Sciences.
    Tisell, Anders
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL. Linköping University, Faculty of Health Sciences.
    Dahlqvist Leinhard, Olof
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Karlsson, T
    Vigren, P
    Lundberg, Peter
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Department of Medicine and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Radiology in Linköping.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurosurgery UHL. Linköping University, Faculty of Health Sciences.
    Kleine-Levin Syndrom (KLS) – A bipolar disorder?2009Conference paper (Other academic)
  • 28.
    Erhardt, Sophie
    et al.
    Karolinska Institute, Sweden .
    Lim, Chai K.
    University of New S Wales, Australia .
    Linderholm, Klas R.
    Karolinska Institute, Sweden .
    Janelidze, Shorena
    Lund University, Sweden .
    Lindqvist, Daniel
    Lund University, Sweden .
    Samuelsson, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Lundberg, Kristina
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences.
    Postolache, Teodor T
    University of Maryland, MD USA .
    Traskman-Bendz, Lil
    Lund University, Sweden .
    Guillemin, Gilles J
    University of New S Wales, Australia .
    Brundin, Lena
    Lund University, Sweden .
    Connecting Inflammation with Glutamate Agonism in Suicidality2013In: Neuropsychopharmacology, ISSN 0893-133X, E-ISSN 1740-634X, Vol. 38, no 5, p. 743-752Article in journal (Refereed)
    Abstract [en]

    The NMDA-receptor antagonist ketamine has proven efficient in reducing symptoms of suicidality, although the mechanisms explaining this effect have not been detailed in psychiatric patients. Recent evidence points towards a low-grade inflammation in brains of suicide victims. Inflammation leads to production of quinolinic acid (QUIN) and kynurenic acid (KYNA), an agonist and antagonist of the glutamatergic N-methyl-D-aspartate (NMDA) receptor, respectively. We here measured QUIN and KYNA in the cerebrospinal fluid (CSF) of 64 medication-free suicide attempters and 36 controls, using gas chromatography mass spectrometry and high-performance liquid chromatography. We assessed the patients clinically using the Suicide Intent Scale and the Montgomery Asberg Depression Rating Scale (MADRS). We found that QUIN, but not KYNA, was significantly elevated in the CSF of suicide attempters (Pandlt;0.001). As predicted, the increase in QUIN was associated with higher levels of CSF interleukin-6. Moreover, QUIN levels correlated with the total scores on Suicide Intent Scale. There was a significant decrease of QUIN in patients who came for follow-up lumbar punctures within 6 months after the suicide attempt. In summary, we here present clinical evidence of increased QUIN in the CSF of suicide attempters. An increased QUIN/KYNA quotient speaks in favor of an overall NMDA-receptor stimulation. The correlation between QUIN and the Suicide Intent Scale indicates that changes in glutamatergic neurotransmission could be specifically linked to suicidality. Our findings have important implications for the detection and specific treatment of suicidal patients, and might explain the observed remedial effects of ketamine. Neuropsychopharmacology (2013) 38, 743-752; doi:10.1038/npp.2012.248; published online 9 January 2013

  • 29.
    Fall, Per-Arne
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Ekman, R.
    Granérus, Ann-Kathrine
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric . Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Wålinder, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    ECT in Parkinson's disease: Changes in motor symptoms, monoamine metabolites and neuropeptides1995In: Journal of Neural Transmission. Parkinson's disease and dementia section., ISSN 0936-3076, Vol. 10, no 2-3, p. 129-140Article in journal (Refereed)
    Abstract [en]

    Electroconvulsive therapy (ECT) was given to 16 non-depressed, non-demented patients with advanced Parkinson's disease (PD). In all the patients an antiparkinsonian effect was seen, lasting for 18 months in one patient, 3-5 months in seven patients, and a few days to four weeks in eight patients. After ECT the levels of homovanillic acid and neuropeptide Y in cerebrospinal fluid (CSF) were significantly increased. The eight patients with long lasting motor improvement after ECT had significantly lower CSF-3-methoxy-4-hydroxyphenylglycol compared to the group with short lasting improvement. Five patients developed transitory mental confusion after ECT. In these patients, and in no others, a high albumin-ratio was found already before ECT was given - an indication of blood CSF barrier damage. Our results suggest that ECT is valuable in patients with drug refractory PD or PD with intolerance to antiparkinsonian drugs.

  • 30.
    Foldemo, Anniqa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences.
    Wärdig, Rikard
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Holmberg, Tommy
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Valter, L
    Östergötlands Läns Landsting.
    Osby, U
    Danderyd Stockholm.
    QUALITY OF LIFE IN METABOLIC RISK PATIENTS WITH PSYCHOSIS IN RELATION TO THE POPULATION in SCHIZOPHRENIA BULLETIN, vol 37, issue , pp 264-2642011In: SCHIZOPHRENIA BULLETIN, Oxford University Press , 2011, Vol. 37, p. 264-264Conference paper (Refereed)
    Abstract [en]

    n/a

  • 31.
    Gunnarsson, Tove
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Cholecystokinin in cerebrospinal fluid2002In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 17, p. 51S-51SConference paper (Other academic)
  • 32.
    Gunnarsson, Tove
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences.
    On the cerebrospinal fluid disposition and neurobiological role of cholecystokinin in man2000Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Cholecystokinin (CCK) is the most abundant neuropeptide in the brain, where it acts as a neurotransmitter and neuromodulator. The tetrapeptide CCK-4 and the octapeptide CCK-8 have been implicated in various behavioural and physiological functions, such as anxiety, pain and satiety. Analyses of the levels of CCK in plasma, CSF and brain tissue have been used in studies aimed at elucidating the pathophysiological mechanisms in psychiatric disorders, but the results have been inconsistent.

    Cerebrospinal fluid (CSF) levels of CCK-4 and CCK-8S were analysed in three groups of healthy subjects lumbar-punctured under different conditions, with the aim to provide reference values for studies on patients, and to investigate putative confounding factors. It was found that the concentrations of CCK-4 and CCK-8S were influenced by age, bedrest or not prior to lumbar puncture, neuraxis distance, position during lumbar puncture, height, atmospheric pressure and storage time. For a correct interpretation of data, these factors should be taken into account in future CSF studies in volunteers and patients.

    Hypothyroidism is associated with depression. Thyroid hormones have been assumed to affect neuronal functions in the CNS, and animal experiments have indicated a relationship between thyroid hormones and CCK. Depressive symptoms were assessed in hypothyroid patients who were also lumbar-punctured before and during L-thyroxine treatment. Thyroid stimulating hormone, tri-iodothyronine and thyroxine in serum correlated with both CCK peptides in the CSF. A negative correlation between CCK-4 and inner tension (anxiety) was found.

    Various studies implicate the involvement of brain-stem structures in the aetiology of panic attacks. Brain-stem auditory evoked potentials were recorded in healthy subjects before and during infusion with the panic-provoking agent CCK-4 or placebo. CCK-4 delayed the latencies of peak I, III and V, and decreased peak III amplitude. This suggests that exogenous CCK-4 affects stimulus processing in the brain stem.

    List of papers
    1. Cholecystokinin peptides in cerebrospinal fluid: a study in healthy male subjects
    Open this publication in new window or tab >>Cholecystokinin peptides in cerebrospinal fluid: a study in healthy male subjects
    Show others...
    1997 (English)In: Regulatory Peptides, ISSN 0167-0115, E-ISSN 1873-1686, Vol. 68, no 1, p. 57-61Article in journal (Refereed) Published
    Abstract [en]

    The clinical reliability of measuring cholecystokinin (CCK) peptides in the cerebrospinal fluid (CSF) has not been fully elucidated. Therefore, we have assayed CCK-8S and CCK-4 in CSF obtained from 14 healthy male subjects, lumbar-punctured at the L4–5 level following a strictly standardised procedure. CSF concentrations of free CCK-8S and free CCK-4 were used as dependent variables while age, height, body weight, atmospheric pressure and some other factors served as independent variables. It was shown that the CCK-8S ratio between the second (7–12 ml) and first (0–6 ml) CSF fractions, correlated significantly with the atmospheric pressure at the time of puncture. Neither CCK-8S nor CCK-4 displayed concentration gradients in CSF. The CCK-4 levels, expressed as pmol l−1 in the total amount of CSF were found to be positively correlated with the neuraxis distance in the lying position and negatively with the neuraxis distance in the sitting position. Furthermore, CCK-4, expressed as pmol l−1 per min of tapping-time (pmol l−1 min−1), showed a negative correlation with storage time, presumably mirroring a proteolytic process. CCK-8S and CCK-4 intercorrelated positively independently of whether expressed as pmol l−1 or pmol l−1 min−1. In conclusion, the results of this exploratory study indicate that the neuraxis distance (in the sitting and lying positions) and storage-time have to be accounted for when interpreting data on CSF levels of CCK-4. Attention has to be paid to the potential influence of atmospheric pressure on the concentration ratio of CCK-8S.

    Keywords
    CCK-4, CCK-8S, Atmospheric pressure, Storage-time, Tapping-time
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-79854 (URN)10.1016/S0167-0115(96)02104-0 (DOI)
    Available from: 2012-08-14 Created: 2012-08-14 Last updated: 2017-12-07Bibliographically approved
    2. Cholecystokinin peptides in cerebrospinal fluid: a study in healthy male subjects lumbar-punctured without preceding strict bed-rest
    Open this publication in new window or tab >>Cholecystokinin peptides in cerebrospinal fluid: a study in healthy male subjects lumbar-punctured without preceding strict bed-rest
    Show others...
    1999 (English)In: Journal of neural transmission, ISSN 0300-9564, E-ISSN 1435-1463, Vol. 106, no 3-4, p. 275-282Article in journal (Refereed) Published
    Abstract [en]

    In a recent study we analysed the concentrations of two forms of cholecystokinin (CCK), CCK-8S (sulphated) and CCK-4 in cerebrospinal fluid (CSF) obtained from 14 healthy male volunteers lumbar-punctured after a minimum of eight hours of strict bed-rest.

    We have now lumbar-punctured another group of 14 healthy males, using the same procedure except for the requirement of strict bed-rest prior to puncture.

    In contrast to our previous study, the concentration of CCK-4 (but not CCK-8S) was significantly higher in the second CSF fraction (7–12 ml) than in the first one (0–6 ml). On using the concentration ratio between the second and first fraction, CCK-8S (but not CCK-4) correlated positively with the atmospheric pressure, which is in contrast to our previous study in which a significant negative correlation was found.

    When the lumbar CSF concentrations were expressed as the concentration per minute of tapping-time (an estimate of the mass flow), atmospheric pressure, age and the neuraxis distance in the lying position made significant contributions to the variance in CCK-8S. A significant positive correlation with atmospheric pressure was found for CCK-4.

    In conclusion, the results indicate that the question of strict bed-rest or not prior to lumbar puncture may have to be considered when interpreting data on lumbar CSF concentrations of CCK. A controlled study is warranted.

    Keywords
    CCK-4, CCK-8, cerebrospinal fluid, atmospheric pressure
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27799 (URN)10.1007/s007020050157 (DOI)12546 (Local ID)12546 (Archive number)12546 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Cerebrospinal fluid levels of monoamine compounds and cholecystokinin peptides after exposure to standardized barometric pressure
    Open this publication in new window or tab >>Cerebrospinal fluid levels of monoamine compounds and cholecystokinin peptides after exposure to standardized barometric pressure
    2000 (English)In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 71, no 11, p. 1131-1136Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Connections between mood changes and weather have been described throughout the ages, and in more recent years, there have been reports on a relationship between atmospheric pressure and neurotransmitter levels in cerebrospinal fluid.

    METHODS: To further investigate this issue under strictly standardized conditions, we have lumbar-punctured 8 healthy males under low (963 hPa) and high (1064 hPa) barometric pressure, using a pressure chamber.

    RESULTS: Under high pressure, the tyrosine concentrations in the cerebrospinal fluid (CSF) were lower, while the cholecystokinin tetrapeptide (CCK-4) levels were higher. No differences between low and high pressure were found for tryptophan, 5-hydroxyindolacetic acid (5-HIAA), dopamine (DA), and sulphated cholecystokinin octapeptide (CCK-8S). The serum level of CCK-8S was higher under high pressure. On comparing concentration ratios between the second and the first CSF fraction, we found significantly increased ratios for homovanillic acid (HVA) and 4-hydroxy-3-methoxyphenylglycol (HMPG), but a decreased ratio for tyrosine under high pressure. The difference in the concentration ratios of HVA between low and high pressure correlated negatively with age. Intraspinal pressure correlated negatively with tapping time at low pressure.

    CONCLUSION: Our results are in line with the hypothesis that atmospheric pressure influences CSF levels of monoamine compounds and cholecystokinin peptides.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27801 (URN)11086668 (PubMedID)12548 (Local ID)12548 (Archive number)12548 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Cholecystokinin peptides in cerebrospinal fluid: a pilot study in hypothyroid patients
    Open this publication in new window or tab >>Cholecystokinin peptides in cerebrospinal fluid: a pilot study in hypothyroid patients
    1999 (English)In: Human Psychopharmacology: Clinical and Experimental, ISSN 0885-6222, E-ISSN 1099-1077, Vol. 14, no 2, p. 113-117Article in journal (Refereed) Published
    Abstract [en]

    The cholecystokinin tetrapeptide (CCK-4) and the sulphated octapeptide (CCK-8) were measured in cerebrospinal fluid obtained from nine hypothyroid patients before and during L-thyroxine treatment. Before treatment, CCK-4 and CCK-8S correlated negatively with S-TSH, whereas CCK-8S also showed a positive correlation with S-T3. During treatment, S-T4 correlated negatively with CCK-8S. CSF collection time was significantly shorter during treatment than prior to treatment for the first (0–6 ml) CSF fraction. On taking CSF collection time into account, the levels of both CCK-4 and CCK-8S in the first CSF fraction were significantly increased during medication. Our results are consistent with an impact of the hypothyroid disorder and L-thyroxine treatment on the disposition of CCK compounds in CSF. This might be due to an altered CSF circulation, but other mechanisms (e.g. metabolism or elimination) cannot be ruled out.

    Keywords
    hypothyroidism, cholecystokinin, cerebrospinal fluid, CSF collection time, atmospheric pressure
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27798 (URN)10.1002/(SICI)1099-1077(199903)14:2<113::AID-HUP76>3.0.CO;2-A (DOI)12545 (Local ID)12545 (Archive number)12545 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. Depressive Symptoms in Hypothyroid Disorder with some Observations on Biochemical Correlates
    Open this publication in new window or tab >>Depressive Symptoms in Hypothyroid Disorder with some Observations on Biochemical Correlates
    2001 (English)In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 43, no 2, p. 70-74Article in journal (Refereed) Published
    Abstract [en]

    Lumbar punctures and ratings of depressive symptoms were done in hypothyroid patients before and during L-thyroxine therapy. Before treatment, the most prominent symptoms were concentration difficulties, lassitude, and reduced sexual interest. All patients suffered from sleep disturbances. Suicidal thoughts did not occur at all. Inner tension was negatively correlated with the anxiogenic cholecystokinin tetrapeptide (CCK-4) in the cerebrospinal fluid (CSF), while reduced sexual interest was negatively correlated with CSF tryptophan. Furthermore, failing memory correlated negatively with T3 as well as T4 in serum. A positive correlation was found between failing memory and serum TSH. All patients improved significantly during treatment. No biochemical correlates were found. In conclusion, hypothyroidism is associated with major depressive symptoms. CSF CCK-4 and tryptophan, as well as serum thyroid hormones, may constitute biochemical correlates for some of these symptoms.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27797 (URN)10.1159/000054869 (DOI)12544 (Local ID)12544 (Archive number)12544 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    6. Acute Effects of Cholecystokinin Tetrapeptide on Brain Stem Auditory Evoked Potentials in Healthy Volunteers
    Open this publication in new window or tab >>Acute Effects of Cholecystokinin Tetrapeptide on Brain Stem Auditory Evoked Potentials in Healthy Volunteers
    Show others...
    2003 (English)In: Pharmacopsychiatry, ISSN 0176-3679, E-ISSN 1439-0795, Vol. 36, no 5, p. 181-186Article in journal (Refereed) Published
    Abstract [en]

    This study investigated the effects of continuous slow intravenous infusion of cholecystokinin tetrapeptide (CCK-4) on brain stem auditory evoked potentials (BSAEP) in healthy subjects. Twenty-four subjects, 15 females and 9males, were assigned to infusion with either placebo or CCK-4 in a randomized, double-blind, parallel group design. BSAEPs, mood, physical symptoms, and vital signs were assessed once before infusion and at 10 min and 40 min after the onset of infusion. In the 16 subjects (N = 8, CCK-4; N = 8, placebo) CCK-4, compared to placebo, delayed peak I latency during early infusion, slowed the latencies of peaks III and V, and decreased the amplitude of peak III throughout the infusion. No significant treatment differences were observed with respect to symptoms, mood, or cardiovascular measures. These preliminary findings suggest that CCK-4 may interfere with information processing in the brain stem auditory pathways and that prolonged intravenous CCK-4 administration may be a useful challenge paradigm for investigating CCK's modulatory role on brain stem mechanisms mediating anxiety and panic in humans.

    Keywords
    Cholecystokinin, CCK-4, brain stem auditory evoked potentials, anxiety, panic
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27796 (URN)10.1055/s-2003-43047 (DOI)12543 (Local ID)12543 (Archive number)12543 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
  • 33.
    Gunnarsson, Tove
    et al.
    Department of Clinical Neuroscience and Family Medicine, Division of Psychiatry, Karolinska Institute, Huddinge Hospital, Sweden.
    Eklundh, Thomas
    Department of Clinical Neuroscience and Family Medicine, Division of Psychiatry, Karolinska Institute, Huddinge Hospital, Sweden.
    Eriksson, Mats
    Department of Internal Medicine, Karolinska Institute, Huddinge Hospital, Sweden.
    Qureshi, G. Ali
    Clinical Research Center, Novum, Karolinska Institute, Huddinge Hospital, Sweden.
    Sjöberg, Stefan
    Department of Internal Medicine, Karolinska Institute, Huddinge Hospital, Sweden.
    Nordin, Conny
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences.
    Cholecystokinin peptides in cerebrospinal fluid: a study in healthy male subjects1997In: Regulatory Peptides, ISSN 0167-0115, E-ISSN 1873-1686, Vol. 68, no 1, p. 57-61Article in journal (Refereed)
    Abstract [en]

    The clinical reliability of measuring cholecystokinin (CCK) peptides in the cerebrospinal fluid (CSF) has not been fully elucidated. Therefore, we have assayed CCK-8S and CCK-4 in CSF obtained from 14 healthy male subjects, lumbar-punctured at the L4–5 level following a strictly standardised procedure. CSF concentrations of free CCK-8S and free CCK-4 were used as dependent variables while age, height, body weight, atmospheric pressure and some other factors served as independent variables. It was shown that the CCK-8S ratio between the second (7–12 ml) and first (0–6 ml) CSF fractions, correlated significantly with the atmospheric pressure at the time of puncture. Neither CCK-8S nor CCK-4 displayed concentration gradients in CSF. The CCK-4 levels, expressed as pmol l−1 in the total amount of CSF were found to be positively correlated with the neuraxis distance in the lying position and negatively with the neuraxis distance in the sitting position. Furthermore, CCK-4, expressed as pmol l−1 per min of tapping-time (pmol l−1 min−1), showed a negative correlation with storage time, presumably mirroring a proteolytic process. CCK-8S and CCK-4 intercorrelated positively independently of whether expressed as pmol l−1 or pmol l−1 min−1. In conclusion, the results of this exploratory study indicate that the neuraxis distance (in the sitting and lying positions) and storage-time have to be accounted for when interpreting data on CSF levels of CCK-4. Attention has to be paid to the potential influence of atmospheric pressure on the concentration ratio of CCK-8S.

  • 34.
    Gunnarsson, Tove
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Leszniewski, W
    Linkoping Univ Hosp, Dept Neurosurg, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Dept Radiol, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Dept Pathol, S-58185 Linkoping, Sweden.
    Bak, J
    Davidsson, L
    Linkoping Univ Hosp, Dept Neurosurg, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Dept Radiol, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Dept Pathol, S-58185 Linkoping, Sweden.
    An intradural cervical chordoma mimicking a neurinoma - Case illustration2001In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 95, no 1, p. 144-144Other (Other academic)
  • 35.
    Gunnarsson, Tove
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences.
    Sjöberg, Stefan
    Department of Internal Medicine, Karolinska Institute, Huddinge Hospital, Sweden.
    Eriksson, Mats
    Department of Internal Medicine, Karolinska Institute, Huddinge Hospital, Sweden.
    Nordin, Conny
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Cholecystokinin peptides in cerebrospinal fluid: a pilot study in hypothyroid patients1999In: Human Psychopharmacology: Clinical and Experimental, ISSN 0885-6222, E-ISSN 1099-1077, Vol. 14, no 2, p. 113-117Article in journal (Refereed)
    Abstract [en]

    The cholecystokinin tetrapeptide (CCK-4) and the sulphated octapeptide (CCK-8) were measured in cerebrospinal fluid obtained from nine hypothyroid patients before and during L-thyroxine treatment. Before treatment, CCK-4 and CCK-8S correlated negatively with S-TSH, whereas CCK-8S also showed a positive correlation with S-T3. During treatment, S-T4 correlated negatively with CCK-8S. CSF collection time was significantly shorter during treatment than prior to treatment for the first (0–6 ml) CSF fraction. On taking CSF collection time into account, the levels of both CCK-4 and CCK-8S in the first CSF fraction were significantly increased during medication. Our results are consistent with an impact of the hypothyroid disorder and L-thyroxine treatment on the disposition of CCK compounds in CSF. This might be due to an altered CSF circulation, but other mechanisms (e.g. metabolism or elimination) cannot be ruled out.

  • 36.
    Haglund, Lena
    Linköping University, Department of Neuroscience and Locomotion. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences.
    Occupational therapy assessment in general psychiatric care1997Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to develop an Instrument to Investigate psychiatric patients' occupational performance In order to identify their need of occupational therapy service. A literature review and analysis of different concepts used to describe the patient's activity resulted In the construction of new concepts which subdivide the activity Into elementary parts; operations, single actions, generated actions, action sequences and simultaneous actions.

    Occupational therapists (n = 38) In general psychiatric care collaborated In a study of the agreement level when deciding whether patients (n = 10) should be Included In, or excluded from, occupational therapy service. The results Indicate the imJ?Orlance of studying In more detail the screening process and the development of screening mstruments.

    One instrument, the Occupational Case Analysis Interview and Rating Scale (OCAIRS), was identified. The instrument, which gives Information about patients' adar.tive occupational functioning, was translated Into Swedish and tested for interrater reliability In two different studies. The result showed that the second version of the instrument had good lnterrater agreement.

    In order to investigate whether a patient's adaptive occupational functioning is related to diagnoses of schizophrenia or mood disorders, a study was made on three groups of inpatients: patients with schizophrenia (n = 18), major depression (n = 20) and bipolar disorders (n = 22). To examine the patient's occupational functioning OCAIRS was used. The result Indicated that the patient's adaptive occupational functioning was related to psychiatric diagnoses. Patients with schizophrenia and with bipolar disorders had great difficulties In adapting to everyday occupation and were In need of intervention from the occupational therapist. Patients with maJor depression, however, do not seem to have the same need of intervention.

    By Interviewing 145 patients, the predictive values of OCAIRS was calculated. OCAIRS seems to predict Inclusion and exclusion Into occupational therapy, seems to select which patients are In immediate need of treatment, and seems to identify those who need a new assessment later on. However, the results Indicate a need to Investigate how the rating of the different components In OCAIRS influence the occupational therapist when judging the patient's need of occupational therapy.

  • 37.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Rahm Hallberg, Ingalill
    Practice models in Swedish psychiatric occupational therapy2000In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, Vol. 7, no 3, p. 107-113Article in journal (Refereed)
    Abstract [en]

    In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown which theoretical approaches and practice models influence Swedish occupational therapists' daily work. In this study a questionnaire (n=334) was used to investigate approaches and models used in Swedish psychiatric care service and in psychiatric occupational therapy service. The results showed that the psychosocial approach influenced both psychiatric care and psychiatric occupational therapy most. The most frequently used practice model was the Model of Human Occupation. However, 75% of the respondents did not identify theoretical thinking based on models from their own field behind their actions. Many practitioners seemed to use knowledge developed by other disciplines more often. Years of clinical experience in the profession or education did not seem to have any impact on the ability to identify the practice models that were used. The results indicate that education in occupational therapy must emphasize knowledge in its own field more than has been done up to now.

  • 38.
    Haglund, Lena
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Clinical perspective on the Swedish version of the Assessment of Communication and Interaction Skills: Stability of assessments2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, no 4, p. 417-423Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to investigate whether ratings according to the Assessment of Communication and Interaction Skills, Swedish version (ACIS-S) are related to the settings in which the skills are assessed, and whether the client's comprehension of the setting is related to the ACIS-S rating scores. The ACIS-S is an observation rating scale applied immediately after each of two to six different social sessions that the client takes part in. The selection of settings relies on the client's judgement of them as being meaningful. In total, nine occupational therapists and 16 clients participated in the study. A total of 71 ratings were made in a mean of 4.4 settings per client. The results indicate that the client's rated comprehension of the settings is not significantly related, in general, to the ACIS-S rating scores given by the occupational therapist. However, the clients ACIS-S scores may vary a lot over settings. In the present study, 13- of the 20-items showed ratings of both the existence and the absence of problems in the same skill - but in different settings - in half or more of the client group. This may rise questions for the practitioners how to implement the ACIS-S in clinical practice, for example, how many and which kind of settings and how many times? Further research in the field is recommended. © 2004 Nordic College of Caring Sciences.

  • 39.
    Hansson, Caroline
    et al.
    University of Gothenburg, Sweden .
    Annerbrink, Kristina
    University of Gothenburg, Sweden .
    Nilsson, Staffan
    Chalmers, Sweden .
    Bah, Jessica
    University of Gothenburg, Sweden .
    Olsson, Marie
    University of Gothenburg, Sweden .
    Allgulander, Christer
    Karolinska Institute, Sweden .
    Andersch, Sven
    University of Gothenburg, Sweden .
    Sjödin, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Eriksson, Elias
    University of Gothenburg, Sweden .
    Dickson, Suzanne L.
    University of Gothenburg, Sweden .
    A possible association between panic disorder and a polymorphism in the preproghrelin gene2013In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 206, no 1, p. 22-25Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate whether polymorphisms in the preproghrelin gene are associated with anxiety disorders, such as panic disorder, in humans. Panic disorder is a severe anxiety disorder, characterized by sudden attacks of intense fear or anxiety in combination with somatic symptoms. The preproghrelin gene codes for two gut-derived circulating peptides that have been linked to anxiety-like behaviour in rodents: ghrelin (an orexigenic, pro-obesity hormone) and obestatin. In the present study, we genotyped three missense mutations in the preproghrelin gene in 215 patients suffering from panic disorder and in 451 controls. The A allele of the rs4684677 polymorphism was significantly associated with panic disorder, while there were no significant associations with the two other polymorphisms studied. We conclude that the rs4684677 (Gln90Leu) polymorphism in the preproghrelin gene may be associated with increased risk of panic disorder. It will be important to confirm these findings in additional panic disorder patient groups.

  • 40.
    Henningsson, S.
    et al.
    Department of Pharmacology, Göteborg University, Göteborg, Sweden.
    Annerbrink, K.
    Department of Pharmacology, Göteborg University, Göteborg, Sweden.
    Olsson, M.
    Department of Pharmacology, Göteborg University, Göteborg, Sweden.
    Allgulander, C.
    Karolinska Institutet, Neurotec Department, Section of Psychiatry, Stockholm, Sweden.
    Andersch, S.
    Institution of Clinical Neuroscience, Göteborg University, Göteborg, Sweden.
    Sjödin, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Gustafson, D.
    Institution of Clinical Neuroscience, Göteborg University, Göteborg, Sweden.
    Skoog, I.
    Institution of Clinical Neuroscience, Göteborg University, Göteborg, Sweden.
    Eriksson, E.
    Department of Pharmacology, Göteborg University, Göteborg, Sweden.
    Westberg, L.
    Department of Pharmacology, Göteborg University, Göteborg, Sweden, Department of Pharmacology, Box 431, Göteborg University, 40530 Göteborg, Sweden.
    Absence of the Arg441His polymorphism in the tryptophan hydroxylase 2 gene in adults with anxiety disorders and depression2007In: American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics, ISSN 1552-4841, Vol. 144, no 6, p. 816-817Other (Other academic)
    Abstract [en]

    [No abstract available]

  • 41.
    Janelidze, Shorena
    et al.
    Lund University, Sweden .
    Ventorp, Filip
    Lund University, Sweden .
    Erhardt, Sophie
    Karolinska Institute, Sweden .
    Hansson, Oskar
    Lund University, Sweden .
    Minthon, Lennart
    Lund University, Sweden .
    Flax, John
    PrecisionMedical Inc, CA USA .
    Samuelsson, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Traskman-Bendz, Lil
    Lund University, Sweden .
    Brundin, Lena
    Lund University, Sweden Michigan State University, MI USA .
    Altered chemokine levels in the cerebrospinal fluid and plasma of suicide attempters2013In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 38, no 6, p. 853-862Article in journal (Refereed)
    Abstract [en]

    Chemokines constitute a class of small inflammatory proteins that control the chemotaxis of leukocytes. They are also present in the central nervous system (CNS) and contribute to diverse physiological functions, such as the regulation of cell migration, axonal growth and neuronal survival. It is to date not known whether chemokines in the CNS are affected in psychiatric disorders. In this study, chemokine levels were measured in the cerebrospinal fluid (CSF) of 137 psychiatric patients in conjunction to a suicide attempt, and 43 healthy controls. A subgroup of patients (n = 42) was followed up with blood samples 12 years after the initial CSF collection, when they did not show suicidal behavior. The follow-up chemokine levels were compared to those of psychiatric patients (n = 17) who had never attempted suicide. Ultrasensitive chemokine multiplex immunoassay was used to quantify eotaxin-1 (CCL11), interferon gamma-induced protein-10 (IP-10, CXCL10), macrophage inflammatory protein-1 beta (MIP-1 beta, CCL4), monocyte chemotactic protein-1 (MCP-1, CCL2), MCP-4 (CCL13) and thymus and activation regulated chemokine (TARC, CCL17). Patients were diagnosed using DSM-III-R/DSM-IV, and assessed using the Comprehensive Psychopathological Rating Scale (CPRS), including subscales, and the Suicidal Intent Scale (SIS). CSF eotaxin-1, MIP-1 beta, MCP-1, MCP-4 and TARC were significantly lower in suicide attempters than in healthy controls. Low chemokine levels were specifically associated with psychotic symptoms and pain. In the samples collected at follow-up, TARC was significantly lower in suicide attempters compared to psychiatric patients who had never attempted suicide. We also found a positive correlation between blood TARC and brain-derived neurotrophic factor (BDNF) levels. Our study thus provides evidence of reduced chemokine levels in suicide attempters, both in the acute suicidal setting, and at long-term, compared to non-attempters. These results warrant future studies on the detailed neurobiological functions of chemokines in psychiatric patients. (C) 2012 Elsevier Ltd. All rights reserved.

  • 42. Jaworski, J
    et al.
    Dahlqvist Leinhard, Olof
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Department of Medicine and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics UHL. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Gladigau, D
    Gustafsson, M C
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurosurgery UHL. Linköping University, Faculty of Health Sciences.
    Follow-up of absolute metabolite concentrations using MR spectroscopy in MS patients with interferon-b treatment2008Conference paper (Other academic)
  • 43.
    Jonsson, Dick
    et al.
    Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
    Wålinder, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Cost-effectiveness of clozapine treatment in therapy-refractory schizophrenia1995In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 92, no 3, p. 199-201Article in journal (Refereed)
    Abstract [en]

    The costs and effects of clozapine treatment of refractory schizophrenic patients have been discussed recently. This study shows that 18 months of clozapine treatment results in an improvement of symptoms and social functioning in approximately 70% of treatment-refractory schizophrenic patients, compared with treatment with conventional neuroleptics during a similar period of time. Treatment with clozapine reduces the cost of inpatient care but places increased demands on active rehabilitation resources in outpatient care. This leads to increased total costs in a short-term perspective, but clozapine treatment is cost-saving for annual maintenance therapy. These costs must be weighed against the positive effects on psychotic symptoms and social functioning.

  • 44.
    Jonsson, Dick
    et al.
    Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
    Wålinder, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    The socioeconomic cost of treatment of therapy-refractory schizophrenic patients in Sweden1994In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 48, no 5, p. 311-313Article in journal (Refereed)
    Abstract [en]

    The aim of the study is to examine the socioeconomic costs of treatment of therapy-refractory schizophrenic patients. The patients usually have a great need for health care and remain in institutions for long periods of time. The method is retrospective, and the data refer to patients who received treatment at the Department of Psychiatry, University Hospital in Linköping, Sweden in 1990. The total annual health care cost for treatment of therapy-refractory schizophrenia is estimated to be SEK 4.8 million (USD 1 = SEK 7.7). Inpatient care amounts to 93% of the total cost, and the cost of outpatient care to 6%. The cost of drugs and laboratory services corresponds to 1 % of the total cost. The high cost of inpatient care and the low cost of outpatient care may indicate that a redistribution of resources from inpatient to outpatient care is necessary. A generalization of the results indicates that the total annual cost of treating all therapy-refractory schizophrenic patients in Sweden is approximately SEK 1.9 billion. The result highlights the need for discussions concerning alternative treatment methods but also focuses on the importance of using health economic evaluations within psychiatry.

  • 45.
    Josefsson, Ann
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Angelsiöö, L.
    Berg, Göran
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Ekström, CM.
    Gunnervik, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Nordin, Conny
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms2002In: Obstetrics and gynecology, ISSN 0029-7844, Vol. 99, no 2, p. 223-228Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To identify and test the predictive power of potential independent risk factors of postpartum depressive symptoms during pregnancy and the perinatal period.

    METHODS: We conducted a case-control study where 132 women with postpartum depressive symptoms were selected as an index group and 264 women without depressive symptoms as a control group. Data related to sociodemographic status, medical, gynecologic, and obstetric history, pregnancy, and perinatal events were collected from standardized medical records.

    RESULTS: The strongest risk factors for postpartum depressive symptoms were sick leave during pregnancy and a high number of visits to the antenatal care clinic. Complications during pregnancy, such as hyperemesis, premature contractions, and psychiatric disorder were more common in the postpartum depressed group of women. No association was found between parity, sociodemographic data, or mode of delivery and postpartum depressive symptoms.

    CONCLUSION: Women at risk for postpartum depression can be identified during pregnancy. The strongest risk factors, sick leave during pregnancy and many visits to the antenatal care clinic, are not etiologic and might be of either behavioral or biologic origin. The possibilities of genetic vulnerability and hormonal changes warrant further investigation to reach a more thorough understanding.

  • 46.
    Josefsson, Ann
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Berg, Göran
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Nordin, Conny
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Prevalence of depressive symptoms in late pregnancy and postpartum2001In: Acta obstetricia et gynecologica Scandinavica, ISSN 0001-6349, Vol. 80, no 3, p. 251-255Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Postnatal depression refers to a non-psychotic depressive episode that begins in or extends into the postpartum period. The aims of this study were to examine the prevalence of depressive symptoms in a pregnant and later postnatal population, to determine the natural course of these symptoms and whether there is an association between antenatal and postnatal depressive symptomatology.

    METHODS: A longitudinal study with a total population of 1,558 consecutively registered pregnant women in the southeast region of Sweden. Presence of depressive symptoms was measured with the Edinburgh Postnatal Depression Scale on four occasions namely in gestational week 35-36, in the maternity ward, 6-8 weeks and 6 months postpartum.

    RESULTS: The prevalence of depressive symptoms during late pregnancy was 17%; in the maternity ward 18%; 6-8 weeks postnatally 13%; and 6 months postnatally, 13%. A correlation between antenatal and postnatal depressive symptoms was found (r=0.50, p<0.0001).

    CONCLUSION: Detection of women at risk for developing postnatal depressive symptoms can be done during late pregnancy. Antenatal care clinics constitute a natural and useful environment for recognition of women with depressive symptoms.

  • 47.
    Josefsson, Ann
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Berg, Göran
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Dahl, Marja-Liisa
    Wadelius, Mia
    Nordin, Conny
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    CYP2D6 genotypes and depressive symptoms during late pregnancy and postpartum2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, Vol. 58, no 1, p. 61-64Article in journal (Refereed)
    Abstract [en]

    The aim of this exploratory was to investigate the theory of a relation between cytochrome P450 2D6 (CYP2D6) genotype and depressive symptoms in late pregnancy and/or postpartum. We studied 145 women with depressive symptoms. CYP2D6 genotype was analysed in leukocyte DNA by polymerase chain reaction (PCR). There were no significant differences in CYP2D6 genotypes between the groups of women being depressed during and/or after pregnancy. The frequencies of CYP2D6 genotypes did not differ from other European studies. This study cannot confirm that depressive symptoms in late pregnancy and postpartum are connected with CYP2D6 genotype. It is, however, noteworthy that the frequency of ultrarapid metabolizers was higher than in a general Caucasian population. This warrants further exploration in a greater study sample, but should also be investigated in a general population with major depression.

  • 48.
    Josefsson, Martin
    et al.
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, The Institute of Technology.
    Roman, Markus
    National Board of Forensic Medicine, Linköping.
    Skogh, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Dahl, Marja-Liisa
    University Hospital, Uppsala.
    Liquid chromatography/tandem mass spectrometry method for determination of olanzapine and N-desmethylolanzapine in human serum and cerebrospinal fluid2010In: Journal of Pharmaceutical and Biomedical Analysis, ISSN 0731-7085, E-ISSN 1873-264X, Vol. 53, no 3, p. 576-582Article in journal (Refereed)
    Abstract [en]

    A validated, accurate and sensitive LC-MS/MS method for determination of olanzapine and its metabolite N-desmethylolanzapine has been developed. The analytes were quantified by tandem mass spectrometry operating in positive electrospray ionization mode with multiple reaction monitoring. Olanzapine and desmethylolanzapine were extracted from serum or cerebral spinal fluid samples, 200 microl, with tert-butyl methyl ether using olanzapine-D3 as internal standard. Calibrations for olanzapine and desmethylolanzapine were linear within the selected range of 0.2-30 ng/ml (6-96 nM) in cerebral spinal fluid and for olanzapine in plasma, in the range of 5-100 ng/ml (16-320 nM). The method was successfully used for the analysis of samples from patients treated with olanzapine in the dose range of 2.5-25mg/day.

  • 49.
    Knott, V.J.
    et al.
    Department of Psychiatry, University of Ottawa, Institute of Mental Health Research, Ottawa, Ont., Canada, Royal Ottawa Hospital, 1145 Carling Avenue, Ottawa, Ont. K1Z 7K4, Canada.
    Mahoney, C.
    Royal Ottawa Hospital, Ottawa, Ont., Canada.
    Gunnarsson, Tove
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Bradwejn, J.
    Department of Psychiatry, University of Ottawa, Institute of Mental Health Research, Ottawa, Ont., Canada.
    Shlik, J.
    Department of Psychiatry, University of Tartu, Tartu, Estonia.
    Acute cholecystokinin effects on event-related potentials in healthy volunteers2002In: Human Psychopharmacology: Clinical and Experimental, ISSN 0885-6222, E-ISSN 1099-1077, Vol. 17, no 6, p. 285-291Article in journal (Refereed)
    Abstract [en]

    This study investigated the effects of a continuous slow infusion of cholecystokinin tetrapeptide (CCK-4), a neuropeptide with panicogenic properties, on brain event-related potentials (ERPs) in healthy adults. Twenty-four volunteers, 15 females and 9 males, were assigned to infusion with either placebo or CCK-4 in a randomized, double-blind, parallel group design. ERPs, elicited within a standard auditory odd-ball paradigm requiring the counting of rare (20%) occurring 'deviant' tones interspersed among more frequent (80%) occurring 'standard' tones, were assessed once before infusion, and at 10 min and 40 min after the onset of infusion. Compared with the placebo, CCK-4 delayed the latencies of N100 and P200 components elicited by 'deviant' stimuli. No significant treatment differences were observed with respect to N200, P300b, mood or adverse symptoms. These preliminary findings suggest that CCK-4 may interfere with information processing relating to the selection of significant stimulating and as such, may be of relevance to mechanisms underlying panic disorder. Copyright © 2002 John Wiley & Sons, Ltd.

  • 50.
    Kvist, EE
    et al.
    Huddinge Univ Hosp, Karolinska Inst, Dept Med Lab Sci & Technol, Div Clin Pharmacol, Stockholm, Sweden Univ Hosp, Dept Med Sci Clin Pharmacol, Uppsala, Sweden Fac Hlth Sci, Dept Neurosci & Locomot, Div Psychiat, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden.
    Al-Shurbaji, A
    Huddinge Univ Hosp, Karolinska Inst, Dept Med Lab Sci & Technol, Div Clin Pharmacol, Stockholm, Sweden Univ Hosp, Dept Med Sci Clin Pharmacol, Uppsala, Sweden Fac Hlth Sci, Dept Neurosci & Locomot, Div Psychiat, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden.
    Dahl, ML
    Huddinge Univ Hosp, Karolinska Inst, Dept Med Lab Sci & Technol, Div Clin Pharmacol, Stockholm, Sweden Univ Hosp, Dept Med Sci Clin Pharmacol, Uppsala, Sweden Fac Hlth Sci, Dept Neurosci & Locomot, Div Psychiat, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden.
    Nordin, Conny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Alvan, G
    Huddinge Univ Hosp, Karolinska Inst, Dept Med Lab Sci & Technol, Div Clin Pharmacol, Stockholm, Sweden Univ Hosp, Dept Med Sci Clin Pharmacol, Uppsala, Sweden Fac Hlth Sci, Dept Neurosci & Locomot, Div Psychiat, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden.
    Stahle, L
    Huddinge Univ Hosp, Karolinska Inst, Dept Med Lab Sci & Technol, Div Clin Pharmacol, Stockholm, Sweden Univ Hosp, Dept Med Sci Clin Pharmacol, Uppsala, Sweden Fac Hlth Sci, Dept Neurosci & Locomot, Div Psychiat, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden.
    Quantitative pharmacogenetics of nortriptyline - A novel approach2001In: Clinical Pharmacokinetics, ISSN 0312-5963, E-ISSN 1179-1926, Vol. 40, no 11, p. 869-877Article, review/survey (Refereed)
    Abstract [en]

    Objective: To quantitatively model nortriptyline clearance as a function of the cytochrome P450 (CYP) 2D6 genotype and to estimate the contribution of genotype to the interindividual variability in steady-state plasma concentration and metabolic clearance. Design: Modelling study using data from two previously published studies. Participants: 20 healthy volunteers receiving single oral doses of nortriptyline and 20 patients with depression on steady-state oral treatment. Methods: A total of 275 nortriptyline plasma concentrations were analysed by standard nonlinear regression and nonlinear mixed effect models. The pharmacokinetic model was a 1-compartment model with first order absorption and elimination. All participants had previously been genotyped with respect to the CYP2D6 polymorphism. Results: A model in which the intrinsic clearance is a linear function of the number of functional CYP2D6 genes and hepatic blood flow is fixed to 60 L/h gave the closest fit of the pharmacokinetic model to the data. Stable estimates were obtained for population pharmacokinetic parameters and interindividual variances. Assuming 100% absorption, the model allows systemic clearance and bioavailability to be estimated. Bioavailability was found to vary between 0.17 and 0.71, depending on the genotype. Using the frequency distribution of CYP2D6 genotype with the above results we estimate that, in compliant Swedish individuals on nortriptyline monotherapy, the number of functional CYP2D6 genes could explain 21% of the total interindividual variance in oral clearance of nortriptyline and 34% of that in steady-state plasma concentrations. Conclusion: Nonlinear mixed-effects modelling can be used to quantify the influence of the number of functional CYP2D6 genes on the metabolic clearance and plasma concentration of drugs metabolised by this enzyme. Gene dose has a significant impact on drug pharmacokinetics and prior knowledge of it may aid in predicting plasma concentration of the drug and thus tailoring patient-specific dosage regimens.

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