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Glans, M. R., Nilsson, J. & Bejerot, S. (2024). Tattoos, piercings, and symptoms of ADHD in non-clinical adults: a cross-sectional study. Frontiers in Psychiatry, 14, Article ID 1224811.
Open this publication in new window or tab >>Tattoos, piercings, and symptoms of ADHD in non-clinical adults: a cross-sectional study
2024 (English)In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 14, article id 1224811Article in journal (Refereed) Published
Abstract [en]

Introduction: Tattoos and piercings are associated with impulsive and risk-taking personality traits, which are also common along the ADHD continuum. However, studies on ADHD and body modification are lacking. Thus, this study aimed to assess the association between body modification and subclinical ADHD symptom severity and to investigate if body modification can serve as an indication for ADHD examination.

Methods: A total of 762 adults (529 women and 233 men) without a diagnosis of ADHD completed the adult ADHD Self-Report Scale (ASRS) and answered questions concerning body modification. Two different ASRS versions were utilized: the 18-item ASRS Symptom Checklist and the 6-item ASRS Screener. Three categorizations of body modifications were analyzed: (i) having at least one tattoo, (ii) having at least one piercing other than ear piercing, and (iii) the combination of simultaneously having at least one tattoo and one piercing. Mean 18-item ASRS total and subscale scores and the proportion of positive results on the 6-item ASRS Screener were compared between those with and those without body modifications while adjusting for covariates age and sex. Additional analyses were performed for >= 2 and >= 3 body modifications.

Results: In our cohort, 26% had a tattoo, 14% had a piercing other than ear piercing, and 8% had a combination of tattoo and piercing. Having any kind of body modification was associated with more pronounced symptoms of ADHD and with a cutoff score on the ASRS screener indicating ADHD. Whereas, the effect sizes were small for tattoos, medium to large effect sizes were seen for >= 2 piercings in the ASRS. Moreover, moderately strong associations emerged for >= 1 piercing and a positive ASRS screening result.

Conclusion: Our results suggest that acquiring a body modification, especially a tattoo, is entering the mainstream in Sweden. Correspondingly, differences in subclinical ADHD symptomatology between non-clinical adults with and without body modifications are subtle. Having >= 2 piercings other than ear piercings, on the other hand, is associated with clinically relevant differences in ADHD symptoms. Moreover, piercing status may serve as an indicator, among others, for further ADHD assessments. However, more research is needed to ascertain the possible signaling functions of body modifications in clinical settings.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024
Keywords
impulsivity, hyperactivity, inattention, tattoo, piercing
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-110942 (URN)10.3389/fpsyt.2023.1224811 (DOI)001142692400001 ()38234366 (PubMedID)2-s2.0-85182494270 (Scopus ID)
Funder
Swedish Research Council, K2012- 62X-22130-04-6
Note

Funding agency:

Bror Gadelius Minnesfond

Available from: 2024-01-23 Created: 2024-01-23 Last updated: 2024-01-23Bibliographically approved
Hylén, U., Särndahl, E., Bejerot, S., Humble, M. B., Hyötyläinen, T., Salihovic, S. & Eklund, D. (2023). Alterations in inflammasome-related immunometabolites in individuals with severe psychiatric disorders. BMC Psychiatry, 23(1), Article ID 268.
Open this publication in new window or tab >>Alterations in inflammasome-related immunometabolites in individuals with severe psychiatric disorders
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2023 (English)In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, no 1, article id 268Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Psychiatric disorders are common and significantly impact the quality of life. Inflammatory processes are proposed to contribute to the emergence of psychiatric disorders. In addition to inflammation, disturbances in metabolic pathways have been observed in individuals with different psychiatric disorders. A suggested key player in the interaction between inflammation and metabolism is the Nod-like receptor 3 (NLRP3) inflammasome, and NLRP3 is known to react to a number of specific metabolites. However, little is known about the interplay between these immunometabolites and the NLRP3 inflammasome in mental health disorders.

AIM: To assess the interplay between immunometabolites and inflammasome function in a transdiagnostic cohort of individuals with severe mental disorders.

METHODS: Mass spectrometry-based analysis of selected immunometabolites, previously known to affect inflammasome function, were performed in plasma from low-functioning individuals with severe mental disorders (n = 39) and sex and aged-matched healthy controls (n = 39) using a transdiagnostic approach. Mann Whitney U test was used to test differences in immunometabolites between psychiatric patients and controls. To assess the relationship between inflammasome parameters, disease severity, and the immunometabolites, Spearman's rank-order correlation test was used. Conditional logistic regression was used to control for potential confounding variables. Principal component analysis was performed to explore immunometabolic patterns.

RESULTS: Among the selected immunometabolites (n = 9), serine, glutamine, and lactic acid were significantly higher in the patient group compared to the controls. After adjusting for confounders, the differences remained significant for all three immunometabolites. No significant correlations were found between immunometabolites and disease severity.

CONCLUSION: Previous research on metabolic changes in mental disorders has not been conclusive. This study shows that severely ill patients have common metabolic perturbations. The changes in serine, glutamine, and lactic acid could constitute a direct contribution to the low-grade inflammation observed in severe psychiatric disorders.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Comorbidity, Inflammasomes, Inflammation, Mental Disorders, Metabolic pathways, Psychoneuroimmunology
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-105613 (URN)10.1186/s12888-023-04784-y (DOI)000975250300004 ()37076825 (PubMedID)2-s2.0-85152978734 (Scopus ID)
Funder
Knowledge Foundation, 20200017
Available from: 2023-04-21 Created: 2023-04-21 Last updated: 2024-02-23Bibliographically approved
Westerberg, B., Holländare, F. & Bejerot, S. (2023). An internet-based behavioral intervention for adults with autism spectrum disorder - A randomized controlled trial and feasibility study. Internet Interventions, 34, Article ID 100672.
Open this publication in new window or tab >>An internet-based behavioral intervention for adults with autism spectrum disorder - A randomized controlled trial and feasibility study
2023 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 34, article id 100672Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The increased prevalence of Autism Spectrum Disorder (ASD) diagnoses in combination with psychiatric comorbidity, has led to an increased need for effective interventions. The evidence for internet-based interventions for several mental health problems is established but has not been evaluated for adults with ASD.

OBJECTIVE: The aim of this randomized controlled trial is to evaluate the feasibility and effects of an internet-based intervention targeting quality of life and psychiatric symptoms (depression and anxiety) in adults with ASD. METHODS: 84 participants were randomly allocated to intervention (n = 42) or control (n = 42). The 18-week internet-based intervention covered a range of themes related to difficulties common in ASD, and exercises based on cognitive behavioral strategies. Participants were provided with individual feedback following each module and were invited to regular chat sessions with peer participants. The primary outcomes were subjective quality of life and sense of coherence, and secondary outcomes were symptoms of depression and anxiety. All outcomes were measured at five occasions and analysed with linear mixed effect models. Participant satisfaction and adherence was also analysed.

RESULTS: Participant satisfaction and adherence was satisfactory but no significant interaction between group and time was found for any outcome measure. Autistic traits were negatively related to quality of life and sense of coherence and positively related to anxiety and depressive symptoms.

CONCLUSIONS: This internet-based intervention showed feasibility regarding adherence and participant satisfaction. However, no significant effects on quality of life, sense of coherence or psychiatric symptoms were found, likely due to limitations in the design and methodology of this specific trial in combination to the heterogeneity of the group. Individuals with ASD may require interventions that are flexible and individually tailored in regard to both format, content and therapeutic support. The current trial provides useful information and suggestions for the future research on internet-based interventions for ASD.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Autism spectrum disorder, Cognitive-behavioral therapy, Internet-based intervention, Psychiatry, Quality of life
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-108661 (URN)10.1016/j.invent.2023.100672 (DOI)001079510200001 ()37772160 (PubMedID)2-s2.0-85171486066 (Scopus ID)
Funder
Region Örebro County, OLL-935396 OLL-879651 OLL-887401 OLL-833131 OLL-785501 OLL-736321 OLL-878311
Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2023-10-25Bibliographically approved
Fresnais, D., Humble, M. B., Bejerot, S., Meehan, A. D. & Fure, B. (2023). Apathy as a Predictor for Conversion From Mild Cognitive Impairment to Dementia: A Systematic Review and Meta-Analysis of Longitudinal Studies. Journal of Geriatric Psychiatry and Neurology, 36(1), 3-17
Open this publication in new window or tab >>Apathy as a Predictor for Conversion From Mild Cognitive Impairment to Dementia: A Systematic Review and Meta-Analysis of Longitudinal Studies
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2023 (English)In: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 36, no 1, p. 3-17Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Apathy is one of the most prevalent neurobehavioral manifestations in mild cognitive impairment (MCI) and is included among the behavioral and psychological symptoms of dementia (BPSD). Studies suggest that the presence of apathy could be associated with increased dementia risk. The role of apathy in conversion from MCI to dementia, and whether apathy could be a relevant predictor for dementia progression, are still matters of investigation.

AIM: To study the relationship between apathy and progression to dementia in individuals with MCI.

METHODS: A systematic literature search in Medline, Embase, Cochrane Library, Epistemonikos, PsychINFO, and CINAHL was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search included longitudinal studies reporting on the association between apathy and dementia.

RESULTS: The main outcome was pooled unadjusted hazard ratios (HR) of apathy in dementia conversion and included 11 studies with 9504 individuals. There was a significant association between apathy and dementia conversion, HR = 1.54; 95% CI, 1.29, 1.84. Subgroup analysis showed a significant association between apathy and progression to AD.

CONCLUSION: Apathy was associated with an increased risk of conversion to AD and all-cause dementia in patients with MCI. The role of apathy as a marker for incident dementia needs to be investigated in large, high-quality studies.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Apathy, behavioral disturbance, cognitive impairment, dementia, elderly
National Category
Neurosciences
Identifiers
urn:nbn:se:oru:diva-98668 (URN)10.1177/08919887221093361 (DOI)000786601700001 ()35446723 (PubMedID)2-s2.0-85129677798 (Scopus ID)
Note

Funding agencies:

Örebro University, School of Medical Sciences, Örebro, Sweden

Karlstad Central Hospital, Karlstad, Sweden

Available from: 2022-04-22 Created: 2022-04-22 Last updated: 2023-12-08Bibliographically approved
Bejerot, S., Sigra, S., Welin, E., Eklund, D., Hylén, U. & Humble, M. B. (2023). Rituximab as an adjunctive treatment for schizophrenia spectrum disorder or obsessive-compulsive disorder: Two open-label pilot studies on treatment-resistant patients. Journal of Psychiatric Research, 158, 319-329
Open this publication in new window or tab >>Rituximab as an adjunctive treatment for schizophrenia spectrum disorder or obsessive-compulsive disorder: Two open-label pilot studies on treatment-resistant patients
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2023 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 158, p. 319-329Article in journal (Refereed) Published
Abstract [en]

In this explorative study, we investigated if an adjunctive treatment with one single dose of the monoclonal antibody rituximab would improve symptoms and function in treatment-resistant patients with schizophrenia spectrum disorder (SSD, n = 9) or obsessive-compulsive disorder (OCD, n = 10), based on the inflammatory hypothesis for mental disorders. Patients were followed for one year. Disability was measured with the Personal and Social Performance score (PSP). At baseline, the mean PANSS score in the SSD group was 99 ± 32 and the mean Y-BOCS score in the OCD group was 27.5 ± 7. Mean PSP scores were 32 ± 10.2 and 42.5 ± 9.9 in the SSD and OCD groups, respectively. Seven had Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS) in retrospect, and 3 SSD patients had schizo-obsessive subtype. 4/8 SSD patients showed a ≥40% reduction in PANSS at endpoint I week 20, however, 7/9 were similarly improved already at week 12. Among the OCD patients, 2/10 showed a ≥35% reduction in Y-BOCS at week 20. Disability was significantly improved only in the SSD group. The percentual decrease of PANSS scores in SSD patients was associated with the increase in immunoglobulin levels week 20 (n = 8: IgG r = 0.85, p = .007; IgA r = 0.79, p = .019; IgM r = 0.73, p = .038). Rituximab was generally well tolerated in these patients. Self-rated improvements since baseline were reported for psychic (p = .021), neurological (p = .059), and autonomic (p < .001) side effects (UKU-SERS-Pat side-effect scale). Anxiety was commonly reported by OCD patients, while an initial increase in psychotic symptoms was seen in a few SSD patients. An RCT is underway to evaluate rituximab in SSD.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
B-Cells, Clinical trial, Monoclonal antibody, Neuroinflammation, Obsessive-compulsive disorder, Schizophrenia, Treatment-resistant
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-103171 (URN)10.1016/j.jpsychires.2022.12.003 (DOI)000976718200001 ()36638622 (PubMedID)2-s2.0-85146076210 (Scopus ID)
Funder
Nyckelfonden, OLL-878311 OLL-779081Torsten Söderbergs stiftelse, M84/19The Swedish Brain Foundation, FO2019-0094
Available from: 2023-01-17 Created: 2023-01-17 Last updated: 2024-02-23Bibliographically approved
Humble, M. B., Eklund, D., Fresnais, D., Hylén, U., Sigra, S., Thunberg, P. & Bejerot, S. (2023). Rituximab for treatment-resistant schizophrenia and/or obsessive-compulsive disorder (OCD): functional connectivity and cytokines associated with symptomatic improvements. Paper presented at 31st European Congress of Psychiatry (EPA 2023), Paris, France, March 25-28, 2023. European psychiatry, 66(Suppl. 1), S629-S629, Article ID EPP1035.
Open this publication in new window or tab >>Rituximab for treatment-resistant schizophrenia and/or obsessive-compulsive disorder (OCD): functional connectivity and cytokines associated with symptomatic improvements
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2023 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 66, no Suppl. 1, p. S629-S629, article id EPP1035Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: Immunological mechanisms may contribute to the causation of mental illness. Autoimmunity is most convincingly shown for anti-NMDA-R encephalitis and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS); disorders that overlap clinically with schizophrenia and OCD. Altered inflammatory cytokine production, glial activation and auto-antibodies have also been associated with schizophrenia and OCD. In these disorders, however, the treatment results with anti-inflammatory or immunomodulating drugs have hitherto been limited and inconsistent. Yet other targets within the immune system may still be effective and new options are warranted for treatment-resistant patients. Rituximab targets B-lymphocytes and is often used in autoimmune disorders such as rheumatoid arthritis, multiple sclerosis and anti-NMDA-R encephalitis.

Objectives: We aimed to investigate whether rituximab is clinically effective, safe and tolerable as add-on therapy in markedly ill, treatment-resistant adult psychiatric patients with schizophrenia or OCD. We also wanted to identify putative mediating mechanisms in treatment responders, such as cytokine changes and functional connectivity (FC).

Methods: In an open pilot study, adults (18-39 years) with treatment-resistant schizophrenia and/or OCD were included. They received an intravenous infusion of rituximab 1000 mg, once at baseline, in addition to their regular psychiatric medication and were followed for 1 year. The main outcome measures were the Positive and Negative Syndrome Scale (PANSS) or Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Clinical Global Impression-Improvement scale (CGI-I) and the Personal and Social Performance scale (PSP). Treatment response was defined as ≥ 40 % decrease in PANSS or ≥ 35 % decrease in Y-BOCS, and much improved according to CGI-I. Resting-state fMRI was applied at baseline and after 5 months. Plasma cytokines were measured at 0, 3 and 5 months. Cognitive tests and the recently developed PsychoNeuroinflammatory Related Signs and Symptoms Inventory (PNISSI) were used to identify and measure symptoms related to neuro-inflammation and cognitive function.

Results: Nineteen patients were treated with rituximab. 3-5 months after treatment, 6/9 patients with schizophrenia and 1/10 with OCD responded. One schizophrenia patient continues with rituximab every 6 months and has reportedly done well for almost 3 years. No severe side effects were reported apart from recurrent abdominal pain in a schizophrenia patient and one case of post-COVID-19 syndrome. Significant changes of FC were detected in responders only and correlated with PSP changes.

Conclusions: Aberrant B-cell activities may contribute to treatment-resistant schizophrenia and be amenable to treatment with rituximab. However, the results of this pilot study need confirmation in placebo-controlled trials.

Place, publisher, year, edition, pages
Cambridge University Press, 2023
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-109391 (URN)10.1192/j.eurpsy.2023.1309 (DOI)001060676601588 ()
Conference
31st European Congress of Psychiatry (EPA 2023), Paris, France, March 25-28, 2023
Available from: 2023-10-25 Created: 2023-10-25 Last updated: 2024-02-23Bibliographically approved
Bejerot, S., Eklund, D., Hesser, H., Hietala, M. A., Kariis, T., Lange, N., . . . Humble, M. B. (2023). Study protocol for a randomized controlled trial with rituximab for psychotic disorder in adults (RCT-Rits). BMC Psychiatry, 23(1), Article ID 771.
Open this publication in new window or tab >>Study protocol for a randomized controlled trial with rituximab for psychotic disorder in adults (RCT-Rits)
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2023 (English)In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, no 1, article id 771Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The role of inflammation in the aetiology of schizophrenia has gained wide attention and research on the association shows an exponential growth in the last 15 years. Autoimmune diseases and severe infections are risk factors for the later development of schizophrenia, elevated inflammatory markers in childhood or adolescence are associated with a greater risk of schizophrenia in adulthood, individuals with schizophrenia have increased levels of pro-inflammatory cytokines compared to healthy controls, and autoimmune diseases are overrepresented in schizophrenia. However, treatments with anti-inflammatory agents are so far of doubtful clinical relevance. The primary objective of this study is to test whether the monoclonal antibody rituximab, directed against the B-cell antigen CD20 ameliorates psychotic symptoms in adults with schizophrenia or schizoaffective disorder and to examine potential mechanisms. A secondary objective is to examine characteristics of inflammation-associated psychosis and to identify pre-treatment biochemical characteristics of rituximab responders. A third objective is to interview a subset of patients and informants on their experiences of the trial to obtain insights that rating scales may not capture.

METHODS: A proof-of-concept study employing a randomised, parallel-group, double-blind, placebo-controlled design testing the effect of B-cell depletion in patients with psychosis. 120 participants with a diagnosis of schizophrenia spectrum disorders (SSD) (ICD-10 codes F20, F25) will receive either one intravenous infusion of rituximab (1000 mg) or saline. Psychiatric measures and blood samples will be collected at baseline, week 12, and week 24 post-infusion. Brief assessments will also be made in weeks 2 and 7. Neuroimaging and lumbar puncture, both optional, will be performed at baseline and endpoints. Approximately 40 of the patients and their informants will be interviewed for qualitative analyses on the perceived changes in well-being and emotional qualities, in addition to their views on the research.

DISCUSSION: This is the first RCT investigating add-on treatment with rituximab in unselected SSD patients. If the treatment is helpful, it may transform the treatment of patients with psychotic disorders. It may also heighten the awareness of immune-psychiatric disorders and reduce stigma.

TRIAL REGISTRATION: NCT05622201, EudraCT-nr 2022-000220-37 version 2.1. registered 14th of October 2022.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Clinical trials, Immunology, Inflammation, Magnetic resonance imaging, Monoclonal antibodies, Schizophrenia & psychotic disorders
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-109377 (URN)10.1186/s12888-023-05250-5 (DOI)001095789000002 ()37872497 (PubMedID)2-s2.0-85174826025 (Scopus ID)
Funder
Örebro UniversitySwedish Research Council, 2022-00288The Swedish Brain Foundation, FO2022-0073Torsten Söderbergs stiftelse, MT4/22
Available from: 2023-10-24 Created: 2023-10-24 Last updated: 2024-01-17Bibliographically approved
Bejerot, S. & Nylander, L. (2022). An overestimation of the prevalence of ASD among psychiatric patients. Journal of autism and developmental disorders, 52(9), 4204-4205
Open this publication in new window or tab >>An overestimation of the prevalence of ASD among psychiatric patients
2022 (English)In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 52, no 9, p. 4204-4205Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Springer, 2022
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-98798 (URN)10.1007/s10803-022-05568-1 (DOI)000788490100002 ()35482273 (PubMedID)2-s2.0-85128971482 (Scopus ID)
Note

Funding agency:

Örebro University

Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2022-08-24Bibliographically approved
Popiolek, K., Bejerot, S., Landén, M. & Nordenskjöld, A. (2022). Association of Clinical and Demographic Characteristics With Response to Electroconvulsive Therapy in Mania. JAMA Network Open, 5(6), Article ID e2218330.
Open this publication in new window or tab >>Association of Clinical and Demographic Characteristics With Response to Electroconvulsive Therapy in Mania
2022 (English)In: JAMA Network Open, E-ISSN 2574-3805, Vol. 5, no 6, article id e2218330Article in journal (Refereed) Published
Abstract [en]

Importance: Knowledge of the effectiveness of electroconvulsive therapy (ECT) in the treatment of manic episodes is based on clinical experience, but empirical evidence is scarce. Moreover, prognostic factors associated with response to ECT in patients with mania are poorly understood.

Objective: To investigate the response to ECT in patients with manic episodes.

Design, Setting, and Participants: This nationwide, register-based observational cohort study was conducted using data from patients admitted to psychiatric departments in Sweden that reported data to the Swedish National Quality Registry for ECT (Q-ECT). Patients admitted to any hospital in Sweden and receiving ECT for a manic episode between 2012 and 2019 were considered for inclusion (605 individuals). The outcome, Clinical Global Impression Improvement scale (CGI-I) score, was available in 571 patients. Data from several national registers were combined to determine clinical and sociodemographic factors. Analysis of data occurred from April through September 2021.

Exposures: Patients treated with ECT for a mania were identified from the Q-ECT.

Main Outcomes and Measures: Response to ECT was defined by a CGI-I score of 1 (very much improved) or 2 (much improved). Remission was defined as a Clinical Global Impression Severity scale (CGI-S) score of 1 (reference range or not ill) or 2 (minimally ill) within 1 week after ECT. Univariate and multivariable regression models were used to investigate associations of sociodemographic factors, psychopharmacology, and comorbidities with response.

Results: Among 571 patients with mania treated with ECT (211 [37.0%] men; median [IQR] age, 46 [31-59] years), 482 patients (84.4%) responded to ECT. Comorbid anxiety and obsessive-compulsive disorder (OCD) were associated with lower odds of response to ECT (adjusted odds ratio [aOR], 0.48; 95% CI, 0.25-0.90 and aOR, 0.17; 95% CI, 0.06-0.56, respectively). Patients who were markedly ill (aOR, 2.93; 95% CI, 1.23-7.00), severely ill (aOR, 2.60; 95% CI, 1.06-6.34), or among the most extremely ill (aOR, 7.94; 95% CI, 2.16-29.21) according to CGI-S score had higher odds of response than those with mild or moderate illness.

Conclusions and Relevance: This study found that ECT was associated with improvement for mania in clinical settings, with especially high response rates in patients with severe illness and those without comorbid anxiety or OCD.

Place, publisher, year, edition, pages
American Medical Association, 2022
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-99778 (URN)10.1001/jamanetworkopen.2022.18330 (DOI)000815225800004 ()35737387 (PubMedID)2-s2.0-85133101068 (Scopus ID)
Available from: 2022-06-28 Created: 2022-06-28 Last updated: 2022-07-27Bibliographically approved
Bejerot, S., Ståtenhag, L. & Glans, M. R. (2022). Below average motor skills predict victimization from childhood bullies: A study of adults with ADHD. Journal of Psychiatric Research, 153, 269-275
Open this publication in new window or tab >>Below average motor skills predict victimization from childhood bullies: A study of adults with ADHD
2022 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 153, p. 269-275Article in journal (Refereed) Published
Abstract [en]

Children with ADHD are frequently clumsy and involved in bullying, both as victims and perpetrators. The relationship between motor skills and bully status is poorly understood. The aim of the current study was to evaluate the effect of motor skills in childhood on bully victimization/perpetration in those with ADHD. In this cross-sectional study, 403 adults diagnosed with ADHD filled out a questionnaire on their recall of bully victimization, bully perpetration, performance in physical education (PE) (defined as performance below average in i.e., ball dexterity, coordination or agility) as a proxy for motor skills, and academic skills at age 12, as compared to their peers. Of the current sample, 63% remembered being victimized and 31% noted they were perpetrators. Thirty-two percent recalled that they performed below average in PE. Being diagnosed with ADHD and having poor motor skills was strongly associated with bully victimization (OR = 2.63; 95% CI:1.62, 4.27, p < .001). Victimization was more common during all measured time periods, from nursery school until the age of 15, among those with poor performance in PE as compared to those without poor performance. No relationship was found between poor motor skills and bully perpetration. CONCLUSION: A crucial role of the cerebellum is coordination and the linking of sequenced motor actions through milli-second timing. Aberrations in this ability makes a person present as "different", which was stated as the most common reason for social exclusion by other children. Therefore, subtle clumsiness (presumed by poor performance in PE class) is suggested to mirror deficits in social skills, which is intuitively observed by peers, leading to victimization.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Attention deficit disorder with hyperactivity, Bullying, Cerebellum, Clumsiness, Motor skills, Victimization
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-100587 (URN)10.1016/j.jpsychires.2022.07.019 (DOI)000862652300010 ()35853352 (PubMedID)2-s2.0-85134210217 (Scopus ID)
Available from: 2022-08-15 Created: 2022-08-15 Last updated: 2022-10-17Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-3587-6075

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