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  • 1.
    Andersen, Lisa M. J.
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Näswall, Katharina
    Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, University of Canterbury, Christchurch, New Zealand.
    Manouilenko, Irina
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Nylander, Lena
    Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden.
    Edgar, Johan
    Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Ritvo, Riva Ariella
    Yale Child Study Center, Yale University School of Medicine, New Haven, USA.
    Ritvo, Edward
    The Neuropsychiatric Institute, UCLA School of Medicine, Los Angeles, USA.
    Bejerot, Susanne
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    The Swedish version of the Ritvo autism and asperger diagnostic scale: revised (RAADS-R). A validation study of a rating scale for adults2011In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 41, no 12, p. 1635-1645Article in journal (Refereed)
    Abstract [en]

    There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75 adults with ASD and 197 comparison cases. Also, a subset completed the Autism Spectrum Quotient (AQ). Three out of four subscales had high internal consistency. Sensitivity was 91% and specificity was 93%. The ASD subjects had significantly higher mean scores on all subscales. ASD females had higher scores than ASD males on the sensory motor subscale, a dimension not included in the AQ. RAADS-R showed promising test re-test reliability.

  • 2.
    Bejerot, Eva
    et al.
    Psykologiska institutionen, Stockholms universitet, Stockholm, Sweden.
    Aronsson, Gunnar
    Psykologiska institutionen, Stockholms universitet, Stockholm, Sweden.
    Hasselbladh, Hans
    Örebro University, Örebro University School of Business.
    Bejerot, Susanne
    Karolinska institutet, Stockholm, Sweden.
    Läkarkåren - en profession med allt mindre stöd och inflytande. Enkätstudie av svenska läkares arbetsmiljö 1992 och 2010: [The medical profession, a profession with less and less support and influence. A questionnaire study the occupational environment of Swedish physicians in 1992 and 2010]2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 50, p. 2652-2656Article in journal (Other academic)
    Abstract [sv]

    Syftet med studien var att undersöka förändringar i läkares arbetsvillkor med särskild inriktning på ledning, styrning och stöd. Jämförelser gjordes av enkätdata från två slumpmässiga urval 1992 (n = 390) och 2010 (n = 1 937). Stora förändringar framkom i flera avseenden. Andelen läkare som upplever sig ha något verksamhetsansvar har minskat med 45 procentandelar, från 76 till 31 procent. Mycket stora försämringar framkom vad gäller stöd i arbetet. Tiden som läggs på fortbildning/inläsning och forskning har minskat. Utnyttjandet av läkarnas högsta kompetens har minskat.

  • 3.
    Bejerot, Susanne
    Karolinska Institute, Stockholm, Sweden.
    An autistic dimension: a proposed subtype of obsessive-compulsive disorder2007In: Autism, ISSN 1362-3613, E-ISSN 1461-7005, Vol. 11, no 2, p. 101-110Article in journal (Refereed)
    Abstract [en]

    This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute mis-perceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.

  • 4.
    Bejerot, Susanne
    Institutionen för klinisk neurovetenskap, Karolins­ka institutet, Stockholm, Sweden.
    Ett överlappande och föränderligt landskap: [An overlapping and changing landscape]2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 39Article in journal (Refereed)
  • 5. Bejerot, Susanne
    Ingen tjänar på att det går inflation i autismspektrumbegreppet: [No one benefits from inflation of the autism spectrum concept]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 47, p. 2978-2930Article in journal (Refereed)
  • 6.
    Bejerot, Susanne
    institutionen för neurovetenskap, psykiatri, Uppsala universitet, Uppsala, Sweden.
    Kapsulotomi vid tvångssyndrom, en överflödig behandlingsform? Läkemedel och beteendeterapi ger god effekt: [Is capsulotomy in obsessive-compulsive syndromes an unnecessary therapeutic method? Good results with drug therapy and behavior therapy]1998In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 95, no 45, p. 5003-5005Article in journal (Refereed)
  • 7. Bejerot, Susanne
    Kvalitetsregister – hot mot vårdkvalitet, arbetsmiljö och klinisk forskning?: [Quality registry--a threat against quality of health care, occupational environment and clinical research?]2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 14, p. 986-986Article in journal (Refereed)
  • 8. Bejerot, Susanne
    Medicinsk kommentar: Psykokirurgi idag – en kritisk betraktelse. Svåra biverkningar av kapsulotomi visar sig efter 50 års användning: [Psychosurgery today--a critical reflection. Severe adverse effects of capsulotomy seen after 50 years of use]2003In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 100, no 32-33, p. 2502-2504Article in journal (Refereed)
    Abstract [sv]

    Kapsulotomi – »det sista halmstrået« för behandling av terapirefraktärt, invalidiserande tvångssyndrom – har i Sverige under lång tid rapporterats ha försumbara risker.

    Efter export av metoden till USA är resultaten mindre framgångsrika. Biverkningar av frontallobstyp kan möjligen progrediera många år efter ingreppet.

    Kritik har nyligen riktats mot bristen på långtidsuppföljningar och studier med oberoende bedömare.

    Trots att kapsulotomi utförts under lång tid är det vetenskapliga kunskapsläget otillräckligt. Bland annat är frågan om terapiresistens och biverkningar knapphändigt belysta.

    Ett referat av en uppföljning av personer som genomgått kapsulotomi publiceras i detta nummer. Denna vetenskapligt invändningsfria studie visar betydligt mindre gynnsamma resultat än vad tidigare studier gjort.

  • 9. Bejerot, Susanne
    Psychosurgery for obsessive-compulsive disorder: concerns remain2003In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 107, no 4, p. 241-243Article in journal (Refereed)
  • 10. Bejerot, Susanne
    Ska toppstyrd registerforskarindustri ersätta patientnära forskning? : [Is top directed registry research industry to substitute near-patient research?]2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 30-31, p. 1918-1918Article in journal (Refereed)
  • 11. Bejerot, Susanne
    ST-handledare - ett omöjligt uppdrag?: [Internship supervisor--an impossible mission?]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 29-31, p. 1785-1786Article in journal (Refereed)
  • 12.
    Bejerot, Susanne
    Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    The relationship between poor motor skills and neurodevelopmental disorders2011In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 53, no 9, p. 779-779Article in journal (Refereed)
  • 13. Bejerot, Susanne
    Tvångssyndromet. Nya aspekter på psykiatrins kameleont: [The obsessive-compulsive syndrome: new aspects of a psychiatric chameleon]1992In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 89, no 36, p. 2842-2844Article in journal (Refereed)
  • 14. Bejerot, Susanne
    Upprättelse! Diagnos kan bli vändpunkt för vuxna med ADHD/autismspektrumstörning: [Rehabilitation! Diagnosis can be a turning point for adults with ADHD/autism spectrum disorders]2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 42, p. 3222-3223Article in journal (Refereed)
  • 15. Bejerot, Susanne
    Utestängd patientgrupp. Nytänkande krävs för vuxna med ADHD/Tourette/autismspektrumtillstånd: [Excluded patient group. A new approach is necessary for adults with ADHD/Tourette syndrome/autism spectrum disorders]2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 19, p. 1508-1508Article in journal (Refereed)
  • 16. Bejerot, Susanne
    et al.
    Bejerot, Nils
    Representativitet i en studie av intravenöst missbruk bland arrestanter i Stockholm1984In: SCI: de två första verksamhetsåren / [ed] J. Ewers, J. Hartelius, Markaryd: Scipio , 1984, p. 90-97Chapter in book (Refereed)
  • 17.
    Bejerot, Susanne
    et al.
    Department of Neuroscience. Psychiatry, University Hospital, Uppsala, Sweden.
    Bodlund, O.
    Department of Psychiatry, University Hospital, Umeå, Sweden.
    Response to high doses of citalopram in treatment-resistant obsessive-compulsive disorder1998In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 98, no 5, p. 423-424Article in journal (Refereed)
    Abstract [en]

    We report a severe case of obsessive-compulsive disorder (OCD) that responded to very high doses of citalopram (160 mg/day) after a poor response to clomipramine 250 mg/day for several years, alone or in combination with buspirone 30 mg/day or flupenthixol 4 mg/day. The patient had previously been submitted for capsulotomy which was declined, probably due to the magical content of her obsessions, which resembled delusions.

  • 18.
    Bejerot, Susanne
    et al.
    Norra Stockholms psykiatri, Stockholm, Sweden.
    Bruno, Kai
    BUP Brommaplan, Stockholm, Sweden.
    Gerland, Gunilla
    Lindquist, Lars
    Infektionskliniken, Karolinska universitetssjukhuset, Huddinge, Sweden.
    Nordin, Viviann
    Sachsska barn- och ungdomssjukhuset, Södersjukhuset, Stockholm, Sweden.
    Pelling, Henrik
    BUP-kliniken, Akademiska sjukhuset, Uppsala, Sweden.
    Humble, Mats B.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Misstänk PANDAS hos barn med akuta neuropsykiatriska symptom. Infektion bakom sjukdomen [Suspect PANDAS in children with acute neuropsychiatric symptoms. Infection behind the disease]: långvarig antibiotikabehandling bör övervägas  [long-term antibiotic therapy should be considered]2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 41, p. 1803-1803, article id CDCDArticle in journal (Refereed)
  • 19.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Edgar, Johan
    Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Humble, Mats B.
    Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
    Poor performance in physical education: a risk factor for bully victimization. A case-control study2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 3, p. 413-419Article in journal (Refereed)
    Abstract [en]

    Aim: Poor social skills are a risk factor for becoming bullied, which could explain why this frequently occurs to children with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). Poor social skills tend to coexist with clumsiness. According to a pilot study, poor performance in physical education (PE) was correlated with bully victimization.

    Methods: Sixty-nine healthy university students reported performance in PE and bully victimization in childhood. In addition, the participants responded to questionnaires for ADHD and ASDs to assess personality traits related to increased risk for bully victimization.

    Results: Below average performance in PE was a risk factor of being bullied in school with an odds ratio of 3.6 [95% confidence interval: 1.23-10.5; p = 0.017]. Strong correlations between poor performance in PE and long duration of victimization (p = 0.007) and poor performance in PE and high frequency of victimization (p = 0.008) were found. Autistic traits were related to performance below average in PE.

    Conclusion: Poor motor skills are a strong risk factor for becoming bullied. Prevention programmes that identify, protect and empower the clumsy children could be an important step to avoid bullying of the most vulnerable children.

  • 20.
    Bejerot, Susanne
    et al.
    Örebro University Hospital. Dept Clin Neurosci, Karolinska Inst, Stockholm, Sweden.
    Edman, Gunnar
    Dept Psychiat, TioHundra AB, Norrtälje, Sweden.
    Anckarsäter, Henrik
    Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Berglund, Gunilla
    Dept Psychol, Stockholm Univ, Stockholm, Sweden.
    Gillberg, Christopher
    Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Hofvander, Björn
    Dept Clin Sci, Lund Univ, Malmö, Sweden.
    Humble, Mats B.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Mörtberg, Ewa
    Dept Psychol, Stockholm Univ, Stockholm, Sweden.
    Råstam, Maria
    Dept Clin Sci, Lund Univ, Malmö, Sweden.
    Ståhlberg, Ola
    Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Frisen, Louise
    Dept Clin Neurosci, Karolinska Inst, Stockholm, Sweden.
    The Brief Obsessive-Compulsive Scale (BOCS): a self-report scale for OCD and obsessive-compulsive related disorders2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 8, p. 549-559Article in journal (Refereed)
    Abstract [en]

    Background: The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive-compulsive symptoms and diagnosis of obsessive-compulsive disorder (OCD). It is widely used throughout child, adolescent and adult psychiatry settings in Sweden but has not been validated up to date.

    Aim: The aim of the current study was to examine the psychometric properties of the BOCS amongst a psychiatric outpatient population.

    Method: The BOCS consists of a 15-item Symptom Checklist including three items (hoarding, dysmorphophobia and self-harm) related to the DSM-5 category "Obsessive-compulsive related disorders", accompanied by a single six-item Severity Scale for obsessions and compulsions combined. It encompasses the revisions made in the Y-BOCS-II severity scale by including obsessive-compulsive free intervals, extent of avoidance and excluding the resistance item. 402 adult psychiatric outpatients with OCD, attention-deficit/hyperactivity disorder, autism spectrum disorder and other psychiatric disorders completed the BOCS.

    Results: Principal component factor analysis produced five subscales titled "Symmetry", "Forbidden thoughts", "Contamination", "Magical thoughts" and "Dysmorphic thoughts". The OCD group scored higher than the other diagnostic groups in all subscales (P < 0.001). Sensitivities, specificities and internal consistency for both the Symptom Checklist and the Severity Scale emerged high (Symptom Checklist: sensitivity = 85%, specificities = 62-70% Cronbach's alpha = 0.81; Severity Scale: sensitivity = 72%, specificities = 75-84%, Cronbach's alpha = 0.94).

    Conclusions: The BOCS has the ability to discriminate OCD from other non-OCD related psychiatric disorders. The current study provides strong support for the utility of the BOCS in the assessment of obsessive-compulsive symptoms in clinical psychiatry.

  • 21.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences.
    Edman, Gunnar
    Department of Clinical Sciences, Danderyds Sjukhus, Karolinska Institutet, Solna, Sweden..
    Frisén, Louise
    Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.
    Humble, Mats B.
    Örebro University, School of Medical Sciences.
    Evidence-Based Brief Obsessive-Compulsive Scale2017In: Journal of Central Nervous System Disease, ISSN 1179-5735, E-ISSN 1179-5735, Vol. 9, article id UNSP 1179573517702867Article in journal (Other academic)
  • 22.
    Bejerot, Susanne
    et al.
    Department of Psychiatry, University Hospital, Uppsala, Sweden.
    Ekselius, L.
    Department of Psychiatry, University Hospital, Uppsala, Sweden.
    von Knorring, L.
    Department of Psychiatry, University Hospital, Uppsala, Sweden.
    Comorbidity between obsessive-compulsive disorder (OCD) and personality disorders1998In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 97, no 6, p. 398-402Article in journal (Refereed)
    Abstract [en]

    The aims of the present study were to examine the frequency of personality disorders in 36 patients with obsessive-compulsive disorder (OCD), and to investigate whether patients with a coexisting personality disorder could be characterized by certain personality traits assessed by means of the Karolinska Scales of Personality (KSP). In total, 27 (75%) of the OCD patients fulfilled the DSM-III-R criteria for a personality disorder, and 13 patients (36%) had an obsessive-compulsive personality disorder. Subjects with a comorbid personality disorder had significantly higher scores on most of the KSP scales, including all anxiety scales, as well as scales measuring indirect aggression, irritability, guilt and detachment, whereas subjects without personality disorders did not differ significantly from healthy controls with regard to personality traits.

  • 23.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden .
    Eriksson, Jonna M.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden .
    Sexuality and gender role in autism spectrum disorder: a case control study2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 1, article id e87961Article in journal (Refereed)
    Abstract [en]

    The 'extreme male brain theory of autism' describes an extreme male pattern of cognitive traits defined as strong systemising abilities paired with empathising weaknesses in autism spectrum disorder. However, beyond these cognitive traits, clinical observations have suggested an ambiguous gender-typed pattern regarding several sexually dimorphic traits. The aim of the present study was to investigate if patterns of non-cognitive sexually dimorphic traits differed between the autism spectrum disorder and control groups. Fifty adults with autism spectrum disorder and intelligence within the normal range, and 53 neurotypical controls responded to questions on gender role, self-perceived gender typicality and gender identity, as well as sexuality. Measures used were a Swedish modification of the Bem Sex Role Inventory and questions on sexuality and gender designed for the purpose of this study. Our results showed that one common gender role emerged in the autism spectrum disorder group. Masculinity (e.g. assertiveness, leadership and competitiveness) was weaker in the autism spectrum disorder group than in the controls, across men and women. Self-perceived gender typicality did not differ between the groups but tomboyism and bisexuality were overrepresented amongst women with autism spectrum disorder. Lower libido was reported amongst both male and female participants with autism spectrum disorder compared with controls. We conclude that the extreme male patterns of cognitive functions in the autistic brain do not seem to extend to gender role and sexuality. A gender-atypical pattern for these types of characteristics is suggested in autism spectrum disorder.

  • 24.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Jonna M.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Bonde, Sabina
    Northern Stockholm Psychiatry, St Göran Hospital, Stockholm, Sweden.
    Carlström, Kjell
    Department of Woman and Child Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden.
    Humble, Mats B.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Uppsala University Hospital, Uppsala, Sweden.
    Eriksson, Elias
    Department of Pharmacology, Institute of Neuroscience and Physiology, Göteborg, Sweden.
    The extreme male brain revisited: gender coherence in adults with autism spectrum disorder2012In: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 201, p. 116-123Article in journal (Refereed)
    Abstract [en]

    Background: The 'extreme male brain' theory suggests that autism spectrum disorder (ASD) is an extreme variant of male intelligence. However, somewhat paradoxically, many individuals with ASD display androgynous physical features regardless of gender.

    Aims: To assess physical measures, supposedly related to androgen influence, in adults with and without ASD.

    Method: Serum hormone levels, anthropometry, the ratio of 2nd to 4th digit length (2D:4D) and psychiatric symptomatology were measured in 50 adults with high-functioning ASD and age- and gender-matched neurotypical controls. Photographs of face and body, as well as voice recordings, were obtained and assessed with respect to gender coherence, blindly and independently, by eight assessors.

    Results: Women with ASD had higher total and bioactive testosterone levels, less feminine facial features and a larger head circumference than female controls. Men in the ASD group were assessed as having less masculine body characteristics and voice quality, and displayed higher (i.e. less masculine) 2D:4D ratios, but similar testosterone levels to controls. Androgynous facial features correlated strongly and positively with autistic traits measured with the Autism-Spectrum Quotient in the total sample. In males and females with ASD dehydroepiandrosterone sulfate did not decrease with age, in contrast to the control group.

    Conclusions: Women with ASD had elevated testosterone levels and several masculinised characteristics compared with controls, whereas men with ASD displayed several feminised characteristics. Our findings suggest that ASD, rather than being characterised by masculinisation in both genders, may constitute a gender defiant disorder.

  • 25.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Jonna M.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Mörtberg, Ewa
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Social anxiety in adult autism spectrum disorder2014In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 220, no 1-2, p. 705-707Article in journal (Refereed)
    Abstract [en]

    A link has been suggested between Autism Spectrum Disorder (ASD) and anxiety disorders. The aim of the study was to examine the severity of social anxiety measured by the Liebowitz Social Anxiety Scale Self-Report and prevalence of Social Anxiety Disorder (SAD) in adults with ASD, with SAD and a non-ASD comparison group. Individuals with ASD showed significantly higher scores of social anxiety and social avoidance relative to the comparison group, but significantly lower scores relative to the SAD sample.

  • 26.
    Bejerot, Susanne
    et al.
    Norra Stockholms psykiatri, Stockholm, Sweden.
    Gardner, Ann
    Järvapsykiatrin, institutionen för klinisk neurovetenskap, Karolinska institutet, Stockholm, Sweden.
    Humble, Mats B.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Diagnostik och terapi utmanar än, trots snabb tillväxt av kunskap [Diagnosis and therapy are still challenging, despite the rapid growth of knowledge]2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 39, p. 1638-1641, article id CYRHArticle, review/survey (Refereed)
    Abstract [sv]

    Psychiatric diagnoses are not reflections of the aetiology of the disorder, but rather lists of symptoms with considerable overlaps, which hamper research and may cause confusion. The diagnoses of autism spectrum disorder, attention deficit hyperactivity disorder and tic disorder are often comorbid along with a number of other symptomatic syndromes. Individual immune responsivity is possibly involved in pathophysiological mechanisms. Multiple environmental factors may contribute to the clinical phenotypes. Recent research supports to some extent the involvement of dietary and nutritional factors in ADHD. In spite of impressive progress in the molecular biological understanding of the pathophysiology of these disorders, treatment options are still limited and more research is warranted.

  • 27.
    Bejerot, Susanne
    et al.
    Karolinska Institutet, Stockholm, Sweden .
    Gardner, Ann
    Järvapsykiatrin, Stockholm, Sweden.
    Humble, Mats B.
    Äldrepsykiatrin, Akademiska sjukhuset, Uppsala, Sweden.
    D-vitaminbrist [Vitamin D deficiency]: vems ansvar? [who's responsibility?]2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 14, p. 812-812Article in journal (Refereed)
  • 28.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences.
    Hesselmark, E.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Pediatric autoimmune neuropsychiatric syndrome (PANS), developmental regression and autism2017In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 41, no Suppl., p. S123-S123Article in journal (Other academic)
    Abstract [en]

    Introduction: Pediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.

    Objectives: The aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.

    Methods: Participants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.

    Results: Twelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.

    Conclusions: Very early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.

  • 29.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences. Department of Psychiatry, School of Medical Sciences, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Hesselmark, Eva
    Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Solna, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
    The Cunningham Panel is an unreliable biological measure2019In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 9, no 1, article id 49Article in journal (Refereed)
  • 30.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden.
    Hesselmark, Eva
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Mobarrez, Fariborz
    Unit of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden.
    Wallén, Håkan
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden.
    Hietala, Max Albert
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Nybom, Rolf
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Wetterberg, Lennart
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Neuromyelitis optica spectrum disorder with increased aquaporin-4 microparticles prior to autoantibodies in cerebrospinal fluid: a case report2019In: Journal of Medical Case Reports, ISSN 1752-1947, E-ISSN 1752-1947, Vol. 13, no 1, article id 27Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Neuromyelitis optica spectrum disorders are severe autoimmune inflammatory diseases of the central nervous system associated with the presence of immunoglobulin G antibodies against the water channel protein aquaporin-4. During exacerbation, specific aquaporin-4 immunoglobulin G may be produced intrathecally. We measured extracellular aquaporin-4 microparticles in the cerebrospinal fluid of a patient who later developed the typical symptoms and signs of a neuromyelitis optica spectrum disorder.

    CASE PRESENTATION: A 17-year-old South American girl developed acute severe motor and vocal tics and difficulties in walking, peripheral numbness, muscle pain, and bilateral headache. At age 22, she had a multitude of motor and psychiatric symptoms. Over the years, she fulfilled the diagnostic criteria for anorexia nervosa, depression, sleep disorder, obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, development coordination disorder, attention-deficit/hyperactivity disorder, hypomania, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, conversion disorder, psychosis, and schizotypal personality syndrome. At age 24, she was found to have elevated titers of aquaporin-4 antibodies in serum, suggestive of probable neuromyelitis optica. She subsequently developed visual impairment, and swollen optic nerves were verified by magnetic resonance imaging. She was thus treated with a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20 (rituximab), and almost all symptoms, including the psychiatric symptoms, rapidly decreased. We found a significant increase of extracellular microparticles of aquaporin-4 in cerebrospinal fluid sampled from our patient when she was 22 years old, 2 years before the full clinical development of neuromyelitis optica.

    CONCLUSIONS: Microparticles of aquaporin-4 represent subcellular arrangements that may influence the pathogenesis of neuromyelitis optica spectrum disorders and may serve as biomarkers for the underlying cellular disturbances. The increase of aquaporin-4 microparticles in cerebrospinal fluid may be used for early diagnostic purposes; for prevention; and for evaluation of effective treatment, long-term follow-up studies, and elucidating the pathophysiology in neuromyelitis optica spectrum disorders. Further studies of aquaporin-4 microparticles in cerebrospinal fluid of patients with neuromyelitis optica and similar neuropsychiatric disorders are thus called for.

  • 31.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Northern Stockholm Psychiatry, St Göran Hospital, Stockholm, Sweden.
    Humble, Mats B.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Childhood clumsiness and peer victimization: a case-control study of psychiatric patients2013In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 13, article id 68Article in journal (Refereed)
    Abstract [en]

    Background: Poor motor and social skills as well as peer victimization are commonly reported in both ADHD and autism spectrum disorder. Positive relationships between poor motor and poor social skills, and between poor social skills and peer victimization, are well documented, but the relationship between poor motor skills and peer victimization has not been studied in psychiatric populations.

    Method: 277 patients (133 males, 144 females), mean age 31 years, investigated for ADHD or autism spectrum disorder in adulthood and with normal intelligence, were interviewed about childhood peer victimization and examined for gross motor skills. The parents completed a comprehensive questionnaire on childhood problems, the Five to Fifteen. The Five to Fifteen is a validated questionnaire with 181 statements that covers various symptoms in childhood across eight different domains, one of them targeting motor skills. Regression models were used to evaluate the relationship between motor skills and the risk and duration of peer victimization, adjusted for sex and diagnosis.

    Results: Victims were described as more clumsy in childhood than their non-victimized counterparts. A significant independent association was found between reportedly poor childhood gross motor skills and peer victimization (adjusted odds ratio: 2.97 [95% confidence interval: 1.46-6.07], n = 235, p = 0.003). In adulthood, the victimized group performed worse on vertical jumps, a gross motor task, and were lonelier. Other factors that were expected to be associated with peer victimization were not found in this highly selected group.

    Conclusion: Poor gross motor skills constitute a strong and independent risk factor for peer victimization in childhood, regardless of sex, childhood psychiatric care and diagnosis.

  • 32. Bejerot, Susanne
    et al.
    Humble, Mats B.
    D-vitamin och graviditet [Vitamin D and pregnancy]: Etnisk-kulturella riktlinjer efterlyses [Ethnocultural guidelines wanted]2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 35, p. 2343-2344Article in journal (Refereed)
  • 33. Bejerot, Susanne
    et al.
    Humble, Mats B.
    Hög förekomst av autism hos svensk-somaliska barn [Increased occurrence of autism among Somali children]: Kan D-vitaminbrist spela in? [Does vitamin D deficiency play a role?]2008In: Tidsskrift for Den norske lægeforening, ISSN 0029-2001, E-ISSN 0807-7096, Vol. 128, no 17, p. 1986-1987Article in journal (Refereed)
  • 34.
    Bejerot, Susanne
    et al.
    Department of Neuroscience, Division of Psychiatry, University Hospital, Uppsala, USA; Karolinska Institutet, Department of Clinical Neurosciences and Family Medicine, Division of Psychiatry, Huddinge University Hospital, Huddinge, Sweden.
    Humble, Mats B.
    Department of Neuroscience, Division of Psychiatry, University Hospital, Uppsala, USA; Karolinska Institutet, Department of Clinical Neurosciences and Family Medicine, Division of Psychiatry, Huddinge University Hospital, Huddinge, Sweden.
    Low prevalence of smoking among patients with obsessive-compulsive disorder1999In: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 40, no 4, p. 268-272Article in journal (Refereed)
    Abstract [en]

    Tobacco smoking is common among psychiatric patients, especially among those with schizophrenia, where the prevalence is extremely high, 74% to 88%, compared with 45% to 70% in patients with other psychiatric diagnoses. Patients with anxiety disorders are less well investigated in this respect, particularly obsessive-compulsive disorder (OCD) patients. Eighty-three psychiatric outpatients with OCD and 110 members of the Swedish OCD Association responded to questions concerning their smoking habits. Among OCD patients, 14% were current smokers (compared with 25% in the general population of Sweden), 72% had never smoked, and 11 previous smokers had stopped, mostly without any difficulties. Since a decreased smoking rate among OCD subjects was confirmed, the smoking prevalences in schizophrenia and OCD, respectively, seem to represent either end of a continuum, and OCD may also differ significantly from other anxiety disorders in this respect. Possible implications of this finding for the purported frontal lobe dysregulation in OCD are discussed.

  • 35.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Section Psychiatry St. Göran, Karolinska Institute, Stockholm, Sweden .
    Humble, Mats B.
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Relevance of motor skill problems in victims of bullying2007In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 120, no 5, p. 1227-1228Article in journal (Refereed)
  • 36.
    Bejerot, Susanne
    et al.
    Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Humble, Mats B.
    Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of clinical neuroscience, Uppsala University hospital, Uppsala, Sweden.
    Gardner, Ann
    Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Endocrine disruptors, the increase of autism spectrum disorder and its comorbidity with gender identity disorder: a hypothetical association2011In: International Journal of Andrology, ISSN 0105-6263, E-ISSN 1365-2605, Vol. 34, no 5 Pt 2, article id e350Article in journal (Refereed)
  • 37.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Center.
    Lindgren, Ann
    Central Health Services in pre-schools, schools and upper secundary schools, Municipality of Norrtälje, Stockholm, Sweden.
    Rosén, Jörgen
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Bejerot, Eva
    Örebro University, Örebro University School of Business.
    Elwin, Marie
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
    Teaching psychiatry to large groups in society2019In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, no 1, article id 148Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a need to educate a range of professionals in caring for individuals with long-term mental disability who reside within our communities. Empathy alone is insufficient. The Kognus 4-Step Education Program was developed to achieve this goal.

    METHOD: The program consisted of independent courses, including an 18-session basic course on psychiatric disability (on-site or online), advanced courses, and highly specialized training programs (Nidotherapy/Peer Consultation). Experts lectured together with clients with psychiatric disabilities. We first report Swedish reforms in which institutionalized patients were relocated to semi-independent individual households. We then describe the design and implementation of the education program. Approximately 50% of participants who were younger than 36 years old lacked any healthcare education. The participants' backgrounds, perceptions, participation in the education program, and costs are presented.

    RESULTS: Between 2009 and 2014, 8959 participants attended the Kognus psychiatry courses online or on-site in Stockholm (basic on-site course, n = 2111; online course, n = 4480; advanced courses, n = 2322; highly specialized programs, n = 46). A total of 73% of the participants satisfactorily attended the basic sessions on-site compared with 11% of the online participants. The developers conducted the education program for the first 3 years. Thereafter, another course provider continued the program with other types of participants. The program was perceived to be equally interesting and meaningful to participants with low and high levels of education, demonstrating the generalizability of the program. The quality of the basic and advanced courses was rated as 4.4 and 4.3, respectively, on a 5-point Likert scale.

    CONCLUSIONS: Personnel without appropriate education who work with people with psychiatric/intellectual disabilities can be educated in large numbers. The Kognus program represents a novel and successful way of training people who have no formal education about some essentials of good mental healthcare. Moreover, the model can be easily implemented elsewhere.

  • 38.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Section Psychiatry St. Göran, Karolinska Institute, Stockholm, Sweden.
    Mörtberg, E.
    Department of Clinical Neuroscience, Section Psychiatry St. Göran, Karolinska Institute, Stockholm, Sweden.
    Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers?2009In: Psychopathology, ISSN 0254-4962, E-ISSN 1423-033X, Vol. 42, no 3, p. 170-176Article in journal (Refereed)
    Abstract [en]

    Background: Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits.

    Methods: Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied.

    Results: There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients.

    Conclusions: Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD.

  • 39.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Nilsonne, Gustav
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Humble, Mats B.
    Örebro University, School of Medical Sciences. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.
    Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults2017In: Lancet psychiatry, ISSN 2215-0374, E-ISSN 2215-0366, Vol. 4, no 6, p. 437-437Article in journal (Refereed)
  • 40.
    Bejerot, Susanne
    et al.
    Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Nordin, Viviann
    Karolinska Institutet, Stockholm, Sweden.
    Autismspektrumsyndrom ersätter Aspergers syndrome och autism [Autism spectrum syndrome replaces Asperger syndrome and autism].2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 39, p. 1660-1663, article id CUH6Article in journal (Refereed)
    Abstract [sv]

    Autism spectrum disorder describes a behaviourally defined impairment in social interaction and communication, along with the presence of restricted interests and repetitive behaviours. Although the etiology is mostly unknown, it is evident that biological factors affect the brain and result in the autistic clinical presentation. Assessment for diagnosing autism spectrum disorder should be comprehensive in order to cover all sorts of problems related to the disorder. Knowledge and experience from working with neurological and psychiatric disorders are a prerequisite for quality in the examination. Up to now, there is no cure for autism spectrum disorder, but support and adaptations in education are nevertheless important for obtaining sufficient life quality for the patients and the family.

  • 41.
    Bejerot, Susanne
    et al.
    Department of Neuroscience, Psychiatry, University Hospital, Uppsala, Sweden.
    Nylander, L
    Lindström, E
    Autistic traits in obsessive-compulsive disorder2001In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 55, no 3, p. 169-176Article in journal (Refereed)
    Abstract [en]

    In contrast to other non-psychotic psychiatric populations, subjects with obsessive-compulsive disorder (OCD) are more prone to have personality disorder from cluster A (the odd and eccentric cluster). The present study aims at further investigating the relationship between these and other personality traits in OCD subjects and their relation to high functioning autism (HFA) and Asperger disorder. Sixty-four subjects with OCD were included. Personality traits were assessed with the Karolinska Scales of Personality (KSP), and personality disorders with DSM-adapted questionnaires. In addition, autistic traits were assessed in 29 videotaped subjects, by 3 independent raters. Twenty percent of the subjects with OCD were identified as also having autistic traits. These subjects scored higher on KSP scales measuring muscular tension, psychasthenia, and inhibition of aggression and lower on socialization as compared with OCD subjects without autistic traits. Additionally, subjects with autistic traits fulfilled criteria for anxious personality disorders and paranoid personality disorders significantly more often than subjects without autistic traits. We propose that OCD is often related to HFA and Asperger disorder. Self-report questionnaires may be useful in establishing the diagnosis. However, those with the most obvious autistic features seem to be less able to identify these traits in themselves.

  • 42.
    Bejerot, Susanne
    et al.
    Department of Psychiatry, Institute of Clinical Neuroscience, Karolinska Institute, St. Göran’s Hospital, Stockholm, Sweden.
    Nylander, Lena
    Department of Neuroscience, Psychiatry, University Hospital, Lund, Sweden.
    Low prevalence of smoking in patients with autism spectrum disorders2003In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 119, no 1-2, p. 177-182Article in journal (Refereed)
    Abstract [en]

    Psychiatric patients are significantly more often smokers than the general population, the only known exception being obsessive-compulsive disorder (OCD) and catatonic schizophrenia. We have investigated nicotine use in subjects with autism spectrum disorders (ASD). Ninety-five subjects (25 females and 70 males) consecutively diagnosed with any ASD and of normal intelligence were included in the study. Only 12.6% were smokers, compared with 19% in the general population and 47% in a control group of 161 outpatients diagnosed with schizophrenia or a schizophreniform disorder. The results suggest that smoking is rare among subjects with ASD, while the opposite was shown for schizophrenia. If replicated, this finding could suggest biological differences between non-catatonic schizophrenia and ASD, and support the theory of a biological link between ASD and a subtype of OCD, and between ASD and catatonic schizophrenia.

  • 43.
    Bejerot, Susanne
    et al.
    Karolinska institutet, Stockholm, Sweden.
    Plenty, Stephanie
    Karolinska institutet, Stockholm, Sweden.
    Humble, Alice
    Malmö University, Malmö, Sweden.
    Humble, Mats B.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Poor Motor Skills: A Risk Marker for Bully Victimization2013In: Aggressive Behavior, ISSN 0096-140X, E-ISSN 1098-2337, Vol. 39, no 6, p. 453-461Article in journal (Refereed)
    Abstract [en]

    Children who are clumsy are often bullied. Nevertheless, motor skills have been overlooked in research on bullying victimization. A total of 2,730 Swedish adults (83% females) responded to retrospective questions on bullying, their talents in physical education (i.e., coordination and balls skills) and school academics. Poor talents were used as indicators of poor gross motor skills and poor academic skills. A subset of participants also provided information on educational level in adulthood, childhood obesity, belonging to an ethic minority in school and socioeconomic status relative to schoolmates. A total of 29.4% of adults reported being bullied in school, and 18.4% reported having below average gross motor skills. Of those with below average motor skills, 48.6% were bullied in school. Below average motor skills in childhood were associated with an increased risk (OR 3.01 [95% CI: 1.97-4.60]) of being bullied, even after adjusting for the influence of lower socioeconomic status, poor academic performance, being overweight, and being a bully. Higher odds for bully victimization were also associated with lower socioeconomic status (OR 2.29 [95% CI: 1.45-3.63]), being overweight (OR 1.71 [95% CI: 1.18-2.47]) and being a bully (OR 2.18 [95% CI: 1.53-3.11]). The findings indicate that poor gross motor skills constitute a robust risk-marker for vulnerability for bully victimization. Aggr. Behav. 39:453-461, 2013. (c) 2013 The Authors. Aggressive Behavior Published by Wiley-Blackwell

  • 44.
    Bejerot, Susanne
    et al.
    Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Stockholm, Sweden .
    Rydén, Eleonore M.
    Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Stockholm, Sweden .
    Arlinde, Christina M
    Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Stockholm, Sweden .
    Two-year outcome of treatment with central stimulant medication in adult attention-deficit/hyperactivity disorder: a prospective study2010In: Journal of Clinical Psychiatry, ISSN 0160-6689, E-ISSN 1555-2101, Vol. 71, no 12, p. 1590-1597Article in journal (Refereed)
    Abstract [en]

    Background: Given that adults with ADHD continue to use stimulants for extended periods of time, studies on the long-term effectiveness and adverse events are warranted. The aims of this study were to investigate factors associated with persistence in treatment in an exploratory manner and to document side effects and reasons for discontinuation.

    Method: The current study describes the systematic follow-up of 133 psychiatric patients with DSM-IV-diagnosed ADHD treated with central stimulants at a specialized outpatient unit between January 1, 2001, and August 31, 2006. A standardized questionnaire, derived from the Targeted Attention-deficit Disorder Symptoms Rating Scale, was used in order to measure improvement of the following target symptoms: hyperactivity, impulsivity, irritability, distractibility, structure/organization problems, inattention, and restlessness.

    Results: Eighty percent of the patients were successfully treated with stimulants at the 6- to 9-month follow-up. Fifty percent remained in treatment after 2 years or more. Forty-five percent were treated for comorbid anxiety and/or depression during the study period. Only 15% dropped out because of lack of efficacy. The amount of clinical response over the first 6 to 9 months (but not at 6 weeks) predicted adherence to treatment at 2 years. The patients' heart rate increased from a least squares mean ± SE of 70 ± 2.2 to 80 ± 2.1 bpm (P = .00003) while blood pressure remained unchanged at the ≥ 2-year follow-up. Severe side effects or drug abuse were not detected in this cohort.

    Conclusions: The long-term treatment outcome shows that stimulants are effective in adult ADHD and side effects tend to be mild.

  • 45.
    Bejerot, Susanne
    et al.
    Department of Neuroscience, University Hospital, Uppsala, Sweden.
    Schlette, P.
    Department of Psychiatry, University Hospital, Umeå, Sweden.
    Ekselius, L.
    Department of Neuroscience, University Hospital, Uppsala, Sweden.
    Adolfsson, R.
    Department of Psychiatry, University Hospital, Umeå, Sweden.
    von Knorring, L.
    Department of Neuroscience, University Hospital, Uppsala, Sweden.
    Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive-compulsive disorder1998In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 98, no 3, p. 243-249Article in journal (Refereed)
    Abstract [en]

    The occurrence of personality disorders was investigated in 36 patients with obsessive-compulsive disorder by means of the SCID Screen questionnaire. In addition, the personality dimensions were explored by means of the Temperament and Character Inventory (TCI). In total, 75% of the patients fulfilled the criteria for a personality disorder according to the SCID Screen questionnaire, mostly (55%) within cluster C. Several significant correlations were found between the separate personality disorders (PD) and subscales of the TCI, the most pronounced being between avoidant and obsessive-compulsive PD and novelty-seeking and self-directedness. Strong correlations were also found between self-directedness and paranoid and borderline PD. In multiple regressions where the presence of PD in clusters A, B and C, respectively, were used as dependent variables and where the separate subscales of the TCI were used as independent variables, the multiple R reached 0.68, 0.76 and 0.80 in clusters A, B and C, respectively. Thus 46-64% of the variance in the personality disorder clusters could be explained by the TCI subscales.

  • 46.
    Bejerot, Susanne
    et al.
    Department of Neuroscience, Psychiatry, University Hospital, Uppsala, Sweden.
    von Knorring, L.
    Department of Neuroscience, Psychiatry, University Hospital, Uppsala, Sweden.
    Ekselius, L.
    Department of Neuroscience, Psychiatry, University Hospital, Uppsala, Sweden.
    Personality traits and smoking in patients with obsessive-compulsive disorder2000In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 15, no 7, p. 395-401Article in journal (Refereed)
    Abstract [en]

    As opposed to other psychiatric populations, subjects with obsessive-compulsive disorder (OCD) smoke less than the general population. The present study aims at further investigating the relationship between smoking in OCD subjects and personality traits. Sixty-four subjects with OCD were interviewed concerning their smoking habits. Personality traits were evaluated using the Karolinska Scales of Personality, and specific obsessive-compulsive personality traits were elicited through self-report questionnaires. Non-smokers were more easily fatigued, more inclined to worry, more remorseful, less self-confident, less impulsive and became uneasy more frequently when urged to speed up, than smokers with OCD. Additionally, non-smokers fulfilled significantly more obsessive-compulsive personality disorder criteria as compared to the smokers (P < 0.001). We propose a clinical subtype of OCD related to non-smoking, psychasthenia, anxiety, and pronounced obsessive-compulsive personality disorder traits.

  • 47.
    Bejerot, Susanne
    et al.
    Karolinska Institute, Department of Clinical Neuroscience Section of Psychiatry, St Göran, Stockholm, Sweden.
    Wetterberg, Lennart
    Karolinska Institute, Department of Clinical Neuroscience Section of Psychiatry, St Göran, Stockholm, Sweden.
    Autism spectrum disorders and psychiatric co-morbidity in adolescents and adults2008In: Clinical Neuropsychiatry, ISSN 1724-4935, Vol. 5, p. 3-8Article in journal (Refereed)
  • 48.
    Bilevicute-Ljunger, Indre
    et al.
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden; ME/CFS-rehabilitation, Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden.
    Maroti, Daniel
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Bejerot, Susanne
    Örebro University, School of Medical Sciences.
    Patients with chronic fatigue syndrome do not score higher on the autism-spectrum quotient than healthy controls: comparison with autism spectrum disorder2018In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 59, no 4, p. 428-432Article in journal (Refereed)
    Abstract [en]

    Background: Clinically, there is an overlap of several symptoms of chronic fatigue syndrome (CFS) and autism spectrum disorder (ASD), including fatigue; brain “fog”; cognitive impairments; increased sensitivity to sound, light, and odour; increased pain and tenderness; and impaired emotional contact.

    Methods: Adults with CFS (n = 59) or ASD (n = 50) and healthy controls (HC; n = 53) were assessed with the Autism-Spectrum Quotient (AQ) in a cross-sectional study. Non-parametric analysis was used to compare AQ scores among the groups. Univariate analysis of variance (ANCOVA) was used to identify if age, sex, or diagnostic group influenced the differences in scores.

    Results: Patients with ASD scored significantly higher on the AQ than the CFS group and the HC group. No differences in AQ scores were found between the CFS and HC groups. AQ results were influenced by the diagnostic group but not by age or sex, according to ANCOVA.    

    Conclusions: Despite clinical observations of symptom overlap between ASD and CFS, adult patients with CFS report few autistic traits in the self-report instrument, the AQ. The choice of instrument to assess autistic traits may influence the results.

  • 49.
    Blomqvist, My
    et al.
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Bejerot, Susanne
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Dahllöf, Göran
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, article id 81Article in journal (Refereed)
    Abstract [en]

    Background: Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population.

    Methods: Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age-and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care.

    Results: Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group.

    Conclusions: Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended.

  • 50.
    Blomqvist, My
    et al.
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Dahllöf, Göran
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Bejerot, Susanne
    Department of Clinical Neuroscience, Karolinska Institutet and Northern Stockholm Psychiatry, St. Göran Hospital, Stockholm, Sweden.
    Experiences of dental care and dental anxiety in adults with autism spectrum disorder2014In: Autism Research and Treatment, ISSN 2090-1925, E-ISSN 2090-1933, Vol. 2014, article id 238764Article in journal (Refereed)
    Abstract [en]

    Dental anxiety is associated with previous distressing dental experiences, such as lack of understanding of the dentist intentions, perceptions of uncontrollability and experiences of pain during dental treatment. People with autism spectrum disorder (ASD) are impaired in building flexible predictions and expectations, which is very much needed during a dental visit. The aims of the study were to investigate if people with ASD have more negative dental experiences and a higher level of dental anxiety compared to a matched control group. Forty-seven adults with ASD and of normal intellectual performance, and 69 age- and sex-matched typically developing controls completed questionnaires on previous dental experiences and dental anxiety, the Dental Anxiety Scale, and the Dental Beliefs Survey. The ASD group experienced pain during dental treatments more often than the controls and 22% had repeatedly experienced being forced to dental treatment they were not prepared for, compared to 3% of the controls. A higher level of dental anxiety was reported by the ASD group. Dental treatment and methods for supporting the communication with patients with ASD need to be developed, in order to reduce the negative dental experiences and dental anxiety in people with ASD.

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