Nordic Journal of Psychiatry最新文献

Objective: This study aimed to investigate the relationship between problematic Internet use (PIU) and suicide probability, aggression, and impulsivity in an adolescent clinical sample.

Methods: Four hundred and eighty-four adolescents who applied to the child psychiatry outpatient clinic of a university hospital were included in the study. They filled out a sociodemographic data form, the Internet Addiction Test (IAT), the Suicide Probability Scale (SPS), the Barratt Impulsiveness Scale-11-Short Form (BIS-11-SF), and the Buss-Perry Aggression Questionnaire (BPAQ).

Results: The time spent on the Internet, BIS-11-SF/MI, BIS-11-SF/AI, SPS subscales, and BPAQ scores of adolescents with PIU were significantly higher compared to those of normal Internet users. Having a computer at home, having a smartphone, time spent on the Internet, older age, SPS/hopelessness, and BPAQ scores were found to be predictive factors of PIU, but psychiatric diagnoses had no predictive effect (p > 0.05). SPS/hopelessness and BPAQ scores were statistically significant in distinguishing adolescents with PIU from those without. BIS-11-SF, SPS/hopelessness scores, and time spent on the Internet were the most important factors in predicting IAT total scores.

Conclusions: Determining the relationship between PIU, aggression, suicidal behavior, and impulsivity in adolescents will be effective in protecting them from potential harm.

Background: Executive functional deficits (EFDs) are very common in patients with Attention Deficit/Hyperactivity Disorder (ADHD). Behavioural ratings of executive functions have high ecological value but vary between informants and observational settings. Objectives of this study were to describe correlations between ratings on behavioural executive functions, ADHD symptoms and functional impairment between different informants.

Materials and methods: The study includes 100 adolescents aged 14-18 with ADHD still experiencing clinically impairing symptoms despite standard treatment. Ratings of EFDs were obtained from teachers, parents and self-reports. Parents and adolescents also rated core symptoms of ADHD and functional impairment. A clinician assessed overall global functioning. The relationship between measures and informants were analysed using Pearson correlations.

Results: There was a significant, strong, positive correlation between all measures reported by the same informant. The overall correlation was small to medium between teacher reported EFDs and both core symptoms of ADHD and functional impairment as reported by parents and adolescents. There was a significant negative correlation between clinicians' assessment of global functioning and ratings of EFDs by all informants.

Conclusions: We found that EFDs were strongly correlated both with higher levels of core symptoms of ADHD, and higher level of functional impairment as reported by the same informant. We also found, in line with previous research, that ratings of symptoms and impairment differs between informants and settings. Our findings underline the importance of multiple informants in both assessment and treatment planning.

Aim: To describe the challenges and strategies involved in recruiting adults to a cross-sectional survey study on psychosocial health and support, with individuals with schizophrenia and type 2 diabetes as the case.

Materials and methods: This descriptive study tracked the recruitment process for a Danish survey study in a register, systematically synthesising all relevant information. This included details on how eligible patients were identified and invited to the study and their reasons for declining. Two recruitment strategies were employed: (1) Recruitment via mental health professionals in psychiatric outpatient clinics in Region Zealand, and (2) Recruitment via phone calls to eligible patients. Descriptive analyses of the recruitment data were conducted.

Results: Three challenges were identified and described: (1) Challenges in identifying eligible patients, (2) Challenges in having mental health professionals to recruit participants, and (3) Patients' inability to complete the questionnaire. The first two challenges were addressed through practical approaches: (1) Identifying eligible patients via electronic health records and medication types, and (2) Directly inviting patients via phone calls from a member of the research team. No additional initiatives were implemented to address the third challenge. Approximately 15% of all eligible patients declined to participate, indicating a high willingness to participate among the remaining individuals.

Conclusions: Exploring various challenges was crucial for understanding the difficulties in recruiting this population, initiating new approaches to address these challenges, and recognising the high willingness to participate. Greater emphasis should be placed on patients' rights to make their own decisions regarding participation in research.

Aim: Coercion in mental health care is under constant debate. Norway has been shown to have relatively high rates of involuntary admissions. The use of coercion in patients with first-episode psychosis (FEP) in Norway is sparsely described, thus limiting an informative debate.

Method: We registered involuntary admissions, involuntary treatment orders, community treatment orders and other coercive measures during the first two years of treatment for all patients diagnosed with a first-episode non-affective psychosis at St Olav's University Hospital from 2012 to 2016. The hospital serves the Sør-Trøndelag County with 313,370 inhabitants in 2016.

Results: A total of 238 patients with FEP were included. 40% of the patients were involuntary admitted at first contact leading to the psychosis diagnose, and during the first two years of treatment 53% of the patients were involuntary admitted. Of the involuntarily admitted patients, 43% were discharged on a community treatment order, and 34% had involuntary treatment orders. Other coercive measures, such as short-term holding, mechanical restraint or short-acting medication, were used in 21% of patients receiving inpatient treatment.

Conclusion: Involuntary admission was relatively common in this cohort of FEP patients, although less used than in previous studies from Norway. Compared to studies from other countries, our findings, along with those from Finland, show among the highest rates of involuntary admissions and involuntary treatment orders published, and are higher than findings in other Nordic countries such as Denmark and Sweden.

Purpose: This study investigated treatment-seeking methods, internalized stigma levels, and perceived social support among mental disorder patients in the eastern and western regions of Turkiye.

Materials and methods: The study was conducted between April 10, 2022, and October 10, 2022, in two centers: Mardin Research and Training Hospital Psychiatry Outpatient Clinic (Southeastern Anatolia Region) and Bagcilar Research and Training Hospital Psychiatry Outpatient Clinic (Marmara Region). Simple random sampling method was used in the selection of participants. 238 patients (119 from each center) diagnosed with DSM-5 disorders participated. Assessment tools included the Help-Seeking Behavior Evaluation Form, Short Form of the Attitude Scale for Seeking Psychological Help (ATSPHS), Internalized Stigma Scale in Mental Illnesses (ISMI), and Multidimensional Perceived Social Support Scale (MSPSS). Data were analyzed using descriptive statistics, chi-square tests, and independent t-tests.

Results: Patients in the western region reported higher perceived support from family and friends, while those in the eastern region experienced greater internalized stigma, including alienation, stereotype endorsement, perceived discrimination, and social withdrawal. Patients in the eastern region demonstrated a stronger preference for traditional healers. Conversely, patients in the western region were more likely to consult psychiatrists.

Conclusion: The study concludes that cultural factors significantly influence patients' attitudes toward treatment and mental health care. It emphasizes the need for culturally sensitive approaches in mental health interventions, particularly in rural and disadvantaged areas. Community-based psychoeducation programs could help reduce stigma and encourage earlier help-seeking behaviors.

Introduction: Legal and medical approaches to mentally ill offenders vary internationally, but those with severe mental disorders are often sentenced to forensic psychiatric care, where one of the main objectives is to prevent recidivism. This retrospective cohort study compared violent recidivism after discharge from such treatment in Sweden and Finland.

Methods: The Swedish cohort included patients discharged between 2009 and 2019, with recidivism data collected until December 2019. Finnish patients discharged between 1999 and 2018 were followed for recidivism until 2019. Violent recidivism was analyzed using cumulative incidence curves and Cox regression models for relevant variables.

Results: The violent recidivism rate was 3294 per 100,000 person-years in Sweden versus 1083 in Finland. The estimated cumulative incidence of violent crime in Sweden was 6.3% at 12 months, 9.9% at 24 months, and 13.6% at 60 months, versus 0.4% at 12 months, 2.7% at 24 months, and 7.6% at 60 months in Finland. Among Swedish patients with schizophrenia spectrum disorder, the recidivism rate was 11.5% at 60 months. A history of substance use disorder was associated with a more than two-fold risk of committing a violent crime in both Sweden and Finland. Conversely, higher age at discharge reduced the risk in both countries.

Conclusion: The rate of violent recidivism among former forensic psychiatric patients is higher in Sweden than in Finland, with the cumulative incidence at five years being 1.8-fold in Sweden (1.5-fold among patients with psychosis). History of substance use disorder and higher age at discharge significantly influenced recidivism risk in both countries.

Aims: This study aimed to investigate the prevalence of problematic gaming and gambling and the co-occurrence of these behaviours in association with depression and generalised anxiety disorder in a representative general working-age adult population in Latvia.

Methods: Data from a survey of 4,912 respondents aged 15-64 in the general population of Latvia were studied. The Game Addiction Scale, the Problem Gambling Severity Index, and the PHQ-9 and GAD-7 scales were used to obtain self-reported data for the target study variables. Descriptive statistics and binary logistic regression models assess the prevalence of the variables and estimate the odds ratios for depression and generalised anxiety disorder.

Results: By adjusting for age, sex, and income level, both problematic gaming and gambling significantly increased the odds of depression and anxiety by an average of three times. The prevalence of the co-occurrence of problematic gaming and gambling was 0.8%, and it did not elevate the odds of depression and anxiety compared to having either problematic gaming or gambling alone, which maintains the overall threefold increase of both depression and anxiety (p < 0.05).

Conclusions: In the general adult population, the presence of problematic gaming and gambling indicates a higher likelihood for the individual burden of mental health problems due to the co-existence of depression or anxiety. Thus, the complexity of problematic gaming and gambling has to be taken into account when planning and implementing effective mental health interventions.

Objective: Comorbidity between Obsessive-Compulsive Disorder (OCD) and Attention Deficit/Hyperactivity Disorder (ADHD) appears complex in terms of etiology, phenomenology, and treatment. There is a need to identify possible factors which are related to the co-occurrence of OCD and ADHD in adults. Cognitive Disengagement Syndrome (CDS) may contribute to this comorbidity through its associations with ADHD, emotional dysregulation, cognitive processes, and neuropsychological deficits.

Methods: In this study, we compared CDS and various sociodemographic and clinical characteristics in OCD patients with (n = 44) and without ADHD (n = 72), and healthy controls (n = 43), using the Yale Brown Obsessive-Compulsive Scale, Wender Utah Rating Scale, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale, Barkley's Adult Sluggish Cognitive Tempo Rating Scale, Beck Depression Inventory, and Beck Anxiety Inventory.

Results: In addition to contamination obsessions (OR = 7.733, p = 0.002), male gender (OR = 3.732, p = 0.031), high anxiety (OR = 1.053, p = 0.02), and high CDS symptoms (OR = 1.145, p = 0.037) were associated with comorbidity between OCD and ADHD.

Conclusion: We suggest that CDS may serve as a valuable construct for understanding the nature of comorbidity between OCD and ADHD.

Purpose: The study aimed to (1) explore nursing staff attitudes towards evidence-based practice in conjunction with implementation of Steps Towards Recovery, and (2) describe nurses' and nurse managers' experiences of working with Steps Towards Recovery, as an example of evidence-based practice.

Materials and methods: The study was carried out in two parts. Part 1 incorporated quantitative questionnaire data using descriptive, non-parametric statistical analyses. Part 2 incorporated qualitative data, from both individual and focus group interviews, using qualitative content analysis and focus group data analysis.

Results: In part 1, positive attitudes were reported. Openness to evidence-based practice was significantly higher after implementation. In part 2, the nursing programme was found to be seen as an important contribution to nursing in psychiatric in-patient care. Evidence-based practice was seen as important but insufficiently used.

Conclusion: Integrating results from nursing research into daily nursing work is described as challenging in psychiatric in-patient care. There is a need to illuminate the gap between theory and practice to achieve evidence-based nursing. Nurses' professional role and responsibility for the development and improvement of nursing are crucial in doing so and must be addressed in nursing education, by nurses themselves, as well as by managers at all levels of health care.

Purpose: Living with undiagnosed autism may have negative consequences for mental health, including increased risk of self-harm and suicidal behaviours. Autism is currently underdiagnosed in adult females. While severe self-harm is associated with complex psychopathologies, it is often assumed to signify the presence of borderline personality disorder, and underlying autism may not be recognised. The purpose of the current study was to explore the prevalence of diagnosed autism, as well as the prevalence of being screen positive for autism and its clinical correlates, in a clinical sample of inpatients with severe self-harm.

Materials and methods: In a national multisite project comprising 12 hospitals, 42 patients (40 female, 2 male; age >18) with frequent (≥ 5) or long (≥ 4 weeks) inpatient admissions due to self-harm during the last year were recruited for a cross-sectional study. The Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R) was used to screen for autism.

Results: Four participants, all female, were diagnosed with autism. When applying different cut-off criteria for the RAADS-R, even the strictest cut-off resulted in a considerably higher proportion of the sample being screen positive for autism. Participants with higher scores on the RAADS-R reported more anxiety, depressive, and trauma-related symptoms, as well as poorer functioning across measures of personality, close relationships, emotion regulation and alexithymia.

Conclusions: These findings highlight the importance of actively screening for and assessing autism in patients with severe self-harm. Undiagnosed autism may involve a risk that unhelpful interactions with the mental health care system exacerbate these patients' difficulties over time.