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Rosen, A., Jernelov, S., Kaldo, V., Forsell, E., Akerstedt, T. & D'onofrio, P. (2018). Cognitive behavior therapy for insomnia - is sleep compression an equally effective and less difficult alternative compared to sleep restriction?. Paper presented at 24th Congress of the European-Sleep-Research-Society (ESRS), SEP 25-28, 2018, Basel, SWITZERLAND. Journal of Sleep Research, 27
Open this publication in new window or tab >>Cognitive behavior therapy for insomnia - is sleep compression an equally effective and less difficult alternative compared to sleep restriction?
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-78100 (URN)000444228300874 ()
Conference
24th Congress of the European-Sleep-Research-Society (ESRS), SEP 25-28, 2018, Basel, SWITZERLAND
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-01Bibliographically approved
Karyotaki, E., Ebert, D. D., Donkin, L., Riper, H., Twisk, J., Burger, S., . . . Cuijpers, P. (2018). Do guided internet-based interventions result in clinically relevant changes for patients with depression?: An individual participant data meta-analysis. Clinical Psychology Review, 63, 80-92
Open this publication in new window or tab >>Do guided internet-based interventions result in clinically relevant changes for patients with depression?: An individual participant data meta-analysis
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2018 (English)In: Clinical Psychology Review, ISSN 0272-7358, E-ISSN 1873-7811, Vol. 63, p. 80-92Article, review/survey (Refereed) Published
Abstract [en]

Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving intemet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Internet-based guided self-help, Psychotherapy, Depression, Meta-analysis
National Category
Psychology
Research subject
Health and Caring Sciences, Health Informatics; Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-77405 (URN)10.1016/j.cpr.2018.06.007 (DOI)000439086800007 ()29940401 (PubMedID)
Available from: 2018-08-29 Created: 2018-08-29 Last updated: 2018-08-29Bibliographically approved
Kaldo, V., Lundin, A., Hallgren, M., Kraepelien, M., Strid, C., Ekblom, Ö., . . . Forsell, Y. (2018). Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses. Occupational and Environmental Medicine, 75(1), 52-58
Open this publication in new window or tab >>Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses
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2018 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 75, no 1, p. 52-58Article in journal (Refereed) Published
Abstract [en]

Objectives Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745). Methods After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months. Results For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2,13), For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2,46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found. Conclusions No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-74018 (URN)10.1136/oemed-2017-104326 (DOI)000419396600009 ()28951431 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved
Shahnavaz, S., Hedman-Lagerlöf, E., Hasselblad, T., Reuterskiöld, L., Kaldo, V. & Dahllöf, G. (2018). Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental Anxiety: Open Trial. Journal of Medical Internet Research, 20(1), e12
Open this publication in new window or tab >>Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental Anxiety: Open Trial
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2018 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, no 1, p. e12-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Cognitive behavioral therapy (CBT) is an evidence-based method for treating specific phobias, but access to treatment is difficult, especially for children and adolescents with dental anxiety. Psychologist-guided Internet-based CBT (ICBT) may be an effective way of increasing accessibility while maintaining treatment effects.

OBJECTIVE:

The aim of this study was to test the hypothesis that psychologist-guided ICBT improves school-aged children's and adolescents' ability to manage dental anxiety by (1) decreasing avoidance and affecting the phobia diagnosis and (2) decreasing the dentalfear and increasing the target groups' self-efficacy. The study also aimed to examine the feasibility and acceptability of this novel treatment.

METHODS:

This was an open, uncontrolled trial with assessments at baseline, posttreatment, and the 1-year follow-up. The study enrolled and treated 18 participants. The primary outcome was level of avoidance behaviors, as measured by the picture-guided behavioral avoidance test (PG-BAT). The secondary outcome was a diagnostic evaluation with the parents conducted by a psychologist. The specific phobia section of the structured interview Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) was used. Other outcome measures included level of dental anxiety and self-efficacy. The ICBT, which employed exposure therapy, comprised 12 modules of texts, animations, dentistry-related video clips, and an exercise package (including dental instruments). Participants accessed the treatment through an Internet-based treatment platform and received Web-based guidance from a psychologist. Treatment also included training at dental clinics. Feasibility and acceptability were assessed by measures of engagement, adherence, compliance, completed measures, patient and parent satisfaction scale, and staff acceptability.

RESULTS:

The level of avoidance (according to the primary outcome measure PG-BAT) and dental anxiety decreased and self-efficacy increased significantly (P<.001), within-group effect sizes for both the primary outcome (Cohen d=1.5), and other outcomes were large in the range of 0.9 and 1.5. According to K-SADS-PL, 53% (8/15) of the participants were free from diagnosable dental anxiety at the 1-year follow-up. At the 1-year follow-up, improvements were maintained and clinically significant, with 60% (9/15) of participants who had been unable to manage intraoral injection of local anesthetics before ICBT reporting having accomplished this task at a dental clinic. The target group showed improvement in all the outcome measures. High levels of feasibility and acceptability were observed for the treatment.

CONCLUSIONS:

ICBT is a promising and feasible treatment for dental anxiety in children and adolescents. Integrating it into routine pediatric dental care would increase access to an effective psychological treatment. The results of this open trial must be replicated in controlled studies.

National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-73910 (URN)10.2196/jmir.7803 (DOI)29358158 (PubMedID)
Available from: 2018-05-04 Created: 2018-05-04 Last updated: 2018-05-08Bibliographically approved
Heinonen, E., Szymanska-von Schultz, B., Kaldo, V., Nasiell, J., Andersson, E., Bergmark, M., . . . Gustafsson, L. L. (2018). MAGDALENA: study protocol of a randomised, placebo-controlled trial on cognitive development at 2 years of age in children exposed to SSRI in utero. BMJ Open, 8(8), Article ID e023281.
Open this publication in new window or tab >>MAGDALENA: study protocol of a randomised, placebo-controlled trial on cognitive development at 2 years of age in children exposed to SSRI in utero
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 8, article id e023281Article in journal (Refereed) Published
Abstract [en]

Introduction Ten per cent of all pregnant women are depressed. Standard therapy of pregnant women with moderate depression is selective serotonin reuptakeinhibitors (SSRI). Observational studies on neurodevelopment after fetal SSRI exposure show conflicting results. Our primary objective is to compare the cognitive development in children exposed to sertraline and maternal depression with those exposed to maternal depression and placebo in utero. We hypothesise that there is a significant neurodevelopmental difference between the groups. As a secondary objective, we study the add-on effect of sertraline to internet-based cognitive behavioural therapy (ICBT) to treat moderate depression during pregnancy. Methods and analysis MAGDALENA is a randomised, placebo-controlled, double-blinded trial in Stockholm Healthcare Region with 2.3 million inhabitants. The women are recruited in weeks 9-21 of pregnancy either through Antenatal Health Clinics or through social media. They are to be diagnosed with moderate depression without ongoing antidepressive therapy or any serious comorbidity. The women in the intervention arm receive sertraline combined with a 12-week period of ICBT; the control arm is treated with placebo and ICBT. We assess the cognitive development in the offspring at the age of 2 years using Bayley Scales of Infant and Toddler Development, third edition (BSID-III). We aim at recruiting 200 women, 100 women in each treatment arm, to ensure statistical power to detect a clinically relevant difference between the groups. Ethics and dissemination This randomised trial will provide long-sought evidence about the effects of SSRI and maternal depression during pregnancy on the neurodevelopment in the offspring. The study is approved by the Regional Ethical Review Board at Karolinska Institutet in Stockholm and the Swedish Medical Products Agency. It is registered with the European Clinical Trials Database (EudraCT), Number: 2013-004444-31. Results will be disseminated at scientific conferences, published in peer-reviewed journals and made available to the public.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
antenatal depression, internet-based cognitive behaviour therapy, serotonin reuptake inhibitors, neurodevelopment, pregnancy, drug metabolism
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-78622 (URN)10.1136/bmjopen-2018-023281 (DOI)000446470200178 ()30082365 (PubMedID)
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2018-11-01Bibliographically approved
Jernelov, S., Lekander, M., Blom, K. & Kaldo, V. (2018). One and ten-year follow-up of insomnia severity after a randomized trial of behavioral self-help treatment for insomnia with or without therapist guidance. Paper presented at 24th Congress of the European-Sleep-Research-Society (ESRS), SEP 25-28, 2018, Basel, SWITZERLAND. Journal of Sleep Research, 27
Open this publication in new window or tab >>One and ten-year follow-up of insomnia severity after a randomized trial of behavioral self-help treatment for insomnia with or without therapist guidance
2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-78099 (URN)000444228300875 ()
Conference
24th Congress of the European-Sleep-Research-Society (ESRS), SEP 25-28, 2018, Basel, SWITZERLAND
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-01Bibliographically approved
Hallberg, J., Kaldo, V., Arver, S., Dhejne, C. & Görts Öberg, K. (2017). A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study. Journal of Sexual Medicine, 14(7), 950-958
Open this publication in new window or tab >>A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study
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2017 (English)In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 7, p. 950-958Article in journal (Refereed) Published
Abstract [en]

Background: The proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity. Aim: To investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients' treatment satisfaction. Methods: Ten men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment. Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD: CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score. Results: Main results were significant decreases of HD symptoms from before to after treatment on HD: CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found. Clinical Implications: The CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option. Strengths and Limitations: This study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary. Conclusion: Although participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure to ensure treatment effectiveness. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Hypersexual Disorder, Sexual Addiction, Cognitive-Behavioral Therapy, Hypersexual Disorder Screening Inventory, Hypersexual Disorder: Current Assessment Scale, Client Satisfaction Questionnaire, Treatment Satisfaction
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-74020 (URN)10.1016/j.jsxm.2017.05.004 (DOI)000405224800012 ()28602666 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved
Sundström, C., Kraepelien, M., Eek, N., Fahlke, C., Kaldo, V. & Berman, A. H. (2017). High-intensity therapist-guided internet-based cognitive behavior therapy for alcohol use disorder: a pilot study. BMC Psychiatry, 17, Article ID 197.
Open this publication in new window or tab >>High-intensity therapist-guided internet-based cognitive behavior therapy for alcohol use disorder: a pilot study
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2017 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 197Article in journal (Refereed) Published
Abstract [en]

Background: A large proportion of individuals with alcohol problems do not seek psychological treatment, but access to such treatment could potentially be increased by delivering it over the Internet. Cognitive behavior therapy (CBT) is widely recognized as one of the psychological treatments for alcohol problems for which evidence is most robust. This study evaluated a new, therapist-guided internet-based CBT program (entitled ePlus) for individuals with alcohol use disorders. Methods: Participants in the study (n = 13) were recruited through an alcohol self-help web site (www.alkoholhjalpen.se) and, after initial internet screening, were diagnostically assessed by telephone. Eligible participants were offered access to the therapist-guided 12-week program. The main outcomes were treatment usage data (module completion, treatment satisfaction) as well as glasses of alcohol consumed the preceding week, measured with the self-rated Timeline Followback (TLFB). Participant data were collected at screening (T0), immediately pre-treatment (T1), post-treatment (T2) and 3 months post-treatment (T3). Results: Most participants were active throughout the treatment and found it highly acceptable. Significant reductions in alcohol consumption with a large within-group effect size were found at the three-month follow-up. Secondary outcome measures of craving and self-efficacy, as well as depression and quality of life, also showed significant improvements with moderate to large within-group effect sizes. Conclusions: Therapist-guided internet-based CBT may be a feasible and effective alternative for people with alcohol use disorders. In view of the high acceptability and the large within-group effect sizes found in this small pilot, a randomized controlled trial investigating treatment efficacy is warranted.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Cognitive behavior therapy, Alcohol use disorders, Alcohol dependence, Internet-based psychotherapy
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-74026 (URN)10.1186/s12888-017-1355-6 (DOI)000405444500001 ()28549424 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved
Görts Öberg, K., Hallberg, J., Kaldo, V., Dhejne, C. & Arver, S. (2017). Hypersexual Disorder According to the Hypersexual Disorder Screening Inventory in Help-Seeking Swedish Men and Women With Self-Identified Hypersexual Behavior. Sexual Medicine, 5(4), E229-E236
Open this publication in new window or tab >>Hypersexual Disorder According to the Hypersexual Disorder Screening Inventory in Help-Seeking Swedish Men and Women With Self-Identified Hypersexual Behavior
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2017 (English)In: Sexual Medicine, E-ISSN 2050-1161, Vol. 5, no 4, p. E229-E236Article in journal (Refereed) Published
Abstract [en]

Introduction: The Hypersexual Disorder Screening Inventory (HDSI) was developed by the American Psychiatric Association for clinical screening of hypersexual disorder (HD). Aims: To examine the distribution of the proposed diagnostic entity HD according to the HDSI in a sample of men and women seeking help for problematic hypersexuality and evaluate some psychometric properties. Methods: Data on sociodemographics, the HDSI, the Sexual Compulsivity Scale (SCS), and the Cognitive and Behavioral Outcomes of Sexual Behavior were collected online from 16 women and 64 men who self-identified as hypersexual. Respondents were recruited by advertisements offering psychological treatment for hypersexual behavior. Main Outcome Measures: The HDSI, covering the proposed criteria for HD. Results: Of the entire sample, 50% fulfilled the criteria for HD. Compared with men, women scored higher on the HDSI, engaged more often in risky sexual behavior, and worried more about physical injuries and pain. Men primarily used pornography, whereas women had sexual encounters. The HD group reported a larger number of sexual specifiers, higher scores on the SCS, more negative effects of sexual behavior, and more concerns about consequences compared with the non-HD group. Sociodemographics had no influence on HD. The HDSI's core diagnostic criteria showed high internal reliability for men (a = 0.80) and women (a = 0.81). A moderate correlation between the HDSI and the SCS was found (0.51). The vast majority of the entire sample (76 of 80, 95%) fulfilled the criteria for sexual compulsivity according to the SCS. Conclusion: The HDSI could be used as a screening tool for HD, although further explorations of the empirical implications regarding criteria are needed, as are refinements of cutoff scores and specific sexual behaviors. Hypersexual problematic behavior causes distress and impairment and, although not included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, HD should be endorsed as a diagnosis to develop evidence-based treatment and future studies on its etiology. Copyright (C) 2017, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine. This is an open access article under the CC BY-NC-ND license.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Hypersexual Disorder, Sexual Compulsivity, Screening Inventory, Hypersexual Disorder Screening Inventory, Gender
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-74024 (URN)10.1016/j.esxm.2017.08.001 (DOI)000418450100002 ()28993093 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved
Bendix, M., Uvnäs-Moberg, K., Petersson, M., Kaldo, V., Åsberg, M. & Jokinen, J. (2017). Insulin and glucagon in plasma and cerebrospinal fluid in suicide attempters and healthy controls. Psychoneuroendocrinology, 81, 1-7
Open this publication in new window or tab >>Insulin and glucagon in plasma and cerebrospinal fluid in suicide attempters and healthy controls
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2017 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 81, p. 1-7Article in journal (Refereed) Published
Abstract [en]

Mental disorders and related behaviors such as suicidality and violence have been associated to dysregulation of e g carbohydrate metabolism. We hypothesized that patients after suicide attempt, compared to healthy controls, would have higher insulin and lower glucagon levels in plasma and cerebrospinal fluid and that these changes would be associated to violent behavior. Twenty-eight medication-free patients (10 women, 18 men), hospitalized after suicide attempt, and 19 healthy controls (7 women, 12 men) were recruited with the aim to study risk factors for suicidal behavior. Psychological/psychiatric assessment was performed with SCID I and II or the SCID interview for healthy volunteers respectively, the Karolinska Interpersonal Violence Scale (KIVS) for assessment of lifetime violence expression behavior, the Montgomery-Asberg-Depression-Scale (MADRS) and the Comprehensive Psychological Rating Scale (CPRS) for symptomatic assessment of depression and appetite. Fasting levels of insulin and glucagon were measured in plasma (P) and cerebrospinal fluid (CSF). Suicide attempters had higher insulin- and lower glucagon-levels in plasma- and CSF compared to controls. Except for P-glucagon these associations remained significant after adjusting for age and/or BMI. Patients reported significantly more expressed interpersonal violence compared to healthy volunteers. Expressed violence was significantly positively correlated with P- and CSF-insulin and showed a significant negative correlation with P-glucagon in study participants. These findings confirm and extend prior reports that higher insulin and lower glucagon levels in plasma and cerebrospinal fluid are associated with suicidal behavior pointing towards a potential autonomic dysregulation in the control of insulin and glucagon secretion in suicidal patients. (C) 2017 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Suicide attempt, Insulin, Glucagon, Aggression, Violence, Depression
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-74025 (URN)10.1016/j.psyneuen.2017.03.019 (DOI)000404815200001 ()28391069 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6443-5279

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