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Olsson, Anna-Karin
Publications (10 of 14) Show all publications
Helldin, L., Mohn, C., Olsson, A.-K. & Hjärthag, F. (2020). Neurocognitive variability in schizophrenia spectrum disorders: relationship to real-world functioning. Scandinavian International Conference on Fluid Power (SICFP), 20, Article ID 100172.
Open this publication in new window or tab >>Neurocognitive variability in schizophrenia spectrum disorders: relationship to real-world functioning
2020 (English)In: Scandinavian International Conference on Fluid Power (SICFP), ISSN 1879-9027, E-ISSN 2215-0013, Vol. 20, article id 100172Article in journal (Refereed) Published
Abstract [en]

Neurocognitive variability exists within the schizophrenia spectrum disorder (SSD) population, with subgroups performing at the same level as healthy samples Here we study the relationship between different levels of neurocognitive responding and real-world functioning. The participants were 291 SSD patients and 302 healthy controls that were assessed with a comprehensive neurocognitive battery. In addition, the patients were assessed with the Specific Level of Functioning Scale (SLOF). The results showed that the mean neurocognitive test responses of the SSD group were significantly below that of the control group. However, there was considerable overlap between the cognitive scores of the two groups, with as many as 24% of the patients performing above the mean healthy score for some domains. Moreover, the patients with the highest level of neurocognitive functioning reached the highest levels of practical and work-related functioning outcome skills. There was no significant relationship between neurocognitive and social function skills. The large differences in cognitive performance and their associations with functional outcome within the patient group are rarely addressed in clinical practice, but indicate a clear need for individualized treatment of SSD. Early identification of cognitive risk factors for poor real-life functional outcome is necessary in order to alert the clinical and rehabilitation services about patients in need of extra care.

Keywords
Functional outcome, Neurocognition, Psychosis, Real-world functioning, Schizophrenia, adult, Article, clinical practice, cognition, cognition assessment, cognitive defect, cognitive function test, continuous performance test, controlled study, disease severity, DSM-IV, education, emotionality, executive function, female, Global Assessment of Functioning, human, intelligence quotient, Letter Number Span test, major clinical study, male, mental disease assessment, mental health service, neuropsychological test, physical activity, priority journal, questionnaire, Rey auditory verbal learning test, risk factor, schizophrenia spectrum disorder, scoring system, social status, Specific Level of Functioning Scale, task performance, test retest reliability, trail making test, Wechsler adult intelligence scale, Wisconsin Card Sorting Test, working memory
National Category
Psychiatry
Identifiers
urn:nbn:se:kau:diva-77586 (URN)10.1016/j.scog.2020.100172 (DOI)2-s2.0-85079287095 (Scopus ID)
Available from: 2020-04-24 Created: 2020-04-24 Last updated: 2020-05-11Bibliographically approved
Olsson, A.-K. (2019). Functional Capacity as a Predictor of Everyday Functioning in Patients with Schizophrenia. (Doctoral dissertation). Karlstad: Karlstads universitet
Open this publication in new window or tab >>Functional Capacity as a Predictor of Everyday Functioning in Patients with Schizophrenia
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall purpose of this thesis is to increase knowledge of the concept of functional capacity and how it is related to everyday functioning for adult patients with schizophrenia spectrum disorders. The thesis comprises three papers (Papers I-III) based on empirical data from a clinically representative sample of outpatients. The results in the first study (Paper I) indicated that the Swedish version of University of California San Diego Performance-based Skills Assessment-Brief (UPSA-B) is a reliable instrument, with good psychometric properties in terms of both validity and reliability. UPSA-B is a performance-based instrument used to assess functional capacity, i.e. the patient’s ability to perform certain everyday tasks, necessary for independent functioning, in a controlled setting. In the second study (Paper II), the aim was to investigate if and how demographic variables and illness activities, together with functional capacity, contribute to predicting real-world functioning milestones. Functional capacity was mainly associated with education level and housing situation. In the third study (Paper III), the aim was to investigate how the patient's self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. The results showed that 37% of patients overestimate their functional performance. The results also showed that clinicians seem to have greater difficulty assessing patients who overestimate their functioning. In summary, this thesis states that using UPSA-B to measure functional capacity offers considerable advantages and plays an important role in capturing functional outcomes. The importance of taking control of limited self-rating ability in patients with schizophrenic spectrum disorders is also demonstrated.

Abstract [en]

The overall purpose of this thesis is to increase knowledge about the concept of functional capacity and the way it is related to everyday functioning for adult patients with schizophrenia spectrum disorders. UCSD Performance-based Skill Assessment-Brief (UPSA-B) is a performance based instrument used to assess functional capacity, the patient’s ability to perform certain everyday tasks in a controlled setting. The result in Paper I indicated that the Swedish version of UPSA-B is a reliable instrument with good psychometric properties. The aim in Paper II was to investigate if and how, demographic variables and illness activities together with functional capacity contribute to predict real-world functioning milestones. Functional capacity was mainly associated with education level and housing situation. In Paper III the aim was to investigate how the patient's self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. The results showed that 37 % of patients overestimate their ability of functional performance. In sum, this thesis states that using UPSA-B to measure functional capacity has great advantages and plays an important role in capturing functional outcomes.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2019. p. 86
Series
Karlstad University Studies, ISSN 1403-8099 ; 2019:2
Keywords
Schizophrenia, Functional capacity, Everyday functioning, Self-awareness, Assessment instrument
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-70681 (URN)978-91-7063-833-6 (ISBN)978-91-7063-866-4 (ISBN)
Public defence
2019-02-22, 1B 309 Sjöströmsalen, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2019-02-01 Created: 2019-01-08 Last updated: 2019-06-05Bibliographically approved
Olsson, A.-K., Hjärthag, F. & Helldin, L. (2019). Overestimated function in patients with schizophrenia: A possible risk factor for inadequate support?. Schizophrenia Research, 206, 194-199
Open this publication in new window or tab >>Overestimated function in patients with schizophrenia: A possible risk factor for inadequate support?
2019 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 206, p. 194-199Article in journal (Refereed) Published
Abstract [en]

People with schizophrenia often demonstrate an impaired ability to assess and report aspects of their everyday functioning, and the aim of this study is to investigate how patients' self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. A total of 222 outpatients with a schizophrenia spectrum disorder participated in this study. They were divided into groups based on their self-rating ability (determined using self-rating questions) and their observed functional capacity (the UCSD Performance-Based Skills Assessment-Brief, UPSA-B). The results showed that patients with impaired functional capacity perform at a similar cognitive level, regardless of their self-rating ability. When comparing patients with unimpaired function to those with impaired function, we found differences in two cognitive domains; premorbid functioning and executive functioning. The results also reveal that clinicians seem to have greater difficulty assessing patients who over-estimate their functioning. Consequently, when clinicians assessed the patients with the Specific Levels of Functioning Scale (SLOF) no significant differences were found between the group with unimpaired function and the group of overestimators. Patients who overestimate their functioning risk receiving inadequate treatment and support.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Functional capacity, Introspective accuracy, Neurocognition, Real-world functional outcomes, Schizophrenia, Self-awareness
National Category
Psychology Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-70680 (URN)10.1016/j.schres.2018.11.027 (DOI)000467810100028 ()30514644 (PubMedID)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-09-12Bibliographically approved
Johansson, M., Olsson, A.-K., Iris, v.-H. D. & Helldin, L. (2019). Overestimating Functioning and Long-term Symptomatic Remission Pattern - How Is It Associated?. Paper presented at Congress of the Schizophrenia-International-Research-Society (SRIS), APR 10-14, 2019, Orlando, FL. Schizophrenia Bulletin, 45, S300-S300
Open this publication in new window or tab >>Overestimating Functioning and Long-term Symptomatic Remission Pattern - How Is It Associated?
2019 (English)In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 45, p. S300-S300Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-72117 (URN)10.1093/schbul/sbz018.534 (DOI)000466725400501 ()
Conference
Congress of the Schizophrenia-International-Research-Society (SRIS), APR 10-14, 2019, Orlando, FL
Available from: 2019-05-23 Created: 2019-05-23 Last updated: 2020-01-07Bibliographically approved
Vikstrom, P., Bjorkman, A., Carlsson, I. K., Olsson, A.-K. & Rosen, B. (2018). Atypical sensory processing pattern following median or ulnar nerve injury: a case-control study. BMC Neurology, 18, Article ID 146.
Open this publication in new window or tab >>Atypical sensory processing pattern following median or ulnar nerve injury: a case-control study
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2018 (English)In: BMC Neurology, ISSN 1471-2377, E-ISSN 1471-2377, Vol. 18, article id 146Article in journal (Refereed) Published
Abstract [en]

Background: Due to brain plasticity a transection of a median or ulnar nerve results in profound changes in the somatosensory areas in the brain. The permanent sensory deprivation after a peripheral nerve injury might influence the interaction between all senses. The aim of the study was to investigate if a median and/or ulnar nerve injury gives rise to a changed sensory processing pattern. In addition we examined if age at injury, injured nerve or time since injury influence the sensory processing pattern. Methods: Fifty patients (40 men and 10 women, median age 43) operated due to a median and/or ulnar nerve injury were included. The patients completed the Adolescent/Adult Sensory Profile questionnaire, which includes a comprehensive characterization on how sensory information is processed and how an individual responds to multiple sensory modalities. AASP categorizes the results into four possible Quadrants of behavioral profiles (Q1-low registration, Q2-sensory seeking, Q3-sensory sensitivity and Q4-sensory avoiding). The results were compared to 209 healthy age and gender matched controls. Anova Matched Design was used for evaluation of differences between the patient group and the control group. Atypical sensory processing behavior was determined in relation to the normative distribution of the control group. Results: Significant difference was seen in Q1, low registration. 40% in the patient group scored atypically in this Quadrant compared to 16% of the controls. No correlation between atypical sensory processing pattern and age or time since injury was seen. Conclusion: A peripheral nerve injury entails altered sensory processing pattern with increased proportion of patients with low registration to sensory stimulus overall. Our results can guide us into more client centered rehabilitation strategies.

Place, publisher, year, edition, pages
BMC, 2018
National Category
Other Medical Sciences not elsewhere specified
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-69471 (URN)10.1186/s12883-018-1152-y (DOI)000445258400001 ()30231852 (PubMedID)
Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2019-12-18Bibliographically approved
Olsson, A.-K., Olsson-Tall, M., Moradi, H., Hjärthag, F. & Helldin, L. (2018). Less symptoms in schizophrenia a risk factor for impaired insight of functioning?. Paper presented at 6th Biennial Conference of the Schizophrenia-International-Research-Society (SIRS), APR 04-08, 2018, Florence, ITALY. Schizophrenia Bulletin, 44, S263-S264
Open this publication in new window or tab >>Less symptoms in schizophrenia a risk factor for impaired insight of functioning?
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2018 (English)In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 44, p. S263-S264Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2018
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-67190 (URN)10.1093/schbul/sby017.643 (DOI)000429541800638 ()
Conference
6th Biennial Conference of the Schizophrenia-International-Research-Society (SIRS), APR 04-08, 2018, Florence, ITALY
Note

Background

People with schizophrenia demonstrate deficits in insight and the ability to self-evaluate their functioning. Research about patients’ ability to recognize their psychotic symptoms is well established, but recent findings show that there are still unexplored fields regarding how patients perceive their level of functioning A previous study showed that patients who overestimate their functioning, also consistently get high scores in interview-based assessment regarding real-world functional performance. The possible consequences of patients’ ability to correctly estimate their function need to be further investigated. The aim of the present study was to examine how the perception of one’s own capacity relate to symptoms in patients with schizophrenia spectrum disorders.

Methods

Data collection took place within the ongoing project Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which examines psychiatric outpatients. In this study, 222 patients with schizophrenia participated. They were divided into four groups based on their results on the UPSA-B and their self-perceived function; two groups with ordinary function (accurate estimators and under -estimators) and two groups with low function (accurate estimators and over-estimators). The groups were compared regarding psychiatric symptoms, examined using the Positive and Negative Syndrome Scale (PANSS). Non-parametric statistics were used to analyze differences in their symptoms.

Results

There were statistically significant differences in the total score of PANSS across the four groups of function. The following analyses showed significant differences in the negative and general domain. Results from the post hoc examination revealed identical patterns in these two symptom domains. The group with Low function accurate estimators have significantly more severe symptoms compared to the other three groups.

Discussion

The result in the present study showed that patients with low function who overestimate their function have less or the same level of symptoms as patients in the two groups with ordinary functioning. In further studies it is important to investigate if this actually is a result of lower symptom level or if it is due to the impaired insight. This is important since the result in the present study mirror previous results where patients who overestimate a low function also, by clinicians, will be perceived as patients with a higher capacity and less difficulties.

Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2019-12-18Bibliographically approved
Hawar, M., Olsson, A.-K., Hjärthag, F., Johansson, M., Olsson-Tall, M. & Helldin, L. (2018). Traditional Risk Factors Not Enough To Explain The Short Lifetime Expectancy In Patients With Schizophrenia. Paper presented at 6th Biennial Conference of the Schizophrenia-International-Research-Society (SIRS), APR 04-08, 2018, Florence, ITALY. Schizophrenia Bulletin, 44, S159-S159
Open this publication in new window or tab >>Traditional Risk Factors Not Enough To Explain The Short Lifetime Expectancy In Patients With Schizophrenia
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2018 (English)In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 44, p. S159-S159Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology with an emphasis on medical psychology
Identifiers
urn:nbn:se:kau:diva-67191 (URN)000429541800385 ()
Conference
6th Biennial Conference of the Schizophrenia-International-Research-Society (SIRS), APR 04-08, 2018, Florence, ITALY
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-06-25Bibliographically approved
Moradi, H., Olsson, A.-K., Hjärthag, F., Harvey, P. & Helldin, L. (2017). SU42. Physical Fitness in Association With Cognitive Performance—Possible Marker of Short Lifetime Expectancy for Patients With Schizophrenia. Paper presented at 16th International Congress on Schizophrenia Research (ICOSR), MAR 24-28, 2017, San Diego, CA. Schizophrenia Bulletin, 43(Suppl 1), S176-S176
Open this publication in new window or tab >>SU42. Physical Fitness in Association With Cognitive Performance—Possible Marker of Short Lifetime Expectancy for Patients With Schizophrenia
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2017 (English)In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 43, no Suppl 1, p. S176-S176Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Patients with schizophrenia have about 20 years shorter lifetime expectancy compared to healthy population. Among these patients, cognitive performance is a predictor of early death while illness severity, as expressed in both symptom activity and remission status, has no relation with length of life. Vital signs, such as blood pressure and heart rate, weight including BMI, and spontaneously reported symptoms did neither indicate an increased risk for early death. This work focus on whether self-rated physical condition and activities, in contrast to vital signs and perceived symptoms, could be related to cognitive performance and length of life.Methods: From the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS) study, 310 participants were categorized into 4 groups from their cognitive performance at baseline: good cognitive function (GCF), n = 114, impaired cognitive function (ICF), n = 90, and severely impaired cognitive function (SICF), n = 45. The fourth group was patients who had passed away during the study time, n = 61. Patients’ perceived physical condition was assessed at baseline using the SF-36, which included 10 questions about everyday physical activities. The 4 groups were compared using ANOVAs and post hoc analyzes.Results: Patients who had deceased reported, on average 9.5 years before their death, a significantly (P < .001) more impaired physical condition compared to the GCF group and the ICF group (P = .028) but did not show any difference compared with the SICF group (P = .424). An item analysis showed that especially physical activities, such as walking a distance or climbing the stairs, were impaired. When only alive patients’ physical status vs cognitive performance were analyzed, the GCP were more physical fit than the ICF (P = .018) and SICF (P = .011), but there were no difference between ICF and SICF.Conclusion: In contrast to vital signs and perceived symptoms of illness, patient reported differences in physical fitness corresponded to differences in their cognitive ability. It has earlier been argued that physical performance is an underappreciated variable for improving ADLs. This study indicates that patents’ physical performance may, several years in advance, offer important information about increased risk of an early death.

Place, publisher, year, edition, pages
Oxford University Press, 2017
National Category
Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-65296 (URN)10.1093/schbul/sbx024.040 (DOI)000397126200476 ()
Conference
16th International Congress on Schizophrenia Research (ICOSR), MAR 24-28, 2017, San Diego, CA
Available from: 2017-11-30 Created: 2017-11-30 Last updated: 2020-05-25Bibliographically approved
Olsson, A.-K., Hjärthag, F. & Helldin, L. (2016). Predicting real-world functional milestones in schizophrenia. Psychiatry Research, 242, 1-6
Open this publication in new window or tab >>Predicting real-world functional milestones in schizophrenia
2016 (English)In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 242, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Schizophrenia is a severe disorder that often causes impairments in major areas of functioning, and most patients do not achieve expected real-world functional milestones. The aim of this study was to identify which variables of demography, illness activity, and functional capacity predict patients' ability to attain real-world functional milestones. Participants were 235 outpatients, 149 men and 86 women, diagnosed with schizophrenia spectrum disorder. Our results showed that younger patients managed to achieve a higher level of functioning in educational level, marital status, and social contacts. Patients' functional capacity was primarily associated with educational level and housing situation. We also found that women needed less support regarding housing and obtained a higher level of marital status as compared with men. Our findings demonstrate the importance of considering current symptoms, especially negative symptoms, and remission stability over time, together with age, duration of illness, gender, educational level, and current functional capacity, when predicting patients' future real-world functioning. We also conclude that there is an advantage in exploring symptoms divided into positive, negative, and general domains considering their probable impact on functional achievements.

Place, publisher, year, edition, pages
Elsevier, 2016
National Category
Applied Psychology
Research subject
Psychology with an emphasis on medical psychology
Identifiers
urn:nbn:se:kau:diva-45865 (URN)10.1016/j.psychres.2016.05.015 (DOI)000381844200001 ()27235985 (PubMedID)
Projects
Clinical Long-term Investigation of Psychosis in Sweden (CLIPS)
Available from: 2016-09-13 Created: 2016-09-13 Last updated: 2019-06-10Bibliographically approved
Helldin, L., Olsson, A.-K. & Hjärthag, F. (2016). Schizophrenia and Short Lifetime Expectancy: The Importance of Identifying Risk Factors Early in the Illness.. In: : . Paper presented at The 5th Biennial Schizophrenia International Research Society Conference, Florence, Italy, April 2016..
Open this publication in new window or tab >>Schizophrenia and Short Lifetime Expectancy: The Importance of Identifying Risk Factors Early in the Illness.
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Psychiatry Applied Psychology
Research subject
Psychology with an emphasis on medical psychology; Psychology
Identifiers
urn:nbn:se:kau:diva-41699 (URN)
Conference
The 5th Biennial Schizophrenia International Research Society Conference, Florence, Italy, April 2016.
Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2019-07-10Bibliographically approved
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