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Helldin, Lars
Publications (10 of 15) Show all publications
Johansson, M., Hjärthag, F. & Helldin, L. (2023). Exploring cross-sectional and longitudinal symptomatic remission and subjective quality of life in Schizophrenia. Psychiatry Research, 328, Article ID 115421.
Open this publication in new window or tab >>Exploring cross-sectional and longitudinal symptomatic remission and subjective quality of life in Schizophrenia
2023 (English)In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 328, article id 115421Article in journal (Refereed) Published
Abstract [en]

Achieving symptomatic remission, as defined by the Remission in Schizophrenia Working Group, is intended tobe a meaningful outcome for individuals with schizophrenia, resulting in enhanced well-being. Cross-sectionalstudies have reported an association between symptomatic remission and subjective quality of life (QoL). Longitudinal studies aimed at examining this association have showed mixed results. The aim of this study was toexplore the relationship between symptomatic remission and subjective QoL, both cross-sectionally andlongitudinally. The study comprised data from what were at most 386 patients with schizophrenia, of whom 122–140 werefollowed over a period of four years. Based on cross-sectional remission status and longitudinal remissionpattern, differences in subjective QoL were explored. Remission status was assessed using the Positive andNegative Syndrome Scale (PANSS), and subjective QoL using the Short Form-36 Health Survey (SF-36). Both the cross-sectional and the longitudinal approach showed that patients in symptomatic remission hadsignificantly higher subjective QoL. Patients who were in non-remission at baseline, but who achieved remissionat follow-up, also had significantly higher subjective QoL at follow-up compared with baseline. The results from the study show a clear association between symptomatic remission and subjective QoL. However, achieving symptomatic remission does not appear to be a guarantee of sustained subjective QoL, andonly continued stable remission appears to result in such an outcome.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Longitudinal, Schizophrenia Spectrum Disorder, Subjective Quality of Life, Symptomatic Remission
National Category
Other Medical Sciences not elsewhere specified Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-94294 (URN)10.1016/j.psychres.2023.115421 (DOI)001076677100001 ()37659163 (PubMedID)2-s2.0-85170063321 (Scopus ID)
Note

This paper was included as a manuscripts in Madeleine Johansson's doctoral thesis entitled 'Longitudinellt perspektiv på symtomatisk remission vid schizofreni' 2023:14. 

Available from: 2023-04-14 Created: 2023-04-14 Last updated: 2023-11-02Bibliographically approved
Mohn, C., Olsson, A.-K., van Dijk Härd, I. & Helldin, L. (2023). Neurocognitive function and mortality in patients with schizophrenia spectrum disorders. Schizophrenia Research: Cognition, 33, Article ID 100284.
Open this publication in new window or tab >>Neurocognitive function and mortality in patients with schizophrenia spectrum disorders
2023 (English)In: Schizophrenia Research: Cognition, E-ISSN 2215-0013, Vol. 33, article id 100284Article in journal (Refereed) Published
Abstract [en]

Individuals with schizophrenia spectrum disorders (SSD) have significantly lower life-expectancy than healthy people. Previously, we have identified baseline neurocognitive function in general and verbal memory and executive function in particular as related to mortality nearly two decades later. In this study, we aim to replicate these findings with a larger and age-matched sample. The patient group consisted of 252 individuals, 44 of whom were deceased and 206 alive. Neurocognition was assessed with a comprehensive battery. Results showed that the deceased group, compared to the living group, had significantly more severe neurocognitive deficits across nearly all domains. There were no differences in sex, remission status, psychosis symptoms, or function level between the groups. Immediate verbal memory and executive function were the strongest predictors of survival status. These results were nearly identical to our previous studies, and we conclude that baseline neurocognitive function is an important predictor for mortality in SSD. Clinicians should be mindful of this relationship in patients with significant cognitive deficits. 

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
adult, Article, cognition, female, Global Assessment of Functioning, human, longevity, major clinical study, male, mortality, Positive and Negative Syndrome Scale, psychosis, Rey auditory verbal learning test, schizophrenia, schizophrenia spectrum disorder, trail making test, verbal memory, Wechsler adult intelligence scale, Wisconsin Card Sorting Test, working memory, Neurocognition
National Category
Neurosciences Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-94358 (URN)10.1016/j.scog.2023.100284 (DOI)001005718600001 ()37078076 (PubMedID)2-s2.0-85151534097 (Scopus ID)
Available from: 2023-04-19 Created: 2023-04-19 Last updated: 2023-06-30Bibliographically approved
Mohn, C., Olsson, A.-K., Johansson, M., Moradi, H. & Helldin, L. (2021). Marginal relationship between affective dispositions and neurocognitive function in patients with schizophrenia spectrum disorders. Nordic Journal of Psychiatry, 75(5), 344-350
Open this publication in new window or tab >>Marginal relationship between affective dispositions and neurocognitive function in patients with schizophrenia spectrum disorders
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2021 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 75, no 5, p. 344-350Article in journal (Refereed) Published
Abstract [en]

Purpose Neurocognitive outcomes are frequently used as indicators of real-world functioning in schizophrenia spectrum disorders (SSD). These test results may be influenced by individual differences, such as affective dispositions. Here we investigate the relationship between positive and negative affect and neuropsychological test scores in a large, mixed-gender, population based group of participants without co-morbid substance abuse. Materials and methods We assessed 129 male and female SSD patients with the Positive and Negative Affect Schedule (PANAS) and a comprehensive neuropsychological test battery. Results and conclusions The neuropsychological test scores were mainly predicted by age and gender, with small contributions from negative psychosis symptoms. There was a statistically significant relationship between Positive Affect and processing speed and between Negative Affect and verbal memory and executive function. However, the level of neurocognitive function variance explained by these affects was only 5%. Thus, the neurocognitive test results were not associated with trait affect in any clinically significant manner. This adds to previous findings of no relationship between affective dispositions and psychosis symptom variables in our participants. We suggest that affective traits constitute an independent dimension that may influence well-being, coping, and real-life outcome in SSD patients directly, and not through neurocognitive function.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Affect, neurocognition, PANAS, psychosis, schizophrenia
National Category
Psychology Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-82522 (URN)10.1080/08039488.2020.1862294 (DOI)000605408200001 ()33403920 (PubMedID)2-s2.0-85099215001 (Scopus ID)
Available from: 2021-01-21 Created: 2021-01-21 Last updated: 2022-05-30Bibliographically approved
Johansson, M., Hjärthag, F. & Helldin, L. (2020). Cognitive markers related to long-term remission status in Schizophrenia Spectrum Disorders. Psychiatry Research, 289, Article ID 113035.
Open this publication in new window or tab >>Cognitive markers related to long-term remission status in Schizophrenia Spectrum Disorders
2020 (English)In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 289, article id 113035Article in journal (Refereed) Published
Abstract [en]

Cognitive impairment is an established feature of schizophrenia. From a cross-sectional perspective, studies have revealed associations between cognition and remission. Few studies have examined this relationship longitudinally. Here we examine which cognitive domains might be related to long-term remission and symptomatic severity. The present study followed 173 outpatients with schizophrenia for five years, divided into groups based on long-term remission status and symptomatic severity, assessed with the Positive and Negative Syndrome Scale. Cognitive functioning was assessed at baseline, with tests of vigilance, executive functions, processing speed, memory and learning, working memory, and premorbid functioning. Cognitive domains related to long-term remission status were executive functions, working memory, and premorbid functioning. The most prominent cognitive differences were found between the group in stable remission with minimal symptoms, and the non-remission group, the first group demonstrating better cognitive functioning. The study highlights the role of premorbid functioning as a cognitive feature in the prediction of long-term remission. It also indicates the possibility of viewing specific cognitive domains as markers for clinical outcome, highlighting the value of early assessment of cognition. In summary, a certain cognitive profile, in coexistence with long-term non-remission, suggests poorer outcome. Hence, this group is in need of increased support.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
adult, alertness, Article, clinical outcome, cognition assessment, controlled study, cross-sectional study, disease severity, executive function, female, human, long term care, longitudinal study, major clinical study, male, middle aged, Positive and Negative Syndrome Scale, priority journal, processing speed, prognosis, remission, schizophrenia spectrum disorder, symptom, task performance, working memory
National Category
Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-78308 (URN)10.1016/j.psychres.2020.113035 (DOI)000558423200015 ()2-s2.0-85084820475 (Scopus ID)
Available from: 2020-06-15 Created: 2020-06-15 Last updated: 2023-04-27Bibliographically approved
Helldin, L., Mohn, C., Olsson, A.-K. & Hjärthag, F. (2020). Neurocognitive variability in schizophrenia spectrum disorders: relationship to real-world functioning. Schizophrenia Research: Cognition, 20, 1-6, 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: Schizophrenia Research: Cognition, E-ISSN 2215-0013, Vol. 20, p. 1-6, 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.

Place, publisher, year, edition, pages
Elsevier, 2020
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
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-77586 (URN)10.1016/j.scog.2020.100172 (DOI)000658476500005 ()2-s2.0-85079287095 (Scopus ID)
Available from: 2020-04-24 Created: 2020-04-24 Last updated: 2021-11-29Bibliographically 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., van Dijk-Hard, I. & 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(2), 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, no 2, 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: 2020-06-25Bibliographically approved
Olsson-Tall, M., Hjärthag, F., Marklund, B., Kylén, S., Carlström, E. & Helldin, L. (2019). The Impact of Repeated Assessments by Patients and Professionals: A 4-Year Follow-Up of a Population With Schizophrenia. Journal of the American Psychiatric Nurses Association, 25(3), 189-199
Open this publication in new window or tab >>The Impact of Repeated Assessments by Patients and Professionals: A 4-Year Follow-Up of a Population With Schizophrenia
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2019 (English)In: Journal of the American Psychiatric Nurses Association, ISSN 1078-3903, E-ISSN 1532-5725, Vol. 25, no 3, p. 189-199Article in journal (Refereed) Published
Abstract [en]

The needs of people with schizophrenia are great, and having extensive knowledge of this patient group is crucial for providing the right support. The aim of this study was to investigate, over 4 years, the importance of repeated assessments by patients with schizophrenia and by professionals. Data were collected from evidence-based assessment scales, interviews, and visual self-assessment scales. The data processing used descriptive statistics, correlation and regression analyses. The results showed that the relationships between several of the patients’ self-rating assessments were stronger at the 4-year follow-up than at baseline. In parallel, the concordance rate between patient assessments and case manager assessments increased. The conclusions drawn are that through repeated assessments the patients’ ability to assess their own situation improved over time and that case managers became better at understanding their patients’ situation. This, in turn, provides a safer basis for assessments and further treatment interventions, which may lead to more patients achieving remission, which can lead to less risk for hospitalization and too early death.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
case manager, patient, remission, repeated assessment, schizophrenia
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-68064 (URN)10.1177/1078390318777785 (DOI)000469395200006 ()2-s2.0-85048037656 (Scopus ID)
Available from: 2018-06-26 Created: 2018-06-26 Last updated: 2019-06-13Bibliographically approved
Moradi, H., Harvey, P. D. & Helldin, L. (2018). Correlates of risk factors for reduced life expectancy in schizophrenia: Is it possible to develop a predictor profile?. Schizophrenia Research, 201, 388-392
Open this publication in new window or tab >>Correlates of risk factors for reduced life expectancy in schizophrenia: Is it possible to develop a predictor profile?
2018 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 201, p. 388-392Article in journal (Refereed) Published
Abstract [en]

Patients with schizophrenia have significantly greater mortality rates than the general population, with an estimated reduced lifespan of 10–20 years. We previously reported on a link between impairment in cognition and premature death in a prospective 20-year study. Patients who had died prematurely showed neurocognitive impairment in nine different cognitive tests compared to those who did not. Based on those findings, in this study the surviving patients in the cohort were divided into three different groups based on neurocognitive impairment and compared on symptom severity including remission status, RAND-36, weight and BMI at onset of illness and baseline of the study, and medical/physical symptomatology (i.e., blood pressure, symptom awareness, vertigo and orthostatic symptoms). Differences were most prominent between the cognitively unimpaired and severely cognitively impaired (SCI) groups, with remission, negative symptoms, general symptoms and PANSS total scores differing. For SF-36 (RAND) Physical functioning and Role limitations due to physical health subscales the SCI were worst. The findings indicate that greater impairments in cognitive ability during the illness are associated with several potential indicators of risk for early mortality. Together these factors may be of guidance for establishing an algorithm to detect patients at risk of premature death early in their illness.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Early detection of risk factors, Premature death, Schizophrenia
National Category
Psychiatry Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-67663 (URN)10.1016/j.schres.2018.05.035 (DOI)000450604800057 ()2-s2.0-85047622004 (Scopus ID)
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2019-03-20Bibliographically 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
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