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  • 1.
    Anclair, Malin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hiltunen, Arto
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Cognitive behavioural therapy and mindfulness for health-related quality of life: Comparing treatments for parents of children with chronic conditions: A pilot feasibility study2017In: Clinical Practice and Epidemiology in Mental Health, ISSN 1745-0179, E-ISSN 1745-0179, Vol. 13, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Background: Research on parents of children with chronic conditions has shown that this parent group frequently suffers from psychological problems such as deteriorating life quality and stress-related disorders. Objective: The present feasibility study focuses on Health-Related Quality of Life (HRQOL) and life satisfaction of parents of children with chronic conditions. Method: The study was conducted using a repeated measures design and applied either group-based cognitive behavioural therapy (CBT; n = 10) or a group-based mindfulness programme (MF; n = 9). The study participants were wait-listed for six months. Results:The results indicate improvements for participants in both treatment groups regarding certain areas of HRQOL and life satisfaction. After eight group therapy sessions, parents in the two treatment groups significantly improved their Mental Component Summary (MCS) scores as well as their scores on the mental subscales Vitality, Social functioning, Role emotional and Mental health. In addition, some of the physical subscales, Role physical, Bodily pain and General health, showed considerable improvement for the MF group. When testing for clinical significance by comparing the samples with mean values of a norm population, the MCS scores were significantly lower at pre-measurements, but no significant differences were observed post-measurement. For the Physical component summary (PCS) scores, a significantly higher score was observed at post-measurement when compared to the norm population. Moreover, the results indicate improvement in life satisfaction regarding Spare time, Relation to child and Relation to partner. Conclusion: The study concludes that CBT and mindfulness may have a positive effect on areas of HRQOL and life satisfaction.

  • 2.
    Broberg, Anders
    et al.
    Psykologiska institutionen, Göteborgs universitet.
    Almqvist, Kjerstin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Appell, Petra
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Axberg, Ulf
    Psykologiska institutionen, Göteborgs universitet.
    Cater, Åsa
    Institutionen för juridik, psykologi och socialt arbete, Örebro universitet.
    Draxler, Helena
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Eriksson, Maria
    Akademin för hälsa, vård och välfärd, Mälardalens högskola.
    Grip, Karin
    Psykologiska institutionen, Göteborgs universitet.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hultmann, Ole
    Psykologiska institutionen, Göteborgs universitet.
    Iversen, Clara
    Sociologiska institutionen, Uppsala universitet.
    Röbäck de Souza, Karin
    Institutionen för socialt arbete, Göteborgs universitet.
    Utveckling av bedömningsinstrument och stödinsatser för våldsutsatta barn2015Report (Other academic)
  • 3.
    Bäccman, Charlotte
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    ME01: Beskrivning och uppföljning av deltagarnas psykologiska status före, under och efter insatsen2012Report (Other academic)
  • 4.
    Bäccman, Charlotte
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Standardiserade beskrivningar för nya psykologiska urvalsinstrument: Separata beskrivningar för antagningsprövningen (AP) och den grundläggande militära utbildningen (GMU)2012Report (Other academic)
  • 5.
    Bäccman, Charlotte
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Almqvist, Kjerstin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Improved resiliency and well-being among military personnel in a Swedish Naval Force after a counter-piracy operation off the coast of Somalia2016In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 57, no 4, p. 350-358Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore: (1) how the psychological health of the members of the first European Union Naval Force (ME01) was affected by international deployment off the coast of Somalia; and (2) if and how organizational and personal factors (e.g., type of personnel category, previous experiences, and resilience) affected their psychological health and well-being post-deployment. The study had an exploratory longitudinal design, where the participants were assessed both before and after deployment (i.e., T1 and T2). The participants (n=129, 120 men, 9 women) were equally distributed between officers (n=68; 64 men, 4 women) and sailors (n=61; 56 men, 5 women). The members' average age was 31years, ranging from 20 to 61. For the majority (78%) ME01 was their first international deployment and officers were, in general, more experienced than sailors. The overall results showed that the members' reported a positive experience with improved resilience and well-being (e.g., sense of coherence). However, the result also showed that type of personnel category (i.e., officer or sailor) affected their psychological health. Why and how these differences among military personnel arise is discussed, but deserves further attention.

  • 6. Harvey, P. D.
    et al.
    Helldin, L.
    Olsson, A-K.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Patterson, T. L.
    Functional Capacity and Functional Disability in Schizophrenia: A Cross-National Study in New York and Sweden2008Conference paper (Refereed)
    Abstract [en]

    Background: Functional disability is a central feature of schizophrenia and has been reported to occur across different countries and systems of care. Recent advances in the assessment of disability have separeted the measuremet of functional capacity: the ability to perform skills required for everyday functioning from the measurement of real-world functional outcomes. This presentation reports on a cross-national study of the correlation between functional capacity measured with the UCSD Performance-based Skills Assessment, Brief version (UPSA-B), casemanager ratings of patient everyday functioning with the Specific Levels Of Functioning (SLOF), and occurrence of real-world functional milestones, including independent living, employment, and marital status. Patients with schizophrenia who lived in an urban American setting and a generally rural region in Sweden were compared on their functional capacity performance and real-world outcomes. Metods:Samples of schizophrenia patients in Sweden (n=146) and New York (n=244) performed the UPSA-B and a neuropsychological assessment and were rated by their case managers. Information from archival records and case managers was used to determine the occurence of the different real world outcomes, including living independently and having ever experienced a stable romantic relationship.Results: Performance on the UPSA-B was essentially identical in the two patient samples, with a total raw score in the New York sample 13.8 and the score in the Swedish sample 13.8. Scores on the case manager ratings of everyday activities were also strikingly similar (New York:49; Sweden:49). Further, the correlation between UPSA-B scores and ratings of everyday activities were quite similar, New York: r=.36 Sweden: r=.27 as were the correlations between NP performance and UPSA-B scores, New York: r=.58; Sweden: r=.55. Also, the proportion of cases who had never been married or had a close relationship was 59% in New York and 64% in Sweden. In notable contrast, 80% of the Swedish patients and 46% of the New York patients were living independently.Implications: Performance-based measures of functional capacity were very similar across samples of people with schizophrenia in very different living environments. These results are consistent with previous studies showing that performance-based measures of cognition are also quite similar across different countries in people with schizophrenia. While measures of functional ability and case manager estimates of patients' real-world outcomes were very similar in level of impairment and correlational structure, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to very divergent outcomes in individuals who have evidence of the same levels of ability and potential.

  • 7. Harvey, P.D
    et al.
    Helldin, L
    Bowie, C.R
    Heaton, R.K
    Olsson, A-K
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Patterson, T.L
    Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden2009In: American Journal of Psychiatry, ISSN 0002-953X, E-ISSN 1535-7228, no 166, p. 821-827Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Recent advances in the assessment of disability in schizophrenia have separated the measurement of functional capacity from real-world functional outcomes. The authors examined the similarity of performance-based assessments of everyday functioning, real-world disability, and achievement of milestones in people with schizophrenia in the United States and Sweden. METHOD: The UCSD Performance-Based Skills Assessment-Brief Version (UPSA-B) and a neuropsychological assessment were administered to schizophrenia patients living in rural areas in Sweden (N=146) and in the New York City area (N=244), and patients' functioning was rated by their case managers. Information from records and case managers was used to determine the frequency of living independently, working, and having ever experienced a stable romantic relationship. RESULTS: Performance on the UPSA-B was essentially identical in the two samples (New York, mean score=13.84; Sweden, mean score=13.30), as were scores on the case manager ratings of everyday activities (New York, mean=49.0; Sweden, mean=48.8). The correlations between UPSA-B score, neuropsychological test performance, and case manager ratings did not differ across the two samples. The proportion of patients who had never had a close relationship and the rate of vocational disability were also nearly identical. However, while 80% of the Swedish patients were living independently, only 46% of the New York patients were. CONCLUSIONS: While scores on performance-based measures of everyday living skills were similar in people with schizophrenia across cultures, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to divergent real-world outcomes among individuals who show evidence of the same levels of ability and potential.

  • 8.
    Hawar, Moradi
    et al.
    Karlstad University.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU Health Care Hospital, Karlstad University.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Johansson, Madeleine
    NU Health Care Hospital.
    Olsson-Tall, Maivor
    NU Health Care Hospitaly.
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU Health Care Hospital.
    Traditional Risk Factors Not Enough To Explain The Short Lifetime Expectancy In Patients With Schizophrenia2018In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 44, p. S159-S159Article in journal (Refereed)
  • 9. Helldin, L
    et al.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Karilampi, U
    Olsson, A-K
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Increase of symptom remission in psychosis: Integrating science and service in the Swedish CLIPS study2009Conference paper (Refereed)
    Abstract [en]

    The Clinical Long term Investigation of Psychosis in Sweden (CLIPS), is a naturalistic longitudinal study, in which about 300 patients diagnosed with schizophrenia, schizoaffective disorder or delusional disorder are evaluated regularly. Besides being a guideline for treatment, the evaluations are also used for scientific research after informed consent, hence combining regular health service with science in a concrete way. As a likely consequence of the annual structured assessments, the percentage of patients in remission has raised from 35 % to about 50 % in the last three years. Several scientific articles have been published on several psychosis related topics within the frame of the CLIPS study, proving that science can be successfully integrated with clinical practise for better evidence based health care, including a higher percentage of patients in remission

  • 10. Helldin, L
    et al.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Löthgren, M
    Hjortsberg, C
    Costs for Schizopsychotic Patients in Sweden2009Conference paper (Refereed)
    Abstract [en]

    199 patients in Western Sweden with chronic psychotic illness are studied. The aim is to provide up-to-date costs for a defined patient population with schizopsychotic disorders in Sweden. Patients have the diagnoses of schizophrenia, schizoaffective disorder or delusional disorders. We identify the actual clinical management of illness and explain cost variability. Costs are combined with information on outcomes and severity of the disorder.Total costs per patient-year amount to 62.320 Euro. Direct costs correspond to 41% and indirect costs to 59% of total costs. Inpatient and outpatient care corresponds to 7% each of total costs, while costs for special housing and assistance at home is estimated to 22% of total costs. Medication only corresponds to 3% of total costs.We conclude that costs differ between patients depending on illness severity. Also a reallocation has taken place during the last 15 years between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home. The main cost driver is indirect costs due to decreased working ability and premature death. Special housing and home-assistance is the second largest cost item. In-patient care corresponds to 7% of total costs, which 15 years ago amounted to 50% of total costs. This reflects the change in care of schizopsychotic patients. Instead of treating patients at institutions, patients are now to a large extent living in their own housing but often receiving some kind of assistance at home provided by the local municipality.

  • 11. Helldin, L.
    et al.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Are there any cognitive differences between patients with schizophrenia, schizoaffective disorder and delusional disorder?2007Conference paper (Refereed)
  • 12. Helldin, L.
    et al.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Could CGI serve as a predictor of remission?2006Conference paper (Refereed)
  • 13.
    Helldin, L.
    et al.
    NU Hlth Care, Psychiat, Trollhattan, Sweden.;Karlstad Univ, Psychol, Karlstad, Sweden..
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU Health Care, Trollhättan, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden .
    Average lifespan among schizophrenia patients is more closely linked to cognitive ability than to symptom activity2015In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 41, p. S140-S141Article in journal (Refereed)
  • 14.
    Helldin, Lars
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. NU Hlth Care, Dept Psychiat, Trollhattan, Sweden..
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. NU Hlth Care, Dept Psychiat, Trollhattan, Sweden..
    Harvey, Philip D.
    Univ Miami, Miller Sch Med, Dept Psychiat, Coral Gables, FL 33124 USA.;Bruce W Carter VA Med Ctr, Res Serv, Miami, FL USA..
    Cognitive performance, symptom severity, and survival among patients with schizophrenia spectrum disorder: A prospective 15-year study2015In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 169, no 1-3, p. 141-146Article in journal (Refereed)
    Abstract [en]

    Patients with schizophrenia have an average lifespan approximately 20 years shorter than the normal population. This study explored if there were any specific common characteristics among patients with schizophrenia spectrum disorder who died prematurely, compared to those who survived or died at a more normative age. The data were obtained from an ongoing twenty-year longitudinal study wherein 67 patients out of 501 participants had died at an average age of 60.5 years. Differences in baseline assessments of symptoms and cognitive ability were compared across patients who died during the time of the study and survivors. Symptom remission was assessed according to the Andreasen remission criteria as presented in 2005. Cognitive performance was assessed with a battery of instruments measuring vigilance, working memory, learning, short-term memory, and executive function. Two patients committed suicide and together they lowered the average lifespan of the study sample by only 0.27 years. The baseline assessments showed no difference in symptoms or remission status between patients who died and those who survived. This finding was in contrast to the cognitive baseline assessments where it was found that those who had died had performed more poorly in multiple domains, especially executive functioning, cognitive flexibility, learning and short-term memory. Survival analysis with Cox models showed that verbal memory and executive functioning were the most substantial independent predictors. Our study shows that although suicide was not a common cause of death, the average age of death is still young for this patient group and cannot be explained by differences in symptom severity. Our findings indicate that cognitive abilities might be of special interest for affective longevity in patients with schizophrenia, either as a marker of special risk or as a target for direct intervention. (C) 2015 Elsevier B.V. All rights reserved.

  • 15.
    Helldin, Lars
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Kane, John M.
    The Zucker Hillside Hospital and the Albert Einstein College of Medicine.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    The importance of cross-sectional remission in schizophrenia for long-term outcome: A clinical prospective study2009In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 115, no 1, p. 67-73Article in journal (Refereed)
  • 16.
    Helldin, Lars
    et al.
    Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden .
    Olsson, Anna-Karin
    Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden .
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden .
    Average life-time among schizophrenia patients is closer linked to cognitive ability than to symptom activity.2015Conference paper (Refereed)
  • 17.
    Helldin, Lars
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU Health Care, Trollhättan, Sweden.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU Health Care, Trollhättan, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Schizophrenia and Short Lifetime Expectancy: The Importance of Identifying Risk Factors Early in the Illness.2016Conference paper (Refereed)
  • 18. Hjortsberg, C
    et al.
    Helldin, L
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Löthgren, M
    Direct and indirect costs for psychotic illness in Sweden2010Report (Refereed)
    Abstract [en]

    In this study the direct and indirect costs for a defined patient population with psychotic illness in Sweden was estimated. The cost analyses are based on data from the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which was an ongoing, single-centre, epidemiological study at the time of this study. A bottom-up costing approach was used to estimate the total costs for schizophrenia, schizoaffective and delusional disorders in Sweden for 2007. Resource use were captured for the patients during one year. 199 patients with a mean age of 51 (63% men) were followed for 12 months. They had a mean (median) of 6.4 (0) inpatient-days, 1.4 (1.2) physician visits, 18.6 (8.4) nurse visits, 1.2 (0) counsellor visits and 6.3 (1.2) visits to other staff including tests and diagnostic procedures per patient- year. The mean cost in our study amounted to 578,000 per patient year which translates to an estimated cost of illness of 16.8 billion SEK for Sweden. Schizophrenia and related disorders significantly interferes with professional activities and as a result, the total burden on society is great. A reallocation has taken place the last 15 years, between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home.

  • 19.
    Hjortsberg, Catharina
    et al.
    Swedish Inst Hlth Econ, IHE, SE-22002 Lund, Sweden.
    Helldin, Lars
    NU Hlth Care, Trollhattan, Sweden.;Karlstad Univ, Karlstad, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology. NU Hlth Care, Trollhattan, Sweden.
    Löthgren, M
    Janssen Cilag, Stockholm, Sweden.
    Costs for patients with psychotic illness: differences depending upon state of remission2011In: The Journal of Mental Health Policy and Economics, ISSN 1091-4358, Vol. 14, no 2, p. 87-93Article in journal (Refereed)
    Abstract [en]

    Psychotic illnesses have a substantial economic burden on patients, family members, friends, and society in general, still there have been limited attempts to estimate the costs associated with this condition. Moreover, nothing is known about the differences in costs between patients depending on disease severity, i.e. state of remission.

    AIM:

    Estimate the direct and indirect costs for a defined patient population with psychotic illness in Sweden, and demonstrate differences in direct costs depending on disease severity (state of remission).

    MATERIALS AND METHODS:

    The cost analyses are based on data from the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which is an ongoing, single-centre, epidemiological study. Resource use and disease severity were captured for the patients during one year, 2007. Total costs per patients are estimated and cost differences between patients, depending on state of remission, are considered.

    RESULTS:

    199 patients with a mean age of 51 (63% men) were followed for 12 months. They had a mean of 6.4 inpatient-days, 1.4 physician visits, 18.6 nurse visits, 1.2 counsellor visits and 6.3 visits to other staff including tests and diagnostic procedures per patient- year. The mean total cost (direct and indirect) amounted to 62,500 per patient and year. Patients in steady state of remission had lower direct costs compared to other patients. Moreover, the size of the various cost items differed between patients' depending on state of remission. Patients in steady remission had almost no inpatient costs.

    DISCUSSION:

    For a comprehensive assessment of treatment of psychotic illnesses it is necessary to provide evidence of the costs related to disease severity. We find that patients suffering from psychotic illness have varying costs depending on their disease severity, and this study indicates that if patients can be kept in remission direct costs will decrease. We can also confirm that reallocation has taken place the last 15 years, between different cost items, from in-patient care at hospitals to out-patient care and assistance at home.

    LIMITATIONS:

    Information about informal care was collected from patients and not from informal carers themselves.

    IMPLICATIONS FOR HEALTH CARE PROVISION AND USE:

    Costs have been reallocated from in-patient care to costs for assistance at home, which is a reflection of the change in care of patients with mental problems that has taken place during the last 15 years. Patients in steady remission have lower costs compared to patients in steady non-remission or patients switching between the two states. A better surveillance of the disorder would lead to lower direct, as well as indirect, costs.

  • 20.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Assessing Family Burden of Psychotic Illness in Clinical Practice2009Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The purpose of this thesis was twofold. One purpose was to create a user-friendly instrument to be used in regular clinical practice to collect information regarding family burden of psychotic illness. The second purpose was to study how family burden could be linked to the patients’ level of functioning, the patients’ cognition and the patients’ own experience of their illness.    

    Two studies were conducted. In the first study (Paper I) the instrument Burden Inventory for Relatives to persons with Psychotic disturbances (BIRP) was created. This instrument contained ten statements and showed good psychometrical properties for those dimensions that were investigated. The instrument measures three dimensions of experienced family burden: practical burden, emotional burden, and the relatives’ own health. In the second study (Paper II) the second part of this thesis purpose was investigated. Results showed that increased family burden could be tied to the patients’ impaired functioning as well as to the patients’ higher self ratings regarding distress. The cognitive connection to family burden is not totally clear though, and should be further investigated. A theoretical model which explains the experienced family burden of psychotic illness is also presented within this thesis.

    The conclusions of this thesis are that BIRP is a useful instrument in regular clinical practise for measuring experienced family burden, and that the patients’ level of functioning and the patients’ own experience of their illness were correlated to the family burden experienced.

  • 21.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    BUP Värmland: en utvärdering av hur personalen uppfattar effekterna av omorganisation och förstärkning av vårdgarantin2012Report (Other academic)
    Abstract [sv]

    Denna rapport redovisar resultatet av en utvärdering som har gjorts om hur personalen vid BUP Värmland uppfattar effekterna av en omorganisation och förstärkningen av vårdgarantin för de olika patientgrupperna. FoU Välfärd Värmland, Karlstads universitet, fick uppdraget av BUP Värmland, Landstinget i Värmland, att under hösten 2011 genomföra utvärderingen vilket gjordes genom en enkätstudie vänd till samtlig personal vid BUP Värmland. 

    Utifrån den höga svarsfrekvensen och utförligheten i svaren, kan det konstateras att personalen vid BUP Värmland är mycket engagerad och mån om att verksamheten skall hålla en hög kvalitet. Organisationens struktur i sig är de flesta svarande nöjda med, men ett stort problem som många beskriver är att mängden patienter upplevs som oproportionerlig i förhållande till befintliga resurser inom BUP Värmland. Detta påverkar också möjligheterna att klara av den förstärkta vårdgarantin som har högprioriterats, enligt de flesta svarande på bekostnad av mer långsiktiga kvalitetsparametrar inom vården. Exempelvis uppges den tydlighet i nya organisationens flöde som var tänkt för patienter med neuropsykiatrisk problematik ha påverkats negativt av en högprioriterad vårdgaranti utifrån de begränsade resurser som finns. Organisationens delar inom BUP Värmland som utgörs av fyra olika enheter, upplevs också av flera i personalen som alltför åtskilda sinsemellan. Personalen är mån om bibehållandet av nuvarande kompetens genom fortbildning och handledning samt rekrytering av ny kompetens för att ännu bättre kunna möta aktuella och framtida vårdbehov.

  • 22.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Screening Family Burden in Clinical Practice: The development of a new instrument and investigation of its correlates to psychotic disorders2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The primary purpose of this thesis is to develop a short and user-friendly instrument for the assessment of family burden caused by psychotic disorders. A secondary purpose is to further investigate variables that might be linked to an increased burden. Of these variables, patients’ reduced functioning will be addressed in more detail. As a final purpose, ratings of disorder-related variables carried out by staff will be compared to similar ratings carried out by relatives. These different purposes are investigated in five studies.

    In the first study (Paper I) the instrument Burden Inventory for Relatives to persons with Psychotic disturbances (BIRP) is created. This new screening instrument contains ten statements and shows good psychometrical properties for those dimensions that are investigated. In the second study (Paper II) results show that increased family burden can be tied to patients’ impaired functioning as well as to patients’ higher self ratings regarding distress. In the third study (Paper III) different parts of patients’ observable behavioral functioning are investigated and results show that most functional dimensions correlate with family burden. Also staff ratings of function are compared with relatives’ ratings and despite similar patterns in ratings there are differences. In the fourth study (Paper IV) demographic variables are studied and results show that only higher age and fewer contact hours correlate significantly with lower burden.  Also, the BIRP instrument shows good stability. In the fifth study (Paper V) correlations with family burden are generally stronger for relatives’ own ratings of illness activity as compared to symptom ratings made by staff. Relatives’ ratings of illness activity do not correlate significantly with staff symptom ratings on all instruments used.

    The conclusions of this thesis are that the new screening instrument BIRP can be considered a good instrument to use in regular clinical practice in order to measure relatives’ burden in connection to psychotic disorders. Also, the thesis contributes with knowledge about what in the psychotic disorder and which demographic factors might be linked to an increase of family burden. Findings also indicate that it matters who does the rating of a disorder-related variable. Furthermore, in this thesis a theoretical framework for family burden is presented.

     

  • 23.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, L.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Are there different attitudes to medication for patients with psychosis, considering their antipsychotic medication and cross sectional remission status?2008Conference paper (Refereed)
    Abstract [en]

    As part of the Clinical Long term Investigation of Psychosis in Sweden (CLIPS), 159 outpatients were investigated regarding their present antipsychotic treatment, symptom severity and their attitude to medication with the DAI-10. The attitude to medication was more positive in the group with less symptom severity, while there were no differences in attitudes between patients treated with clozapine, olanzapine or risperidone

  • 24.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, L.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    How is family burden correlated to the patients´ symptoms, function, quality of life and attitude to medication?2008Conference paper (Refereed)
  • 25.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, L.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    How is family burden correlated to the patients' symptoms, function, quality of life and attitude to medication?2008In: European Neuropsychopharmacology, Vol. 18, no 4, p. 468-Article in journal (Refereed)
    Abstract [en]

    Earlier research has concluded that symptom severity is an important factor for explaining family burden related to psychotic illness. Some studies also point out the impaired function of the ill person as a contributing factor to the burden. However, there are few investigations that also considerate the ill persons own view of his/her quality of life and attitude to medication. This study investigates how persons with psychosis symptom severity, functional disability, quality of life and attitude to medication, could be correlated to family burden.

  • 26.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, L.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Illness activity of medical history: what is most important for family burden in schizophrenia? The impact of remission2007Conference paper (Refereed)
  • 27.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, L.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Illness activity or medical history: what is most important for family burden in schizophrenia? The impact of remission2007In: European Neuropsychopharmacology, Vol. 17, p. 498-Article in journal (Refereed)
  • 28.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, L.
    Olsson, A-K.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Function in patients with psychosis measured by UPSA-B in relation to their cross sectional remission status2008Conference paper (Refereed)
    Abstract [en]

    This study investigates how cross sectional remission and functional performance in psychotic outpatients are linked together. Even though there are some differences between the remission groups there are also substantial overlaps between the groups, proving that functional performance and symptom severity are two separate dimensions

  • 29.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, Lars
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Karilampi, Ulla
    Department of Psychology, Göteborg University.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Illness Related Components for the Family Burden of Relatives to Patients with Psychotic Illness2010In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 45, no 2, p. 275-283Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has shown that symptom severity often implies an increased family burden. Few other illness related variables have, however, been investigated in this context. This study investigates how family burden is affected by symptom, function, and cognition, as well as how the patient perceives his/her illness and quality of life. Method: A total of 99 relatives, to as many patients diagnosed with psychosis and with their illness at a stable level, participated in this study. The relatives estimated their perceived burden, the patients rated the distress caused by their illness as well as the quality of their lives, and the care staff rated the patients’ symptom and function as well as tested their cognitive abilities. Results: Increased family burden can be tied to the patients’ increased symptom severity, to their impaired functioning as well as to the patients’ higher self ratings regarding distress. The family burden is also connected to the patient’s reduced working memory and reduced executive functioning, but this connection is not totally clear and should be further investigated. Of the variables that the patients were rated on, it was the overall functional ability measured with GAF that had the single most impact on perceived family burden. Conclusions: To control illness related variables such as symptoms, impaired functioning, impaired working memory and executive functioning, as well as the patients’ own experiences of distress, is important in order to lessen the burden for the relatives. All aspects of family burden are, however, not explained by these factors, which is why further research within this realm is required.

  • 30.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, Lars
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Family burden and demographic correlates in a naturalistic Swedish test-retest setting following relatives to persons with psychotic disorders2011Manuscript (preprint) (Other academic)
  • 31.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, Lars
    Karlstad University, Faculty of Economic Sciences, Communication and IT.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Psychometric Properties of the Burden Inventory for Relatives of Persons with Psychotic Disturbances2008In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 103, p. 58p. 323-335Article in journal (Refereed)
    Abstract [en]

    Earlier studies have shown that close relatives are heavily burdened when a family member has schizophrenia. The current purpose was twofold, (1) to examine the psychometric properties for a test of the burden of family members, one used in Swedish clinical practice (the Care Burden Scale for Relatives) and (2) develop a shortened version with the same or better psychometric properties. Ninety-nine close relatives, 34 men and 65 women, of the same number of patients who had been diagnosed either with schizophrenia or with schizoaffective disorder, were studied. Participants completed the Care Burden Scale for Relatives and a visual analogue scale measuring perceived global burden on which the total burden was assessed. Patients of the close relatives were assessed on clinical tests often used in the psychiatric care, in an attempt to validate the external criteria, such as severity of symptoms and level of functioning. The resulting instrument, Burden Inventory for Relatives of persons with Psychotic disturbances, showed good psychometric properties which simplifies data collection from relatives of patients with psychotic disturbances. In this study, relatives of those patients not in remission evinced a significant greater family burden.

  • 32.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, Lars
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Relatives' and staff ratings of present illness activity from psychotic disorder and their relation to perceived family burden2011Manuscript (preprint) (Other academic)
  • 33.
    Hjärthag, Fredrik
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, Lars
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology. NU Healthcare, Dept Psychiat, S-46185 Trollhattan, Sweden.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology. NU Healthcare, Dept Psychiat, S-46185 Trollhattan, Sweden.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Family burden and functional assessment in the Swedish CLIPS-study: Do staff and relatives agree on individuals with psychotic disorders' functional status?2012In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 47, no 4, p. 581-587Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    In this study, the individuals with psychotic disorders' daily life function was investigated on six dimensions considering their relations to family burden. Functional ratings carried out by relatives and staff were also compared.

    METHODS:

    Totally 88 relatives, to as many individuals diagnosed with a psychotic disorder, participated in this study. Relatives were to rate their own perceived burden and their ill relatives' physical functioning, personal care skills, interpersonal relationships, social acceptability, activities, and work skills. The outpatient staff, in all 24 case managers also rated the patients' functional level on the same assessment tool as did the relatives.

    RESULTS:

    Most dimensions of patients' everyday functioning were highly correlated to relatives' burden. The two functional dimensions "interpersonal relationships" and "activities" were best at classifying burden when rated by relatives. Also, comparing independent functional ratings by relatives and staff showed that despite great agreements on most dimensions, they differed significantly on "social acceptability" where relatives rated the function to be poorer and "activities" where relatives rated the function to be better.

    CONCLUSIONS:

    Relatives, who perceive individuals with a psychotic disorder to be limited in their ability to interpersonal relationships and limited in their ability to activate in everyday life, are more likely to perceive a higher burden. Even though staff and relatives mainly agree on the patients' functional ability, they often differ in ratings regarding patients' social acceptability and ability to activate in everyday life. This should be worth considering in clinical practice as well as in future research.

  • 34.
    Ingvarsdotter, K
    et al.
    Malmö University.
    Persson, K.
    Malmö University.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Östman, M.a
    Malmö University.
    How Professionals View Multifamily Psychoeducation: A Qualitative Study2016In: Psychiatric quarterly, ISSN 0033-2720, E-ISSN 1573-6709, Vol. 87, no 2, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Severe mental illness causes suffering for the patient as well as the patient’s immediate family. The Swedish National Board of Health and Welfare has recommended the implementation of multifamily psychoeducation in order to assist patient and family in the recovery process. The aim of this study was to determine how introducing multifamily psychoeducation in Sweden has been viewed by professionals. Semi-structured interviews were conducted with 11 service providers, who were involved in evaluating multifamily psychoeducation. Our main findings fell under the headings of defensive culture and unsuitable model. Resistance to introducing the new intervention was found on multiple levels. The model proposed was considered too rigid for both the target group and the organizations because it could not be adjusted to the needs of patients, families, or facilitators. Despite good evidence for the effectiveness of the intervention, there were difficulties introducing the multifamily psychoeducation model in clinical practice. The feasibility of an intervention needs to be evaluated before adopting it as a national guideline.

  • 35. Johansson, Madeleine
    et al.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology. Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    What could be learned from a decade with standardized remission criteria in schizophrenia spectrum disorders: An exploratory follow-up study2018In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 195, no May, p. 103-109Article in journal (Refereed)
    Abstract [en]

    A decade has passed since the standardized remission criteria of schizophrenia spectrum disorders-the Andreasen Criteria-were defined. Over 2000 studies have been published, but only a few describe symptomatic remission over time. In this prospective study we followed patients for 3 and 5 years, respectively. The aim was to investigate how different symptoms affect the occurrence of remission and how the remission cut-off level affects remission sustainability. The participants were patients diagnosed with schizophrenia spectrum disorders (DSM-IV). First, the importance of each core symptom for remission was examined using the Positive and Negative Syndrome Scale (n = 274). Second, we investigated which items affect patients to either go in and out of remission or never achieve remission (n = 154). Third, we investigated how the sustainability of remission is affected by a cut-off set to 2 (minimal) and 3 (mild) points, respectively (n = 154). All core symptoms affected the occurence of remission, to a higher or lesser extent. Delusions and Hallucinatory behavior contributed the strongest to fluctuation between remission and non-remission, while the contribution of Mannerism and posturing was very marginal. Negative symptoms were enhanced when remission was never achieved. Moreover, the study found that remission duration was significantly longer for the cut-off score 2 rather than 3. The study shows that, over time, remission criteria discriminate between being stable, unstable, or never in remission. Patients with only a minimal occurrence of symptom intensity exhibit a significantly longer remission duration compared to patients with mild symptom intensity, indicating that the treatment goal should be minimal symptom intensity.

  • 36. Karilampi, U.
    et al.
    Helldin, L.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Archer, T.
    Verbal learning in schizopsychotic outpatients and healthy volunteers as a function of cognitive performance levels2007In: Archives of Clinical Neuropsychology, 22, 161-174Article in journal (Refereed)
  • 37.
    Lugnegård, Tove
    et al.
    Sahlgrenska akademin Göteborg.
    Unenge Hallerbäck, Maria
    Sahlgrenska akademin Göteborg.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Gillberg, C
    Sahlgrenska akademin Göteborg.
    Social Cognition Impairments in Asperger Syndrome and Schizophrenia2013In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 143, p. 277-284Article in journal (Refereed)
    Abstract [en]

    Social cognition impairments are well described in both autism spectrum disorders, including Asperger syndrome (AS), and in schizophrenia spectrum disorders. However, little is known about whether there are differences between the two groups of disorders regarding this ability. The aim of this study was to compare social cognition abilities in AS and schizophrenia. Fifty-three individuals (26 men, 27 women) with a clinical diagnosis of AS, 36 (22 men, 14 women) with a clinical diagnosis of schizophrenic psychosis, and 50 non-clinical controls (19 men, 31 women) participated in the study. Clinical diagnoses were confirmed either by Structured Clinical Interview on DSM-IV diagnosis or the Diagnostic Interview for Social and Communication Disorders. Verbal ability was assessed using the Vocabulary subtest of the WAIS-III. Two social cognition instruments were used: Reading the Mind in the Eyes Test (Eyes Test) and the Animations Task. On the Eyes Test, patients with schizophrenia showed poorer results compared to non-clinical controls; however, no other group differences were seen. Both clinical groups scored significantly lower than the comparison group on the Animations Task. The AS group performed somewhat better than the schizophrenia group. Some differences were accounted for by gender effects. Implicit social cognition impairments appear to be at least as severe in schizophrenia as they are in AS. Possible gender differences have to be taken into account in future research on this topic.

  • 38. Moradi, Hawar
    et al.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Harvey, Philip
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    SU42. Physical Fitness in Association With Cognitive Performance—Possible Marker of Short Lifetime Expectancy for Patients With Schizophrenia2017In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 43, no Suppl 1, p. S176-S176Article in journal (Other academic)
    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.

  • 39.
    Nordmarker, Anki
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Perrin-Wallqvist, Renée
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Archer, Trevor
    Gothenburg University, Sweden.
    The roles of gender and personality factors in vandalism and scrawl-graffiti among Swedish adolescents.2016In: PsyCh Journal, ISSN 2046-0252, E-ISSN 2046-0260, Vol. 5, no 3, p. 180-190Article in journal (Refereed)
    Abstract [en]

    A total of 360 upper secondary school students in Sweden were divided into three grouping variables: gender (male, female), vandalism (involved, not involved), and scrawl-graffiti (involved, not involved). Relevant to the discussion of whether or not scrawl-graffiti may be construed as vandalism or art, the aim of the study was to explore whether or not personality factors known to be linked to vandalism in general (such as impulsivity, affectivity, emotional disability, and optimism) are related also to involvement in scrawl-graffiti, and, furthermore, how the gender factor relates to vandalism and scrawl-graffiti, respectively. The analysis showed that impulsiveness was a significant variable related to vandalism as well as to scrawl-graffiti. Further analysis indicated that vandalism was predicted by non-planning impulsiveness whereas scrawl-graffiti was predicted by motor impulsiveness. Analyses showed also that there were significant gender differences related to both vandalism and scrawl-graffiti, whereby male participants were significantly more involved in vandalism than female participants, while the latter were significantly more involved in scrawl-graffiti than the former.

  • 40. Olsson, A-K
    et al.
    Helldin, L
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Norlander, Torsten
    Psychometric properties of a performance-based measurement of functional capacity2012In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 197, no 3, p. 290-294Article in journal (Refereed)
    Abstract [en]

    The UCSD Performance-based Skills Assessment - Brief version (UPSA-B) describes the functions of patients without negative influences of environmental factors such as unemployment or shortage in housing. The aim of the present study is to further explore the psychometric properties of the UPSA-B as well as to ensure that the Swedish version can be used in clinical practice and for research purposes. Participants were 211 patients, 135 men and 76 women, diagnosed with schizophrenia, schizoaffective disorder, or delusional disorder. Results indicate that the UPSA-B is a reliable instrument with good psychometric properties regarding validity and reliability. The instrument also had a capacity to reveal differences between various patient groups, both diagnostic groups and groups based on remission status. The conclusion drawn is that the UPSA-B is a valuable instrument that could be used in future cross-national studies to describe the level of functioning for patients with schizophrenia and other psychotic illnesses.

  • 41.
    Olsson, Anna-Karin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. NU-sjukvården, Trollhättan.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. NU-sjukvården, Trollhättan.
    Predicting real-world functional milestones in schizophrenia2016In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 242, p. 1-6Article in journal (Refereed)
    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.

  • 42.
    Olsson, Anna-Karin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Helldin, Lars
    Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden.
    Why Don’t You Give Me a Call?: The Impact of Memory Deficits on Everyday Activities.2015Conference paper (Refereed)
  • 43.
    Olsson, Anna-Karin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Olsson-Tall, Maivor
    NU Hlth Care Hosp, Stockholm, Sweden.
    Moradi, Hawar
    NU Hlth Care Hosp, Stockholm, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Hlth Care Hosp, Stockholm, Sweden.
    Less symptoms in schizophrenia a risk factor for impaired insight of functioning?2018In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 44, p. S263-S264Article in journal (Refereed)
  • 44.
    Olsson, Maivor
    et al.
    Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Carlström, Eric
    Academy of Sahlgrenska, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Nursing, Health and Culture, UniversityWest, Trollhättan, Sweden.
    Marklund, Bertil
    Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Primary Health Care Research Development and Education Centre, Vänersborg, County Administration of West Sweden, Sweden.
    Helldin, Lars
    Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Assessment of Distress and Quality of Life: A Comparison of Self-Assessments by Outpatients with a Schizopsychotic Illness and the Clinical Judgment of Nurses2015In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 29, no 5, p. 284-289Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate how self-assessments of perceived distress and quality of life in patients with schizopsychotic illness are associated with nurse assessments of symptoms, function and life situation. Data were obtained through interviews that used evidence-based rating and visual analogue self-rating scales. Descriptive statistics, correlation and regression analyses were used to process the data. The results demonstrated that the patient self-ratings did not correlate with the nurse assessments, and the perceived distress was not affected by remission status. The findings indicate that patient self-assessments are not a sufficient basis for decisions regarding appropriate treatment interventions.

  • 45.
    Olsson-Tall, Maivor
    et al.
    Göteborgs universitet; NU-sjukvården.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Marklund, Bertil
    Göteborgs universitet; FoUU-enheten, Primärvården FyrBoDal .
    Kylén, Sven
    FoUU-enheten, Primärvården FyrBoDal; Chalmers tekniska högskola .
    Carlström, Eric
    Göteborgs universitet.
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU-sjukvården.
    The Impact of Repeated Assessments by Patients and Professionals: A 4-Year Follow-Up of a Population With Schizophrenia2018In: Journal of the American Psychiatric Nurses Association, ISSN 1078-3903, E-ISSN 1532-5725Article in journal (Refereed)
    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.

  • 46.
    Olsson-Tall, Maivor
    et al.
    NU Hlth Care Hosp, Trollhättan, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Olsson, Anna-Karin
    NU Hlth Care Hosp, Trollhättan, Sweden.
    Johansson, Madeleine
    NU Hlth Care Hosp, Trollhättan, Sweden.
    Moradi, Hawar
    NU Hlth Care Hosp, Trollhättan, Sweden.
    Helldin, Lars
    NU Hlth Care Hosp, Trollhättan, Sweden.
    Can Insight Lead To Remission - For Patients With Schizophrenia?2018In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 44, p. S265-S265Article in journal (Refereed)
  • 47.
    Persson, Karin
    et al.
    Malmö University.
    Östman, Margareta
    Malmö University.
    Ingvarsdotter, Karin
    Malmö University.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    A Mismatch of Paradigms Disrupts the Introduction of Psycho-Educative Interventions for Families of Persons with SMI: An Interview Study with Staff from Community Services2018In: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789Article in journal (Refereed)
    Abstract [en]

    Treatment and support of people diagnosed with severe mental illness in Sweden takes place in out-patient psychiatric services or municipality services. Most of the responsibility for support in daily life are provided by the close family. One crucial matter is how to support these families. This research project aimed to investigate the Swedish construction with shared responsibility between county psychiatric care and municipality social care for consumers with severe mental illness affects actions in municipalities in relation to family support. Ten representatives from five municipality settings were interviewed. Five semi-structured interviews were analysed using a thematic analysis. The following themes emerged; One overarching theme, “a mismatch of paradigms”, and sub-themes: (a) “accentuating differences”, (b) “doubts about including the entire family in the same session” and (c) “lack of a uniform family support policy”. We conclude that a shared mandate needs a dialogue between psychiatric and municipality services concerning this mismatch.

  • 48. Unenge Hallerbäck, M.
    et al.
    Lugnegård, T.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Gillberg, C.
    Reading the Mind in the Eyes: test-retest reliability of a Swedish version2008Conference paper (Refereed)
  • 49. Unenge Hallerbäck, Maria
    et al.
    Lugnegård, T
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Gillberg, C
    The Reading the Mind in the Eyes Test: Test-retest reliability of a Swedish version2009In: Cognitive Neuropsychiatry, ISSN 1354-6805, E-ISSN 1464-0619, Vol. 14, no 2, p. 127-143Article in journal (Refereed)
    Abstract [en]

    Introduction: The Reading the Mind in the Eyes Test is a widely used facial affect recognition test. The present study aimed to provide Swedish nonpatient reference values, examine test-retest reliability, and to elucidate strengths and weaknesses of the instrument.Methods: A Swedish version of the test was completed by 158 university students. Fifty-eight participants completed the test twice, 3 weeks apart. The Bland Altman method was used to examine the test-retest reliability.Results: Distribution of responses of the 158 participants is detailed and compared with the English version. The limits of agreement was +/- 4.3.Conclusions: A test score variation in the range of +/-4 (out of 24 possible) is to be expected for the same individual. When the Reading the Mind in the Eyes Test is used, one has to take into account that an obtained test score must be regarded as an approximation

  • 50.
    Widemalm, My
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    The forum as a friend: parental mental illness and communication on open Internet forums2015In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 50, no 10, p. 1601-1607Article in journal (Refereed)
    Abstract [en]

    PURPOSE:The aim of this study was to identify how daughters or sons to parents suffering from mental illness perceive their situation. The objective was to provide new knowledge based on what they communicate on open Internet forums.

    METHODS:The sample consisted of forum posts written by individuals who reported that they had mentally ill parents. Data collection comprised 301 comments from 35 forum threads on 5 different Swedish Internet forums, and predetermined inclusion criteria were used. Data were analyzed qualitatively using thematic analysis.

    RESULTS:The analysis generated four themes: "Caregiver burden," "Knowledge seeking," "Support from the forum," and "Frustration and powerlessness over health care." The results showed that parents' mental illness affected the forum writers on several levels, and they often felt stigmatized. The writers often lacked knowledge of their parents' mental illness and sought out Internet forums for information and support from peers in similar situations. The psychiatric care given to the parents was a source of dissatisfaction among the forum writers, who often felt that their parents did not receive adequate care.

    CONCLUSIONS:This study shows that fear of stigmatization and perceived lack of care and support caused forum writers to anonymously seek out Internet forums for information and support from others with similar experiences. The role of social support and the attractiveness of anonymity and availability typical for open Internet forums ought to be considered by health care professionals and researchers when developing new ways for providing support for children or adolescents with a mentally ill parent.

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