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  • 1.
    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)
  • 2.
    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)
  • 3.
    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.

  • 4.
    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)
  • 5.
    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.

  • 6.
    Johansson, Madeleine
    et al.
    NU Hlth Care Hosp, Trollhattan, Sweden..
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU Hlth Care Hosp, Trollhattan, Sweden.
    Iris, van Dijk-Hard
    NU Hosp Grp, Liverpool, Merseyside, England..
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU Hlth Care Hosp, Trollhattan, Sweden.
    Overestimating Functioning and Long-term Symptomatic Remission Pattern - How Is It Associated?2019In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 45, p. S300-S300Article in journal (Other academic)
  • 7. 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.

  • 8.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Functional Capacity as a Predictor of Everyday Functioning in Patients with Schizophrenia2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

  • 9.
    Olsson, Anna-Karin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Department of Psychiatry, NU-Hospital Group, Trollhättan, 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). Department of Psychiatry, NU-Hospital Group, Trollhättan, Sweden.
    Overestimated function in patients with schizophrenia: A possible risk factor for inadequate support?2019In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 206, p. 194-199Article in journal (Refereed)
    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.

  • 10.
    Olsson, Anna-Karin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU-sjukvården, Trollhättan.
    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). 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.

  • 11.
    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)
  • 12.
    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)
  • 13.
    Vikstrom, Pernilla
    et al.
    Lunds universitet.
    Bjorkman, Anders
    Lunds universitet.
    Carlsson, Ingela K.
    Lunds universitet.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). NU Hlth Care, Dept Psychiat, Trollhattan.
    Rosen, Birgitta
    Lunds universitet.
    Atypical sensory processing pattern following median or ulnar nerve injury: a case-control study2018In: BMC Neurology, ISSN 1471-2377, E-ISSN 1471-2377, Vol. 18, article id 146Article in journal (Refereed)
    Abstract [en]

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

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