Hans Arinell

Adolescent Depression: Social Network and Family Climate—A Case-control Study

In a study of a total high-school population, 2300 students aged 16-17 years were screened for depression (BDI, CES-DC). Those with a self-evaluation indicating depression, together with controls matched for sex, age, and class were interviewed (DICA-R-A). The 177 pairs, where both individuals were interviewed and the control had no lifetime diagnosis of depression, were analysed in the form of paired differences for psychosocial factors and compared within diagnostic groups. The psychosocial factors were measured with the ISSI subscales and six attitude questions about family climate (KSP). Adolescents with an episode of major depression during part of the last year did not differ from their controls. Those with long-lasting depressive symptoms, i.e. dysthymia with or without episodes of major depression, had a more limited social interaction and were not satisfied with it. They also evaluated their family climate and attachment network as being more inadequate than did their controls. Depressed adolescents with comorbid conduct disorder had a more negative evaluation of availability and adequacy of both social interaction and attachment network than their controls. This group had a very negative view of their family climate. Since this is a case-control study conclusions cannot be drawn about cause and effect.

Psychometric properties of Eating Disorder Inventory for children (EDI-C) in Swedish girls with and without a known eating disorder

Objective: To evaluate the Swedish version of the Eating Disorder Inventory (EDI-C) for the internal consistency, factor structure and ability to discriminate between adolescent girls with and without a known eating disorder (ED). Methods: Completely answered EDI-C questionnaires were available from 201 girls diagnosed with an ED and from 2073 schoolgirls. The girls were adolescents attending grade 7–12. Results: Internal consistency was 0.70–0.91 for the ED group. Eleven factors with eigenvalue >2.2 explained 56% of the variance and showed satisfying correspondence to the proposed constructs of EDI-C. A discriminant analysis classified 85.6% of the cases correctly. The three most important discriminating subscales were Drive for Thinness, Asceticism and Body Dissatisfaction. All subscales except Maturity Fears showed significantly higher mean values for the ED group. Conclusions: The results indicate that the psychometric properties of EDI-C are comparable to the properties of EDI-2. EDI-C should be preferred for adolescents since its statements suit this age group.

Six years after the wave. Trajectories of posttraumatic stress following a natural disaster

BACKGROUND The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure. METHODS Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (n=2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group. RESULTS Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors. CONCLUSIONS These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors.

Adolescent depression and stressful life events: A case-control study within diagnostic subgroups

Life events in depressed adolescents were studied in a case-control design. A total population of 16- to 17-year-old students in the 1st year of high school were screened for depression (n=2300). Every student with indication of depression and one control matched for sex, age, and grade in school was interviewed diagnostically (DICA-R-A). All participating matched pairs in whom the control had no lifetime depressive disorder were used for analysis of life events (177 pairs). They were divided into six subgroups on the basis of depressive and conduct disorders. Depressed and control adolescents were compared with regard to 21 events and conditions of stressful character. Events for total life were studied. Adolescents with depressive disorder had experienced more stressful events and conditions in life than healthy controls. The most characteristic events concerned the important relations to family and friends. The subgroup with comorbid conduct disorder was the most burdened and had much more illness, con...

The Drinking Motives Questionnaire among Swedish psychiatric patients: an exploration of the four-factor structure

INTRODUCTION AND AIMS Alcohol use above hazardous limits is common among persons with psychiatric disorders, and there is limited knowledge about motives for drinking. The objective of this study was to explore the adequacy of the four-factor structure of drinking motives in an adult psychiatric outpatient population in Sweden by confirming the factor structure in the Drinking Motives Questionnaire (DMQ-R) and in alternative models. DESIGN AND METHODS In total, 371 patients responded to the DMQ-R along with the Alcohol Use Disorders Identification Test (AUDIT). AUDIT was used to assess frequency of alcohol consumption, number of drinks consumed on a typical occasion and binge drinking frequency. Confirmatory factor analysis was used to examine the construct validity of the DMQ-R and alternative models, including the short form, DMQ-R SF. RESULTS Fit statistics suggested that the original four-factor model had questionable fit (root mean square error of approximation [RMSEA] = 0.10, comparative fit index [CFI] = 0.89, standardised root mean square residual [SRMR] = 0.08). The model with the best fit indices was the DMQ-R SF (RMSEA = 0.07, CFI = 0.97, SRMR = 0.04). When using DMQ-R SF in further analyses enhancement, the most strongly endorsed motives were related to quantity and AUDIT sum score. Coping motives were most strongly related to AUDIT sum score, frequency and binge drinking. Social motives were only related to binge drinking, whereas conformity motives were not statistically associated with any motives. DISCUSSION AND CONCLUSIONS The study implies that the 12-item short form, DMQ-R SF, could be more appropriate than the original DMQ-R in this group. [Öster C, Arinell H, Nehlin C. The Drinking Motives Questionnaire among Swedish psychiatric patients: An exploration of the four-factor structure. Drug Alcohol Rev 2017;36:400-407].

Anthroposophic lifestyle and salivary cortisol are associated with a lower risk of sensitization during childhood

Infants from anthroposophic families have low cortisol levels and low risk of IgE‐sensitization during first 2 years of life. Our aim was to study the impact of an anthroposophic lifestyle and cortisol levels at 6 months on allergy sensitization up to age 5 years.

Alcohol Habits and Health Care Use in Patients with Psychiatric Disorders

ABSTRACT Objective: It is common for persons with psychiatric disorders to also have alcohol problems. Studies in the general population as well as in clinical samples have found hazardous or harmful alcohol habits to be particularly prevalent in the presence of psychiatric disorders. This study sought to explore the relationships between drinking habits and health care utilization (psychiatric as well as general medical) in persons seeking psychiatric treatment and to investigate the associations among age, sex, and type or number of diagnoses and health care use and costs. For the planning of targeted interventions, we also sought to identify subgroups with a high prevalence of hazardous drinking habits. Methods: From a psychiatric clinic for affective disorders at a university hospital in Sweden, patients who had been screened for hazardous drinking (N = 609) were selected. Patients with primary psychosis or substance use disorder receive treatment at other clinics and did not participate. Medical records data were grouped and compared. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) was used for diagnoses and the Alcohol Use Disorders Identification Test for screening. Patients were grouped by drinking habits and sex, age, and diagnosis group, and their psychiatric as well as general medical health care use was compared. Results: Abstainers used psychiatric care more than all other drinking groups (p < .001). Psychiatric health care costs were higher in abstainers and low-risk drinkers (1.64 to 1). No differences in general medical care could be identified between drinking groups. Specific subgroups with higher rates of hazardous drinking could not be identified (44% of all males and 34% of all females reported such habits). Inconclusive results from previous research are most likely due to different methods used to classify drinking problems. Conclusions: Abstainers and low-risk drinkers used psychiatric health care to a higher cost than the other drinking groups. Possible explanations are discussed from a clinical and scientific perspective. This study clarifies the need for uniform measures when classifying alcohol use in studies of relationships between alcohol use and health care use. There is also a need to separate former drinkers from abstainers in future studies.