Lars Jacobsson

Development of a new inventory for assessing memories of parental rearing behaviour

A new inventory (EMBU) to assess the own memories of parental rearing behaviour was constructed. EMBU is comprised of 81 questions grouped in 15 subscales and two additional questions referring to consistency and strictness of parental rearing behaviour to be answered in a four‐step scale for the father and for the mother separately. The subscales cover such rearing practices as for example overinvolvement, affection, overprotectiveness, guilt engendering, rejection.

Perception of stigma among family members of individuals with schizophrenia and major affective disorders in rural Ethiopia.

Background: Many studies from the Western world have reported on stigmatisation of people with mental illnesses and its negative consequences, but few studies have addressed the issue in traditional rural societies. The present study aimed to estimate the extent and socio-demographic distribution of stigma as perceived by relatives of mentally ill individuals in rural Ethiopia. Method: A total of 178 relatives of individuals who were diagnosed as suffering from schizophrenia or major affective disorders in a community-based survey were interviewed using the Family Interview Schedule. Results: About 75 % of the respondents perceived that they were stigmatised or had experienced some sort of stigma due to the presence of mental illness in the family, 42 % were worried about being treated differently and 37 % wanted to conceal the fact that a relative was ill. Those from the older age group (45+) and urban residents were more likely to perceive stigma as a major problem, but otherwise differences were few between socio-demographic groups. The illness was attributed to supernatural forces by 27 % and praying was suggested as a preferred method to deal with the problem by 65 %. Conclusion: Stigma was found to be a common problem, with few differences between socio-demographic groups or between types of mental disorder. Beliefs about causes differ from those held by professionals. Popular beliefs and attitudes must be taken into account when planning for intervention.

Functional conservation of the effector protein translocators PopB/YopB and PopD/YopD of Pseudomonas aeruginosa and Yersinia pseudotuberculosis

Virulent Yersinia species cause systemic infections in rodents, and Y. pestis is highly pathogenic for humans. Pseudomonas aeruginosa, on the other hand, is an opportunistic pathogen, which normally infects only compromised individuals. Surprisingly, these pathogens both encode highly related contact‐dependent secretion systems for the targeting of toxins into eukaryotic cells. In Yersinia, YopB and YopD direct the translocation of the secreted Yop effectors across the target cell membrane. In this study, we have analysed the function of the YopB and YopD homologues, PopB and PopD, encoded by P. aeruginosa. Expression of the pcrGVHpopBD operon in defined translocation‐deficient mutants (yopB/yopD ) of Yersinia resulted in complete complementation of the cell contact‐dependent, YopE‐induced cytotoxicity of Y. pseudotuberculosis on HeLa cells. We demonstrated that the complementation fully restored the ability of Y. pseudotuberculosis to translocate the effector molecules YopE and YopH into the HeLa cells. Similar to YopB, PopB induced a lytic effect on infected erythrocytes. The lytic activity induced by PopB could be prevented if the erythrocytes were infected in the presence of sugars larger than 3 nm in diameter, indicating that PopB induced a pore of similar size compared with that induced by YopB. Our findings show that the contact‐dependent toxin‐targeting mechanisms of Y. pseudotuberculosis and P. aeruginosa are conserved at the molecular level and that the translocator proteins are functionally interchangeable. Based on these similarities, we suggest that the translocation of toxins such as ExoS, ExoT and ExoU by P. aeruginosa across the eukaryotic cell membrane occurs via a pore induced by PopB.

The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia.

A cross‐sectional survey was conducted on 10468 rural and semi‐urban adults in an Ethiopian district using the Self Reporting Questionnaire (SRQ) to detect the prevalence of mental distress and its association with socio‐demographic risk factors. Fifty‐eight per cent of the study population were women, 74% were Muslim, 79% were illiterate. Those experiencing 11 or more symptoms out of the 20 SRQ items were considered as having mental distress. Accordingly, the prevalence of mental distress was 17%, which is comparable with the previous hospital‐based studies in Ethiopia and elsewhere. However, it was higher than the previous community‐based studies in Ethiopia. Mental distress was more prevalent among women. Part of the explanation was that women in the study population were older and that they were more often widowed or divorced, which were factors associated with mental distress. Illiteracy, which was more common among women and older individuals, was also independently associated with mental distress.

Legal abortion: a painful necessity.

This study was conducted to increase knowledge about the psychosocial background and current living conditions of Swedish women seeking abortion, along with their motives for abortion and their feelings towards pregnancy and abortion. Two hundred and eleven women answered a questionnaire when they consulted the gynaecologist for the first time. The study indicates that legal abortion may be sought by women in many circumstances and is not confined to those in special risk groups. For example, most women in the sample were living in stable relationships with adequate finances. The motives behind a decision to postpone or limit the number of children revealed a wish to have children with the right partner and at the right time in order to combine good parenting with professional career. The study shows that prevailing expectations about lifestyle render abortion a necessity in family planning. One-third of the women had had a previous abortion(s) and 12% had become pregnant in a situation where they had felt pressured or threatened by the man. Two-thirds of the women characterised their initial feelings towards the pregnancy solely in painful words while nearly all the others reported contradictory feelings. Concerning feelings towards the coming abortion, more than half expressed both positive and painful feelings such as anxiety, relief, grief, guilt, anguish, emptiness and responsibility, while one-third expressed only painful feelings. However, almost 70% stated that nothing could change their decision to have an abortion. Thus, this study highlights that contradictory feelings in relation to both pregnancy and the coming abortion are common but are very seldom associated with doubts about the decision to have an abortion.

Onset and clinical course of schizophrenia in Butajira-Ethiopia--a community-based study.

Abstract.Background:There are reports on favourable course and outcome of schizophrenia in lowincome countries. The aim of the present study was to examine onset and clinical course of the illness in a community-based sample in rural Ethiopia based on crosssectional information.Method:A two-stage survey was carried out in Butajira-Ethiopia, a predominantly rural district. Altogether 68,378 individuals aged 15–49 years were CIDI-interviewed, of whom 2,159 were identified as cases according to the CIDI interview with regard to psychotic or affective disorders. Key informants identified another group of 719 individuals as being probable cases and a total of 2,285 individuals were SCAN-interviewed. The present paper reports on cases with schizophrenia.Results:There were 321 cases of schizophrenia giving an estimated lifetime prevalence of 4.7/1,000). Of the cases,83.2% (N = 267) were males. Mean age of first onset of psychotic symptoms for males was 23.8 (sd 8.6) compared to 21.0 (sd 7.8) for females (P = 0.037; 95 %CI 0.16–5.47). Over 80% had negative symptoms and over 67% reported continuous course of the illness. Less than 10% had a history of previous treatment with neuroleptic medication. About 7% were vagrants, 9 % had a history of assaultive behaviour,and 3.8% had attempted suicide. The male to female ratio was nearly 5:1.Conclusion:This large community-based study differs from most previous studies in terms of higher male to female ratio, earlier age of onset in females and the predominance of negative symptoms.

Enzymes related to biogenic amine metabololism and personality charateristics in depressed patients

Levels of the activity of enzyme systems involved in the synthesis and metabolism of biogenic amines have been linked in several reports in the literature with various psychopathological conditions and with variations in personality characteristics. In particular, significant negative correlations have been reported between levels of MAO‐activity and sensation seeking. In the present study levels of MA0 and DBH‐activity were investigated in a series of 30 depressed patients, admitted consecutively, who completed a new personality inventory, the KSP, assumed to measure relatively stable personality traits. Our findings appeared to be consistent with those of earlier authors in that the most pronounced significant (negative) correlation occurred between MAO‐activity levels and the monotony avoidance subscale of the KSP. This particular subscale is aimed precisely at measuring thrill‐seeking and bears a close relation to the Sensation Seeking Scale used by other authors. In addition a weak positive correlation was found between the same subscale and levels of DBH‐activity. Finally a weak negative correlation emerged between levels of MAO and the Guilt subscale of the KSP.

Schizophrenia: illness impact on family members in a traditional society - rural Ethiopia

Abstract.Background: Studies have consistently shown that both the subjective and objective dimensions of burden among family members of schizophrenia patients and other psychiatric disorders are prevalent. However, as most of these reports were from western societies, we lack information on the subject in developing countries. Method: The study was conducted within the framework of the ongoing epidemiological study of course and outcome of schizophrenia and bipolar disorders in a rural population of 15–49 years of age. Three hundred and one cases of schizophrenia and their close relatives participated in the study. Results: Family burden is a common problem of relatives of cases with schizophrenia. Financial difficulty is the most frequently endorsed problem among the family burden domains (74.4 %). Relatives of female cases suffered significantly higher social burden (Z = 2.103; p = 0.036). Work (Z = 2.180; p = 0.029) and financial (Z = 2.088; p = 0.037) burdens affected female relatives more often than males. Disorganised symptoms were the most important factors affecting the family members in all family burden domains. Prayer was found to be the most frequently used coping strategy in work burden (adj. OR = 1.99; 95 % CI = 1.08–3.67; p = 0.026). Conclusion: Negative impact of schizophrenia on family members is substantial even in traditional societies such as those in Ethiopia where family network is strong and important. The scarce existing services in the developing countries should include family interventions and support at least in the form of educating the family members about the nature of schizophrenia illness and dealing with its stigma and family burden.

Psychological Reactions to the Medical Investigation and Surgical Treatment of Infertility

The psychological effects of the medical investigation and surgical treatment of infertility were investigated. For 2 years 30 women with a diagnosis of tubal damage and 29 men were followed with repeated interviews. Negative effects on sexual life were recorded in all individuals and were associated with the planning of intercourse. Semen analysis was psychologically difficult to half of the men and feelings of shame and degradation were common. Fear and anxiety were increased before reconstructive tubal surgery and postoperative depression was observed in 10 women. Most couples overestimated their chances of having a child and half of them expected pregnancy to occur within a few months. After 2 years the need for professional support and counseling had increased. The medical procedure has psychological side effects in the infertile couple and may provoke anxiety. The investigation should be comprehensive and short, and psychologically traumatic investigations like basal body temperature records should be used with caution. During the period of somatic investigation and treatment repeated discussions about the marital relationship and sexual life should be initiated and psychosocial counseling should be offered to all couples.

Major demographic, social and economic factors associated to suicide rates in Latvia 1980–98

Objective: The aim of this study is to analyse the dynamics of suicide rates in Latvia 1980–98, when dramatic social and economical changes took place. Special attention is given to demographic risk groups and major socioeconomic correlates influencing the dynamics of suicide rates.