Gymnastik- och idrottshögskolan, GIH

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  • 1. Lindegård, Agneta
    et al.
    Jonsdottir, Ingibjörg H
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Lindwall, Magnus
    Gerber, Markus
    Changes in mental health in compliers and non-compliers with physical activity recommendations in patients with stress-related exhaustion.2015In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 15, article id 272Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of research regarding the long-lasting effects of a more physically active lifestyle in patients with mental disorders. In the present study, clinical data were analysed to examine if initially physically inactive patients, clinically diagnosed with stress-related exhaustion, taking part in 12-month multimodal treatment (MMT), differ at the 18-month follow-up regarding mental health, depending on whether they did or did not comply with the physical activity (PA) recommendations resembling those of the American College of Sports Medicine.

    METHODS: The study population consisted of 69 patients (65 % women) who were referred to a stress clinic due to stress-related exhaustion. All patients received MMT. A major goal was to increase patients' PA levels. The patients received general comprehensive instructions including personal advice regarding the positive effects of PA on mental health and could self-select for an 18-week coached exercise program. Changes in mental health symptoms over an 18-month period were compared between non-compliers (n = 26), mild compliers (n = 22) and strong compliers (n = 21) with the PA recommendations included in the MMT.

    RESULTS: Non-compliers, mild and strong compliers did not differ regarding burnout, depression and anxiety at baseline. Although substantial improvements occurred in all groups, mild and strong compliers reported significantly lower burnout and depression levels at the 18-month follow-up than the non-complying group (p < .05). The general pattern of findings was corroborated, if standard cut-off criteria for clinical burnout were used.

    CONCLUSIONS: Compliance with PA recommendations is associated with decreased levels of burnout and depression in patients with stress-related exhaustion. Thus, the promotion of a more active lifestyle among patients with stress-related exhaustion should be implemented as a part of MMT, to achieve a more sustainable decrease of symptoms of burnout and depression.

    TRIAL REGISTRATION: This is not a clinical trial.

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  • 2.
    Monell, Elin
    et al.
    Karolinska Inst, Dept Med Biostat & Epidemiol, Stockholm, Sweden.;Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.;Stockholm Hlth Care Serv, Stockholm, Sweden..
    Meyer, Caroline
    Univ Warwick, WMG, Coventry, W Midlands, England.;Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England.;Warwickshire NHS Partnership Trust, Coventry, W Midlands, England..
    Szwajda, Agnieszka
    Karolinska Inst, Dept Med Biostat & Epidemiol, Stockholm, Sweden..
    Forsén Mantilla, Emma
    Karolinska Inst, Dept Med Biostat & Epidemiol, Stockholm, Sweden.;Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.;Stockholm Hlth Care Serv, Stockholm, Sweden..
    Taking the LEAP: study protocol for a randomized, multicentre, naturalistic, efficacy trial of the compuLsive Exercise Activity theraPy (LEAP) - a cognitive behavioral program specifically targeting compulsive exercise in patients with eating disorders2021In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, no 1, article id 369Article in journal (Refereed)
    Abstract [en]

    Background About half of Swedish eating disorder patients report exercising compulsively and compulsive exercise (CE) is prevalent in all diagnoses and both genders. Yet there are no systematic treatments targeting CE in specialist care. This study aims to evaluate the effects of The CompuLsive Exercise Activity TheraPy (LEAP) - a promising group treatment targeting compulsive exercise, in Swedish eating disorder patients. Method One hundred twenty-eight adult females and males suffering from anorexia nervosa, bulimia nervosa or other specified feeding and eating disorders (type 1, 2, or 4) with CE will be recruited via four specialist eating disorder treatment units. Participants will be randomized to receive treatment as usual (control group) or treatment as usual plus LEAP (intervention group). The groups will be assessed on key variables (e.g., BMI, eating disorder symptoms, exercise cognitions and behaviors) at three occasions: initially, after 3 months and after 6 months. Discussion The project takes place in a clinical setting, including both male and female patients with different eating disorder diagnoses with CE, enabling a good indication of the efficacy of LEAP. If our results are positive, LEAP has the potential of benefiting about half of the eating disorder population, with remission and recovery hopefully improving as a result.

  • 3.
    Norén Selinus, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Region Västmanland - Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Uppsala, Sweden.
    Durbeej, Natalie
    Department of Clinical Neuroscience, Centre for Psychiatry Research & Education, Karolinska Institutet & Stockholm County Council, Stockholm, Sweden; Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Zhan, Yiqiang
    German Center for Neurogenerative Diseases, Ulm, Germany; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden..
    Lundström, Sebastian
    Center for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Göteborg, Sweden.; Gillberg Neuropsychiatry Centre, University of Gothenburg, Göteborg, Sweden.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Inattention and hyperactivity symptoms in childhood predict physical activity in adolescence.2021In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, no 1, article id 629Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity has been documented to influence several aspects of physical and mental health. Growing evidence shows that physical activity can improve attention. Less is known about how symptoms of inattention and hyperactivity / impulsivity in childhood are associated with physical activity in adolescence. We aimed to explore this relationship further.

    METHODS: We used a cohort of 3949 Swedish children (1884 boys and 2065 girls) with data collected at ages 9 (or 12) and 15. We investigated the influence of symptoms of inattention and hyperactivity / impulsivity in childhood - age 9/12 (inattention and hyperactivity/impulsivity separately) on self-rated physical activity at age 15, using multiple logistic regression models. We considered potential confounders such as sex, parental education level, physical activity in childhood and neurodevelopmental comorbidity. A cluster robust sandwich estimator was applied to adjust the standard errors for the nested twin data when computing the regression models.

    RESULTS: Symptoms of inattention in childhood (9/12) predicted less physical activity in adolescence (age 15) (OR = 0.83 CI = 0.78-0.89), whereas the opposite was true for hyperactivity/impulsivity (OR = 1.08 CI = 1.02-1.10). These associations still remained when taking possible confounders into account including neurodevelopmental and neurodevelopmental related comorbidity.

    CONCLUSIONS: These findings support the importance of helping children and adolescents with inattention symptoms to engage in physical activity in suitable settings.

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  • 4.
    Ojala, Olivia
    et al.
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden. olivia.ojala@ki.se..
    Kuja-Halkola, Ralf
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden..
    Bjureberg, Johan
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden; Department of Psychology, Stanford University, Stanford, CA, USA..
    Ohlis, Anna
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden..
    Cederlöf, Martin
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden..
    Norén Selinus, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Region Västmanland - Uppsala University, Centre for Clinical Research, Västmanland Hospital, Västerås, Sweden..
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden..
    Larsson, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden..
    Lundström, Sebastian
    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Centre for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Hellner, Clara
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden..
    Associations of impulsivity, hyperactivity, and inattention with nonsuicidal self-injury and suicidal behavior: longitudinal cohort study following children at risk for neurodevelopmental disorders into mid-adolescence.2022In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 22, no 1, article id 679Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The knowledge of how the separate Attention-Deficit/Hyperactivity Disorder (ADHD) subdimensions (impulsivity, hyperactivity, and inattention) are associated with nonsuicidal self-injury (NSSI) and suicidal behavior (SB) is limited. The objective of this study was to investigate the associations of childhood ADHD subdimensions with NSSI and SB in children at risk of neurodevelopmental disorders (NDDs; including ADHD).

    METHODS: The sample (N = 391) included twin pairs where at least one twin screened positive for at least one NDD or common comorbidity at age 9 or 12. Data on ADHD subdimensions was collected through a telephone interview with a caregiver/legal guardian at age 9 or 12, and data on NSSI and SB was collected through an in-person clinical assessment at age 15. The associations between the ADHD subdimensions and NSSI or SB were tested in three different models: (1) univariable, (2) together with the other ADHD subdimensions, and (3) in a confounder-adjusted model including other NDD symptoms in addition to ADHD subdimensions, for NSSI and SB separately.

    RESULTS: A total of 32 (8.2%) adolescents reported life-time engagement of NSSI, and 18 (4.6%) SB. Childhood impulsivity was associated with SB and childhood inattention with NSSI, in all models. Hyperactivity was not meaningfully associated with any of the outcomes.

    CONCLUSION: Impulsivity and inattention, but not hyperactivity, may be of particular importance in understanding SB and NSSI. Brief screening for impulsivity and inattention in childhood could facilitate detection of children vulnerable to NSSI and SB and indicate valuable information for preventive and intervention strategies.

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  • 5.
    Seidel, Maria
    et al.
    Tech Univ Dresden, Div Psychol & Social Med & Dev Neurosci, Fac Med, Fetscherstr 74, D-01307 Dresden, Germany.;Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Ehrlich, Stefan
    Tech Univ Dresden, Div Psychol & Social Med & Dev Neurosci, Fac Med, Fetscherstr 74, D-01307 Dresden, Germany..
    Breithaupt, Lauren
    Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA.;Massachusetts Gen Hosp, Eating Disorders Clin & Res Program, Boston, MA 02114 USA..
    Welch, Elisabeth
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Ctr Eating Disorders, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Wiklund, Camilla
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Hubel, Christopher
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden.;Kings Coll London, Inst Psychiat Psychol & Neurosci, Social Genet & Dev Psychiat Ctr, London, England.;South London & Maudsley NHS Fdn Trust, UK Natl Inst Hlth Res NIHR, Biomed Res Ctr BRC, London, England.;Aarhus Univ, Aarhus Business & Social Sci, Natl Ctr Register Based Res, Aarhus, Denmark..
    Thornton, Laura M.
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Savva, Androula
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Fundin, Bengt T.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Pege, Jessica
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Billger, Annelie
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Abbaspour, Afrouz
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Schaefer, Martin
    Tech Univ Dresden, Div Psychol & Social Med & Dev Neurosci, Fac Med, Fetscherstr 74, D-01307 Dresden, Germany.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Boehm, Ilka
    Tech Univ Dresden, Div Psychol & Social Med & Dev Neurosci, Fac Med, Fetscherstr 74, D-01307 Dresden, Germany..
    Zvrskovec, Johan
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden.;Kings Coll London, Inst Psychiat Psychol & Neurosci, Social Genet & Dev Psychiat Ctr, London, England..
    Rosager, Emilie Vangsgaard
    Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark..
    Hasselbalch, Katharina Collin
    Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark..
    Leppa, Virpi
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden..
    Sjogren, Magnus
    Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark.;Mental Hlth Ctr Ballerup, Eating Disorder Res Unit, Ballerup, Denmark..
    Nergardh, Ricard
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Feusner, Jamie D.
    Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA..
    Ghaderi, Ata
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Social Genet & Dev Psychiat Ctr, London, England.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Bulik, Cynthia M.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Solna, Sweden.;Univ N Carolina, Dept Psychiat, Chapel Hill, NC 27515 USA.;Univ N Carolina, Dept Nutr, Chapel Hill, NC 27515 USA..
    Study protocol of comprehensive risk evaluation for anorexia nervosa in twins (CREAT): a study of discordant monozygotic twins with anorexia nervosa2020In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 20, no 1, article id 507Article in journal (Refereed)
    Abstract [en]

    Background Anorexia nervosa (AN) is a severe disorder, for which genetic evidence suggests psychiatric as well as metabolic origins. AN has high somatic and psychiatric comorbidities, broad impact on quality of life, and elevated mortality. Risk factor studies of AN have focused on differences between acutely ill and recovered individuals. Such comparisons often yield ambiguous conclusions, as alterations could reflect different effects depending on the comparison. Whereas differences found in acutely ill patients could reflect state effects that are due to acute starvation or acute disease-specific factors, they could also reflect underlying traits. Observations in recovered individuals could reflect either an underlying trait or a "scar" due to lasting effects of sustained undernutrition and illness. The co-twin control design (i.e., monozygotic [MZ] twins who are discordant for AN and MZ concordant control twin pairs) affords at least partial disambiguation of these effects. Methods Comprehensive Risk Evaluation for Anorexia nervosa in Twins (CREAT) will be the largest and most comprehensive investigation of twins who are discordant for AN to date. CREAT utilizes a co-twin control design that includes endocrinological, neurocognitive, neuroimaging, genomic, and multi-omic approaches coupled with an experimental component that explores the impact of an overnight fast on most measured parameters. Discussion The multimodal longitudinal twin assessment of the CREAT study will help to disambiguate state, trait, and "scar" effects, and thereby enable a deeper understanding of the contribution of genetics, epigenetics, cognitive functions, brain structure and function, metabolism, endocrinology, microbiology, and immunology to the etiology and maintenance of AN.

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