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  • 1. Abdollahi, Abbas
    et al.
    LeBouthillier, Daniel M.
    Najafi, Mahmoud
    Asmundson, Gordon J. G.
    Hosseinian, Simin
    Shahidi, Shahriar
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Kalhori, Atefeh
    Sadeghi, Hassan
    Jalili, Marzieh
    Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 219, s. 58-63Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals.

    Methods: In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment.

    Results: Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group.

    Limitations: No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear.

    Conclusions: The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals.

  • 2.
    Albrecht, Sophie C.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Radboud University, The Netherlands.
    Rajaleid, Kristiina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 215, s. 143-151Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Psychosocial work factors can affect depressive moods, but research is inconclusive if flexibility to self-determine working hours (work-time control, WTC) is associated with depressive symptoms over time. We investigated if either sub-dimension of WTC, control over daily hours and control over time off, was related to depressive symptoms over time and examined causal, reversed-causal, and reciprocal pathways.

    METHODS: The study was based on four waves of the Swedish Longitudinal Occupational Survey of Health which is a follow-up of representative samples of the Swedish working population. WTC was measured using a 5-item index. Depressive symptoms were assessed with a brief subscale of the Symptom Checklist. Latent growth curve models and cross-lagged panel models were tested.

    RESULTS: Best fit was found for a model with correlated intercepts (control over daily hours) and both correlated intercepts and slopes (control over time off) between WTC and depressive symptoms, with stronger associations for control over time off. Causal models estimating impacts from WTC to subsequent depressive symptoms were best fitting, with a standardised coefficient between -0.023 and -0.048.

    LIMITATIONS: Results were mainly based on self-report data and mean age in the study sample was relatively high.

    CONCLUSION: Higher WTC was related to fewer depressive symptoms over time albeit small effects. Giving workers control over working hours - especially over taking breaks and vacation - may improve working conditions and buffer against developing depression, potentially by enabling workers to recover more easily and promoting work-life balance.

  • 3. Andersson, Gerhard
    et al.
    Hesser, Hugo
    Veilord, Andrea
    Svedling, Linn
    Andersson, Fredrik
    Sleman, Owe
    Mauritzson, Lena
    Sarkohi, Ali
    Claesson, Elisabet
    Zetterqvist, Vendela
    Lamminen, Mailen
    Eriksson, Thomas
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression2013Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, affectiv, Vol. 151, nr 3, s. 986-994Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.

    Method

    Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n=33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.

    Results

    Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery–Åsberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post-treatment showed a Cohen′s d=1.46, with a similar large effect at 3-year follow-up,d=1.78. For the group CBT the corresponding within-group effects were d=0.99 and d=1.34, respectively.

    Limitations

    The study was small with two active treatments and there was no placebo or credible control condition.

    Conclusions

    Guided ICBT is at least as effective as group-based CBT and long-term effects can be sustained up to 3 years after treatment.

  • 4. Bi, Yu-Han
    et al.
    Pei, Jin-Jing
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Hao, Changfu
    Yao, Wu
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    The relationship between chronic diseases and depression in middle-aged and older adults: A 4-year follow-up study from the China Health and Retirement Longitudinal Study.2021Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 289, s. 160-166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Evidence of the association between common chronic diseases and depression is sparse.

    Methods: Totally 7819 participants aged 45+ without depression at baseline were followed-up (2011-2015) to detect incident depression. Chronic diseases and depression were defined by self-reported diagnosis and the Center for Epidemiological Studies Depression Scale (CES-D10), respectively. Cox proportional hazards model was used to explore the association between chronic diseases and depression adjusting for age, gender, education, marital/living conditions, area, smoking, drinking, economic status, BMI and health insurance.

    Results: During an average of 3.42 years follow-up, 2271 participants developed depression (85 per 1000 person-year). Chronic diseases were related to significantly higher risk of depression (HR = 1.38). A higher risk of depression was also associated with specific diseases: stomach/other digestive diseases (HR = 1.19), diabetes (HR = 1.22), arthritis/rheumatism (HR = 1.30), and kidney diseases (HR = 1.34) (P < 0.05). The risk of depression increased with increasing in the number of chronic diseases (1: HR = 1.27, 2: HR = 1.49, and 3+: HR = 1.51, P-trend < 0.001). No significant difference was observed across age, gender, education, and area.

    Limitations: Chronic diseases and depression were based on self-reported diagnosis and measurement scale, respectively, which could lead to information bias. Some unmeasured confounders might have biased the results.

    Conclusions: The occurrence of depression in people aged 45+ is associated with number of chronic diseases in a dose-response fashion. These results may provide guidance on preventing depression and improving the quality of life in middle and late adulthood.

  • 5. Björkenstam, Emma
    et al.
    Vinnerljung, Bo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan. Karolinska Institutet, Sweden.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Impact of childhood adversities on depression in early adulthood: A longitudinal cohort study of 478,141 individuals in Sweden2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 223, s. 95-100Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Although the relationship between childhood adversity (CA) and depression is widely accepted, there is little information on what proportion of depression is attributable to CA. Method: We used a Swedish cohort of 478,141 individuals born in 1984-1988 in Sweden. Register-based CA indicators included parental death, parental substance abuse and psychiatric morbidity, parental criminality, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Estimates of risk of depression, measured as retrieval of prescribed antidepressants and/or psychiatric care with a clinical diagnosis of depression, between 2006 and 2012 were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using a Cox regression analysis. Results: All CAs predicted depression in early adulthood. Furthermore, the predictive association between the CA indicators and depression was graded, with highest HRs observed for 4+ CAs (HR: 3.05 (95% CI 2.83-3.29)) for a clinical diagnosis for depression and HR: 1.32 (95% CI 1.25-1.41) for antidepressant medication after adjustments were made for important confounding factors. Of the studied CAs, child welfare intervention entailed highest HR for depression. Conclusion: Regardless of causality issues, children and youth with a history of multiple CA should be regarded as a high-risk group for depression by professionals in social, and health service's that come into contact with this group.

  • 6.
    Blomqvist, Sandra
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Xu, Tianwei
    Persitera, Paraskevi
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Låstad, Lena
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi. Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för pedagogik och didaktik.
    Magnusson Hanson, Linda
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Associations between cognitive and affective job insecurity and incident purchase of psychotropic drugs: A prospective cohort study of Swedish employees2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 266, s. 215-222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Previous research suggests that job insecurity is associated with poor mental health, but research examining how different aspects of job insecurity relate to clinical measures of poor mental health are lacking. We aimed to investigate the association between cognitive and affective job insecurity and incident purchases of psychotropic drugs.

    Methods: We included 14,586 employees participating in the Swedish Longitudinal Occupational Survey of Health (SLOSH), who answered questions on cognitive and/or affective job insecurity in 2010, 2012 or 2014. Respondents were followed in the Swedish Prescribed Drug Register (2.5 years on average). We investigated the association between job insecurity and incident psychotropic drugs with marginal structural Cox models.

    Results: Affective job insecurity was associated with an increased risk of purchasing any psychotropic drugs (Hazard Ratio (HR) 1.40 (95% Confidence Interval (CI) 1.04–1.89)) while cognitive job insecurity was not (HR 1.15 (95% CI 0.92–1.43)). Cognitive and affective job insecurity were both associated with antidepressants, affective job insecurity with anxiolytics, but no association was found with sedatives. Women and younger workers seemed to have higher risk compared to men and older workers, but differences were not statistically significant.

    Limitations: Although job insecurity and psychotropic drugs were assessed through independent sources and several covariates were considered, unmeasured confounding cannot be ruled out.

    Conclusions: The findings support that affective job insecurity is a risk factor for psychotropic drug treatment, that it may be relevant to distinguish between different types of job insecurity, and to consider sex and age as moderating factors.

  • 7.
    Carlbring, Per
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Hägglund, Malin
    Umeå universitet.
    Luthström, Anne
    Umeå universitet.
    Dahlin, Mats
    Kadowaki, Åsa
    Vernmark, Kristofer
    Andersson, Gerhard
    Linköpings universitet/Karolinska Institutet.
    Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial2013Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 148, nr 2-3, s. 331-337Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Internet-based cognitive behavior therapy for depression has been tested in several trials but there are no internet studies on behavioral activation (BA), and no studies on BA over the internet including components of acceptance and commitment therapy (ACT). The aim of this study was to develop and test the effects of internet-delivered BA combined with ACT against a waiting list control condition as a first test of the effects of treatment.

    Methods

    Selection took place with a computerized screening interview and a subsequent semi-structured telephone interview. A total of 80 individuals from the general public were randomized to one of two conditions. The treatment lasted for 8 weeks after which both groups were assessed. We also included a 3 month follow-up. The treatment included interactive elements online and a CD-ROM for mindfulness and acceptance exercises. In addition, written support and feedback was given by a therapist every week.

    Results

    Results at posttreatment showed a large between group effect size on the Beck Depression inventory IId=0.98 (95%CI=0.51–1.44). In the treated group 25% (10/40) reached remission defined as a BDI score≤10 vs. 5% (2/40) in the control group. Results on secondary measures were smaller. While few dropped out from the study (N=2) at posttreatment, the average number of completed modules was M=5.1 out of the seven modules.

    Limitations

    The study only included a waiting-list comparison and it is not possible to determine which treatment components were the most effective.

    Conclusions

    We conclude that there is initial evidence that BA with components of ACT can be effective in reducing symptoms of depression.

  • 8.
    Halonen, Jaana I.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Finnish Institute of Occupational Health, Finland; Finnish Institute for Health and Welfare, Finland.
    Hiilamo, Aapo
    Butterworth, Peter
    Wooden, Mark
    Ervasti, Jenni
    Virtanen, Marianna
    Sivertsen, Børge
    Aalto, Ville
    Oksanen, Tuula
    Kivimäki, Mika
    Lallukka, Tea
    Psychological distress and sickness absence: Within- versus between-individual analysis2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 264, s. 333-339Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Uncertainty remains whether associations for psychological distress and sickness absence (SA) observed between and within individuals differ, and whether age, gender and work-related factors moderate these associations.

    Methods: We analyzed SA records of 41,184 participants of the Finnish Public Sector study with repeated survey data between 2000 and 2016 (119,024 observations). Psychological distress was measured by the General Health Questionnaire (GHQ-12), while data on SA days were from the employers' registers. We used a hybrid regression estimation approach adjusting for time-variant confounders-age, marital status, occupational class, body mass index, job contract type, months worked in the follow-up year, job demand, job control, and workplace social capital-and time-invariant gender (for between-individual analysis).

    Results: Higher levels of psychological distress were consistently associated with SA, both within- and between-individuals. The within-individual association (incidence rate ratio (IRR) 1.68, 95% CI 1.61-1.75 for SA at high distress), however, was substantially smaller than the between-individual association (IRR 2.53, 95% CI 2.39-2.69). High levels of psychological distress had slightly stronger within-individual associations with SA among older (>45 years) than younger employees, lower than higher occupational class, and among men than women. None of the assessed work unit related factors (e.g. job demand, job control) were consistent moderators.

    Limitations: These findings may not be generalizable to other working sectors or cultures with different SA policies or study populations that are male dominated.

    Conclusions: Focus on within-individual variation over time provides more accurate estimates of the contribution of mental health to subsequent sickness absence.

  • 9. Henje Blom, Eva
    et al.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Ingvar, Martin
    Åsberg, Marie
    Mobarrez, Fariborz
    Serlachius, Eva
    Pro-inflammatory cytokines are elevated in adolescent females with emotional disorders not treated with SSRIs2012Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 136, nr 3, s. 716-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Adults with major depressive disorder (MDD) show elevated levels of IL-6 and TNF-alpha. Studies of adolescents with MDD or anxiety disorders (AD) are few and present conflicting results.

    METHODS: We studied plasma cytokines in a clinical sample of adolescent females with MDD and/or clinical AD (n=60, mean age 16.8 years), compared to healthy controls (n=44; mean age 16.5 years).

    RESULTS: The clinical sample showed significantly higher values of IL-2 (Z=-4.09, p>0.0001), IL1-beta (Z=-2.40, p<0.05) and IL-10 (Z=-2.38, p<0.05) as compared to controls. The subgroup of the clinical sample not treated with SSRIs had a significant difference of IL-6 (Z=-2.26, p<0.05) in addition to the difference of IL-2 and IL1-beta, but showed no difference of IL-10 as compared to the controls. SSRI treatment was related to IL-6, explaining 26% of the variance in the clinical sample after controlling for BMI and symptom severity. In the clinical sample, levels of IL-6 and IFN-gamma were positively correlated with self-assessed symptoms of anxiety and/or depression (corr.coeff 0.35 resp 0.40 at p<0.05).

    LIMITATIONS: The cross-sectional design does not allow for conclusions on causality. The sample sizes were relatively small and a large drop-out in the clinical sample may have influenced the representativity.

    DISCUSSION: The study suggests that pro-inflammatory cytokines are part of the pathophysiology of emotional disorders in adolescent females and that SSRIs have anti-inflammatory properties. The findings prompt further studies on the specific mechanisms involved and may contribute to the development of more effective treatment and prevention.

  • 10. Honk, Ludwig
    et al.
    Stenfors, Cecilia U. D.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Goldberg, Simon B.
    Hendricks, Peter S.
    Osika, Walter
    Dourron, Haley Maria
    Lebedev, Alexander
    Petrovic, Predrag
    Simonsson, Otto
    Longitudinal associations between psychedelic use and psychotic symptoms in the United States and the United Kingdom2024Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 351, s. 194-201Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It has long been speculated that psychedelic use could provoke the onset of psychosis, but there is little evidence to support this conjecture. Using a longitudinal research design with samples representative of the US and UK adult populations with regard to sex, age, and ethnicity (n = 9732), we investigated associations between psychedelic use and change in the number of psychotic symptoms during the two-month study period. In covariate-adjusted regression models, psychedelic use during the study period was not associated with a change in the number of psychotic symptoms unless it interacted with a personal or family history of bipolar disorder, in which case the number of symptoms increased, or with a personal (but not family) history of psychotic disorders, in which case the number of symptoms decreased. Taken together, these findings indicate that psychedelic use may affect psychotic symptoms in individuals with a personal or family history of certain disorders characterized by psychotic symptomatology.

  • 11. Hu, Yaoyue
    et al.
    Ruiz, Milagros
    Bobak, Martin
    Martikainen, Pekka
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Max Planck Institute for Demographic Research, Germany; University of Helsinki, Finland.
    Do multigenerational living arrangements influence depressive symptoms in mid-late life? Cross-national findings from China and England2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 277, s. 584-591Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: While living alone predicts depression in diverse ageing populations, the impact of multi-generational living is unclear. This study compared mid-late life depressive symptoms by living arrangements between societies with distinct kinship ties.

    Methods: Repeated data on depressive symptoms and living arrangements over 4 years from 16,229 Chinese (age >= 45) and 10,403 English adults (age >= 50) were analyzed using multilevel mixed-effects logistic regression. Elevated depressive symptoms were identified using the Center for Epidemiological Depression Scale criteria in each study.

    Results: Higher odds ratios (ORs) of elevated depressive symptoms were found in both Chinese and English adults aged<60 living with no partner but with children/grandchildren, compared to those living with a partner only. These ORs were greater for men (Chinese men: 3.09, 95% confidence interval: 2.00-4.78; English men: 3.44, 1.36-8.72) than for women (Chinese women: 1.77, 1.23-2.56; English women: 2.88, 1.41-3.67), after controlling for socioeconomic position, health behaviors, and health status. This male disadvantage was also observed for English, but not for Chinese, adults aged<60 living alone. For adults aged 60+, the increased odds among those living with no partner but with children/grandchildren and those living alone were smaller in both countries.

    Limitations: Bias may exist because depressed participants are more likely to experience divorce or separation prior to baseline.

    Conclusions: The relationship between living arrangements and depressive symptoms appears robust and consistent across social contexts, although the mechanisms differ. The protective role of partners in both China and England supports targeting those who do not live with partners to reduce depression.

  • 12. Korhonen, Kaarina
    et al.
    Moustgaard, Heta
    Tarkiainen, Lasse
    Östergren, Olof
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Costa, Giuseppe
    Urhoj, Stine Kjaer
    Martikainen, Pekka
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany.
    Contributions of specific causes of death by age to the shorter life expectancy in depression: a register-based observational study from Denmark, Finland, Sweden and Italy2021Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 295, s. 831-838Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The reasons for the shorter life expectancy of people with depression may vary by age. We quantified the contributions of specific causes of death by age to the life-expectancy gap in four European countries.

    Methods: Using register-based cohort data, we calculated annual mortality rates in between 1993 and 2007 for psychiatric inpatients with depression identified from hospital-care registers in Denmark, Finland and Sweden, and between 2000 and 2007 for antidepressant-treated outpatients identified from medication registers in Finland and Turin, Italy. We decomposed the life-expectancy gap at age 15 years by age and cause of death.

    Results: The life-expectancy gap was especially large for psychiatric inpatients (12.1 to 21.0 years) but substantial also for antidepressant-treated outpatients (6.3 to 14.2 years). Among psychiatric inpatients, the gap was largely attributable to unnatural deaths below age 55 years. The overall contribution was largest for suicide in Sweden (43 to 45%) and Finland (37 to 40%). In Denmark, 'other diseases' (25 to 34%) and alcohol-attributable causes (10 to 18%) had especially large contributions. Among antidepressant-treated outpatients, largest contributions were observed for suicide (18% for men) and circulatory deaths (23% for women) in Finland, and cancer deaths in Turin (29 to 36%). Natural deaths were concentrated at ages above 65 years.

    Limitations: The indication of antidepressant prescription could not be ascertained from the medication registers.

    Conclusions: Interventions should be directed to self-harm and substance use problems among younger psychi-atric inpatients and antidepressant-treated young men. Rigorous monitoring and treatment of comorbid somatic conditions and disease risk factors may increase life expectancy for antidepressant-treated outpatients, especially women.

  • 13. Lager, Emil
    et al.
    Melin, Bo
    Hemmingsson, Tomas
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Sörberg Wallin, Alma
    The evolving relationship between premorbid intelligence and serious depression across the lifespan - A longitudinal study of 43,540 Swedish men2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 211, s. 37-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    An association between higher intelligence and lower probability of serious depression has previously been established. Yet, to our knowledge, no large prospective study has examined the relationship across the lifespan.

    Methods:

    A cohort of 49,321 Swedish men was followed from conscription in 1969-70 (age 18-20) through to 2008. Odds ratios (OR) for first time hospitalisation for depression (FTHD) were calculated in relation to intelligence for distinct time periods across the lifespan, while controlling for established risk factors for depression.

    Results:

    There was a linear association between higher intelligence in youth and lower odds for FTHD during the entire follow-up period, 1973-2008. The association got progressively weaker across the lifespan. During 1973-80, one step down on the stanine scale was associated with an unadjusted increase in OR of 1.34 [95% confidence interval (CI) 1.26-1.42], adjusted OR 1.23 [1.15-1.32]; while, during 2001-2008, the ORs were less than half of the magnitude of the first period, unadjusted 1.14 [1.07-1.21], and adjusted 1.09 [1.01-1.17].

    Limitations:

    The study includes men only, and the number of available places for in-patient care decreased during the follow-up period.

    Conclusion:

    For the first time, we have shown that the association between lower intelligence and depression decreases over time. The attenuation of the association in the adjusted models suggests a slower accumulation of depressogenic stressors among people with a higher IQ-score. Further exploration of intelligence's role in the etiology of depression across the lifespan is required in order to facilitate adequate diagnoses and ameliorating interventions.

  • 14. Liu, Bojing
    et al.
    Lavebratt, Catharina
    Nordqvist, Tobias
    Fandiño-Losada, Andrés
    Theorell, Töres
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Forsell, Yvonne
    Lundberg, Ingvar
    Working conditions, serotonin transporter gene polymorphism (5-HTTLPR) and anxiety disorders: a prospective cohort study2013Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 151, nr 2, s. 652-659Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The etiology and pathology of anxiety disorders involve both genetic and environmental influences. Adverse working conditions may contribute to the development of anxiety. The serotonin transporter-linked polymorphic region (5-HTTLPR) has been implicated in stress sensitivity. Therefore, we investigated the potential interplay between 5-HTTLPR and job-related risk factors in the prediction of the occurrence of anxiety.

    METHODS: We conducted a prospective study using the first two waves of a Swedish population-based cohort. At Wave I, 1585 individuals without anxiety, depression or dysthymia who were active in the labor market during both waves were included. Information on job demands, skill discretion, decision authority and social climate was collected at Wave I. After a three year interval, the presence of anxiety disorders was determined at Wave II. All 1585 participants were genotyped for 5-HTTLPR. Both additive and multiplicative models were considered in examining the potential interaction between 5-HTTLPR and adverse working conditions on the development of anxiety.

    RESULTS: Anxiety was associated with high job demands but not with 5-HTTLPR. An interaction was observed between 5-HTTLPR and high job demands among females. Individuals with 5-HTTLPR high expression genotype (LL) developed anxiety disorders more frequently when exposed to high job demands compared to 'LS/SS' carriers.

    LIMITATIONS: A limited number of participants developed anxiety.

    CONCLUSIONS: High job demands predict the development of anxiety. The 5-HTT polymorphism has a moderating effect on the relationship between high job demands and anxiety among females.

  • 15.
    Magnusson Hanson, Linda L.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Madsen, Ida E. H.
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet.
    Theorell, Töres
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Burr, Hermann
    Rugulies, Reiner
    Antidepressant use and associations with psychosocial work characteristics: A comparative study of Swedish and Danish gainfully employed2013Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 149, nr 1-3, s. 38-45Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although depression is common, prevalence estimates of antidepressant use among the workforce and undisputed evidence relating psychosocial work characteristics to depression is scarce. This study cross-sectionally assesses the prevalence of antidepressant use among employed in Sweden and Denmark and prospectively examines associations between work characteristics and antidepressant use. METHODS: Data on work demands, influence and learning possibilities was collected 2005-2006 from two representative samples of employed aged 20-59 years from Sweden (n=4351) and Denmark (n=8064) and linked to purchases of antidepressants through national prescription drug registries. Standardized 12-month prevalences were calculated. Cox regressions on work characteristics and incident use were performed separately and estimates pooled. RESULTS: Employed Swedish residents had higher standardized prevalence than Danish, 6.0% compared to 5.0%. Working fast and conflicting demands were associated with incident use when estimates were pooled, but adjustment for baseline health attenuated these estimates. Emotionally disturbing situations were related to any incident use, and more strongly to use >179 defined daily dosages/year, even after adjustment for various covariates. LIMITATIONS: Statistics based on national prescription drug registries are influenced by, e.g., treatment seeking behaviours and other reasons for prescription than depression. Selective drop-out may also affect prevalence estimates. CONCLUSIONS: The study indicates that use of antidepressants among the workforce is relatively high and that employed Swedish residents had higher prevalence of antidepressant use than Danish. Relationships between work characteristics and antidepressant use were, however, similar with emotional demands showing the strongest association, indicating that particular groups of employees may be at increased risk.

  • 16. Mikkonen, Janne
    et al.
    Moustgaard, Heta
    Remes, Hanna
    Martikainen, Pekka
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). University of Helsinki, Finland; The Max Planck Institute for Demographic Research, Germany.
    Intergenerational transmission of depressive symptoms - The role of gender, socioeconomic circumstances, and the accumulation of parental symptoms2016Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 204, s. 74-82Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The relationship between parental and offspring depression is well established. Evidence regarding the significance of gender, socioeconomic circumstances, and the accumulation of parental symptoms in intergenerational transmission is, however, mixed and scarce.

    Methods

    Using a 20% random sample of Finns born between 1986 and 1996 (n=138,559), we performed a Cox proportional hazards regression to analyze the incidence of depressive symptoms between ages 15–20 by exposure to maternal and paternal depressive symptoms earlier in life. Depressive symptoms were inferred from antidepressantpurchases and/or a diagnosis of depression at outpatient or inpatient health services.

    Results

    Exposure to maternal depressive symptoms posed an equal risk for girls and boys (hazard ratio, HR, 2.09 vs. 2.28 respectively, p=0.077), whereas the effect of paternal depressive symptoms was weaker for girls (HR 1.77 vs. 2.22, p<0.001). Parental socioeconomic status neither confounded nor moderated these effects. Dual exposure to both maternal and paternal depressive symptoms posed a larger risk than single exposure, and children exposed recurrently at ages 0–5 and 9–14 faced an elevated risk compared with those exposed at only one period.

    Limitations

    Since depressive symptoms were inferred from prescription purchases and treatment records, we were unable to observe untreated depression or to determine the underlying condition the antidepressants were prescribed for.

    Conclusions

    Our results support the idea that maternal depression affects both genders equally, whereas paternal depression affects girls less than boys. We show that parental depression and low socioeconomic status are mainly independent risk factors of adolescent depressive symptoms and do not cause an interactive effect.

  • 17.
    Nyberg, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Rajaleid, Kristiina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Hammarström, Anne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Uppsala University, Sweden.
    Does social and professional establishment at age 30 mediate the association between school connectedness and family climate at age 16 and mental health symptoms at age 43?2019Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 246, s. 52-61Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The aim was to use a theoretical framework developed by Bronfenbrenner in order to investigate if the association between school connectedness and family climate at age 16 and mental health symptoms at age 43 is mediated by social and professional establishment at age 30.

    Methods

    Data were drawn from The Northern Swedish Cohort, a prospective population-based cohort. The present study included 506 women and 577 men who responded to questionnaires at age 16 (in year 1981), age 30 (in 1995) and age 43 (in 2008). Mediation was tested by fitting structural equation models (SEM) and estimating direct effects between proximal processes (school connectedness and family climate) and symptoms of depression and anxiety respectively, and indirect effects via social and professional establishment (professional activity, educational level, and civil status).

    Results

    The standardised estimate for the direct path from school connectedness to depression was -0.147 (p = .000) and the indirect effect mediated by professional activity -0.017 (p = .011) and by civil status -0.020 (p = .002). The standardised direct effect between school connectedness and anxiety was -0.147 (p = .000) and the indirect effect mediated by civil status -0.018 (p = .005). Family climate was not significantly associated with the outcomes or mediators.

    Limitations

    Self-reported data; mental health measures not diagnostic; closed cohort; intelligence, personality and home situation before age 16 not accounted for.

    Conclusions

    Professional and social establishment in early adulthood appear to partially mediate the association between adolescent school connectedness and mental health symptoms in middle-age.

  • 18. Nyström, Markus B. T.
    et al.
    Stenling, Andreas
    Sjöström, Emma
    Neely, Gregory
    Lindner, Philip
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Hassmén, Peter
    Andersson, Gerhard
    Martell, Christopher
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Behavioral activation versus physical activity via the internet: A randomized controlled trial2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 215, s. 85-93Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A major problem today is that only about fifty percent of those affected by depressionseeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments.

    Method/results: Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control-group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges gav treatment =1.01, control group =0.47). This held true also when each of the four treatment groups was compared to the control group, with one exception: Physical activity without treatment rationale.

    Limitations: The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose-response analysis did not detect any significant differences on account of modules completed.

    Conclusions: The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes.

  • 19. Pitkänen, Joonas
    et al.
    Remes, Hanna
    Aaltonen, Mikko
    Martikainen, Pekka
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany.
    Moderating role of sociodemographic factors in parental psychiatric treatment before and after offspring severe self-harm2023Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 327, s. 145-154Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Parental psychiatric disorders are known risk factors for adolescent self-harm. Although this association is likely to have a bidirectional element, evidence on changes in parental psychiatric treatment following offspring self-harm is scarce.

    Methods: Finnish children born in 1987–1996 with a hospital-treated episode of self-harm between the ages 13 and 19 years (N = 3636) were identified using administrative register data, and their biological mothers (N = 3432) and fathers (N = 3167) were followed two years before and after the episode. Data on purchases of psychotropic medication, specialized psychiatric treatment and psychiatric sickness allowances were used to examine psychiatric treatment among parents. Differences by parental education, employment and living arrangements were assessed, and offspring self-harm was compared with offspring accidental poisonings and traffic accidents.

    Results: Psychiatric treatment peaked among mothers during the three-month period after offspring self-harm, after which the treatment prevalence decreased but remained slightly elevated relative to the time preceding offspring self-harm. Higher levels of education and being employed increased the likelihood of treatment right after the episode. Among fathers, changes in treatment were negligible. Treatment trajectories around the comparison events of accidents were similar in shape but more muted than among the parents whose children had self-harmed.

    Limitations: General practitioner visits or other data from primary health care were not available.

    Conclusion: Mothers receive increased psychiatric treatment after stressful offspring events. Our results indicate that prevention of self-harm and accidents would be beneficial not only for those directly concerned but also for their family members.

  • 20.
    Rådmark, Lina
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Magnusson Hanson, Linda L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Montgomery, S.
    Bojner Horwitz, E.
    Osika, W.
    Mind and body exercises (MBE), prescribed antidepressant medication, physical exercise and depressive symptoms – a longitudinal study2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 265, s. 185-192Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Earlier studies show that participation in mind and body exercises (MBE) is cross-sectionally associated with high levels of depressive symptoms and antidepressants. This study investigates the longitudinal interrelationship between depressive symptoms, MBE and antidepressants.

    Methods: 3269 men and 4318 women aged 24–74 years participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH). Measures of MBE practice and depressive symptoms were drawn from the SLOSH questionnaire, data on prescription drugs were obtained from the Swedish Prescribed Drug Register. Structural Equation Modeling (SEM) was used to analyze temporal relationships.

    Results: Both MBE practice and antidepressants in 2012 was associated with higher levels of depressive symptoms two years later. Depressive symptoms in turn were associated with higher levels of later MBE practice and antidepressants. These relationships seemed to be explained by confounding by indication and were of higher magnitude for antidepressants than for MBE.

    Conclusion: Overall, SEM analysis shows that MBE and antidepressant treatment were both bi-directionally associated with depressive symptoms over time. Part of the explanation is likely to be confounding by indication: those with symptoms of depression more likely to undertake treatment, and MBE alone may be more common among those with less severe depression. The results clarify some of our findings from earlier studies and give some important, new information on what people are doing to manage depressive symptoms on a societal level, regarding self-care, medication, and the combination of both.

  • 21.
    Sjöberg, Linnea
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Karlsson, Björn
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Atti, Anna-Rita
    Skoog, Ingmar
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 221, s. 123-131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Depression prevalence in older adults varies largely across studies, which probably reflects methodological rather than true differences. This study aims to explore whether and to what extent the prevalence of depression varies when using different diagnostic criteria and rating scales, and various samples of older adults. Methods: A population-based sample of 3353 individuals aged 60-104 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were examined in 2001-2004. Point prevalence of depression was estimated by: 1) diagnostic criteria, ICD-10 and DSM-IV-TR/DSM-5; 2) rating scales, MADRS and GDS-15; and 3) self-report. Depression prevalence in sub-samples by dementia status, living place, and socio-demographics were compared. Results: The prevalence of any depression (including all severity grades) was 4.2% (moderate/severe: 1.6%) for ICD-10 and 9.3% (major: 2.1%) for DSM-IV-TR; 10.6% for MADRS and 9.2% for GDS-15; and 9.1% for selfreport. Depression prevalence was lower in the dementia-free sample as compared to the total population. Furthermore, having poor physical function, or not having a partner were independently associated with higher depression prevalence, across most of the depression definitions. Limitations: The response rate was 73.3% and this may have resulted in an underestimation of depression. Conclusion: Depression prevalence was similar across all depression definitions except for ICD-10, showing much lower figures. However, independent of the definition used, depression prevalence varies greatly by dementia status, physical functioning, and marital status. These findings may be useful for clinicians when assessing depression in older adults and for researchers when exploring and comparing depression prevalence across studies.

  • 22. Sorjonen, Kimmo
    et al.
    Nilsonne, Gustav
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Ingre, Michael
    Melin, Bo
    Curiosity might not help after all: Predicted trajectories for need for cognition and anxiety and depression symptoms based on findings by Zainal and Newman (2022)2022Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 302, s. 412-414Artikel i tidskrift (Övrigt vetenskapligt)
  • 23. Sorjonen, Kimmo
    et al.
    Nilsonne, Gustav
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden; Charité – Universitätsmedizin Berlin, Germany.
    Ingre, Michael
    Melin, Bo
    Questioning the vulnerability model: Prospective associations between low self-esteem and subsequent depression ratings may be spurious2022Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 315, s. 259-266Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: According to the vulnerability model, low self-esteem makes people more depressed. Support for the vulnerability model comes almost exclusively from analyses using cross-lagged panel models, showing a negative effect of initial self-esteem on subsequent depression ratings when adjusting for initial depression. However, it is well known that such adjusted effects are susceptible to regression toward the mean.

    Methods: Data from four waves of measurements in five different samples (total N = 2703) were analyzed with two different cross-lagged panel models, two different random intercept cross-lagged panel models, and two different latent change score models, predicting change forwards as well as backwards in time.

    Results: High initial self-esteem predicted both decreased and increased depression ratings between measurements and an increase in self-esteem between measurements predicted a concurrent decrease in depression ratings.

    Limitations: Only data from two western countries, Switzerland and USA, were analyzed. Whether the main finding, that a prospective effect of self-esteem on subsequent depression ratings might be spurious, applies to other countries and cultures remains an open question.

    Conclusions: Due to the incongruent results, any causal effect of self-esteem on depression ratings, and thus the vulnerability model as such, cannot be corroborated by the data and models analyzed here. Instead, we propose, tentatively, that prospective associations between self-esteem and depression ratings may be spurious due to a combination of reasons, including regression toward the mean. The indication that depression might not be affected by measures to improve individuals' self-esteem is of clinical relevance.

  • 24. Taipale, Heidi
    et al.
    Niederkrotenthaler, Thomas
    Tanskanen, Antti
    Cullen, Alexis E.
    Helgesson, Magnus
    Berg, Lisa
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    Sijbrandij, Marit
    Klimek, Peter
    Mittendorfer-Rutz, Ellenor
    Persistence of antidepressant use among refugee youth with common mental disorder2021Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 294, s. 831-837Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The objective of this study was to investigate whether persistence of antidepressant use differs between refugee youth and Swedish-born youth after a diagnosis of a common mental disorder (CMD), and if clinical and sociodemographic factors are associated with antidepressant discontinuation.

    Methods: Youth aged 16-25 years, with an incident diagnosis of CMD (depression, post-traumatic stress disorder (PTSD), anxiety disorders) accessing specialized healthcare in Sweden 2006-2016 were included. New users were identified with a one-year washout period. Refugees (N=1575) were compared with Swedish-born youth (N=2319). Cox regression models [reported as adjusted Hazard Ratios (HRs) with 95% confidence intervals (CIs)] were used to investigate factors associated with discontinuation of antidepressant use.

    Results: Among youth (mean age 20.9 years, SD 2.7, 50% females), the median duration of antidepressant use differed considerably between refugee (101 days, IQR 31-243) and Swedish-born youth (252 days, IQR 101-558). Refugees were more likely to discontinue treatment (HR 1.61, 95% CI 1.47-1.77). Factors associated with an increased risk for discontinuation in refugees included ≤5 years duration of formal residency (HR 1.28, 95% CI 1.12-1.45), antidepressant type, and dispensing lag (time from prescription to dispensing) of >7 days (1.43, 1.25-1.64), whereas PTSD (0.78, 0.64-0.97) and anxiolytic use (0.79, 0.64-0.96) were associated with a lower discontinuation risk.

    Limitations: Only persons treated in specialized healthcare could be included.

    Conclusion: The relatively short treatment durations among refugee youth suggest that antidepressant treatment may not be optimal in CMD, and better monitoring of treatment as well as transcultural education of healthcare personnel are warranted.

  • 25.
    Triolo, Federico
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). University of Modena and Reggio Emilia, Italy.
    Sjöberg, Linnea
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Vetrano, Davide L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Italy; Università Cattolica del Sacro Cuore, Italy.
    Darin-Mattsson, Alexander
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Bertolotti, Marco
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Dekhtyar, Serhiy
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Social engagement in late life may attenuate the burden of depressive symptoms due to financial strain in childhood2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 263, s. 336-343Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: It remains poorly understood if childhood financial strain is associated with old-age depression and if active social life may mitigate this relationship.

    Aims: To investigate the association between childhood financial strain and depressive symptoms during aging; to examine whether late-life social engagement modifies this association.

    Method: 2884 dementia-free individuals (aged 60 + ) from the Swedish National study of Aging and CareKungsholmen were clinically examined over a 15-year follow-up. Presence of childhood financial strain was ascertained at baseline. Depressive symptoms were repeatedly assessed with the Montgomery-angstrom sberg Depression Rating Scale. Social engagement comprised information on baseline social network and leisure activities. Linear, logistic and mixed-effect models estimated baseline and longitudinal associations accounting for sociodemographic, clinical, and lifestyle factors.

    Results: Childhood financial strain was independently associated with a higher baseline level of depressive symptoms (beta = 0.37, 95%CI 0.10-0.65), but not with symptom change over time. Relative to those without financial strain and with active social engagement, depressive burden was increased in those without financial strain but with inactive social engagement (beta = 0.43, 95%CI: 0.15-0.71), and in those with both financial strain and inactive engagement (beta = 0.99, 95%CI: 0.59-1.40). Individuals with financial strain and active social engagement exhibited similar depressive burden as those without financial strain and with active social engagement.

    Limitations: Recall bias and reverse causality may affect study results, although sensitivity analyses suggest their limited effect.

    Conclusions: Early-life financial strain may be of lasting importance for old-age depressive symptoms. Active social engagement in late-life may mitigate this association.

  • 26. Wall-Wieler, Elizabeth
    et al.
    Bolton, James
    Liu, Can
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska Institutet, Sweden.
    Wilcox, Holly
    Roos, Leslie L.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska Institutet, Sweden.
    Intergenerational involvement in out-of-home care and death by suicide in Sweden: A population-based cohort study2018Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 238, s. 506-512Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Individuals involved in out-of-home care are at higher risk of death by suicide. We aimed to determine whether parents with two generations of involvement in out-of-home care (themselves as children, and their own children) are at increased risk of death by suicide than parents with no involvement or parents with one generation of involvement in out-of-home care. Method: This population-based cohort study included all individuals born in Sweden between 1973 and 1980 who had at least one child between 1990 and 2012 (n=487,948). Women (n=259,275) and men (n=228,673) were examined separately. Results: When compared with mothers with no involvement in out-of-home care, mothers with two generations of involvement were at more than five times greater risk of death by suicide (aHR=5.52; 95% CI 2.91-10.46); mothers with one generation of involvement were also at significantly higher risk of death by suicide (mothers were in care as children: aHR=2.35; 95% CI 1.27-4.35; child was placed in care: aHR=3.23; 95% CI 1.79-5.83). Involvement in out-of-home care (in either generation) did not affect risk of death by suicide for fathers. Limitations: Reason for placement in out-of-home care is not known; these reasons could also be associated with risk of death by suicide Conclusion: Mothers with involvement in out- of-home care, either as children or when their child was placed in care, are at significantly higher risk of death by suicide. Mental health services should be provided to individuals involved in out-of-home care.

  • 27. Wu, Jia-Jia
    et al.
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Zhengzhou University, China.
    Yao, Wu
    Yan, Zhen
    Pei, Jin-Jing
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Late-life depression and the risk of dementia in 14 countries: a 10-year follow-up study from the Survey of Health, Ageing and Retirement in Europe2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 274, s. 671-677Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Depression is the most common mental health problem and often co-occurs with dementia in old age. This study investigates the in fluence of late-life depression on risk of dementia.

    Methods: A total of 16210 dementia-free participants aged 60+ from the Survey of Health, Aging, and Retirement in Europe were followed up for 10 years to detect incident dementia. Depression was assessed by a 12-item Europe-depression scale, dementia was determined by physician diagnosis reported by the participants and their informants. Fine and Gray model was performed to explore the association between depression and incident dementia taking into account competing risk of death.

    Results: During an average of 8 years follow-up, 1030 (6.35%) incident dementia were identi fied. Late-life depression was related to higher subdistribution hazard ratio (sHR) of dementia (sHR=1.52, 95%CI: 1.32-1.75) after adjusting for age, gender, country, education, smoking, drinking, living arrangement, BMI, chronic disease, and physical activity. Further, the risk was only existed in those below age of 80 (sHR=1.75, 95%CI: 1.47-2.07). In addition, a dose-response association was observed between the severity of depression and dementia risk (p for trend<0.001).

    Limitation: The ascertainment of depression and dementia was based on information reported by the participants and/or their informants, which might result in information bias. The causal relationship could not be determined because limited follow-up time.

    Conclusions: Late-life depression is associated with higher incidence of dementia in a dose-response fashion. Interventions targeting depression patients aged 60-79 years and those with severe depression may be e ffective strategies to prevent dementia.

  • 28. Zhuo, Lai-Bao
    et al.
    Pei, Jin-Jing
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Yan, Zhen
    Yao, Wu
    Hao, Chang-Fu
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Working life job strain status and cognitive aging in Europe: A 12-year follow-up study2021Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 295, s. 1177-1183Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline.

    Methods: Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline.

    Results: Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job.

    Limitations: Information on working conditions was based on self-reported recollections.

    Conclusions: Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

  • 29. Zhuo, Lai-Bao
    et al.
    Yao, Wu
    Yan, Zhen
    Giron, Maria S. T.
    Pei, Jing-Jing
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Zhengzhou University, China.
    Impact of effort reward imbalance at work on suicidal ideation in ten European countries: The role of depressive symptoms2020Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, s. 214-221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Evidence of the association between effort reward imbalance (ERI) and suicidal ideation is sparse. This study examined the influence of ERI at work on suicidal ideation and the mediating effect of depressive symptoms. Methods: There were 4963 workers aged 50 + without suicidal ideation at baseline in the Survey of Health, Aging and Retirement in Europe, these workers were followed-up for 8-years to detect incident suicidal ideation. ERI was measured by a short ERI questionnaire. Suicidal ideation was evaluated by one item derived from the 12-item Europe-depression scale, and depressive symptoms were assessed by the remaining 11 items in the scale. Cox models were employed to explore the relationship adjusting for potential confounders. Mediation analysis was used to test the mediating effect of depressive symptoms. Results: A significantly higher incidence of suicidal ideation was related with high effort (HR = 1.51) and low reward (HR = 1.42), respectively. A high effort-low reward imbalance was associated with even higher risk of suicidal ideation (HR = 1.96) as compared to low effort-high reward combination. The association was varied by gender, region, education and household income. Depressive symptoms mediated a modest proportion (natural indirect effect 14.4%) of the total association between ERI and suicidal ideation. Limitation: Suicidal ideation definition based on self-administered questionnaires which could lead to false negatives. And some unmeasured confounders might have biased the results. Conclusions: Efforts in promoting balanced effort-reward at work may reduce suicidal ideation among working population aged 50+. Avoiding depressive symptoms may further enhance such efforts.

  • 30.
    Åhlin, Julia K.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Halonen, Jaana
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Finnish Institute for Health and Welfare, Finland.
    Madsen, Ida E. H.
    Rugulies, Reiner
    Sørensen, Jeppe K.
    Magnusson Hanson, Linda L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Interrelationships between job demands, low back pain and depression: A four-way decomposition analysis of direct and indirect effects of job demands through mediation and/or interaction2021Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 282, s. 219-226Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Psychosocial work stressors may lead to low back pain (LBP) through depressive symptoms or to depression through LBP. Depressive symptoms or LBP may also modify these associations.

    Methods: We examined prospective interrelationships between job demands, LBP and depsive symptoms. We used comparable data from three consecutive biennial surveys in 2010-2016, from the Swedish Longitudinal Occupational Survey of Health (SLOSH) and the Work Environment and Health in Denmark (WEHD) cohorts, broadly representative of the working populations in Sweden and Denmark. We conducted multivariate counterfactual based mediation analyses allowing for four-way decomposition of the total effect of job demands, on incident LBP (N=2813, 2701) and incident major depression (N=3707, 5496). The four components estimated direct and indirect effects through mediation and/or interaction.

    Results: We observed no association between job demands and incident LBP four years later, but job demands was associated with later major depression (relative risks=1.88, 95% confidence interval=1.45-2.31 in SLOSH and 1.64, 1.18-2.11 in WEHD, adjusted for age, sex, panel (SLOSH data), education, cohabitation, physically strenuous work and chronic diseases. About 37% of the association was attributed to interaction between job demands and LBP in SLOSH. No interaction was found in WEHD. LBP partly mediated the relationship, by 14% in SLOSH and 2%, while statistically insignificant in WEHD.

    Limitations: Possible limitations include lack of comparable data on disabling low back pain, different scales for depressive symptoms, misclassification and residual confounding. Conclusions: This suggests mainly a direct effect of job demands on major depression, or through other pathways than LBP.

  • 31.
    Åhlin, Julia K.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Rajaleid, Kristiina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Jansson-Fröjmark, Markus
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Magnusson Hanson, Linda L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Job demands, control and social support as predictors of trajectories of depressive symptoms2018Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 235, s. 535-543Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Job demands, job control and social support have been associated with depressive symptoms. However, it is unknown how these work characteristics are associated with different trajectories of depressive symptoms, which this study aimed to examine. Methods: We included 6679 subjects in the Swedish Longitudinal Occupational Survey of Health (SLOSH), who completed biennial questionnaires in 2006-2016. Group-based trajectory models identified groups with similar development of depressive symptoms. Multinomial logistic regression estimated associations between baseline demands, control, social support and trajectories of depressive symptoms. Results: We identified six depression trajectories with varying severity and stability across four measurements. High job demands and low social support, but not low control, were associated with higher probability of belonging to subsequent trajectories with higher symptom level compared to very low symptom level. Adjusted risk ratios ranged from 1.26, 95% CI = 1.06-1.51 (low symptom trajectory) to 2.51, 95% CI = 1.43-4.41 (persistent severe symptom trajectory). Results also indicated that onset of high demands, low control and low social support increases depressive symptoms over time. Limitations: The results were based on self-reported data and all individuals did not have complete data in all waves. Conclusions: The results indicated that especially perceptions of high job demands and low social support are associated with higher or increasing levels of depressive symptoms over time. This support the supposition that high job demands, and low social support may have long-term consequences for depressive symptoms and that interventions targeting job demands and social support may contribute to a more favourable course of depression.

  • 32.
    Öst, Lars-Göran
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Haukeland University Hospital, Norway; Karolinska Institutet, Sweden.
    Enebrink, Pia
    Finnes, Anna
    Ghaderi, Ata
    Havnen, Audun
    Kvale, Gerd
    Salomonsson, Sigrid
    Wergeland, Gro Janne
    Cognitive behavior therapy for adult depressive disorders in routine clinical care: A systematic review and meta-analysis2023Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 331, s. 322-333Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Different cognitive behavioral therapies (CBT) have strong research support for treatment of adult depressive disorders (DD). Given the scarcity of knowledge about the performance of CBT in routine clinical care, a systematic review and meta-analysis of CBT for adults with DD treated in this context was conducted.

    Methods: Published studies until the end of September 2022, were systematically searched in Ovid MEDLINE, Embase OVID, and PsycINFO. The effectiveness of CBT, methodological quality, and moderators of treatment outcome were examined, and benchmarked by meta-analytically comparing with efficacy studies for DD.

    Results: Twenty-eight studies, comprising 3734 participants, were included. Large within-group effect sizes (ES) were obtained for DD-severity at post-treatment, and follow-up, on average 8 months post-treatment. Benchmarking analysis showed that effectiveness studies had very similar ESs as efficacy studies at post-treatment (1.51 vs. 1.71) and follow-up (1.71 vs. 1.85). Remission rates were also very similar; effectiveness studies 44 % and 46 %, efficacy studies 45 % and 46 %, at post-treatment and follow-up, respectively.

    Limitations: Only studies published in English-language peer-reviewed journals were included and the use of pre-post ES in the meta-analyses could contribute to biased outcomes.

    Conclusions: CBT for DD is an effective treatment when delivered in routine clinical care and the outcomes of effectiveness studies for DD are comparable to the effects obtained in efficacy studies.

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