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  • 401. Björkenstam, C.
    et al.
    Björkenstam, E.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Boden, R.
    Reutfors, J.
    Suicide in first episode psychosis: A nationwide cohort study2014In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 157, no 1-3, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background: Relatively little is known about suicide in diagnostic subtypes of first episode psychosis (FEP). Our aim was to assess suicide rates and potential risk factors for suicide in FEP. Methods: This is a national register-based cohort study of patients born in 1973-1978 in Sweden and who were hospitalized with a FEP between ages 15 and 30 years (n = 2819). The patients were followed from date of discharge until death, emigration, or 31st of December 2008. The suicide rates for six diagnostic subtypes of FEP were calculated. Suicide incidence rate ratios (IRRs) were calculated to evaluate the association between suicide and psychiatric, familial, social, and demographic factors. Results: In total 121 patients died by suicide. The overall suicide rate was 4.3 (95% confidence interval [CI] 3.5-5.0) per 1000 person-years. The highest suicide rates were found in depressive disorder with psychotic symptoms and in delusional disorder. In an adjustedmodel, the strongest risk factors for suicide were self-harm (IRR 2.7, CI 1.7-4.4) or a conviction for violent crime (IRR 2.0, CI 1.3-3.2). Also having a first-degree relative with a schizophrenia/bipolar diagnosis (IRR 2.1, CI 1.2-3.6) or substance use disorder (IRR 2.0, CI 1.2-3.2) were significant risk factors for suicide. Conclusions: Impulsive behavior such as self-harm as well as having a family history of severe mental disorder or substance use are important risk factors for suicide in FEP.

  • 402. Björkenstam, C.
    et al.
    Weitoft, G.R.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Nordstrom, P.
    Hallqvist, J.
    Ljung, R.
    School grades, parental education and suicide: a national register-based cohort study2010In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738Article in journal (Refereed)
    Abstract [en]

    Background To investigate whether school performance is a risk factor for suicide death later in life and, if so, to what extent this is explained by intergenerational effects of parental education.

    Methods This population-based cohort study comprises national birth cohorts between 1972 and 1981 in Sweden. We followed 898 342 students, graduating between 1988 and 1997 from the 9 years of compulsory school, equivalent to junior high school, until 31 December 2006, generating 11 148 758 person-years and 1490 suicides. Final school grades, in six categories, and risk of suicide were analysed with Poisson regression.

    Results The incidence rate ratio (RR) for suicide death for students with the lowest grades was 4.57 (95% CI 2.82 to 7.40) for men and 2.67 (1.42 to 5.01) for women compared to those with highest grades after adjustment for a number of sociodemographic and parental morbidity variables, such as year of graduation, parental education, lone parenthood, household receiving social welfare or disability pension, place of schooling, adoption, maternal age and parent's mental illness. Students with grades in the middle categories had RRs in between. These relationships were not modified by parental education.

    Conclusions The strong association between low school grades and suicide in youth and young adulthood emphasises the importance of both primary and secondary prevention in schools.

  • 403.
    Björkenstam, Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. University of California, USA; Karolinska Institutet, Sweden .
    Andersson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Dalman, Christina
    Cochran, Susan
    Kosidou, Kyriaki
    Suicide in married couples in Sweden: Is the risk greater in same-sex couples?2016In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 31, no 7, p. 685-690Article in journal (Refereed)
    Abstract [en]

    Minority sexual orientation is a predictor of suicide ideation and attempts, though its association with suicide mortality is less clear. We capitalize on Sweden's extensively linked databases, to investigate whether, among married individuals, same-sex marriage is associated with suicide. Using a population-based register design, we analyzed suicide risk among same-sex married women and men (n = 6456), as compared to different-sex married women and men (n = 1181723) in Sweden. We selected all newly partnered or married individuals in the intervening time between 1/1/1996 and 12/31/2009 and followed them with regard to suicide until 12/31/2011. Multivariate Poisson regression was used to calculate adjusted incidence risk ratios (IRR) with 95 % confidence intervals (CI). The risk of suicide was higher among same-sex married individuals as compared to different-sex married individuals (IRR 2.7, 95 % CI 1.5-4.8), after adjustment for time at risk and socioeconomic confounding. Sex-stratified analyses showed a tentatively elevated risk for same-sex married women (IRR 2.5, 95 % CI 0.8-7.7) as compared to different-sex married women. Among same-sex married men the suicide risk was nearly three-fold greater as compared to different-sex married (IRR 2.895 % CI 1.5-5.5). This holds true also after adjustment for HIV status. Even in a country with a comparatively tolerant climate regarding homosexuality such as Sweden, same-sex married individuals evidence a higher risk for suicide than other married individuals.

  • 404.
    Björkenstam, Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. University of California, USA; Karolinska Institutet, Sweden.
    Björkenstam, Emma
    Andersson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Cochran, Susan
    Kosidou, Kyriaki
    Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population?2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 3, p. 396-403Article in journal (Refereed)
    Abstract [en]

    Introduction

    Sexual minority individuals have a higher risk of anxiety and depression compared with heterosexuals. However, whether the higher risk is spread equally across the sexual minority population is not clear.

    Aim

    To investigate the association between sexual orientation and self-reported current anxiety and a history of diagnosis of depression, paying particular attention to possible subgroup differences in risks within the sexual minority population, stratified by sex and to examine participants' history of medical care for anxiety disorders and depression.

    Methods

    We conducted a population-based study of 874 lesbians and gays, 841 bisexuals, and 67,980 heterosexuals recruited in 2010 in Stockholm County. Data were obtained from self-administered surveys that were linked to nationwide registers. Main Outcome Measures: By using logistic regression, we compared risks of current anxiety, histories of diagnosed depression, and register-based medical care for anxiety and/or depression in lesbian and gay, bisexual, and heterosexual individuals.

    Results

    Bisexual women and gay men were more likely to report anxiety compared with their heterosexual peers. Bisexual individuals and gay men also were more likely to report a past diagnosis of depression. All sexual minority groups had an increased risk of having used medical care for anxiety and depression compared with heterosexuals, with bisexual women having the highest risk.

    Conclusion

    Bisexual women appear to be a particularly vulnerable sexual minority group. Advocating for nondiscrimination and protections for lesbian, gay, and bisexual people is a logical extension of the effort to lower the prevalence of mental illness.

  • 405.
    Björkenstam, Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Karolinska Institutet, Sweden; University of California, USA.
    Ekselius, Lisa
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Social Work. National Board of Health and Welfare, Sweden.
    Gerdin, Bengt
    Björkenstam, Emma
    Suicide risk and suicide method in patients with personality disorders2016In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 83, p. 29-36Article in journal (Refereed)
    Abstract [en]

    Objective: The influence of psychopathology on suicide method has revealed different distributions among different psychiatric disorders. However, evidence is still scarce. We hypothesized that having a diagnosis of personality disorder (PD) affect the suicide method, and that different PD clusters would influence the suicide method in different ways. In addition, we hypothesized that the presence of psychiatric and somatic co-morbidity also affects the suicide method. Method: We examined 25,217 individuals aged 15-64 who had been hospitalized in Sweden with a main diagnosis of PD the years 1987-2013 (N = 25,217). The patients were followed from the date of first discharge until death or until the end of the follow-up period, i.e. December 31, 2013, for a total of 323,508.8 person-years, with a mean follow up time of 11.7 years. The SMR, i.e. the ratio between the observed number of suicides and the expected number of suicides, was used as a measure of risk. Results: Overall PD, different PD-clusters, and comorbidity influenced the suicide method. Hanging evidenced highest SMR in female PD patients (SMR 34.2 (95% CI: 29.3-39.8)), as compared to non-PD patients and jumping among male PD patients (SMR 24.8 (95% CI: 18.3-33.6)), as compared to non PD-patients. Furthermore, the elevated suicide risk was related to both psychiatric and somatic comorbidity. Conclusion: The increased suicide risk was unevenly distributed with respect to suicide method and type of PD. However, these differences were only moderate and greatly overshadowed by the overall excess suicide risk in having PD. Any attempt from society to decrease the suicide rate in persons with PD must take these characteristics into account.

  • 406.
    Björkenstam, Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Karolinska Institutet, Sweden; University of California, USA.
    Kosidou, Kyriaki
    Björkenstam, Emma
    Childhood adversity and risk of suicide: cohort study of 548 721 adolescents and young adults in Sweden2017In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 357, article id j1334Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To examine the relation between childhood adversity, the role of school performance, and childhood psychopathology and the risk of suicide. DESIGN Cohort study of register based indicators of childhood adversity (at ages 0-14) including death in the family (suicide analysed separately), parental substance abuse, parental psychiatric disorder, substantial parental criminality, parental separation/single parent household, receipt of public assistance, and residential instability. SETTING Swedish medical birth register and various Swedish population based registers. PARTICIPANTS 548 721 individuals born 1987-91. MAIN OUTCOME MEASURES Estimates of suicide risk at ages 15-24 calculated as incidence rate ratios adjusted for time at risk and confounders. Results Adjusted incidence rate ratios for the relation between childhood adversity and suicide during adolescence and young adulthood ranged from 1.6 (95% confidence interval 1.1 to 2.4) for residential instability to 2.9 (1.4 to 5.9) for suicide in the family. There was a dose-response relation between accumulating childhood adversity and risk: 1.1 (0.9 to 1.4) for those exposed to one adversity and 1.9 (1.4 to 2.5) and 2.6 (1.9 to 3.4) for those exposed to two and three or more adversities, respectively. The association with increased risk of suicide remained even after adjustment for school performance and childhood psychopathology. CONCLUSION Childhood adversity is a risk factor for suicide in adolescence and young adulthood, particularly accumulated adversity. These results emphasise the importance of understanding the social mechanisms of suicide and the need for effective interventions early in life, aiming to alleviate the risk in disadvantaged children.

  • 407.
    Björkenstam, Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Karolinska Institutet, Sweden; University of California, USA.
    Kosidou, Kyriaki
    Björkenstam, Emma
    Dalman, Christina
    Andersson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Cochran, Susan
    Self-reported suicide ideation and attempts, and medical care for intentional self-harm in lesbians, gays and bisexuals in Sweden2016In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 70, no 9, p. 895-901Article in journal (Refereed)
    Abstract [en]

    Background Minority sexual orientation is a robust risk indicator for self-reported suicidal ideation and attempts. However, little is known about patterns of medical care for intentional self-harm in this vulnerable population. We investigate sexual orientation-related differences in self-reported lifetime suicide symptoms and medical care for intentional self-harm between 1969 and 2010, including age at initial treatment and recurrence. Methods We used data from the Stockholm Public Health Cohort, a population-based sample of 874 lesbians/gays, 841 bisexuals and 67980 heterosexuals, whose self-administered surveys have been linked to nationwide registers. Estimates of risk for medical care were calculated as incidence rate ratios (IRR) with 95% CIs. Results Both suicidal ideation and attempts were more commonly reported by lesbian/gay and bisexual (LGB) individuals. Adjusting for risk-time and confounding, lesbians (IRR 3.8, 95% CI 2.7 to 5.4) and bisexual women (IRR 5.4, 95% CI 4.4 to 6.6) experienced elevated risk for medical care for intentional self-harm, as compared to heterosexual women. Gay men evidenced higher risk (IRR 2.1, 95% CI 1.3 to 3.4) as compared to heterosexual men. Recurrent medical care was more frequent in LGB individuals, especially in bisexual women and gay men. Lesbian and bisexual women were also younger than heterosexual women when they first received medical care for intentional self-harm. Conclusions Positive histories of suicidal ideation, attempts and medical care for intentional self-harm, including higher levels of recurrence, are more prevalent among LGB individuals in contrast to heterosexuals. Lesbian/bisexual women evidence an earlier age of onset of treatment. Tailored prevention efforts are urgently needed.

  • 408. Björkenstam, E.
    et al.
    Björkenstam, C.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Reutfors, J.
    Bodén, R.
    A five year diagnostic follow-up of 1840 patients after a first episode non-schizophrenia and non-affective psychosis2013In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 150, no 1, p. 205-210Article in journal (Refereed)
    Abstract [en]

    Objective

    It is not clear which patients with a first psychotic episode will develop schizophrenia. We performed a diagnostic follow-up of patients treated for a first time non-affective, non-schizophrenia psychosis and explored potential predictors of a subsequent schizophrenia or schizoaffective diagnosis.

    Methods

    This register-based cohort study comprises individuals born between 1973 and 1978 in Sweden, with a first hospital-treated psychosis excluding schizophrenia, schizoaffective disorder, bipolar disorder and depressive disorder with psychotic symptoms (n = 1840). The patients were followed for five years regarding subsequent diagnoses. Psychiatric, social, family history of psychiatric illness, premorbid intellectual level, head injuries and obstetrical complications were investigated by logistic regression as predictors of schizophrenia or schizoaffective diagnosis.

    Results

    During the follow-up, 18% were diagnosed with schizophrenia or schizoaffective disorder, 5% were diagnosed with bipolar disorder, whereas 29% were not re-admitted to a psychiatric clinic. Patients with a first-degree relative hospitalized for schizophrenia and/or bipolar disorder had an increased risk of subsequent diagnosis for schizophrenia or schizoaffective disorder (odds ratio 1.9 and 95% confidence interval 1.1 to 3.0)), whereas previous severe criminality was associated with a decreased risk (odds ratio 0.5, 95% confidence interval 0.3–0.8).

    Conclusion

    Diagnostic outcome was diverse after a first non-schizophrenia and non-affective psychosis. Family history of severe mental illness and no previous conviction for severe criminality were the strongest risk factors for a future schizophrenia or schizoaffective diagnosis.

  • 409. Björkenstam, Emma
    et al.
    Burström, Bo
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Björkenstam, Charlotte
    Pebley, Anne R.
    Cumulative exposure to childhood stressors and subsequent psychological distress. An analysis of US panel data2015In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 142, p. 109-117Article in journal (Refereed)
    Abstract [en]

    Research has shown that childhood stress increases the risk of poor mental health later in life. We examined the effect of childhood stressors on psychological distress and self-reported depression in young adulthood. Data were obtained from the Child Development Supplement (CDS) to the national Panel Study of Income Dynamics (PSID), a survey of US families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood (TA) data drawn from a national sample of young adults, 18-23 years old. This study included data from participants in the CDS and the TA (n = 2128), children aged 4-13 at baseline. Data on current psychological distress was used as an outcome variable in logistic regressions, calculated as odds ratios (OR) with 95% confidence intervals (CI). Latent Class Analyses were used to identify clusters based on the different childhood stressors. Associations were observed between cumulative exposure to childhood stressors and both psychological distress and self-reported depression. Individuals being exposed to three or more stressors had the highest risk (crude OR for psychological distress: 2.49 (95% Cl: 1.16-5.33), crude OR for self-reported depression: 2.07 (95% CI: 1.15-3.71). However, a large part was explained by adolescent depressive symptoms. Findings support the long-term negative impact of cumulative exposure to childhood stress on psychological distress. The important role of adolescent depression in this association also needs to be taken into consideration in future studies.

  • 410. Björkenstam, Emma
    et al.
    Burström, Bo
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Kosidou, Kyriaki
    Childhood adversity and psychiatric disorder in young adulthood: An analysis of 107,704 Swedes2016In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 77, p. 67-75Article in journal (Refereed)
    Abstract [en]

    Childhood adversity (CA) is associated with increased risks of psychiatric disorder in young adulthood, but details in this association are less known. We aimed to explore the association of a range of CA indicators with psychiatric disorder in young adulthood, and the impact of age at exposure, disorder type and accumulation of indicators. We capitalized on Sweden's extensive and high-quality registers and analyzed a cohort of all Swedes (N = 107,704) born in Stockholm County 1987-1991. Adversities included familial death, parental substance misuse and psychiatric disorder, parental criminality, parental separation, public assistance recipiency and residential instability. Age at exposure was categorized as: 0-6.9 years (infancy and early childhood), 7-11.9 years (middle childhood), and 12-14 years (early adolescence). Psychiatric disorders after age 15 were defined from ICD codes through registers. Risks were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI). Results showed that exposure to at least one CA was associated with an increased risk of psychiatric disorder (HR 1.4, 95% CI: 1.3-1.4). Risks were increased for mood, anxiety, and psychotic disorders and ADHD but not for eating disorders. The risk varied with type of disorder but was similar for all exposure periods. Individuals with multiple (3+) CAs had a two-fold risk of psychiatric disorder (HR 2.0, 95% CI: 1.9-2.1). In conclusion, our findings support the long-term negative impact of CA on mental health, regardless of developmental period of exposure. Given that experience of CA is common, efforts should be put to alleviate the burden of childhood adversities for children, particularly among the most disadvantaged.

  • 411. Björkenstam, Emma
    et al.
    Cheng, Siwei
    Burström, Bo
    Pebley, Anne R.
    Björkenstam, Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Sociology. University of California, USA; Karolinska Institutet, Sweden.
    Kosidou, Kyriaki
    Association between income trajectories in childhood and psychiatric disorder: a Swedish population-based study2017In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 71, no 7, p. 648-654Article in journal (Refereed)
    Abstract [en]

    Background Childhood family income variation is an understudied aspect of households' economic context that may have distinct consequences for children. We identified trajectories of childhood family income over a 12-year period, and examined associations between these trajectories and later psychiatric disorders, among individuals born in Sweden between 1987 and 1991 (n=534 294).

    Methods We used annual income data between the ages of 3-14 years and identified 5 trajectories (2 high-income upward, 1 downward and 2 low-income upward trajectories). Psychiatric disorders in the follow-up period after age 15 were defined from International Classification of Disease (ICD)-codes in a nationwide patient register. Multiadjusted risks for all psychiatric disorders, as well as for specific psychiatric diagnoses, were calculated as HRs with 95% CIs.

    Results Of the 5 identified income trajectories, the constant low and the downward trajectories were particularly associated with later psychiatric disorder. Children with these trajectories had increased risks for psychiatric disorder, including mood, anxiety, psychotic disorders and attention deficit/hyperactivity disorder. The association remained, even after adjusting for important variables including parental psychiatric disorder. In contrast, the relationship was reversed for eating disorders, for which children in higher income trajectories had elevated risks.

    Conclusions Findings show that children growing up in a household characterised by low or decreasing family income have an increased risk for psychiatric disorder. Continued work is needed to reduce socioeconomic inequalities in psychiatric disorders. Policies and interventions for psychiatric disorders should consider the socioeconomic background of the family as an important risk or protective factor.

  • 412. Björkenstam, Emma
    et al.
    Dalman, Christina
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Ringbäck Weitoft, Gunilla
    Walder, Deborah J.
    Burström, Bo
    Childhood household dysfunction, school performance and psychiatric care utilisation in young adults: a register study of 96 399 individuals in Stockholm County2016In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 70, no 5, p. 473-480Article in journal (Refereed)
    Abstract [en]

    Background Exposure to childhood household dysfunction increases the risk of psychiatric morbidity. Although school performance also has been linked with psychiatric morbidity, limited research has considered school performance as a mediating factor. To address this gap in the literature, the current register study examined whether school performance mediates the association between childhood household dysfunction (experienced between birth and age 14 years) and psychiatric care utilisation in young adulthood.

    Methods We used a Swedish cohort of 96 399 individuals born during 1987–1991. Indicators of childhood household dysfunction were familial death, parental substance abuse and psychiatric morbidity, parental somatic disease, parental criminality, parental separation/single-parent household, public assistance recipiency and residential instability. Final school grades from the 9th year of compulsory school were used to create five categories. Estimates of risk of psychiatric care utilisation (measured as inpatient, outpatient and primary care) after the age of 18 years were calculated as HRs with 95% CIs. Mediation was tested with the bootstrap approach.

    Results Cumulative exposure to childhood household dysfunction was positively associated with psychiatric care utilisation. Specifically, individuals exposed to three or more indicators with incomplete school grades had the highest risk (HR=3.7 (95% CI 3.3 to 4.1) after adjusting for demographics), compared to individuals exposed to no indicators with highest grades. School performance was found to mediate the relationship.

    Conclusions Our findings suggest that future efforts to prevent or mitigate the negative effects of childhood household dysfunction on psychiatric morbidity may benefit from integration of strategies that improve school performance among vulnerable youth.

  • 413. Björkenstam, Emma
    et al.
    Ekselius, Lisa
    Burström, Bo
    Kosidou, Kyriaki
    Björkenstam, Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Karolinska Institutet, Sweden; University of California, USA.
    Association between childhood adversity and a diagnosis of personality disorder in young adulthood: a cohort study of 107,287 individuals in Stockholm County2017In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 32, no 8, p. 721-731Article in journal (Refereed)
    Abstract [en]

    Childhood adversity (CA) may increase the risk for later developing of personality disorder (PD). However, less is known about the association between cumulative CA and PD, and the role of childhood psychopathology and school performance. The current study examined the relationship between a range of CAs and a diagnosis of PD in young adulthood, and the roles of childhood psychopathology and school performance in this relationship. All individuals born in Stockholm County 1987-1991 (n = 107,287) constituted our cohort. Seven CAs were measured between birth and age 14: familial death, parental criminality, parental substance abuse and psychiatric morbidity, parental separation and/or single-parent household, household public assistance and residential instability. Individuals were followed from their 18th birthday until they were diagnosed with PD or until end of follow-up (December 31st 2011). Adjusted estimates of risk of PD were calculated as hazard ratios (HR) with 95% confidence intervals (CI). Associations were observed between cumulative CA and PD. During the follow-up 770 individuals (0.7%) were diagnosed with PD. Individuals exposed to 3+ CAs had the highest risks of being diagnosed with PD (HR 3.0, 95% CI 2.4-3.7). Childhood psychopathology and low school grades further increased the risk of PD among individuals exposed to CA. Cumulative CA is strongly associated with a diagnosis of PD in young adulthood. Our findings indicate that special attention should be given in schools and health services to children exposed to adversities to prevent decline in school performance, and to detect vulnerable individuals that may be on negative life-course trajectories.

  • 414. Björkenstam, Emma
    et al.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Björkenstam, Charlotte
    Kosidou, Kyriaki
    Association of Cumulative Childhood Adversity and Adolescent Violent Offending With Suicide in Early Adulthood2018In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 75, no 2, p. 185-193Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE Childhood adversity (CA) is associated with an increased risk of suicide in young adulthood that might be explained by maladaptive trajectories during adolescence. Although adolescent violent offending is linked with suicide, little is known about its role in the association between CA and suicide. OBJECTIVE To examine whether adolescent violent offending mediates the association between CA and suicide in early adulthood. DESIGN, SETTING, AND PARTICIPANTS This population-based, longitudinal cohort study with a follow-up time spanning 5 to 9 years included 476 103 individuals born in Sweden between 1984 and 1988. The study population was prospectively followed up from 20 years of age until December 31, 2013, with respect to suicide. Data analysis was performed from January 1, 1984, to December 31, 2013. EXPOSURES Register-based CAs included parental death, parental substance abuse and psychiatric disorder, parental criminal offending, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Adolescent violent offending was defined as being convicted of a violent crime between the ages of 15 and 19 years. MAIN OUTCOMES AND MEASURES Estimates of risk of suicide after 20 years of age (from 2004 if born in 1984 and from 2008 if born in 1988) until the end of 2013 were calculated as incidence rate ratios (IRRs) with 95% CIs using Poisson regression analysis. Adjustments were made for demographics and psychiatric disorder. In addition, binary mediation analysis with logistic regression was used. RESULTS A total of 476 103 individuals (231 699 [48.7%] female) were included in the study. Those with a conviction for violent offending had been exposed to all CAs to a greater extent than those with no violent offending. Cumulative CA was associated with risk of suicide in nonconvicted (adjusted IRR, 2.4; 95% CI, 1.5-3.9) and convicted youths, who had a higher risk of suicide (adjusted IRR, 8.5; 95% CI, 4.6-15.7). Adolescent violent offending partly mediated the association between CA and suicide. CONCLUSIONS AND RELEVANCE Individuals with a history of CA who also engage in violent offending in adolescence have a high risk of suicide. Interventions to prevent externalizing behavior during childhood and increased support to youths with delinquent behavior may have the potential to prevent suicide related to CA.

  • 415. Björkenstam, Emma
    et al.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Adverse childhood experiences and disability pension in early midlife: results from a Swedish National Cohort Study2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no 3, p. 472-477Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have examined the association between adverse childhood experiences (ACEs) and disability pension (DP). The current study aimed to investigate the relationship between different ACEs, cumulative ACEs, and DP, and the mediating role of school performance. Methods: We used a Swedish cohort of 522 880 individuals born between 1973 and 1978. ACEs included parental death, parental substance abuse and psychiatric disorder, substantial parental criminality, household public assistance, parental DP and child welfare intervention. Estimates of risk of DP in 2008 were calculated as odds ratios (OR) with 95% confidence intervals (CIs). Results: A total of 2.3% (3.0% females, 1.7% males) received DP in 2008. All studied ACEs increased the odds for DP, particularly child welfare intervention and household public assistance. Cumulative ACEs increased the odds of DP in a graded manner. Females exposed to 4+ ACEs had a 4-fold odds (OR: 4.0, 95% CI 3.5-4.5) and males a 7-fold odds (OR: 7.1, 95% CI: 6.2-8.1). School performance mediated the ACEs-DP association. Conclusion: This study provides evidence that ACEs is associated with increased odds of DP, particularly when accumulated. The effects of ACEs should be taken into account when considering the determinants of DP, and when identifying high-risk populations.

  • 416. Björkenstam, Emma
    et al.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Karolinska Institutet, Sweden.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Impact of childhood adversities on depression in early adulthood: A longitudinal cohort study of 478,141 individuals in Sweden2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 223, p. 95-100Article in journal (Refereed)
    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.

  • 417.
    Björklund, Asa K
    et al.
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Light, Sara
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Hedin, Linnea
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Elofsson, Arne
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Quantitative assessment of the structural bias in protein-protein interaction assays.2008In: Proteomics, ISSN 1615-9853, E-ISSN 1615-9861, Vol. 8, no 22, p. 4657-46667Article in journal (Refereed)
    Abstract [en]

    With recent publications of several large-scale protein-protein interaction (PPI) studies, the realization of the full yeast interaction network is getting closer. Here, we have analysed several yeast protein interaction datasets to understand their strengths and weaknesses. In particular, we investigate the effect of experimental biases on some of the protein properties suggested to be enriched in highly connected proteins. Finally, we use support vector machines (SVM) to assess the contribution of these properties to protein interactivity. We find that protein abundance is the most important factor for detecting interactions in tandem affinity purifications (TAP), while it is of less importance for Yeast Two Hybrid (Y2H) screens. Consequently, sequence conservation and/or essentiality of hubs may be related to their high abundance. Further, proteins with disordered structure are over-represented in Y2H screens and in one, but not the other, large-scale TAP assay. Hence, disordered regions may be important both in transient interactions and interactions in complexes. Finally, a few domain families seem to be responsible for a large part of all interactions. Most importantly, we show that there are method-specific biases in PPI experiments. Thus, care should be taken before drawing strong conclusions based on a single dataset.

  • 418.
    Björklund, Catarina
    et al.
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Adolfsson, Hans
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Jansson, Katarina
    Lindberg, Jimmy
    Vrang, Lotta
    Hallberg, Anders
    Rosenquist, Åsa
    Samuelsson, Bertil
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Discovery of Potent BACE-1 Inhibitors Containing a New Hydroxyethylene (HE) Scaffold: Exploration of P1’ Alkoxy Residues and an Aminoethylene (AE) Central Core2010In: Bioorganic & Medicinal Chemistry, ISSN 0968-0896, E-ISSN 1464-3391, Vol. 18, no 4, p. 1711-1723Article in journal (Refereed)
    Abstract [en]

    In a preceding study we have described the development of a new hydroxyethylene (HE) core motif displaying P1 aryloxymethyl and P1’ methoxy substituents delivering potent BACE-1 inhibitors. In a continuation of this work we have now explored the SAR of the S1’ pocket by introducing a set of P1’ alkoxy groups and evaluated them as BACE-1 inhibitors. Previously the P1 and P1’ positions of the classical HE template have been relatively little explored due to the complexity of the chemical routes involved in modifications at these positions. However, the chemistries developed for the current HE template renders substituents in both the P1 and P1’ positions readily available for SAR exploration. The BACE-1 inhibitors prepared displayed IC50 values in the range of 4-45 nM, where the most potent compounds featured small P1’ groups. The cathepsin D selectivity which was high for the smallest P1’ sustituents (P1’=ethoxy, fold selectively >600) dropped for larger groups (P1’=benzyloxy, fold selectivity of 1.6). We have also confirmed the importance of both the hydroxyl group and its stereochemistry preference for this HE transition state isostere by preparing both the deoxygenated analogue and by inverting the configuration of the hydroxyl group to the R-configuration, which as expected resulted in large activity drops. Finally substituting the hydroxyl group by an amino group having the same configuration (S), which previously have been described to deliver potent BACE-1 inhibitors with advantageous properties, surprisingly resulted in a large drop in the inhibitory activity.

  • 419.
    Björklund, Catarina
    et al.
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Oscarson, Stefan
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Benkestock, Kurt
    Borkakoti, Neera
    Jansson, Katarina
    Lindberg, Jimmy
    Vrang, Lotta
    Hallberg, Anders
    Rosenquist, Åsa
    Samuelsson, Bertil
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Design and synthesis of potent and selective BACE-1 inhibitors2010In: Journal of Medicinal Chemistry, ISSN 0022-2623, E-ISSN 1520-4804, Vol. 53, no 4, p. 1458-1464Article in journal (Refereed)
    Abstract [en]

    Several highly potent BACE-1 protease inhibitors have been developed from an inhibitor series containing a novel hydroxyethylene (HE) core structure displaying aryloxymethyl or benzyloxymethyl P1 side chains and a methoxy P1’ side chain. The target molecules were readily synthesized from chiral carbohydrate starting materials, furnishing the inhibitor compounds in good overall yields. The inhibitors show both high BACE-1 potency and good selectivity against cathepsin D, where the most potent inhibitor furnish a BACE-1 IC50 value of 0.32 nM and displays > 3000 fold selectivity over cathepsin D.

  • 420.
    Björklund, Justina A.
    et al.
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Sellström, Ulla
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    de Wit, Cynthia A.
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Aune, M.
    Lignell, S.
    Darnerud, P. O.
    Comparisons of polybrominated diphenyl ether and hexabromocyclododecane concentrations in dust collected with two sampling methods and matched breast milk samples2012In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, no 4, p. 279-288Article in journal (Refereed)
    Abstract [en]

    Household dust from 19 Swedish homes was collected using two different sampling methods: from the occupants own home vacuum cleaner after insertion of a new bag and using a researcher-collected method where settled house dust was collected from surfaces above floor level. The samples were analyzed for 16 polybrominated diphenyl ether (PBDE) congeners and total hexabromocyclododecane (HBCD). Significant correlations (r = 0.600.65, Spearman r = 0.470.54, P < 0.05) were found between matched dust samples collected with the two sampling methods for ?OctaBDE and ?DecaBDE but not for ?PentaBDE or HBCD. Statistically significantly higher concentrations of all PBDE congeners were found in the researcher-collected dust than in the home vacuum cleaner bag dust (VCBD). For HBCD, however, the concentrations were significantly higher in the home VCBD samples. Analysis of the bags themselves indicated no or very low levels of PBDEs and HBCD. This indicates that there may be specific HBCD sources to the floor and/or that it may be present in the vacuum cleaners themselves. The BDE-47 concentrations in matched pairs of VCBD and breast milk samples were significantly correlated (r = 0.514, P = 0.029), indicating that one possible exposure route for this congener may be via dust ingestion. Practical Implications The statistically significant correlations found for several individual polybrominated diphenyl ether (PBDE) congeners, ?OctaBDE and ?DecaBDE between the two dust sampling methods in this study indicate that the same indoor sources contaminate both types of dust or that common processes govern the distribution of these compounds in the indoor environment. Therefore, either method is adequate for screening ?OctaBDE and ?DecaBDE in dust. The high variability seen between dust samples confirms results seen in other studies. For hexabromocyclododecane (HBCD), divergent results in the two dust types indicate differences in contamination sources to the floor than to above-floor surfaces. Thus, it is still unclear which dust sampling method is most relevant for HBCD as well as for ?PentaBDE in dust and, further, which is most relevant for determining human exposure to PBDEs and HBCD.

  • 421.
    Björklund, Åsa K.
    et al.
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Ekman, Diana
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Elofsson, Arne
    Stockholm University, Faculty of Science, Department of Biochemistry and Biophysics.
    Expansion of Protein Domain Repeats2006In: PloS Computational Biology, ISSN 1553-734X, E-ISSN 1553-7358, Vol. 2, no 8, p. 959-970Article in journal (Refereed)
    Abstract [en]

    Many proteins, especially in eukaryotes, contain tandem repeats of several domains from the same family. These repeats have a variety of binding properties and are involved in protein-protein interactions as well as binding to other ligands such as DNA and RNA. The rapid expansion of protein domain repeats is assumed to have evolved through internal tandem duplications. However, the exact mechanisms behind these tandem duplications are not well-understood. Here, we have studied the evolution, function, protein structure, gene structure, and phylogenetic distribution of domain repeats. For this purpose we have assigned Pfam-A domain families to 24 proteomes with more sensitive domain assignments in the repeat regions. These assignments confirmed previous findings that eukaryotes, and in particular vertebrates, contain a much higher fraction of proteins with repeats compared with prokaryotes. The internal sequence similarity in each protein revealed that the domain repeats are often expanded through duplications of several domains at a time, while the duplication of one domain is less common. Many of the repeats appear to have been duplicated in the middle of the repeat region. This is in strong contrast to the evolution of other proteins that mainly works through additions of single domains at either terminus. Further, we found that some domain families show distinct duplication patterns, e. g., nebulin domains have mainly been expanded with a unit of seven domains at a time, while duplications of other domain families involve varying numbers of domains. Finally, no common mechanism for the expansion of all repeats could be detected. We found that the duplication patterns show no dependence on the size of the domains. Further, repeat expansion in some families can possibly be explained by shuffling of exons. However, exon shuffling could not have created all repeats.

  • 422.
    Björling, Thomas
    Stockholm University, Faculty of Science, Department of Physical, Inorganic and Structural Chemistry.
    Synthesis and characterisation of Zintl hydrides2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The synthesis, structural characterisation and the properties of the Zintl hydrides AeE2H2 and AeAlSiH (Ae = Ba, Ca, Sr; E = Al, Ga, In, Si, Zn) are reported. The first hydride in this class of compounds is SrAl2H2 which was discovered under an experiment by Gingl, who hydrogenated SrAl2 at various temperatures. (Gingl et al, Journal of Alloys and Compounds 306 (2000) 127-132). The intention was to form alanates, e.g. AlH4-, by terminating the three dimensional four connected aluminium network in SrAl2. The new hydride, SrAl2H2, has a partially conserved aluminium network. The three dimensional anionic network in SrAl2 is reduced to two dimensions in the hydride, with aluminium bonded to both aluminium and hydrogen. This type of bonding configuration has not been observed before.

    The hydrogenation of SrAl2 is straight forward, 190 oC and 50 bar, compared to the difficult synthesis of alanates and alane, AlH3. The latter synthesises uses aluminium in its zero oxidation state in contrast to the synthesis of SrAl2H2 from SrAl2. (In the SrAl2-precursor aluminium is reduced by the electropositive metal to -I.) Thus, the discovery shows a different route to alanates by using precursors with aluminium in a reduced state. If SrAl2H2 is further hydrogenated at 250 oC the two dimensional network breaks and Sr2AlH7 forms.

    We wanted to investigate if SrAl2H2 was a singularity or if other similar compounds exist. We wanted to study how hydrogenation of precursors similar to the aluminide result in 1) new routes to compounds with high hydrogen content, as alanates, 2) to investigate how the E-H bond is affected as function of the network composition among different ternary hydrides, in particular BaAlxSi2-xHx, and choice of active metal.

    BaGa2H2 and SrGa2H2, two hydrides isostructural with SrAl2H2, were synthesized from its precursors BaGa2 and SrGa2. In addition three ternary hydrides BaAlSiH, CaAlSiH and SrAlSiH were manufactured from their related AeAlSi precursors.

    All powders were characterized by neutron and x-ray diffraction methods.

    An increased stability towards water/moisture compared to ordinary saline hydrides was noticed, especially for the ternary hydrides. Heat stability was measured with DSC (differential scanning calorimetry). The hydrides BaGa2H2 and SrGa2H2 decompose around 300 oC at 1 atm. This is similar to isostructural SrAl2H2. The ternary hydrides BaAlSiH and SrAlSiH decompose at 600 oC, at 1 atm, which is the highest noticed temperature for compounds with Al-H bonds. Inelastic neutron scattering experiments showed that these hydrides Al-H and Sr-H bonds are really weak, even weaker then the Al-H interactions in alanates and alanes. These hydrides are probably stabilized be their lattices. The electric properties among the ternary hydrides were measured with IR-spectroscopy (diffuse reflectance). The ternary hydrides, AeAlSiH, are indirect semi conductors. BaGa2H2 and SrGa2H2 are conductors. The ternary hydrides, AeAlxSi2-xHx, may have adjustable band gaps, which we were not able to determine.

    This work is leading into a new research area within the field of metal hydrides.

  • 423. Blair, Mitch
    et al.
    Stewart-Brown, Sarah
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bremberg, Sven
    Barnhälsovetenskap2013 (ed. 1.)Book (Other academic)
  • 424. Blom, Victoria
    et al.
    Richter, Anne
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden; Stockholm County Council, Sweden.
    Hallsten, Lennart
    Svedberg, Pia
    The associations between job insecurity, depressive symptoms and burnout: The role of performance-based self-esteem2018In: Economic and Industrial Democracy, ISSN 0143-831X, E-ISSN 1461-7099, Vol. 39, no 1, p. 48-63Article in journal (Refereed)
    Abstract [en]

    Despite agreement on the negative effects of job insecurity, more knowledge needs to be generated on the health effects in terms of burnout and depressive symptoms and for whom job insecurity has these negative effects. The present study aims to investigate the associations between job insecurity and burnout and depressive symptoms respectively, by studying the moderation influences of performance-based self-esteem (PBSE), a form of contingent self-esteem. A population-based sample with 4145 twins was used. The results showed that job insecurity was significantly associated with both burnout and depressive symptoms, and that PBSE acted as a moderator, so that the associations were stronger for individuals with high PBSE than for individuals with low PBSE. The study contributes by including a personality characteristic to gain more knowledge about the mechanisms of job insecurity on mental ill-health, and by illustrating that job insecurity has an impact on severe health outcomes in terms of burnout and depressive symptoms.

  • 425. Blom, Victoria
    et al.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Bodin, Lennart
    Bergström, Gunnar
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Svedberg, Pia
    Work-Home Interference and Burnout A Study Based on Swedish Twins2014In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 4, p. 361-366Article in journal (Refereed)
    Abstract [en]

    Objective: This study sets out to investigate the impact of work-home interference on burnout in women and men, while taking genetic and family environmental factors into account. Methods: A total of 4446 Swedish twins were included in the study. The effects of work-home conflict (WHC) and home-work conflict (HWC) on burnout between and within pairs were analyzed with co-twin control analyses. Results: Both WHC and HWC were significantly associated with burnout. Genetic factors may be involved in the association between HWC and burnout in women. Familial factors were not involved for WHC and burnout, neither for women nor for men. Conclusions: This study shows the importance to encounter WHC per se to prevent burnout. Because of genetic confounding in HWC and burnout in women, preventive efforts may also take into account individual characteristics.

  • 426.
    Blomqvist, Helen
    Stockholm University, Faculty of Science, Department of Physical, Inorganic and Structural Chemistry.
    Magnesium ions stabilizing solid-state transition metal hydrides2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis is focused on hydrides containing first-row transition metal–hydrido complexes counterbalanced by magnesium. In particular, fundamental properties of the promising hydrogen storage material Mg2NiH4 have been studied. Results presented in the thesis provide detailed knowledge of the electronic structure and bonding mechanisms and are of significance for improving the hydrogen desorption process of complex transition metal hydrides in general.Two competing stabilization mechanisms in Mg2NiH4 have been identified; presence of microtwinning in the structure and the extra Mg added to the melt-cast Mg2Ni starting alloys, which acts as stabilizing dopant in the Mg2NiH4 system. When eliminating both stabilization mechanisms, the hydrogen release pressure was doubled at 453 K. Mg2NiH4 behaves like a heavily doped semiconductor at lower temperatures, but the conductivity is counteracted by the introduction of microtwinning in the structure at elevated temperatures, which makes the hydride non-conducting at » 400 K. The conductivity can be regained by reducing the amount of microtwinning with an applied mechanical pressure. Size, coordination and type of cation framework have decisive roles in determining the structure type of complex metal hydrides, as shown by ab initio total-energy calculations. Compared to the rich variety of Pd-based complex hydrides, the few Ni hydrido complexes hitherto found only contain Mg2+, solely or in combination with Ca2+, Sr2+, Yb2+, Eu2+ or La3+. Apparently the rather weak Ni–H bond needs a small and polarizing cation, e.g. Mg2+, to be stabilized in the solid state. The rather strong Mg–H interaction makes Mg2NiH4 a hybrid of ionic and complex transition metal hydride. This stabilization mechanism where electron density is redistributed by the polarizable hydrido ligand explains why Mg2NiH4 is very sensitive to disturbances of the crystal ordering, e.g. doping and ball milling, which profoundly affect stability, conductivity, color, structure and phasetransition conditions. Mg2+ also has the ability to stabilize Mn hydrido complexes, as observed in the novel Mg3MnH~6 compound, synthesized at GPa pressure in the solid state.

  • 427.
    Blomqvist, Jan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Av egen kraft - med andras stöd2013In: Hjälpande möten i vård och omvärld: brukare, praktiker och forskare reflekterar / [ed] Ingemar Ljungqvist, Håkan Jenner, Stockholm: Liber, 2013, p. 182-210Chapter in book (Other academic)
  • 428.
    Blomqvist, Jan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Dogmer som dödar: Vägval för svensk narkotikapolitik2017In: Dogmer som dödar: Vägval för svensk narkotikapolitik / [ed] Niklas Eklund, Mikaela Hildebrand, Stockholm: Verbal , 2017, p. 291-311Chapter in book (Other academic)
  • 429. Blomqvist, Jan
    et al.
    Raitasalo, Kirsimarja
    Koski-Jännes, Anja
    Klingemann, Justyna
    Melberg, Hans Olov
    Schreckenberg, Dirk
    Peschel, Christine
    Popular Images of Adiction in five European Countries2014Report (Other academic)
  • 430. Blomqvist, My
    et al.
    Ek, Ulla
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    Fernell, Elisabeth
    Holmberg, Kirsten
    Westerlund, Joakim
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Dahlloö, Göran
    Cognitive ability and dental fear and anxiety2013In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 121, no 2, p. 117-120Article in journal (Refereed)
    Abstract [en]

    Dental fear and anxiety (DFA), as well as dental behavior management problems, are common in children and adolescents. Several psychological factors in the child, and parental DFA, have been studied and found to correlate to the child's DFA. The aim of this study was to investigate the relationship between cognitive ability and DFA in a population-based group of children with identified behavior and learning problems. In conjunction with a dental examination at 11yr of age, 70 children were assessed with regard to DFA using the Children's Fear Survey Schedule Dental Subscale (CFSS-DS), and their cognitive ability was assessed using the Wechsler Intelligence Scale for Children. In addition, parental DFA was measured using the Corah Dental Anxiety Scale. The results revealed that DFA was significantly correlated to verbal intelligence quotient (IQ) but not to any other cognitive index. A significant correlation was found between parental DFA and child DFA. The results indicate that the child's verbal capacity may be one factor of importance in explaining dental fear in children.

  • 431.
    Blomqvist, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Alexanderson, Kristina
    Vahtera, Jussi
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 8, article id e0203433Article in journal (Refereed)
    Abstract [en]

    Background The evidence is insufficient regarding the association between organizational downsizing and employee mental health. Our aim was to analyze trajectories of prescribed sedatives and anxiolytics with a sufficiently long follow-up time to capture anticipation, implementation and adaption to a downsizing event among stayers, changers and those who become unemployed compared to unexposed employees. Method Swedish residents aged 20-54 years in 2007, with stable employment between 2004 and 2007, were followed between 2005 and 2013 (n = 2,305,795). Employment at a workplace with staff reductions >= 18% between two subsequent years in 2007-2011 (n = 915,461) indicated exposure to, and timing of, downsizing. The unexposed (n = 1,390,334) were randomized into four corresponding sub-cohorts. With generalized estimating equations, we calculated the odds ratios (OR) of purchasing prescribed anxiolytics or sedatives within nine 12-month periods, from four years before to four years after downsizing. In order to investigate whether the groups changed their probability of purchases over time, odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated contrasting the prevalence of purchases during the first and the last 12-month period within four time periods for each exposure group. Results The odds of purchasing anxiolytics increased more for stayers (OR 1.03, 95% CI 1.01-1.06) and unemployed (OR 1.08, 95% CI 1.03-1.14) compared to unexposed before downsizing, and purchases continued to increase after downsizing for stayers. Among those without previous sickness absence, stayers increased their purchases of anxiolytics from the year before the event up to four years after the event. Trajectories for sedatives were similar but less pronounced. Conclusion This study indicates that being exposed to downsizing is associated with increased use of sedatives and anxiolytics, especially before the event, if the employee stays in the organization or becomes unemployed.

  • 432. Bloomfield, Kim
    et al.
    Grittner, Ulrike
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Piontek, Daniela
    Drinking patterns at the sub-national level: What do they tell us about drinking cultures in European countries?2017In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 34, no 4, p. 342-352Article in journal (Refereed)
    Abstract [en]

    Aim:

    A drinking pattern is not only a major drinking variable, but is also one indicator of a country's drinking culture. In the present study, we examine drinking patterns within and across the neighbouring countries of Denmark and Germany. The aim of the research is to determine to what extent drinking patterns differ or are shared at the sub-national level in the two countries.

    Method:

    Data came from the German 2012 Epidemiological Survey of Substance Use (n = 9084) 18-64 years (response rate 54%), and the Centre for Alcohol and Drug Research's 2011 Danish national survey (n = 5133) 15-79 years (response rate 64%), which was reduced to a common age range, producing a final n = 4016. The drinking pattern variable included abstention, moderate drinking, heavy drinking, risky single occasion drinking (RSOD), and was investigated with bivariate statistics and gender-specific hierarchical cluster analysis.

    Results:

    For men three clusters emerged: one highlighting abstention and RSOD, moderate/heavy drinking, RSOD and RSOD + heavy drinking. For women, two clusters appeared: one highlighting abstention and moderate/heavy drinking and the other highlighting RSOD and RSDO + heavy drinking. The clusters revealed different geographical patterning: for men, a west vs. east divide; for women, a north-south gradient.

    Conclusions:

    The analysis could identify for each gender clusters representing both separate and shared drinking patterns as well as distinctive geographical placements. This new knowledge can contribute to a new understanding of the dynamics of drinking cultures and could indicate new approaches to prevention efforts and policy initiatives.

  • 433. Boccardi, Virginia
    et al.
    Calvani, Riccardo
    Limongi, Federica
    Marseglia, Anna
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Mason, Alexandra
    Noale, Marianna
    Rogoli, Domenico
    Veronese, Nicola
    Crepaldi, Gaetano
    Maggi, Stefania
    Consensus paper on the executive summary of the international conference on Mediterranean diet and health: a lifelong approach an Italian initiative supported by the Mediterranean Diet Foundation and the Menarini Foundation2018In: Nutrition, ISSN 0899-9007, Vol. 51-52, p. 38-45Article in journal (Refereed)
    Abstract [en]

    The Mediterranean Diet Foundation, in collaboration with the International Menarini Foundation, organized the International Conference on Mediterranean Diet and Health: A Lifelong Approach. The Conference was held in Ostuni (Puglia, Italy) from March 30 to April 1, 2017. The event received the endorsement of the American Federation for Aging Research, the Research Consortium Luigi Amaducci, the European Nutrition for Health Alliance, the European Union Geriatric Medicine Society, the Clinical Section of the International Association of Gerontology and Geriatrics European Region, the National Research Council Research Project on Aging, the Italian Society of Gerontology and Geriatrics, and the Italian Society of Clinical Nutrition and Metabolism.During the conference, results were presented from major studies on dietary interventions aiming to assess the efficacy of the Mediterranean diet in the prevention of chronic diseases and the potential underlying mechanisms. Twenty-six international speakers, in seven different sessions, discussed the biological basis, clinical impact, health policy, and behavioral implications of the Mediterranean diet, and its use in potential interventions for health promotion.

  • 434.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    An explorative review of the Lean office concept2013In: Journal of Corporate Real Estate, ISSN 1463-001X, E-ISSN 1479-1048, Vol. 15, no 3/4, p. 167-180Article in journal (Refereed)
    Abstract [en]

    Purpose – The concept of Lean office design has emerged, claiming to support an efficient labour process. This article aims to investigate how the two main perspectives identified in the Lean office: the neo-Tayloristic approach and the team-based approach, based in different historical backgrounds, use the office design to shorten lead time and free up time.

    Design/methodology/approach – An extensive review is done in the article of what the Lean office concept means for different research areas and to practitioners.

    Findings – The study presents the two Lean office perspectives in relation to each other, something that has not been done before since it is only recently the team-based Lean office was introduced. The study also presents possible risk and benefits of two perspectives from an employee and organizational perspective.

    Research limitations/implications – Since this is a first exploratory review of the Lean office concept based on theories and examples from design practice, further empirical studies are needed to determine risks and benefits of the concept.

    Practical implications – The clarifying examples in the article make it useful for people involved in the design and building process of offices.

    Originality/value – The article brings together the fields of labour process, office research and facility management with the design practice and presents the two perspectives Lean office design in relation to each other, which has not been done before since the team-based Lean office has only recently been introduced.

  • 435.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Royal Institute of Technology, Sweden.
    Are you sitting comfortably? Office design and worker wellbeing2014In: Safety Management, ISSN 1069-2118, Vol. 16, p. 17-19Article in journal (Refereed)
  • 436.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lean i arbetslivet: Lean inom kontorsdesign2013In: Lean i arbetslivet / [ed] Per Sederblad, Stockholm: Liber, 2013, 1, p. 162-189Chapter in book (Other academic)
  • 437.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    L'impact de la conception architecturale des bureaux sur le confort et le bien-être desemployés (Eng. The impact of architectural design offices in the comfort andwell-being of employees): Le confort au travail : Quenous apprend la psychologie environnementale? (Eng. Comfort at work: What canwe learn from environmental psychology?)2013In: L'impact de la conception architecturale des bureaux sur le confort et le bien-être desemployés / [ed] L. Rioux, J. Le Roy, L. Rubens & J. Le Conte, Quebec City,Canada: Presses Universitaires de Laval , 2013, 1, p. 17-39Chapter in book (Other academic)
  • 438.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. School of Architecture, School of Architecture & Built Environment, The Royal Institute of Technology, Sweden.
    Office type's association to employees' welfare: Three studies2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 4, p. 779-790Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The workplace is important for employees' daily life and well-being. This article investigates exploratory the office design's role for employees' welfare from different perspectives.

    OBJECTIVE: By comparing different studies of the office, type's influence on different factors of employees' welfare the aim is to see if any common patterns exist in office design's impact.

    METHODS: The three included studies investigate office type's association with employees' welfare by measuring its influence on: a) perception of leadership, b) sick leave, and c) job satisfaction.The sample consists of office employees from a large, national representative work environment survey that work in one of the seven identified office types in contemporary office design: (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Statistical method used is multivariate logistic and linear regression analysis with adjustment for background factors.

    RESULTS: Overall results show that shared-room office, traditional open plan offices and flex-office stand out negatively, but to different degree(s) on the different outcomes measured.

    CONCLUSIONS: This explorative comparison of different studies finds a pattern of office types that repeatedly show indications of negative influence on employees' welfare, but further studies are needed to clarify this.

  • 439.
    Bodin Danielsson, Christina
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Wulff, Cornelia
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Office design's impact on sick leave rates:  2014In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 57, no 2, p. 139-147Article in journal (Refereed)
    Abstract [en]

    The effect of office type on sickness absence among office employees was studied prospectively in 1852 employees working in (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Sick leaves were self-reported two years later as number of (a) short and (b) long (medically certified) sick leave spells as well as (c) total number of sick leave days. Multivariate logistic regression analysis was used, with adjustment for background factors. A significant excess risk for sickness absence was found only in terms of short sick leave spells in the three open-plan offices. In the gender separate analysis, this remained for women, whereas men had a significantly increased risk in flex-offices. For long sick leave spells, a significantly higher risk was found among women in large open-plan offices and for total number of sick days among men in flex-offices. Practitioner Summary: A prospective study of the office environment's effect on employees is motivated by the high rates of sick leaves in the workforce. The results indicate differences between office types, depending on the number of people sharing workspace and the opportunity to exert personal control as influenced by the features that define the office types.

  • 440. Bodin, Maja
    et al.
    Stern, Jenny
    Käll, Lisa Folkmarson
    Centre for Gender Research, Humanistiskt centrum, Uppsala, Sweden; Centre for Dementia Research, Linköping University, Linköping, Sweden.
    Tydén, Tanja
    Larsson, Margareta
    Coherence of pregnancy planning within couples expecting a child2015In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 10, p. 973-978Article in journal (Refereed)
  • 441.
    Bognar, Greg
    Stockholm University, Faculty of Humanities, Department of Philosophy. La Trobe University, Australia.
    Is disability mere difference?2016In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 42, no 1, p. 46-49Article in journal (Refereed)
  • 442.
    Bogren, Alexandra
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Alcohol short-circuits important part of the brain': Swedish newspaper representations of biomedical alcohol research2017In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, no 3, p. 177-187Article in journal (Refereed)
    Abstract [en]

    The media has a central role in communicating and constructing health knowledge, including communicating research findings related to alcohol consumption. However, research on news reporting about alcohol is still a relatively small field; in particular, there are few studies of the reporting of biomedical alcohol and drug research, despite the assumed increasing popularity of biomedical perspectives in public discourse in general. The present article addresses the representational `devices' used in Swedish press reporting about biomedical alcohol research, drawing on qualitative thematic analysis of the topics, metaphors, and optimist versus critical frames used in presenting biomedical research findings. In general, the press discourse focuses on genetic factors related to alcohol problems, on the role of the brain and the reward system in addiction, and on medication for treating alcohol problems. Metaphors of `reconstruction' and `reprograming' of the reward system are used to describe how the brain's function is altered in addiction, whereas metaphors of `undeserved reward' and `shortcuts' to pleasure are used to describe alcohol's effects on the brain. The study indicates that aspects of the Swedish press discourse of biomedical alcohol research invite reductionism, but that this result could be understood from the point of view of both the social organization of reporting and the intersection of reporting, science, and everyday understandings rather than from the point of view of the news articles only. Moreover, some characteristics of the media portrayals leave room for interpretation, calling for research on the meanings ascribed to metaphors of addiction in everyday interaction.

  • 443. Bohman, H
    et al.
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Päären, A
    Jonsson, U
    Somatic symptoms in adolescence as a predictor of in-patient care for mental disorders in adulthood2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 1Article in journal (Other academic)
    Abstract [en]

    Background

    Somatic symptoms such as headache, abdominal pain and dizziness, are common among young people and often associated with poor everyday functioning and concurrent mental disorders. Yet, relatively few studies have examined the long-term consequences of such symptoms. The aim of the study was to investigate if somatic symptoms in adolescence predict adulthood hospital based care for mental disorders.

    Methods

    The total school population of 16-17-year olds, in the city of Uppsala, Sweden, was screened for depression in 1991-1993. Adolescents with positive screening and the same number of healthy controls took part in a semi-structured diagnostic interview of mental disorders. In addition, 21 different self-rated functional somatic symptoms were assessed. The participants were followed up in the national patients register about 20 years later (n = 337). The associations between somatic symptoms in adolescence and in-patient care and out-patient hospital based mental health care in adulthood were analysed using binary logistic regression analysis.

    Results

    Adolescents with somatic symptoms had an excess risk of later psychiatric hospital based health care. The presence of multiple somatic symptoms (≥5) in adolescence was associated with psychiatric hospital based care in adulthood also when controlling for depression and anxiety in adolescence as well as sex and potential psychosocial confounders (OR 3.29, p = 0.046). The presence of just any somatic symptom (≥1) in adolescence predicted later hospital based mental health care for mood disorders (OR 8.49, p = 0.041) whereas adolescent depression, anxiety and sex did not, when mutually adjusted for.

    Conclusions

    Somatic symptoms in adolescence are a strong independent predictor of severe mental health problems in adulthood. The link between adolescent somatic symptoms and adult mood disorders are particularly strong even when somatic symptoms are compared head to head with concurrent depression and anxiety.

  • 444. Bohman, Hannes
    et al.
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Cleland, Neil
    Lundberg, Mathias
    Päären, Aivar
    Jonsson, Ulf
    Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood: a long-term community-based follow-up study2018In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 12, article id 42Article in journal (Refereed)
    Abstract [en]

    Background: Somatic symptoms are common and costly for society and correlate with suffering and low functioning. Nevertheless, little is known about the long-term implications of somatic symptoms. The objective of this study was to assess if somatic symptoms in adolescents with depression and in their matched controls predict severe mental illness in adulthood by investigating the use of hospital-based care consequent to different mental disorders. Methods: The entire school population of 16-17-year-olds in the city of Uppsala, Sweden, was screened for depression in 1991-1993 (n = 2300). Adolescents with positive screenings (n = 307) and matched non-depressed controls (n = 302) participated in a semi-structured diagnostic interview for mental disorders. In addition, 21 different self-rated somatic symptoms were assessed. The adolescents with depression and the matched non-depressed controls were engaged in follow-up through the National Patient Register 17-19 years after the baseline study (n = 375). The outcome measures covered hospital-based mental health care for different mental disorders according to ICD-10 criteria between the participants' ages of 18 and 35 years. Results: Somatic symptoms were associated with an increased risk of later hospital-based mental health care in general in a dose-response relationship when adjusting for sex, adolescent depression, and adolescent anxiety (1 symptom: OR = 1.63, CI 0.55-4.85; 2-4 symptoms: OR = 2.77, 95% CI 1.04-7.39; >= 5 symptoms: OR = 5.75, 95% CI 1.98-16.72). With regards to specific diagnoses, somatic symptoms predicted hospital-based care for mood disorders when adjusting for sex, adolescent depression, and adolescent anxiety (p<0.05). In adolescents with depression, somatic symptoms predicted later hospital-based mental health care in a dose-response relationship (p<0.01). In adolescents without depression, reporting at least one somatic symptom predicted later hospital-based mental health care (p<0.05). Conclusions: Somatic symptoms in adolescence predicted severe adult mental illness as measured by hospital-based care also when controlled for important confounders. The results suggest that adolescents with somatic symptoms need early treatment and extended follow-up to treat these specific symptoms, regardless of co-occurring depression and anxiety.

  • 445. Bohman, Hannes
    et al.
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Päären, Aivar
    Jonsson, Ulf
    Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years2017In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 117Article in journal (Refereed)
    Abstract [en]

    Background: Earlier research has investigated the association between parental separation and long-term health outcomes among offspring, but few studies have assessed the potentially moderating role of mental health status in adolescence. The aim of this study was to analyze whether parental separation in childhood predicts depression in adulthood and whether the pattern differs between individuals with and without earlier depression. Methods: A community-based sample of individuals with adolescent depression in 1991-93 and matched non-depressed peers were followed up using a structured diagnostic interview after 15 years. The participation rate was 65% (depressed n = 227; non-depressed controls n = 155). Information on parental separation and conditions in childhood and adolescence was collected at baseline. The outcome was depression between the ages 19-31 years; information on depression was collected at the follow-up diagnostic interview. The statistical method used was binary logistic regression. Results: Our analyses showed that depressed adolescents with separated parents had an excess risk of recurrence of depression in adulthood, compared with depressed adolescents with non-separated parents. In addition, among adolescents with depression, parental separation was associated with an increased risk of a switch to bipolar disorder in adulthood. Among the matched non-depressed peers, no associations between parental separation and adult depression or bipolar disorder were found. Conclusions: Parental separation may have long-lasting health consequences for vulnerable individuals who suffer from mental illness already in adolescence.

  • 446. Bojner Horwitz, Eva
    et al.
    Hogstedt, Christer
    Wistén, Pelle
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kulturen – en viktig insats för hållbar folkhälsa: seminarier, antologi och underlag för fortsatta insatser2015In: Kultur & folkhälsa: antologi om forskning och praktik / [ed] Eva Bojner Horwitz, Christer Hogstedt, Pelle Wistén och Töres Theorell, Stockholm: Tolvnitton förlag , 2015, p. 9-11Chapter in book (Other academic)
  • 447. Bojner Horwitz, Eva
    et al.
    Hogstedt, Christer
    Wistén, Pelle
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Varför har inte fler studier publicerats? Reflektioner om seminarieserien om kultur och folkhälsa2015In: Kultur & folkhälsa: antologi om forskning och praktik / [ed] Eva Bojner Horwitz, Christer Hogstedt, Pelle Wistén, Töres Theorell, Stockholm: Tolvnitton förlag , 2015, p. 239-246Chapter in book (Other academic)
  • 448. Bojner Horwitz, Eva
    et al.
    Osika, Walter
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hållbarhetstestning och implementering av kulturaktiviteter – forskarsamhällets roll2015In: Kultur & folkhälsa: antologi om forskning och praktik / [ed] Eva Bojner Horwitz, Christer Hogstedt, Pelle Wistén, Töres Theorell, Stockholm: Tolvnitton förlag , 2015, p. 107-114Chapter in book (Other academic)
  • 449. Bokenberger, Kathleen
    et al.
    Sjölander, Arvid
    Dahl Aslan, Anna K.
    Karlsson, Ida K.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Pedersen, Nancy L.
    Shift work and risk of incident dementia: a study of two population-based cohorts2018In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 33, no 10, p. 977-987Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate the association between shift work and incident dementia in two population-based cohorts from the Swedish Twin Registry (STR). The STR-1973 sample included 13,283 participants born 1926-1943 who received a mailed questionnaire in 1973 that asked about status (ever/never) and duration (years) of shift work employment. The Screening Across the Lifespan Twin (SALT) sample included 41,199 participants born 1900-1958 who participated in a telephone interview in 1998-2002 that asked about night work status and duration. Dementia diagnoses came from Swedish patient registers. Cox proportional-hazards regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Potential confounders such as age, sex, education, diabetes, cardiovascular disease and stroke were included in adjusted models. In genotyped subsamples (n = 2977 in STR-1973; n = 10,366 in SALT), APOE epsilon 4 status was considered in models. A total of 983 (7.4%) and 1979 (4.8%) dementia cases were identified after a median of 41.2 and 14.1 years follow-up in the STR-1973 and SALT sample, respectively. Ever shift work (HR 1.36, 95% CI 1.15-1.60) and night work (HR 1.12, 95% CI 1.01-1.23) were associated with higher dementia incidence. Modest dose-response associations were observed, where longer duration shift work and night work predicted increased dementia risk. Among APOE epsilon 4 carriers, individuals exposed to 20 years of shift work and night work had increased dementia risk compared to day workers. Findings indicate that shift work, including night shift work, compared to non-shift jobs is associated with increased dementia incidence. Confirmation of findings is needed.

  • 450. Bokenberger, Kathleen
    et al.
    Ström, Peter
    Aslan, Anna K. Dahl
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Pedersen, Nancy L.
    Shift work and cognitive aging: a longitudinal study2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, p. 485-493Article in journal (Refereed)
    Abstract [en]

    Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed. Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986-2012. Night work history (ever/never) from 1998-2002 was available from a subsample (N = 320). Early adult cognitive test scores were available for 77 men. Results In latent growth curve modeling, there were no main effects of any-type or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand. Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.

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