Background Assortative mating is common in patients with mental disorders, both for specific diso... more Background Assortative mating is common in patients with mental disorders, both for specific disorders and across the spectrum of mental disorders. Assortative mating may play a key role in mental disorders because the person with the close relation to an individual with a mental disorder is also likely to have mental disorders, poorer cognitive abilities or lower social functioning, which may further intensify problems for both partners and their offspring. When one parent is ill, the care for the child will often depend on the other parent. Thus, assortative mating will most likely contribute to outcomes in the offspring. Therefore, the objective of this study was to investigate possible diagnoses of a mental illness, cognitive ability and social functioning in individuals who have biological children by partners with schizophrenia or bipolar disorder. Further, we also aimed to explore differences in polygenic risk scores derived from genome-wide association studies for schizophre...
BackgroundStudies of the association between pre-deployment cognitive ability and post-deployment... more BackgroundStudies of the association between pre-deployment cognitive ability and post-deployment post-traumatic stress disorder (PTSD) have shown mixed results.AimsTo study the inflence of pre-deployment cognitive ability on PTSD symptoms 6–8 months post-deployment in a large population while controlling for pre-deployment education and deployment-related variables.MethodStudy linking prospective pre-deployment conscription board data with post-deployment self-reported data in 9695 Danish Army personnel deployed to different war zones in 1997–2013. The association between pre-deployment cognitive ability and post-deployment PTSD was investigated using repeated-measure logistic regression models. Two models with cognitive ability score as the main exposure variable were created (model 1 and model 2). Model 1 was only adjusted for pre-deployment variables, while model 2 was adjusted for both pre-deployment and deployment-related variables.ResultsWhen including only variables recorded...
Disruptions in hot cognition, i.e., the processing of emotionally salient information, are preval... more Disruptions in hot cognition, i.e., the processing of emotionally salient information, are prevalent in most neuropsychiatric disorders and constitute a potential treatment target. EMOTICOM is the first comprehensive neuropsychological test battery developed specifically to assess hot cognition. The aim of the study was to validate and establish a Danish language version and reference data for the EMOTICOM test battery. To evaluate the psychometric properties of 11 EMOTICOM tasks, we collected data from 100 healthy Danish participants (50 males, 50 females) including retest data from 49 participants. We assessed test-retest reliability, floor and ceiling effects, taskintercorrelations, and correlations between task performance and relevant demographic and descriptive factors. We found that test-retest reliability varied from poor to excellent while some tasks exhibited floor or ceiling effects. Intercorrelations among EMOTICOM task outcomes were low, indicating that the tasks capture different cognitive constructs. EMOTICOM task performance was largely independent of age, sex, education, and IQ as well as current mood, personality, and self-reported motivation and diligence during task completion. Overall, many of the EMOTICOM tasks were found to be useful and objective measures of hot cognition although select tasks may benefit from modifications to avoid floor and ceiling effects in healthy individuals.
, S. B. (2021). Psychodynamic and systemic group treatment for women with a history of childhood ... more , S. B. (2021). Psychodynamic and systemic group treatment for women with a history of childhood sexual abuse: five-year follow-up of a randomized controlled trial.
Objective: Mounting evidence suggests that immune dysfunction may play a crucial role in the path... more Objective: Mounting evidence suggests that immune dysfunction may play a crucial role in the pathophysiology of autism spectrum disorders (ASD). In addition, several studies have reported that congenital and postnatal infections may contribute to the neurobiological basis of ASD. This study aimed to investigate the relationship between infections during pregnancy and after birth, and ASD. Methods: A case-control study design was adopted. Both cases and controls were retrieved from a historic birth cohort (HBC) maintained at Statens Serum Institute in Copenhagen/Denmark and were followed up retrospectively during pregnancy and after birth over four pre-defined periods. Study subjects were followed-up utilizing Danish nationwide health registers for outpatient and hospital admissions due to infections. Associations between infections and ASD were analyzed using Mantel-Haenszel estimate of the odds ratio (OR) and logistic regression models. Results: In total, 414 ASD cases and 820 controls were followed-up during pregnancy and a mean 16.3 years after birth. Crude, but not adjusted estimates showed that ASD cases had an increased risk of hospital admission due to infection at the end of the first year of life (OR = 1.48 [range: 1.07-2.05], P = 0.02) and at the end of the follow-up period (OR = 1.30 [range: 1.02-1.64], P = 0.03). Conclusion: The present findings indicate that infections have a potential role in the pathophysiology of ASD; however, further studies are necessary to determine if infections etiologically contribute to ASD or if they act as an epiphenomenon due to distorted immunity in children with ASD.
Social Psychiatry and Psychiatric Epidemiology, 2019
Purpose Evidence exists of an association between pre-morbid lower cognitive ability and higher r... more Purpose Evidence exists of an association between pre-morbid lower cognitive ability and higher risk of hospitalization for depressive disorder in civilian cohorts. The purpose of this study was to examine the relationship of cognitive ability at conscription with post-deployment depression and the influence of (1) baseline factors: age, gender, and pre-deployment educational level, (2) deployment-related factors: e.g., war-zone stress and social support, and (3) co-morbid PTSD. Methods An observational cohort study linking conscription board registry data with post-deployment self-report data. The study population consisted of Danish Army military personnel deployed to different war zones from 1997 to 2015. The association between cognitive ability at conscription and post-deployment depression was analyzed using repeated-measure logistic regression models. Results Study population totaled 9716 with a total of 13,371 deployments. Low-level cognitive ability at conscription was found to be weakly associated with post-deployment probable depression after adjustment for more important risk factors like gender, education, and deployment-related factors [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.88-0.99]. The co-occurrence rate with PTSD was nearly 60%. When adding co-morbid PTSD as an independent variable, the association between cognitive ability and probable depression became insignificant, OR 0.95, CI 0.89-1.02. Conclusions Low cognitive ability at conscription is a risk factor for depression among returning military personnel, but unimportant compared to gender, education, and deployment-related factors. Part of this effect may be related to co-morbid PTSD. Use of cognitive ability score as an isolated selection tool cannot be recommended because of low predictive performance.
Visual short-term memory (vSTM) is a cognitive resource that declines with age. This study invest... more Visual short-term memory (vSTM) is a cognitive resource that declines with age. This study investigated whether electroencephalography (EEG) correlates of vSTM vary with cognitive development over individuals' lifespan. We measured vSTM performance and EEG in a lateralized whole-report task in a healthy birth cohort, whose cognitive function (intelligence quotient) was assessed in youth and late-middle age. Higher vSTM capacity (K; measured by Bundesen's theory of visual attention) was associated with higher amplitudes of the contralateral delay activity (CDA) and the central positivity (CP). In addition, rightward hemifield asymmetry of vSTM (K) was associated with lower CDA amplitudes. Furthermore, more severe cognitive decline from young adulthood to late-middle age predicted higher CDA amplitudes, and the relationship between K and the CDA was less reliable in individuals who show higher levels of cognitive decline compared to individuals with preserved abilities. By con...
BackgroundStudies investigating early developmental factors in relation to psychopathology have m... more BackgroundStudies investigating early developmental factors in relation to psychopathology have mainly focused on schizophrenia. The personality dimension of neuroticism seems to be a general risk factor for psychopathology, but evidence on associations between early developmental precursors and personality traits is almost non-existent. This study is therefore the first to investigate associations between early motor developmental milestones and neuroticism in adulthood.MethodMothers of 9125 children of the Copenhagen Perinatal Cohort recorded 12 developmental milestones during the child's first year of life. A subsample of the cohort comprising 1182 individuals participated in a follow-up when they were aged 20–34 years and were administered the Eysenck Personality Questionnaire (EPQ). Associations between motor developmental milestones and level of neuroticism, extraversion and psychoticism were analysed by multiple linear regression adjusting for for sex, single-mother statu...
IntroductionIn a previous study women with long-term sequalae of child sexual abuse (CSA) were ra... more IntroductionIn a previous study women with long-term sequalae of child sexual abuse (CSA) were randomly assigned to analytic (Group A) or systemic group psychotherapy (Group S). Pre-post-analysis indicated that both therapies led to significant improvement, but overall Group S had significantly better outcome than Group A. As gains tended to rise in Group A during follow-up and decline in Group S, no statistically significant difference was detected in gains between the two treatment modalities after one year.ObjectivesThis study investigates if gains are maintained five year following termination, and if the groups differ in gains.Methods106 women started on allocated intervention. Psychological distress (GSI from SCL-90R), psycho-social functioning (GAF), and global life quality (GLQ), were assessed before and after treatment and one and five years following termination.Results86 patients (81%) completed group therapy, 68 (64%) completed the one-year follow-up and 64 (60%) the fiv...
The few existing long-term, neuropsychological follow-up studies of early-onset schizophrenia (EO... more The few existing long-term, neuropsychological follow-up studies of early-onset schizophrenia (EOS) patients have reported relative stability in some cognitive functions but abnormal developmental trajectories in verbal memory, set shifting, aspects of attention, and speed of information processing throughout late adolescence into early adulthood. The current 5-year followup study compared the development of specific cognitive functions in EOS patients (N=17) from the time of first-episode to chronic phase with that of healthy controls (N=38) and secondarily to patients with other early-onset, non-organic, non-affective psychoses (EOP) (N=11). Speed of processing of executive functions, set shifting, and attention improved significantly in the healthy controls and reflected continuous functional maturation during late adolescence and early adulthood. The developmental progression of attention and set shifting but not speed of processing of executive functions was significantly subnormal in EOS patients. Other specific cognitive functions that had attained functional maturity in the healthy controls around the time of the baseline assessment showed normal development in EOS patients during the follow-up period, indicating stable cognitive deficits. These results suggest post-onset developmental deficits in two out of the three aspects of attention and executive functions that have protracted maturational trajectories and that overlap the age of onset of EOS. No significant difference in the development of any specific cognitive function was found between the EOS and EOP group.
Premorbid prediction of psychosis-spectrum disorders has implications for both understanding etio... more Premorbid prediction of psychosis-spectrum disorders has implications for both understanding etiology and clinical identification. The current study used a longitudinal high-risk for psychosis design that included children of parents with schizophrenia as well as two groups of controls (children whose parents had no mental illness, and children with at least one parent with a nonpsychotic psychiatric diagnosis). Premorbid neurological factors and an indication of social function, as measured when participants were 10-13 years of age, were combined to predict psychosis-spectrum disorders in adulthood. Through a combination of childhood predictors, the model correctly classified 82% (27 of 33) of the participants who eventually developed a psychosis-spectrum outcome in adulthood. With replication, multivariate premorbid prediction, including genetic risk, social, and neurological variables, could potentially be a useful
To investigate clinically significant change in the emotional condition of relatives of patients ... more To investigate clinically significant change in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation. Methods: Participants were 62 pairs of relatives and patients. Relatives completed the anxiety and depression scales from the Symptom Checklist-90-R (SCL-90-R) when the patients were admitted to sub-acute rehabilitation and at discharge. Improvement in emotional condition was investigated using the following criteria: (i) statistically reliable improvement; and (ii) clinically significant change (CSC). Results: At admission, 53.2% and 58.1% of relatives had scores above cutoff values on the anxiety and depression scales, respectively. On the anxiety scale 69.7% of these experienced a reliable improvement according to the Reliable Change Index (RCI) and 45.5% also obtained CSC, as their end-point was below the cutoff value. On the depression scale the corresponding figures were 44.4% and 41.7%, respectively. When comparing relatives with and without CSC, we found that CSC in symptoms of anxiety was associated with significantly better functional improvement during rehabilitation and a shorter period of post-traumatic amnesia in the patients. Conclusion: Of the relatives who reported scores above cutoff values on the anxiety and depression scales at patient's admission, approximately 40% experienced CSC in anxiety and depression during the patient's rehabilitation. Relatives of patients experiencing improvement during inpatient rehabilitation are more likely to experience CSC in anxiety.
To investigate the emotional well-being of relatives of patients with a severe brain injury in th... more To investigate the emotional well-being of relatives of patients with a severe brain injury in the acute setting, as well as risk factors associated with high anxiety and depression scores and impaired quality-of-life. Clinical convenience sample. Participants included 45 relatives of patients with severe brain injury recruited at a NICU. All relatives completed selected scales from the SCL-90-R and SF-36 ∼ 14 days after injury. Data concerning the condition of the patient were also collected. Of the relatives, 51% and 69% reported anxiety and depression, respectively, as well as significantly impaired quality-of-life compared to normal reference populations. Regression analysis revealed that up to 20% of the variance in depression and anxiety scores could be explained by the CRASH 2 Mortality prediction. The majority of the relatives had severely impaired quality-of-life and symptoms of anxiety and depression during the patient's NICU stay. Future research is required to explore stressors and evaluate effects of psychological intervention in the acute setting.
Objective: Psychological adversities among young children may be associated with childhood overwe... more Objective: Psychological adversities among young children may be associated with childhood overweight and obesity. We examined if an increased level of child behavioural problems was associated with body size among a selected group of 2-6 year old children, who were all predisposed to develop overweight. Methods: Cross-sectional analyses were conducted using baseline data from the "Healthy Start" intervention study. A total of 3058 children were invited to participate, and data from 583 children who were all predisposed for obesity was analyzed. The Danish version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess child stress by the SDQ Total Difficulties (SDQ-TD) score and the Prosocial Behavior (PSB) score. Height and weight were measured, and BMI z-scores were calculated. Results: A direct, but non-significant linear trend was found between SDQ-TD score and BMI z-score (β = 0.021, p = 0.11). Having an SDQ-TD score above the 90 th percentile was associated with BMI z-score (β = 0.36, p = 0.05). PSB score was not associated with BMI z-score. Analyses were adjusted for parental socioeconomic status, parental BMI, family structure, dietary factors, physical activity, and family stress level. Conclusion: The results suggested a threshold effect between SDQ-TD score and BMI z-score, where BMI z-score was associated with childhood behavioural problems only for those with the highest scores of SDQ-TD. No significant association between PSB score and BMI z-score was found.
Journal of Neurology, Neurosurgery & Psychiatry, 1988
Twenty five patients with conservatively treated cerebral arteriovenous malformation were followe... more Twenty five patients with conservatively treated cerebral arteriovenous malformation were followed up for a mean of 10-6 years after diagnosis. The follow up included neuropsychological examination. Bleeding did not occur after the time of diagnosis. Three patients had moderate to severe neurological deficits, five had moderate to severe intellectual impairment. Nineteen had an unaffected occupational status. It is concluded that the outcome in conservatively treated patients may be no worse than in surgically treated patients.
The effect of breast-feeding on brain development, especially cognitive and visual, has been exam... more The effect of breast-feeding on brain development, especially cognitive and visual, has been examined in many studies. The aim of this article is to summarize this group's studies and relate them to results from reviews and meta-analyses. In two separate studies of visual development in term infants, visual acuity was better in breast-fed than in formula-fed infants, which is in accordance with the results from a meta-analysis. Among studies examining the association between breast-feeding and cognitive development most find a positive association, even when controlling for relevant confounding factors. A positive effect was found in two different samples of young adults using two different intelligence quotient tests. The most plausible explanation for this effect is the differences in composition between human milk and infant formula (e.g. docosahexaenoic acid). It could also be because mothers who choose to breast-feed on average stimulate and support their infants better. Further, unidentified factors may also correlate with both infant feeding and development of cognitive and intellectual ability, so-called residual confounding.
Background: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD),... more Background: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD), despite the detrimental consequences the disorder can impose on mother and child. Research on alternative methods of prevention and treatment of PPD is warranted. Previous studies have suggested that long-chain n23 polyunsaturated fatty acids (PUFAs) might have a beneficial effect on depression. Objective: The objective was to explore the association between intake of fish and n23 PUFAs during pregnancy and PPD in the Danish National Birth Cohort (DNBC). Design: Exposure information from the DNBC was linked to the Danish patient and prescription registries for data on clinically identified cases of depression up to 1 y postpartum. Intake of fish and n23 PUFAs was assessed in midpregnancy with a food-frequency questionnaire. Admission to the hospital for PPD (PPD-admission) and prescription of antidepressants (PPD-prescription) were treated as separate outcomes. A total of 54,202 women were included in the present study sample. Results: Rates of depression were 0.3% (PPD-admission) and 1.6% (PPD-prescription). No association was observed between fish intake and risk of PPD-admission [crude odds ratio of 1.01 (95% CI: 0.52, 1.97) and adjusted odds ratio of 0.82 (95% CI: 0.42, 1.64)], whereas a higher risk of PPD-prescription was found for the lowest compared with the highest fish intake group [crude odds ratio of 1.61 (95% CI: 1.26, 2.06) and adjusted odds ratio of 1.46 (95% CI: 1.12, 1.90)]. No association was observed with respect to n23 PUFA intake. Conclusion: Overall, our data from a large prospective cohort linked with high-quality registers showed little evidence to support an association between intake of fish or n23 PUFAs and PPD.
Background Assortative mating is common in patients with mental disorders, both for specific diso... more Background Assortative mating is common in patients with mental disorders, both for specific disorders and across the spectrum of mental disorders. Assortative mating may play a key role in mental disorders because the person with the close relation to an individual with a mental disorder is also likely to have mental disorders, poorer cognitive abilities or lower social functioning, which may further intensify problems for both partners and their offspring. When one parent is ill, the care for the child will often depend on the other parent. Thus, assortative mating will most likely contribute to outcomes in the offspring. Therefore, the objective of this study was to investigate possible diagnoses of a mental illness, cognitive ability and social functioning in individuals who have biological children by partners with schizophrenia or bipolar disorder. Further, we also aimed to explore differences in polygenic risk scores derived from genome-wide association studies for schizophre...
BackgroundStudies of the association between pre-deployment cognitive ability and post-deployment... more BackgroundStudies of the association between pre-deployment cognitive ability and post-deployment post-traumatic stress disorder (PTSD) have shown mixed results.AimsTo study the inflence of pre-deployment cognitive ability on PTSD symptoms 6–8 months post-deployment in a large population while controlling for pre-deployment education and deployment-related variables.MethodStudy linking prospective pre-deployment conscription board data with post-deployment self-reported data in 9695 Danish Army personnel deployed to different war zones in 1997–2013. The association between pre-deployment cognitive ability and post-deployment PTSD was investigated using repeated-measure logistic regression models. Two models with cognitive ability score as the main exposure variable were created (model 1 and model 2). Model 1 was only adjusted for pre-deployment variables, while model 2 was adjusted for both pre-deployment and deployment-related variables.ResultsWhen including only variables recorded...
Disruptions in hot cognition, i.e., the processing of emotionally salient information, are preval... more Disruptions in hot cognition, i.e., the processing of emotionally salient information, are prevalent in most neuropsychiatric disorders and constitute a potential treatment target. EMOTICOM is the first comprehensive neuropsychological test battery developed specifically to assess hot cognition. The aim of the study was to validate and establish a Danish language version and reference data for the EMOTICOM test battery. To evaluate the psychometric properties of 11 EMOTICOM tasks, we collected data from 100 healthy Danish participants (50 males, 50 females) including retest data from 49 participants. We assessed test-retest reliability, floor and ceiling effects, taskintercorrelations, and correlations between task performance and relevant demographic and descriptive factors. We found that test-retest reliability varied from poor to excellent while some tasks exhibited floor or ceiling effects. Intercorrelations among EMOTICOM task outcomes were low, indicating that the tasks capture different cognitive constructs. EMOTICOM task performance was largely independent of age, sex, education, and IQ as well as current mood, personality, and self-reported motivation and diligence during task completion. Overall, many of the EMOTICOM tasks were found to be useful and objective measures of hot cognition although select tasks may benefit from modifications to avoid floor and ceiling effects in healthy individuals.
, S. B. (2021). Psychodynamic and systemic group treatment for women with a history of childhood ... more , S. B. (2021). Psychodynamic and systemic group treatment for women with a history of childhood sexual abuse: five-year follow-up of a randomized controlled trial.
Objective: Mounting evidence suggests that immune dysfunction may play a crucial role in the path... more Objective: Mounting evidence suggests that immune dysfunction may play a crucial role in the pathophysiology of autism spectrum disorders (ASD). In addition, several studies have reported that congenital and postnatal infections may contribute to the neurobiological basis of ASD. This study aimed to investigate the relationship between infections during pregnancy and after birth, and ASD. Methods: A case-control study design was adopted. Both cases and controls were retrieved from a historic birth cohort (HBC) maintained at Statens Serum Institute in Copenhagen/Denmark and were followed up retrospectively during pregnancy and after birth over four pre-defined periods. Study subjects were followed-up utilizing Danish nationwide health registers for outpatient and hospital admissions due to infections. Associations between infections and ASD were analyzed using Mantel-Haenszel estimate of the odds ratio (OR) and logistic regression models. Results: In total, 414 ASD cases and 820 controls were followed-up during pregnancy and a mean 16.3 years after birth. Crude, but not adjusted estimates showed that ASD cases had an increased risk of hospital admission due to infection at the end of the first year of life (OR = 1.48 [range: 1.07-2.05], P = 0.02) and at the end of the follow-up period (OR = 1.30 [range: 1.02-1.64], P = 0.03). Conclusion: The present findings indicate that infections have a potential role in the pathophysiology of ASD; however, further studies are necessary to determine if infections etiologically contribute to ASD or if they act as an epiphenomenon due to distorted immunity in children with ASD.
Social Psychiatry and Psychiatric Epidemiology, 2019
Purpose Evidence exists of an association between pre-morbid lower cognitive ability and higher r... more Purpose Evidence exists of an association between pre-morbid lower cognitive ability and higher risk of hospitalization for depressive disorder in civilian cohorts. The purpose of this study was to examine the relationship of cognitive ability at conscription with post-deployment depression and the influence of (1) baseline factors: age, gender, and pre-deployment educational level, (2) deployment-related factors: e.g., war-zone stress and social support, and (3) co-morbid PTSD. Methods An observational cohort study linking conscription board registry data with post-deployment self-report data. The study population consisted of Danish Army military personnel deployed to different war zones from 1997 to 2015. The association between cognitive ability at conscription and post-deployment depression was analyzed using repeated-measure logistic regression models. Results Study population totaled 9716 with a total of 13,371 deployments. Low-level cognitive ability at conscription was found to be weakly associated with post-deployment probable depression after adjustment for more important risk factors like gender, education, and deployment-related factors [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.88-0.99]. The co-occurrence rate with PTSD was nearly 60%. When adding co-morbid PTSD as an independent variable, the association between cognitive ability and probable depression became insignificant, OR 0.95, CI 0.89-1.02. Conclusions Low cognitive ability at conscription is a risk factor for depression among returning military personnel, but unimportant compared to gender, education, and deployment-related factors. Part of this effect may be related to co-morbid PTSD. Use of cognitive ability score as an isolated selection tool cannot be recommended because of low predictive performance.
Visual short-term memory (vSTM) is a cognitive resource that declines with age. This study invest... more Visual short-term memory (vSTM) is a cognitive resource that declines with age. This study investigated whether electroencephalography (EEG) correlates of vSTM vary with cognitive development over individuals' lifespan. We measured vSTM performance and EEG in a lateralized whole-report task in a healthy birth cohort, whose cognitive function (intelligence quotient) was assessed in youth and late-middle age. Higher vSTM capacity (K; measured by Bundesen's theory of visual attention) was associated with higher amplitudes of the contralateral delay activity (CDA) and the central positivity (CP). In addition, rightward hemifield asymmetry of vSTM (K) was associated with lower CDA amplitudes. Furthermore, more severe cognitive decline from young adulthood to late-middle age predicted higher CDA amplitudes, and the relationship between K and the CDA was less reliable in individuals who show higher levels of cognitive decline compared to individuals with preserved abilities. By con...
BackgroundStudies investigating early developmental factors in relation to psychopathology have m... more BackgroundStudies investigating early developmental factors in relation to psychopathology have mainly focused on schizophrenia. The personality dimension of neuroticism seems to be a general risk factor for psychopathology, but evidence on associations between early developmental precursors and personality traits is almost non-existent. This study is therefore the first to investigate associations between early motor developmental milestones and neuroticism in adulthood.MethodMothers of 9125 children of the Copenhagen Perinatal Cohort recorded 12 developmental milestones during the child's first year of life. A subsample of the cohort comprising 1182 individuals participated in a follow-up when they were aged 20–34 years and were administered the Eysenck Personality Questionnaire (EPQ). Associations between motor developmental milestones and level of neuroticism, extraversion and psychoticism were analysed by multiple linear regression adjusting for for sex, single-mother statu...
IntroductionIn a previous study women with long-term sequalae of child sexual abuse (CSA) were ra... more IntroductionIn a previous study women with long-term sequalae of child sexual abuse (CSA) were randomly assigned to analytic (Group A) or systemic group psychotherapy (Group S). Pre-post-analysis indicated that both therapies led to significant improvement, but overall Group S had significantly better outcome than Group A. As gains tended to rise in Group A during follow-up and decline in Group S, no statistically significant difference was detected in gains between the two treatment modalities after one year.ObjectivesThis study investigates if gains are maintained five year following termination, and if the groups differ in gains.Methods106 women started on allocated intervention. Psychological distress (GSI from SCL-90R), psycho-social functioning (GAF), and global life quality (GLQ), were assessed before and after treatment and one and five years following termination.Results86 patients (81%) completed group therapy, 68 (64%) completed the one-year follow-up and 64 (60%) the fiv...
The few existing long-term, neuropsychological follow-up studies of early-onset schizophrenia (EO... more The few existing long-term, neuropsychological follow-up studies of early-onset schizophrenia (EOS) patients have reported relative stability in some cognitive functions but abnormal developmental trajectories in verbal memory, set shifting, aspects of attention, and speed of information processing throughout late adolescence into early adulthood. The current 5-year followup study compared the development of specific cognitive functions in EOS patients (N=17) from the time of first-episode to chronic phase with that of healthy controls (N=38) and secondarily to patients with other early-onset, non-organic, non-affective psychoses (EOP) (N=11). Speed of processing of executive functions, set shifting, and attention improved significantly in the healthy controls and reflected continuous functional maturation during late adolescence and early adulthood. The developmental progression of attention and set shifting but not speed of processing of executive functions was significantly subnormal in EOS patients. Other specific cognitive functions that had attained functional maturity in the healthy controls around the time of the baseline assessment showed normal development in EOS patients during the follow-up period, indicating stable cognitive deficits. These results suggest post-onset developmental deficits in two out of the three aspects of attention and executive functions that have protracted maturational trajectories and that overlap the age of onset of EOS. No significant difference in the development of any specific cognitive function was found between the EOS and EOP group.
Premorbid prediction of psychosis-spectrum disorders has implications for both understanding etio... more Premorbid prediction of psychosis-spectrum disorders has implications for both understanding etiology and clinical identification. The current study used a longitudinal high-risk for psychosis design that included children of parents with schizophrenia as well as two groups of controls (children whose parents had no mental illness, and children with at least one parent with a nonpsychotic psychiatric diagnosis). Premorbid neurological factors and an indication of social function, as measured when participants were 10-13 years of age, were combined to predict psychosis-spectrum disorders in adulthood. Through a combination of childhood predictors, the model correctly classified 82% (27 of 33) of the participants who eventually developed a psychosis-spectrum outcome in adulthood. With replication, multivariate premorbid prediction, including genetic risk, social, and neurological variables, could potentially be a useful
To investigate clinically significant change in the emotional condition of relatives of patients ... more To investigate clinically significant change in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation. Methods: Participants were 62 pairs of relatives and patients. Relatives completed the anxiety and depression scales from the Symptom Checklist-90-R (SCL-90-R) when the patients were admitted to sub-acute rehabilitation and at discharge. Improvement in emotional condition was investigated using the following criteria: (i) statistically reliable improvement; and (ii) clinically significant change (CSC). Results: At admission, 53.2% and 58.1% of relatives had scores above cutoff values on the anxiety and depression scales, respectively. On the anxiety scale 69.7% of these experienced a reliable improvement according to the Reliable Change Index (RCI) and 45.5% also obtained CSC, as their end-point was below the cutoff value. On the depression scale the corresponding figures were 44.4% and 41.7%, respectively. When comparing relatives with and without CSC, we found that CSC in symptoms of anxiety was associated with significantly better functional improvement during rehabilitation and a shorter period of post-traumatic amnesia in the patients. Conclusion: Of the relatives who reported scores above cutoff values on the anxiety and depression scales at patient's admission, approximately 40% experienced CSC in anxiety and depression during the patient's rehabilitation. Relatives of patients experiencing improvement during inpatient rehabilitation are more likely to experience CSC in anxiety.
To investigate the emotional well-being of relatives of patients with a severe brain injury in th... more To investigate the emotional well-being of relatives of patients with a severe brain injury in the acute setting, as well as risk factors associated with high anxiety and depression scores and impaired quality-of-life. Clinical convenience sample. Participants included 45 relatives of patients with severe brain injury recruited at a NICU. All relatives completed selected scales from the SCL-90-R and SF-36 ∼ 14 days after injury. Data concerning the condition of the patient were also collected. Of the relatives, 51% and 69% reported anxiety and depression, respectively, as well as significantly impaired quality-of-life compared to normal reference populations. Regression analysis revealed that up to 20% of the variance in depression and anxiety scores could be explained by the CRASH 2 Mortality prediction. The majority of the relatives had severely impaired quality-of-life and symptoms of anxiety and depression during the patient's NICU stay. Future research is required to explore stressors and evaluate effects of psychological intervention in the acute setting.
Objective: Psychological adversities among young children may be associated with childhood overwe... more Objective: Psychological adversities among young children may be associated with childhood overweight and obesity. We examined if an increased level of child behavioural problems was associated with body size among a selected group of 2-6 year old children, who were all predisposed to develop overweight. Methods: Cross-sectional analyses were conducted using baseline data from the "Healthy Start" intervention study. A total of 3058 children were invited to participate, and data from 583 children who were all predisposed for obesity was analyzed. The Danish version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess child stress by the SDQ Total Difficulties (SDQ-TD) score and the Prosocial Behavior (PSB) score. Height and weight were measured, and BMI z-scores were calculated. Results: A direct, but non-significant linear trend was found between SDQ-TD score and BMI z-score (β = 0.021, p = 0.11). Having an SDQ-TD score above the 90 th percentile was associated with BMI z-score (β = 0.36, p = 0.05). PSB score was not associated with BMI z-score. Analyses were adjusted for parental socioeconomic status, parental BMI, family structure, dietary factors, physical activity, and family stress level. Conclusion: The results suggested a threshold effect between SDQ-TD score and BMI z-score, where BMI z-score was associated with childhood behavioural problems only for those with the highest scores of SDQ-TD. No significant association between PSB score and BMI z-score was found.
Journal of Neurology, Neurosurgery & Psychiatry, 1988
Twenty five patients with conservatively treated cerebral arteriovenous malformation were followe... more Twenty five patients with conservatively treated cerebral arteriovenous malformation were followed up for a mean of 10-6 years after diagnosis. The follow up included neuropsychological examination. Bleeding did not occur after the time of diagnosis. Three patients had moderate to severe neurological deficits, five had moderate to severe intellectual impairment. Nineteen had an unaffected occupational status. It is concluded that the outcome in conservatively treated patients may be no worse than in surgically treated patients.
The effect of breast-feeding on brain development, especially cognitive and visual, has been exam... more The effect of breast-feeding on brain development, especially cognitive and visual, has been examined in many studies. The aim of this article is to summarize this group's studies and relate them to results from reviews and meta-analyses. In two separate studies of visual development in term infants, visual acuity was better in breast-fed than in formula-fed infants, which is in accordance with the results from a meta-analysis. Among studies examining the association between breast-feeding and cognitive development most find a positive association, even when controlling for relevant confounding factors. A positive effect was found in two different samples of young adults using two different intelligence quotient tests. The most plausible explanation for this effect is the differences in composition between human milk and infant formula (e.g. docosahexaenoic acid). It could also be because mothers who choose to breast-feed on average stimulate and support their infants better. Further, unidentified factors may also correlate with both infant feeding and development of cognitive and intellectual ability, so-called residual confounding.
Background: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD),... more Background: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD), despite the detrimental consequences the disorder can impose on mother and child. Research on alternative methods of prevention and treatment of PPD is warranted. Previous studies have suggested that long-chain n23 polyunsaturated fatty acids (PUFAs) might have a beneficial effect on depression. Objective: The objective was to explore the association between intake of fish and n23 PUFAs during pregnancy and PPD in the Danish National Birth Cohort (DNBC). Design: Exposure information from the DNBC was linked to the Danish patient and prescription registries for data on clinically identified cases of depression up to 1 y postpartum. Intake of fish and n23 PUFAs was assessed in midpregnancy with a food-frequency questionnaire. Admission to the hospital for PPD (PPD-admission) and prescription of antidepressants (PPD-prescription) were treated as separate outcomes. A total of 54,202 women were included in the present study sample. Results: Rates of depression were 0.3% (PPD-admission) and 1.6% (PPD-prescription). No association was observed between fish intake and risk of PPD-admission [crude odds ratio of 1.01 (95% CI: 0.52, 1.97) and adjusted odds ratio of 0.82 (95% CI: 0.42, 1.64)], whereas a higher risk of PPD-prescription was found for the lowest compared with the highest fish intake group [crude odds ratio of 1.61 (95% CI: 1.26, 2.06) and adjusted odds ratio of 1.46 (95% CI: 1.12, 1.90)]. No association was observed with respect to n23 PUFA intake. Conclusion: Overall, our data from a large prospective cohort linked with high-quality registers showed little evidence to support an association between intake of fish or n23 PUFAs and PPD.
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Papers by E. Mortensen