Papers by Sophia Eberhard
International Journal of Environmental Research and Public Health, Dec 25, 2023
International Journal of Integrated Care, Jun 4, 2008
The Lancet Psychiatry, Aug 1, 2023
Background: Risky alcohol use is associated with an increased risk for developing alcohol use dis... more Background: Risky alcohol use is associated with an increased risk for developing alcohol use disorder, and may negatively affect the course of other psychiatric disorders. The importance of detection and intervention in risky alcohol use has repeatedly been underlined in the scientific literature, though less is written regarding general psychiatric populations. The overall aim of this thesis was to increase knowledge about risky alcohol use in general psychiatric patients, detection, prevalence and intervention, and to further explore the area of risky alcohol use in psychiatric patients of different age groups, with a focus on the use of new technologies. Methods: Non-psychotic psychiatric outpatients (n =1670) completed two self-rating forms concerning alcohol and drug habits (AUDIT, DUDIT) (Study I). Participants with scores indicating risky alcohol use (n = 344) were randomised to intervention (immediate advice) or control (advice after 6 months) (Study II). To improve diagnostic accuracy, the decision was made to build a smartphone application for digitalised screening and follow-up. 'The Blue App' was developed in six stages, described in Paper III (Study III). Adolescents admitted to a child and adolescent emergency inpatient unit (n = 96) completed two computerised self-rating forms concerning alcohol and drug habits (AUDIT-C, DUDIT), using the Blue App (Study IV). Results: In the adult psychiatric outpatient sample, risky alcohol use was prevalent in 22% of the women and 30% of the men, with the highest frequencies of risky and binge drinking in the youngest quartile (Study I). About half of the adult patients who received the brief intervention had reduced their consumption to non-risky levels by follow-up 6 months later (Study II). A sophisticated and easy-to-use web-based mobile phone application corresponding to the unit's needs was developed (Study III). In the adolescent psychiatric inpatient sample, risky alcohol use was prevalent in 33% of the girls and 22% of the boys, with rates at least as common as in adolescents in the general population. The diagnostic groups found to have the highest prevalence of risky alcohol use in the adolescent sample were anxiety and affective disorder (Study IV). Conclusions: Risky drinking seems to be common in both the adolescent and adult general psychiatric sample; in the adolescent sample at least as common as in the Swedish general population, in the adult sample clearly above frequencies found in the Swedish general population. A brief intervention on risky alcohol use, based on motivational interviewing principles seems to be effective in adults. New technology for psychiatric health care (eMental health) have shown promising results. A technically advanced and easy-to-use web-based mobile phone application (The Blue App) corresponding to the unit's needs for better methods for digitalized screening to improve diagnostic accuracy was developed.
Journal of Mental Health, May 4, 2015
Hazardous alcohol use in psychiatric patients may increase the risk of the development of a subst... more Hazardous alcohol use in psychiatric patients may increase the risk of the development of a substance use disorder and negatively affect the course of the psychiatric disorder. To investigate the prevalence of hazardous alcohol and drug use in a Swedish psychiatric outpatient population with particular focus on hazardous alcohol consumption and assess relationships of hazardous alcohol use to sex, age and psychiatric diagnosis. General psychiatric outpatients, n = 1,679, completed a self-rating Alcohol Use Disorders Identification Test (AUDIT). Hazardous or harmful alcohol habits occurred among 22% of all women and 30% of all men with higher prevalence among younger patients. Nine percent of all women and 22 % of all men reported binge drinking. Binge drinking was more frequent in younger subjects. Women with a personality disorder diagnosis had a higher frequency of at risk drinking. Apart from that, psychiatric diagnosis was unrelated to rate of hazardous drinking. Hazardous alcohol use was common in this psychiatric outpatient population. With regard to possible risks related to drinking in psychiatric patients, alcohol habits should be assessed as a part of good clinical practice.
JMIR Research Protocols, Nov 12, 2018
Background: New methods are needed for collecting data of in-and outpatients and for improving ou... more Background: New methods are needed for collecting data of in-and outpatients and for improving outpatient compliance after discharge. Mobile technologies, such as smartphone apps, have shown promising results, (eg, helping unwell people by offering support and resources). Screening for the condition, including comorbidities, is a vital part of psychiatric care. Comorbid conditions, especially in emergency evaluation, are often missed, leading to inaccurate diagnosis and treatment. One way of improving diagnostic accuracy is to use a structured diagnostic process. Digitalized screening and follow-up have the advantage of making administration and scoring easier and less time consuming, thereby increasing response rate. To address these problems, we decided to create a smartphone app called The Blue App. The Blue App was developed through 6 steps, described in the manuscript.
International Journal of Environmental Research and Public Health, Dec 23, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Environmental Research and Public Health, Dec 28, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of addiction, Oct 19, 2021
Introduction. Underage drinking is associated with poor mental health. Early detection for risky ... more Introduction. Underage drinking is associated with poor mental health. Early detection for risky alcohol use is recommended, although less implemented in adolescent care. e objective of this study was to investigate the prevalence of risky alcohol use and psychiatric comorbidity. Methods. Over a nine-month period, 145 eligible adolescents admitted to the child and adolescent emergency unit in Malmö, Sweden, were offered computerized screening with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) and Drug Use Disorders Identification Test (DUDIT). Results. Ninety-six patients (73 girls and 23 boys) agreed to participate. e most common diagnoses were affective disorder (41%) and anxiety disorder (27%). Risky alcohol use was found among 33% of the girls and 22% of the boys (p � 0.45) and did not differ between diagnostic categories. ere was a positive correlation between AUDIT-C and DUDITscores (p � 0.019). Among adolescents with risky alcohol use, 33% of the girls and 60% of the boys also had a risky drug use. Conversely, 47% of the girls and 60% of the boys with risky drug use also had a risky alcohol use. Conclusion. In view of the poor prognosis of risky alcohol use in adolescents, alcohol and drug habits should be assessed when adolescents seek psychiatric emergency care.
Issues in Mental Health Nursing, Feb 8, 2021
There is growing evidence that lay health workers providing counselling is a feasible approach of... more There is growing evidence that lay health workers providing counselling is a feasible approach of addressing the universally large treatment gap for mental disorders. This study illuminates the experiences of the counsellors in the Youth Friendship Bench in Zimbabwe, a pilot project where students provide problem-solving therapy to adolescents with common mental disorders. Twelve interviews were analysed using content analysis. The first theme "Working in a meaningful project" describes how the counsellors managed to create an alliance with the clients. The project was perceived as helpful, meaningful and urgent, and the counsellors' experienced a professional and individual development through the support of the Friendship Bench organization. The second theme "Encountering obstacles" illuminates how counsellors experienced situations where they failed to reach out to clients, felt unprepared and inadequate, and how they combated preconceptions and taboos. In the third theme, "Carrying an emotional burden," the counsellors described experiences of recognising own problems and empathising with the client.
Social Psychiatry and Psychiatric Epidemiology, Mar 18, 2009
International Journal of Environmental Research and Public Health
Evidence is lacking on how to understand the reasons for variations, both in prevalence of ADHD a... more Evidence is lacking on how to understand the reasons for variations, both in prevalence of ADHD and ADHD medication prescribing patterns in children and adolescents, within Region Skåne. These variations are not in line with current national clinical guidelines and seem to have increased over time. This qualitative interview study illuminates pediatric psychiatrists’ attitudes toward ADHD and their experiences of prescribing ADHD medication. Eleven pediatric psychiatrists described the complex interplay of variables that they experienced while assessing a child, which had influence on their decision to prescribe medication. Being part of a local unit’s culture influenced how ADHD medications were prescribed. They wished that the assessment of the child’s symptoms was consistent with guidelines in every unit but noted that such alignment was not implemented. They pointed out that an ADHD diagnosis is dependent on the surrounding’s motivation and capacity to adapt to the present state...
International Journal of Environmental Research and Public Health
Evidence is lacking on how to manage imminent suicidality in adolescents with self-harm. Brief Ad... more Evidence is lacking on how to manage imminent suicidality in adolescents with self-harm. Brief Admission by Self-referral (BA) is a crisis-management intervention, developed for adults with self-harm at risk for suicide. Structured, individualized and based on responsible autonomy, BA aims to provide a respite while minimizing negative effects of hospitalization. This qualitative interview study illuminates adolescents’ experiences of BA, adapted for this target group. Nineteen adolescents aged 14 to 19 years, described BA as helpful for timely rest and recovery to save themselves from impulses to self-harm. The individual contract, which is a prerequisite for access to BA, was perceived to give access to professional support in a safe environment, also among adolescents not using their contract. Being trusted with responsibility to self-admit was also hard work with struggles of self-doubt. Challenges included experiencing distrust from staff and fear of not being able to abstain f...
Introduction Underage drinking is associated with poor mental health. Early detection for risky a... more Introduction Underage drinking is associated with poor mental health. Early detection for risky alcohol use is recommended, although less implemented in adolescent care. The objective of this study was to investigate the prevalence of risky alcohol use and psychiatric comorbidity. Methods Over a nine-month period, 145 eligible adolescents admitted to the child and adolescent emergency unit in Malmö, Sweden, were offered computerized screening with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) and Drug Use Disorders Identification Test (DUDIT). Results Ninety-six patients (73 girls and 23 boys) agreed to participate. The most common diagnoses were affective disorder (41%) and anxiety disorder (27%). Risky alcohol use was found among 33% of the girls and 22% of the boys (p=0.45) and did not differ between diagnostic categories. There was a positive correlation between AUDIT-C and DUDIT scores (p=0.019). Among adolescents with risky alcohol use, 33% of the girls and 60...
Background: Risky alcohol use is associated with an increased risk for developing alcohol use dis... more Background: Risky alcohol use is associated with an increased risk for developing alcohol use disorder, and may negatively affect the course of other psychiatric disorders. The importance of detection and intervention in risky alcohol use has repeatedly been underlined in the scientific literature, though less is written regarding general psychiatric populations. The overall aim of this thesis was to increase knowledge about risky alcohol use in general psychiatric patients, detection, prevalence and intervention, and to further explore the area of risky alcohol use in psychiatric patients of different age groups, with a focus on the use of new technologies. Methods: Non-psychotic psychiatric outpatients (n =1670) completed two self-rating forms concerning alcohol and drug habits (AUDIT, DUDIT) (Study I). Participants with scores indicating risky alcohol use (n = 344) were randomised to intervention (immediate advice) or control (advice after 6 months) (Study II). To improve diagnos...
Social Psychiatry and Psychiatric Epidemiology, 2009
Background Hazardous alcohol use is associated with an increased risk for development of a substa... more Background Hazardous alcohol use is associated with an increased risk for development of a substance use disorder, leading to negative outcomes in psychiatric patients. Aims In order to investigate whether psychiatric outpatients' hazardous alcohol consumption could be reduced by way of a brief intervention by telephone. Method Non-psychotic psychiatric outpatients, n = 1,670, completed a self-rating form concerning alcohol habits (AUDIT). Participants with scores indicating risk consumption (n = 344) were randomised to intervention (immediate advice) or control (advice after 6 months). Results Hazardous alcohol habits occurred among 19% of the women and 24% of the men. In the intervention group, half of the patients reduced their alcohol consumption to non-hazardous levels at 6-month follow-up (ITT analysis). In women, 41.5% in the intervention group had no hazardous consumption at follow-up compared to 24.7% in the control group (P = 0.003), corresponding figure for men was 49.1 and 34.0%. Conclusion Brief intervention seems to be effective to reduce hazardous alcohol consumption in psychiatric outpatients.
JMIR Research Protocols
New methods are needed for collecting data of in- and outpatients and for improving outpatient co... more New methods are needed for collecting data of in- and outpatients and for improving outpatient compliance after discharge. Mobile technologies, such as smartphone apps, have shown promising results, (eg, helping unwell people by offering support and resources). Screening for the condition, including comorbidities, is a vital part of psychiatric care. Comorbid conditions, especially in emergency evaluation, are often missed, leading to inaccurate diagnosis and treatment. One way of improving diagnostic accuracy is to use a structured diagnostic process. Digitalized screening and follow-up have the advantage of making administration and scoring easier and less time consuming, thereby increasing response rate. To address these problems, we decided to create a smartphone app called The Blue App. The Blue App was developed through 6 steps, described in the manuscript. The aim of this paper is to describe (1) the development of The Blue App and (2) 2 planned research studies to evaluate the app. Two studies will be performed. Study 1 has a descriptive design, mapping comorbidities before and after the introduction of The Blue App. Study 2 has a randomized controlled design, measuring compliance with outpatient treatments as well as depressive symptoms, rated as changes in Montgomery-Åsberg Depression Scale scores during a 1-year follow-up. We have described app development. Data collection for Study 1 started in autumn 2017. Study 2 will start in autumn 2018. We expect to have enrolled the 150 patients in Study 2 by December 2019. Final results will be published in a scientific journal. A technically advanced and easy-to-use Web-based mobile phone app corresponding to the unit's needs was developed, and 2 studies are planned to evaluate its usefulness. RR1-10.2196/10121.
BACKGROUND New methods are needed for collecting data of in- and outpatients and for improving ou... more BACKGROUND New methods are needed for collecting data of in- and outpatients and for improving outpatient compliance after discharge. Mobile technologies, such as smartphone apps, have shown promising results, (eg, helping unwell people by offering support and resources). Screening for the condition, including comorbidities, is a vital part of psychiatric care. Comorbid conditions, especially in emergency evaluation, are often missed, leading to inaccurate diagnosis and treatment. One way of improving diagnostic accuracy is to use a structured diagnostic process. Digitalized screening and follow-up have the advantage of making administration and scoring easier and less time consuming, thereby increasing response rate. To address these problems, we decided to create a smartphone app called The Blue App. The Blue App was developed through 6 steps, described in the manuscript. OBJECTIVE The aim of this paper is to describe (1) the development of The Blue App and (2) 2 planned research ...
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Papers by Sophia Eberhard