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  • 1.
    Björkdahl, Anna
    et al.
    Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet.
    Perseius, Kent-Inge
    The Swedish Red Cross University College, Department of Technology and Welfare.
    Samuelsson, Mats
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet.
    Lindberg, Mathilde Hedlund
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet.
    Sensory rooms in psychiatric inpatient care: Staff experiences.2016In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 25, no 5, p. 472-479Article in journal (Refereed)
    Abstract [en]

    There is an increased interest in exploring the use of sensory rooms in psychiatric inpatient care. Sensory rooms can provide stimulation via sight, smell, hearing, touch and taste in a demand-free environment that is controlled by the patient. The rooms may reduce patients' distress and agitation, as well as rates of seclusion and restraint. Successful implementation of sensory rooms is influenced by the attitudes and approach of staff. This paper presents a study of the experiences of 126 staff members who worked with sensory rooms in a Swedish inpatient psychiatry setting. A cross-sectional descriptive survey design was used. Data were collected by a web based self-report 12-item questionnaire that included both open- and closed-ended questions. Our findings strengthen the results of previous research in this area in many ways. Content analyses revealed three main categories: hopes and concerns, focusing on patients' self-care, and the room as a sanctuary. Although staff initially described both negative and positive expectations of sensory rooms, after working with the rooms, there was a strong emphasis on more positive experiences, such as letting go of control and observing an increase in patients' self-confidence, emotional self-care and well-being. Our findings support the important principals of person-centred nursing and recovery-oriented mental health and the ability of staff to implement these principles by working with sensory rooms.

  • 2.
    Bygren, Lars Olov
    et al.
    Karolinska Institute / Dept Community Med & Rehabil, Umeå.
    Weissglas, Gösta
    Umeå University.
    Wikström, Britt-Maj
    Karolinska Institute.
    Konlaan, Boinkum Benson
    Red Cross University College of Nursing. Dept Community Med & Rehabil, Umeå.
    Grjibovski, Andrej
    Norwegian Inst Publ Hlth, Div Epidemiol, Oslo, Norway.
    Karlsson, Ann-Brith
    Dept Community Med & Rehabil, Umeå.
    Andersson, Sven-Olof
    Umeå University.
    Sjöström, Michael
    Karolinska Institute.
    Cultural Participation and Health: A Randomized Controlled Trial Among Medical Care Staff2009In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 71, no 4, p. 469-473Article in journal (Refereed)
    Abstract [en]

    Objective: Population studies demonstrate that attending cultural events is conducive to improved health when baseline health, income, education, and health habits are taken into account. Animal experiments suggest possible mechanisms. We studied the link in humans between attending cultural events and health in a randomized controlled trial. Methods: Members of the local government officers' union in the health services in Umea, Sweden, were invited to the experiment and 101 people registered for fine arts visits once a week for 8 weeks. They chose films, concerts, or art exhibitions visits, or singing in a choir and were then randomized into 51 cases, starting at once, and 50 controls starting after the trial. Health was assessed before randomization and after the experimental period using the instrument for perceived health, short form (SF)-36, and tests of episodic memory, saliva-cortisol and immunoglobulin. The results were analyzed using a mixed design analysis of variance. Results: The SF-36 Composite Score called physical health improved in the intervention group and decreased among controls during the experiment (F(1,87) = 7.06, p = .009). The individual factor of the SF-36 called social functioning, improved more in the intervention group than among controls (F(1,98) = 8.11, p = .005) as well as the factor vitality (F(1,98) = 5.26, p = .024). The six other factors and the Mental Health Composite Score, episodic memory, cortisol and immunoglobulin levels did not change otherwise than among controls. Mechanisms are left to be identified. Conclusion: Fine arts stimulations improved perceived physical health, social functioning, and vitality.

  • 3.
    Cederberg Persson, Annika
    et al.
    The Swedish Red Cross University College.
    Selander, Emelie
    The Swedish Red Cross University College.
    Hur upplever patienter med självskadebeteende bemötandet inom vården?: "Men jag skär mig inte för att dö, utan för att överleva" (Pålsson, 2004, s.11)2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is growing rapidly today, with a population that is getting worse within a younger age. Parts of mental illness is linked to what we callself-harm, or self-mutilation. This in order to alleviate his/her anxiety as a result of a compulsion or impulse to add injury to one’s body, motivated by a need to master mental health or to regain emotional balance.

    Purpose: The purpose of this study was to illustrate how patients with self-injury behavior experience the attitudes and treatment in their received care.

    Method: This study is a qualitative content analysis with an inductive approach of autobiographies written by persons with self-harm.

    Result: Positive treatment strengthens patient self-esteem, relieves inner suffering and anxiety, and provides a foundation for a trustworthy relationship between caregivers and patients, while negative treatment, stigmatization, preconceptions and ignorance of healthcare professionals contribute to an insecure care experience for this patient group.

    Conclusion: Nurses working with self-injurypatients should reflect on their treatment, occupational role and responsibility towards the patient, as this group often feels poorly treated in care.

    Clinical significance: The content of this study addresses the problemsof caring for patients with self-harm, which may help nurses and healthcare staff to contribute to better treatment and better care.

  • 4.
    Ekdahl, Susanne
    et al.
    Nyckeln Competence Center for Pedagogics in Healthcare, Kalmar County Hospital.
    Idvall, Ewa
    Department of Care Science, Faculty of Health and Society, Malmö University, Department of Intensive Care and Perioperative Medicine, Skåne University Hospital.
    Perseius, Kent-Inge
    Red Cross University College of Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Family skills training in dialectical behaviour therapy: The experience of the significant others2014In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 28, no 4, p. 235-241Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to describe significant others’ experiences of dialectical behaviour therapy- family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms. Methods: The study had a descriptive mixed method design. Data were collected with free text questionnaires (n= 44), group interviews (n= 53) and the HAD scale (n= 52) and analysed by qualitative content analysis and descriptive and inferential statistics. Results: The results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one group, that DBT-FST is a beneficial intervention and most beneficial for those with the highest anxiety- and depressive symptoms.

  • 5.
    Ekdahl, Susanne
    et al.
    Nyckeln Competence Center for Pedagogics in Healthcare, Kalmar County Hospital, Kalmar.
    Idvall, Ewa
    Samuelsson, Mats
    Perseius, Kent-Inge
    Department of Health Science, Ersta Sköndal University College, Stockholm.
    A Life Tiptoeing: Being a Significant Other to Persons With Borderline Personality Disorder2011In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 25, no 6, p. 69-76Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of this study was to describe significant others' experiences of living close to a person with borderline personality disorder and their experience of encounter with psychiatric care.

    Methods

    Data were collected by free-text questionnaires and group interviews and were analyzed by qualitative content analysis.

    Results and Conclusion

    The results revealed four categories: a life tiptoeing; powerlessness, guilt, and lifelong grief; feeling left out and abandoned; and lost trust. The first two categories describe the experience of living close to a person with BPD, and the last two categories describe encounter with psychiatric care.

  • 6.
    Hjalmarsson, Erik
    et al.
    Division of Psychiatry, Malmö University Hospital, Malmö.
    Kåver, Anna
    Karolinska Institute, Department of Clinical Neuroscience, Stockholm.
    Perseius, Kent-Inge
    Karolinska Institute, Department of Clinical Neuroscience, Stockholm.
    Cederberg, Kerstin
    Child and Adolescent Psychiatry.
    Ghaderi, Ata
    Department of Psychology, Uppsala University, Uppsala.
    Dialectical behaviour therapy for borderline personality disorder among adolescents and young adults: Pilot study, extending the research findings in new settings and cultures2008In: Clinical Psychologist, ISSN 1328-4207, E-ISSN 1742-9552, Vol. 12, no 1, p. 18-29Article in journal (Refereed)
    Abstract [en]

    The aim of this paper was to investigate the feasibility and impact of dialectical behaviour therapy (DBT) for patients with borderline personality disorder (BPD) in a clinical outpatient setting. Eighteen clinicians were trained and supervised in using DBT. Twenty-seven female patients were assessed on a number of variables before the treatment, as well as 5 and 12 months after the start of the DBT. Despite some barriers, DBT could be implemented successfully, and the professionals reported increased competence 1 year after the start of the therapy. Low treatment dropout rates suggested that DBT was well accepted by the patients. One year after the start of treatment, the patients reported significant decrease on most variables measuring psychological distress and number of parasuicidal behaviours. The study provides preliminary support for the feasibility and impact of DBT in the outpatient treatment of BPD in a cultural setting outside the United States.

  • 7.
    Nisell, Margret
    Department of Woman and Child Health Child and Adolescent Psychiatric Unit, Karolinska Institutet.
    Psychosocial aspects on children with imperforate anus and their parents2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The overall aim of this thesis was to explore psychosocial consequences on children with high and intermediate imperforate anus and their parents.

    Material/Methods: Paper I was an explorative study involving interviews. The purpose was to illuminate the children s and parents experiences of imperforate anus (IA) and to create a baseline for further research. In Papers II-V, study-specific questionnaires were used to collect data from 25 children (8-13 years old) with high and intermediate imperforate anus and from their parents. The questionnaires comprised 45 items for the children and 59 items for the parents, covering psychosocial issues, items on child bowel function, and on experiences of hospital care. The parents also filled in the Child Behavior Checklist (CBCL), and the children s teachers filled in the Teacher s Report Form (TRF). Thirty children with juvenile chronic arthritis and 32 children with no chronic condition, along with their parents, served as Comparison Groups. In Paper VI, the psychometric properties of the child self-reported psychosocial items were evaluated with Rasch analysis.

    Results: Four categories of effects of the malformation were disclosed in the interviews: physical, emotional, social, and family effects. The emotional effects permeated the interviews; the parents suffering was evident. In the questionnaires the children with imperforate anus reported being generally happy, they liked school, and had good relationships with peers. According to their parents, the children had fecal incontinence and constipation. In the CBCL, the children with imperforate anus were assessed to have more emotional/behavioral problems than the children with juvenile chronic arthritis. On the CBCL competence scales no differences were found between groups. In the TRF, the teachers reported few emotional/behavioral problems for the children with imperforate anus, though they assessed them to be less adapted in school than were the children with no chronic condition. Differences were found in answers on the psychological items, between the children and their mothers, on the pair level. The mothers of children with imperforate anus rated lower on their child s expression of will and on respecting their child s will, than did the other mothers. Fathers scored school items optimistically. Several parents of children with imperforate anus reported positive experiences in relation to their child s condition involving child development, parental development, and strengthening of family unity. The psychometric properties of the psychological and the social dimension in the child self-report questionnaire were reasonably good.

    Conclusions: The children with imperforate anus might have some psychosocial difficulties, though informants do not agree. According to self-report questionnaires, the children appear to be well-adjusted, despite functional bowel problems. Parents of children with imperforate anus have to go through difficult experiences associated with their child s malformation, though some parents also report positive experiences. Psychosocial issues seem crucial to children with imperforate anus and to their parents, and qualified individualized assistance should be a central part of their continuing care to ameliorate or prevent difficulties. Collaboration with expertise from child and adolescent psychiatry may be required. Child autonomy needs more attention. Psychosocial interventions are requested as well as a follow-up study on these children and their parents. Further development of the measurement tools, the study-specific questionnaires, is required.

  • 8.
    Nisell, Margret
    Department of Woman and Child Health Child and Adolescent Psychiatric Unit, Karolinska Institutet.
    Psychosocial consequences of high and intermediate imperforate anus2005Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Imperforate anus including lack of a normal anorectum is an uncommon malformation. The parents of children born with high and intermediate imperforate anus have to take a big responsibility for the follow-up treatment. It has been revealed that children with imperforate anus have psychosocial problems, though knowledge of this is limited.

    Aim: The overall aim of this thesis was to explore psychosocial consequences on children with high and intermediate imperforate anus and their parents.

    Methods: In Paper I, the purpose was to illuminate the children s and parents experiences of imperforate anus and to create a baseline for further research. Interviews were done with three patients with high imperforate anus who had had severe problems with the malformation, and with their parents (5). Answers to the open-ended questions were analyzed with a qualitative method, editing analysis style . In Paper II and Paper III, study-specific questionnaires were used to collect data from 25 children (8-13 years old) with high and intermediate imperforate anus, and from their parents. The questionnaires comprised 59 items for the parents and 45 items for the children, covering psychosocial domains, one physical domain and one domain on experiences of hospital care. The parents filled in the Child Behavior Checklist (CBCL), and the children s teachers filled in the Teacher s Report Form (TRF). Two groups of children along with their parents served as comparison groups. They included 30 children with juvenile chronic arthritis and 32 healthy children.

    Results: Paper I: The parents were outspoken in the interviews, and the children s answers were meagre. Four categories of effects of the malformation were revealed: physical, emotional, social, and family. The emotional effects permeated the interviews; the parents suffering was overwhelming. In Paper II, the children with imperforate anus displayed an overall positive attitude; they reported that they were in a good mood, that they liked school, and that they had good relationships with peers. Furthermore, the children had fecal incontinence and constipation, according to parents. In the CBCL, the children in the index group were assessed to have significantly more emotional/behavioral problems than the children in Comparison Group I. In the TRF, the teachers reported few symptoms for the index group children. Paper III showed disagreement on psychosocial variables from children with imperforate anus and their mothers (on a pair level). Differences were found in particular on psychological variables, i.e. the child s emotional life. The competence scales in the CBCL revealed no differences between the index group and the other two groups. In the TRF, the teachers assessed the children with imperforate anus to be less adapted and adjusted in school than the children in comparison groups.

    Conclusions: Parents of children with high imperforate anus have to go through difficult experiences associated with the malformation. Children with imperforate anus in this study seem to be well adjusted psychosocially, despite fecal incontinence and/or constipation. The children might have some psychosocial difficulties, though informants do not agree. It is vital to assess the children s psychosocial function from more than a single informant. Psychosocial issues are crucial to children with imperforate anus and to their parents, and qualified advice and assistance should be a central part of their continuing care. Perhaps collaboration with expertise from child and adolescent psychiatry may be required.

  • 9. Perseius, Kent-Inge
    Att tämja en vulkan: om emotionell instabilitet och självskadebeteende2012 (ed. 1)Book (Other academic)
  • 10. Perseius, Kent-Inge
    Borderline personality disorder: studies of suffering, quality of life and dialectical behavioural therapy2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aims of the present thesis were: * To investigate how women patients with borderline personality disorder (BPD) perceive their suffering, quality of life and encounter with psychiatric care (paper 11 and III). * To describe BPD patients' and psychiatric professionals' perceptions of receiving and giving dialectical behavioural therapy, DBT (paper I). * To investigate how starting treatment of BPD patients with DBT affected the psychiatric professionals' experience of occupational stress and professional burnout (paper IV) Due to the different types of research questions the thesis deal with, it uses a mix of qualitative and quantitative research methods. In two of the studies (11 and 111) the main methods were qualitative. Data from free format questionnaires, individual- as well as group interviews and biographical texts, were analysed with content analysis or a hermeneutic approach. In study Ill the methods were quantitative. A summated rating scale measuring healthrelated quality-of-life (HRQOL) was analysed with descriptive and inferential statistics. In study IV quantitative and qualitative methods were combined. Two burnout inventories were analysed with descriptive and inferential statistics, and data from free format questionnaires and group interviews were analysed with qualitative content analysis. The main findings were that BPD patients suffer to an extent that is often unendurable, leading to deliberate self-harm (DSH) and suicide attempts to relieve suffering or just try to get away from it all (paper 11). In study Ill the BPD patients showed significantly poorer quality-of-life (even physical) than normal population controls of comparable age. The suffering, suicide attempts, DSH and poor quality-of-life (paper 11 and 111) put the patients in a position of voluntarily or involuntarily getting involved with psychiatric care. Study II revealed a double role of the psychiatric care in relation to BPD patients. On one hand, psychiatric professionals can add to the suffering by not being understanding and being disrespectful, on the other hand they can be helpful and relieve suffering by being respectful, understanding and validating. There was a clear relationship between the patients' experience of validation and the experience of being helped. DBT seems (both from the patients' and psychiatric professionals' perspective) to be a treatment with a philosophy, content and structure being able to relieve BPD patients suffering and helping them to independence and a bearable life-situation (paper I). Study IV confirms previous findings that psychiatric professionals experience treatment of self-harming patients as profoundly stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients due to its high degree of structure and specific techniques. The DBT team-work and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some professionals felt also improved their handling of other work stressors not related to DBT. This finding also corresponds to BPD patients' perceptions of the mindfulness component in DBT, which they reported as particularly helpful (paper 1). It should be noted that the patient samples in the thesis may be considered as a "worse off" subgroup among BPD patients, as they usually entered special treatment programs after a period of escalating symptoms, which standard psychiatric services had had difficulties handling. The rather small number of participants and the lack of equivalent andlor concurrent control groups in the quantitative studies limit the generalization of the results.

  • 11.
    Perseius, Kent-Inge
    Red Cross University College of Nursing.
    Personlighetsstörningar2014In: Omvårdnad vid psykisk ohälsa: på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur AB, 2014, 2, p. 215-245Chapter in book (Other academic)
  • 12.
    Perseius, Kent-Inge
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Personlighetsstörningar2010In: Omvårdnad vid psykisk ohälsa: på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur, 2010, 1, p. 173-195Chapter in book (Other academic)
  • 13.
    Perseius, Kent-Inge
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Andersson, Eva
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Åsberg, Marie
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Samuelsson, Mats
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Health-related quality of life in women patients with borderline personality disorder2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 302-307Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aims of the study were to: (i) test the reliability of a health-related quality of life (HRQOL) instrument [Swedish Health-Related Quality of Life Survey (SWED-QUAL)] on women patients with borderline personality disorder (BPD); (ii) compare their HRQOL to a normal population group comparable in age; and (iii) test for subgroup differences in HRQOL considering psychiatric DSM axis-I comorbidity. METHOD: The study was conducted in connection to a randomized, controlled trial of psychotherapy for women BPD patients. Seventy-five women with BPD diagnosis were administered the SWED-QUAL. Statistic reliability was evaluated with inter-item correlations, total-item correlations and internal consistency criterions. The BPD patients' SWED-QUAL results were compared with data extracted from a published study and subgroup differences due to axis-I comorbidity were analysed. RESULTS AND CONCLUSIONS: SWED-QUAL could be considered as an instrument with acceptable reliability when assessing HRQOL in BPD patients. The BPD patients suffered significant impairments in HRQOL overall health dimensions compared to normal population. There were no subgroup differences due to axis-I comorbidity, which indicate that BPD in itself might be a predictor of substantial HRQOL impairment.

  • 14.
    Perseius, Kent-Inge
    et al.
    Department of Clinical Neuroscience, Psychiatry Section, Psychiatry Center, Karolinska Hospital, Karolinska Institutet, Stockholm.
    Ekdahl, Susanne
    Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet.
    Asberg, Marie
    Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet.
    Samuelsson, Mats
    Red Cross University College of Nursing.
    To tame a volcano: patients with borderline personality disorder and their perceptions of suffering2005In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 19, no 4, p. 160-168Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate life situations, suffering, and perceptions of encounter with psychiatric care among 10 patients with borderline personality disorder. The results are based on a hermeneutic interpretation of narrative interviews in addition to biographical material (diary excerpts and poems). The interpretation revealed three comprehensive theme areas: life on the edge , the struggle for health and dignity-a balance act on a slack wire over a volcano , and the good and the bad act of psychiatric care in the drama of suffering . These theme areas form a movement back and forth-from despair and unendurable suffering to struggle for health and dignity and a life worth living. Common beliefs regarding these patients among personnel and implications for psychiatric care are discussed in relation to the results.

  • 15. Perseius, Kent-Inge
    et al.
    Kåver, A
    Ekdahl, S
    Department of Health and Behavioural Science, Psychology Section, Kalmar University.
    Åsberg, Marie
    Department of Clinical Neuroscience Psychiatry Center, Karolinska Institute; Karolinska University Hospital.
    Samuelsson, Mats
    Red Cross University College of Nursing. Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute.
    Stress and burnout in psychiatric professionals when starting to use dialectical behavioural therapy in the work with young self-harming women showing borderline personality symptoms2007In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 14, no 7, p. 635-643Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate how starting to use dialectical behavioural therapy (DBT) in the work with young self-harming women showing symptoms of borderline personality disorder affected the psychiatric professionals (n = 22) experience of occupational stress and levels of professional burnout. The study was carried out in relation to an 18-month clinical psychiatric development project, and used a mix of quantitative and qualitative research methods [a burnout inventory, the Maslach burnout inventory-General Survey (MBI-GS), free format questionnaires and group interviews]. The result confirms previous reports that psychiatric health professionals experience treatment of self-harming patients as very stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients. The teamwork and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some therapists felt also improved their handling of other work stressors not related to DBT. The inventory for professional burnout, the MBI-GS, showed no significant changes over the 18-month period, although there was a tendency for increased burnout levels at the 6-month assessment, which had returned to baseline levels at 18 months.

  • 16.
    Perseius, Kent-Inge
    et al.
    Karolinska Institutet, Department of Clinical Neuroscience, Psychiatry Section, Psychiatry Center, Karolinska Hospital, Stockholm.
    Ojehagen, Agneta
    Lund University, Department of Clinical Neuroscience, Division of Psychiatry, University Hospital, Lund.
    Ekdahl, Susanne
    Kalmar University, Department of Health and Behavioural Science, Psychology Section, Kalmar.
    Asberg, Marie
    Karolinska Institutet, Department of Clinical Neuroscience, Psychiatry Section, Psychiatry Center, Karolinska Hospital, Stockholm.
    Samuelsson, Mats
    Red Cross University College of Nursing.
    Treatment of suicidal and deliberate self-harming patients with borderline personality disorder using dialectical behavioral therapy: the patients’ and the therapists’ perceptions.2003In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 17, no 5, p. 218-227Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate patients and therapists perception of receiving and giving dialectical behavioral therapy (DBT). Ten deliberate self-harm patients with borderline personality disorder and four DBT-therapists were interviewed. The interviews were analyzed with qualitative content analysis. The patients unanimously regard the DBT-therapy as life saving and something that has given them a bearable life situation. The patients and the therapists are concordant on the effective components of the therapy: the understanding, respect, and confirmation in combination with the cognitive and behavioral skills. The experienced effectiveness of DBT is contrasted by the patient's pronouncedly negative experiences from psychiatric care before entering DBT.

  • 17.
    Perseius, Kent-Inge
    et al.
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Samuelsson, Mats
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Andersson, Eva
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Berndtsson, Tord
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Götmark, Håkan
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Henriksson, Freddie
    Stockholm School of Economics.
    Kåver, Anna
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Nilsonne, Åsa
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Åsberg, Marie
    Department of Clinical Neuroscience, Psychiatry section, Karolinska Institute.
    Does dialectical behavioural therapy reduce treatment cost for patients with borderline personality disorder: A pilot study2004In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 24, no 2, p. 27-30Article in journal (Refereed)
    Abstract [en]

    Objective: In order to assess costs - consequences of dialectal behavioural therapy (DBT) in suicidal women with borderline personality disorder (BPD), the present study takes advantage of pilot data collected during a training phase, in relation to a large scale randomised controlled trail (RCT). Method: Under a 18 month period, 22 suicidal women with BPD were treated with outpatient DBT, with focus on reducing parasuicidal behaviour. Outcome data collected retrospectively 12 months before therapy start, were compared to prospective data collected up to 18 months in therapy. The cost - analysis included direct health care costs only. Results & Conclusions: The results suggest that DBT may have a positive impact on treatment costs, which decreased significantly during the last 12 months in a 18 month therapy period. The reduction of costs is due to decrease in the number of psychiatric inpatient days. The conclusions that can be drawn from the results are, however, limited as the study was not made in RCT conditions and indirect costs to society were not assessed.

  • 18.
    Petersson, Suzanne
    et al.
    Lund Univeristy / Kalmar County Council.
    Clinton, David
    Karolinska Institutet.
    Brudin, Lars
    Kalmar County Council.
    Perseius, Kent-Inge
    The Swedish Red Cross University College.
    Perfectionism in Eating Disorders: Are Long-Term Outcomes Influenced by Extent and Changeability in Initial Perfectionism?2018In: Journal for Person-Oriented Research, ISSN 2002-0244, Vol. 4, no 1, p. 1-14Article in journal (Refereed)
    Abstract [en]

    Purpose: Perfectionism has been found to predict outcomes in the treatment of eating disorders (ED). In the present study, we took advantage of longitudinal data to: a) investigate whether there are different patterns of perfectionism during the first six months after admission in a clinical sample of patients with ED, and b) describe how these patterns are related to long-term outcome. Methods: A sample of patients (N=294) from the Coordinated Evaluation and Research at Specialized Units for Eating Disorders database was divided into clusters according to perfectionism patterns measured with the EDI-2 perfectionism scale at baseline, and six months in treatment. Cluster analysis was performed on the extent and perseverance/changeability of self-oriented and socially described perfectionism. Outcome was measured with the EDI-2 and the SCL-63. Frequencies of eating disorder diagnoses were investigated. Results: Five clusters were identified. Low perfectionism was associated with lower levels of ED and psychiatric symptomatology at baseline. There were no significant differences between clusters on outcome variables at 36-month follow-up. Conclusions: Results indicated better psychiatric and psychological health three years after the initial measure. Patterns of relations between the extent and possible changes of perfectionism, measured with the EDI-P at baseline and after six months, did not appear to be associated with long-term outcomes on psychiatric health ratings.

  • 19.
    Petersson, Suzanne
    et al.
    AnorexiBulimiCenter, Division of Psychiatry, Kalmar County Council.
    Perseius, Kent-Inge
    Nyckeln Competence Center for Health Pedagogics, Kalmar County Council.
    Johnsson, Per
    Department of Psychology, Lund University, Lund.
    Perfectionism and sense of coherence among patients with eating disorders2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 6, p. 409-415Article in journal (Refereed)
    Abstract [en]

    Background: There is a substantial body of research on eating disorders and perfectionism. Also there are several studies on eating disorders and sense of coherence (SOC), but studies regarding all three subjects are sparse. Perfectionism and the degree of SOC are considered central and aggravating aspects of psychiatric conditions, not least in relation to eating disorders. Aims: The present study aimed to describe the relationship between perfectionism as operationalized by Garner in the Eating Disorder Inventory-2 and SOC as defined by Antonovsky in the SOC-29 scale. The hypothesis was that SOC should be negatively associated with perfectionism. Methods: Data from the two self-measuring instruments collected from 95 consecutively recruited eating disorder outpatients were analysed with descriptive and inferential statistics. Results: The patients in the present study scored consistently with other Swedish eating disorder samples on the Perfectionism subscale in the Eating Disorder Inventory-2 (EDI-P) and on the SOC-29, indicating a higher degree of perfectionism and weaker SOC than normal population groups. Perfectionism was significantly correlated to SOC. The correlation was negative, confirming the study hypothesis. The hypothesis was further confirmed in a subgroup analysis comparing patients with different degrees of SOC related to their EDI-P scores. Conclusions: Perfectionism is associated with SOC in patients with eating disorders. Clinical implications: The clinical implications derived from the study could be a recommendation to focus on the SOC in patients with an eating disorder with the hope of lowering the patients’ perfectionism as well.

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