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Biomedical subjects

M Berglund

Publications and source records attributed to M Berglund.

At least 91 records · Page 5Linked to original sources
PubMed1988

Delirium tremens: a prospective long-term follow-up study.

A follow-up by health insurance records of 716 male hospital-treated alcoholics revealed a tendency to a more favorable long-term adjustment in patients with delirium tremens at first admission compared with others. Standardized ratings at first admission indicated that the delirium patients had lower frequencies of depressive symptomatology, personality disturbance and social complications. Slight cerebral impairment at first admission was more frequent in the delirium patients, perhaps indicating a more severe abuse. In a subsample of 105 personally followed-up patients it was found that subjects with delirium later during the course of their illness were characterized by a lower level of social stability at first admission, compared with those with an initial delirium or with no history of delirium tremens. Contrary to initial delirium, later delirium was related to an unfavorable course. Six subjects with a history of delirium tremens were found to have taken up social drinking. Patterns and processes of improvement were found to be related more to background characteristics in terms of personality disturbance and social stability than to the severity of withdrawal symptoms.

Alcohol Drinking↗
PubMed1988

The Swedish Alcohol Use Inventory (AVI), a self-report inventory for differentiated diagnosis in alcoholism.

AVI is a self-report inventory intended for standardized and differentiated assessment and diagnosis in alcoholism; it includes 75 items adapted from Horn and Wanberg's Alcohol Use Inventory (AUI) and an assessment of the alcohol intake during a typical week of heavy drinking. The drinking profile is presented in five second-order factor scales: 'alcohol abuse', 'psychological benefits', 'interpersonal complications', 'social drinking' and 'daily drinking' and in 17 first-order factor scales. The reliability and specificity of the scales are satisfactory. Preliminary norms based on a sample of more than 600 alcoholic patients are available. Using the original American scoring and norms the results indicate important similarities in the alcoholism pattern between Sweden and the U.S.A.

Adult↗
PubMed1987

Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric ward. A path analysis study of the importance of patient involvement in treatment planning.

Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric treatment programme were analysed using a path analysis method. The programme used two models of treatment planning, one with and one without active participation of the patient in formulating a written treatment contract. A causal structural model, which explained 23% of the variance in the model, was used in the final analysis. The results indicated a positive relationship between a cooperation contract procedure and the level of expectations of improvement as well as high ratings of the importance of the patients own effort in treatment. The level of expectations of improvement were related to the symptom level at discharge and global improvement during treatment, indicating a better treatment outcome for the patients of the cooperation contract group, while the importance of own effort was not related to treatment outcome. Symptoms at discharge were mainly determined by symptoms at admission and global improvement, and also by expectations of improvement, initial psychic status and social background. The explained variance was 63%. Satisfaction with treatment was mainly determined by global improvement, symptoms at discharge and expectations of improvement. The explained variance was 60%. It is concluded that attention to patient expectations of improvement viewed as an important intermediate variable, is related to a an improvement in treatment outcome.

Adult↗
PubMed1987

Normalization of regional cerebral blood flow in alcoholics during the first 7 weeks of abstinence.

Twenty-two institutionalized alcoholics were studied after 1, 3, 5 and 7 weeks of abstinence with measurements of the regional cerebral blood flow (rCBF), psychometric testing and clinical ratings. Twenty-two healthy volunteers served as age-matched controls. Mean rCBF was significantly reduced in the alcoholics at all measurements compared to the controls. The older alcoholics (median cut) showed a 9% increase of rCBF from the 1st to the 7th week (P less than 0.01). The mean rCBF in these alcoholics also increased more in the right than in the left hemisphere (P less than 0.05) during the investigation. The differences between the alcoholics and the controls were most pronounced in the right frontal lobe. The mean flow changes were correlated to improvement in clinical state. Right hemisphere and frontal lobe flow decreases were more accentuated in older alcoholics.

Adult↗
PubMed1987

Individualized measures of outcome versus standardized rating scales in evaluation of in-hospital psychiatric treatment. A methodological study.

The differentiating power of two individually related measures of outcome, target complaints and psychiatrists' evaluation of individually defined treatment objectives, were studied in two models of treatment planning, one with and one without active patient participation. Target complaints were measured at admission, after 5 days and at discharge. Treatment objectives were initially defined in written treatment contracts and evaluated at discharge. These measures were compared with patients' self-reported symptoms as well as with independently rated clinical symptoms at admission and discharge. Both target complaints and psychiatrists' evaluations measured improvement during treatment. The differentiating power between the two experimental conditions was, however, much weaker than that of the symptom rating scales. The psychiatrists' evaluations were strongly influenced by state at discharge and only to a minor extent by changes during treatment. It is concluded that symptom rating scales are superior to individualized measures of outcome in studies on a general psychiatric ward, possibly because the patients are fairly homogenous concerning anxiety.

Goals↗
PubMed1987

Mortality in severe depression. A prospective study including 103 suicides.

Twelve hundred and six psychiatric in-patients, 506 men and 700 women, with severe depression/melancholia were rated at discharge with a multi-dimensional diagnostic schedule during 1956-1969. The sample was followed up until December 31, 1983. A total of 476 deaths were recorded including 103 suicides. Suicides and to a small proportion diseases of the nervous system constituted the total excess mortality in unipolar disorders. In bipolar disorders there was also an increased mortality from physical disorders, while the suicide frequency was lower (9% versus 4%). Male suicides had higher initial ratings for the items brittle, sensitive, marital problems, acute onset and lower ratings for psychomotor retardation than other men. Female suicides had a higher frequency of attempted suicides than other women. Acute onset and attempted suicide were associated with suicides early in the course contrary to the other differentiating items. The suicide frequency was similar in admissions during 1956-1962 compared with those during 1963-1969.

Adult↗
PubMed1987

Suicide in alcoholism. A prospective study of 55 cases with autopsy findings.

In a previous paper we reported prospective ratings for 88 alcoholic suicides. At the initial admission they had more often signs of peptic ulcer, depression, dysphoria and brittleness than other alcoholics. In 55 of these alcoholics an autopsy was performed at the Department of Forensic Medicine, University Hospital, Lund. In 37 cases the blood alcohol level was measured (at time of death). Alcoholics with brittleness had more often blood alcohol levels over 0.1% than others, and alcoholics with dysphoria more often negative tests even if the suicide generally was associated with previous drinking. Concerning the blood alcohol level alcoholics with peptic ulcer did not differ from the others. Alcoholics with initial depression had more often previous suicide attempts. Twenty (36%) of the alcoholics had experienced a personal loss during the year preceding the suicide. The possible implications of the findings for suicide prevention strategies is discussed.

Alcoholism↗
PubMed1987

Suicide in psychiatric patients. A prospective study of 67 cases without initial signs of severe depression or alcoholism.

All cases from the county, who were subjected to post-mortem examination at the Department of Forensic Medicine, University of Lund with a diagnosis of suicide during 1949-1984, were compared with the inpatient register at the Department of Psychiatry, University Hospital, Lund during 1949-1969. During these years all patients were rated at discharge with a multidimensional schedule. All patients with initial ratings of severe depression/melancholia and alcoholism were analyzed separately and excluded from the present sample. The ratings of the suicide cases were compared with those of 8,046 other inpatients. There were 67 suicide cases, 36 men and 31 women. The suicide cases had higher frequencies of the item easily led/dependent/immature personality (34% versus 18%) and of attempted suicides (19% versus 8%). There were no differences in ratings of symptoms as slight depression and anxiety or of situational factors. Attempted suicide was related to suicides early in the course, while easily led/dependent/immature was not so related. At the time of the suicide there was a higher frequency of never married and a lower frequency of married subjects in the present series compared with suicides in severe depression/melancholia and alcoholism.

Adolescent↗
PubMed1987

Ageing and recovery from alcoholism.

Fifty-five dependent (DSM-III) male alcoholics, chosen for good social adjustment, were personally followed up about 20 years after their first admission to hospital. The conditions of all the alcoholics were evaluated with a multidimensional diagnostic schedule when first admitted. At the follow-up, 11 were abstainers, 11 reported a change to social drinking via abstinence, and 10 reported a change to social drinking by gradual stages. Improvement after the age of 45 was mainly due to gradual change to social drinking. This type of improvement was in half of the cases attributed to a decreased tolerance for alcohol. In the present sample, there were no indications of any relationship between premature ageing and gradual change to social drinking. It is hypothesised that physiological processes of normal ageing with concomitant changes in reactions to alcohol may be of importance for remission from alcoholism in middle-aged and older alcoholics. The relationships of personality, social factors and the degree of alcohol-dependence to patterns of successful long-term adjustment are discussed.

Adult↗
PubMed1987

A prospective study of successful long-term adjustment in alcohol dependence: social drinking versus abstinence.

A series of 1312 alcoholics admitted to the Department of Psychiatry, University Hospital, Lund, Sweden, from 1949 through 1969 was followed up by record data up to 31 December 1980. The conditions of the patients were evaluated with a multidimensional diagnostic rating schedule when first admitted. Two decades after their first admission, 70 male alcoholics with a good social adjustment were chosen for personal examination and of these 60 (86%) were interviewed. Social drinking was twice as common as abstinence among the former alcohol-dependent subjects. Abstainers had a higher frequency of initial ratings indicating lack of internal control of behavior and were less often socially stable when first admitted as compared with the social drinkers. Early improvement was related to initial abstinence; the subjects who improved later in life more often reported a gradual change from alcohol abuse to social drinking.

Adaptation, Psychological↗
PubMed1987

Different patterns of successful long-term adjustment in genetically defined subtypes of alcoholics.

In this personal two-decade follow-up of 55 socially well adjusted male alcoholics it was found that patterns of successful adjustment differed significantly between type 1 and type 2 alcoholics, as defined by Cloninger, Bohman and co-workers, with a higher frequency of stable sporadic abuse ("atypical abuse") and lower frequency of social drinking or abstinence in type 2 alcoholics (p less than .01). In this sample atypical abuse was related to psychiatric and social outcome characteristics as favourable as in social drinking and abstinence.

Alcohol Drinking↗
PubMed1986

Successfully adjusted alcoholics lost to long-term follow-up. A prospective study.

In a two-decade personal follow-up of male alcoholics who had been assessed by a multidimensional diagnostic schedule when first admitted to hospital, the attrition rate was somewhat higher (14%) in a sample chosen for good social adjustment (N = 70) than in a comparison group (N = 35) of subjects with a disability pension (9%). In the good social adjustment sample, outcome status did not differ between subjects causing follow-up difficulties compared with the others. In both samples there was a higher frequency of personality disturbance with lack of internal control of behaviour (initial ratings) in subjects who were lost or caused other follow-up difficulties compared with the others (P less than 0.05). Among the socially well adjusted alcoholics the frequency of psychopathic behaviour when first admitted was higher in the lost than in the interviewed subjects (P less than 0.001).

Alcoholism↗
PubMed1986

Selenium status in patients with liver cirrhosis and alcoholism.

1. Selenium status and blood levels of other nutrients related to lipid peroxidation were studied in patients with advanced alcoholic liver cirrhosis, in male alcoholics who had been abstinent for at least 1 month and in healthy control subjects. 2. Plasma Se was decreased in alcoholic cirrhosis but not among alcoholics in abstinence. Platelet glutathione peroxidase (EC 1.11.1.9; GSH-Px) activity was decreased in cirrhotic patients, whereas GSH-Px in blood and plasma was the same as in controls for both groups of patients. 3. Plasma retinol and plasma alpha-tocopherol were decreased in alcoholic cirrhosis, whereas plasma ascorbic acid was the same in all groups. 4. The decreases in platelet GSH-Px, plasma Se and alpha-tocopherol indicate a deranged antioxidant defence in patients with advanced alcoholic cirrhosis, but the levels of these and other nutrients were generally not correlated to common clinical chemical indicators of liver disease.

Adult↗
PubMed1986

Suicide in male alcoholics with peptic ulcers.

Eighty-seven male alcoholics with peptic ulcers and 913 without peptic ulcers were first admitted to the Department of Psychiatry of Lund, Sweden during the period 1956-1969. In the initial ratings rigidity/perfectionism, strain/tenseness, sleep disturbances, the asthenic syndrome, and heredity for alcoholism/personality disturbances/suicide were more frequent in the peptic ulcer group than in the others. Patients with peptic ulcers were more often married and less often unmarried or showed antisocial/criminal indications of antisociality/criminality. A follow-up by records was performed on January 1, 1981. Seventeen percent in the peptic ulcer group and 6% in the other group had committed suicide (p less than 0.001). Mortality (suicides excluded) was similar in the two groups as was the social adjustment among the survivors. Within the peptic ulcer group strain/tenseness was significantly related to future suicide, while operation, heredity, and rigidity/perfectionism were not.

Adult↗
PubMed1986

To keep the alcoholic in out-patient treatment. A differentiated approach through treatment contracts.

Eighty-two alcoholics were offered a 2-year out-patient programme characterized by stressing the patients' own decisions both in joining the programme and in the choice of objectives and methods, by repeated feedbacks through treatment evaluations, and by relapse prevention. The 58 patients who accepted were more often married than the others. All but eight completed the programme. The most important treatment components were ranked by the patients. Individual counselling was ranked highest, followed by evaluations of contract with therapist, disulfiram and biofeedback by means of gamma-GT. Patients with alcohol dependence more often preferred instrumental components, such as disulfiram and gamma-GT, while the others more often preferred psychological components, such as individual counselling and contract evaluations. Preference of psychological components was not found to be related to degree of personality disturbances. It is suggested that to effectively keep the patients in treatment in the present programme depends on the combination of patients' active engagement, continuous feedback and individualized treatment objectives.

Adult↗
PubMed1986

Stability of treatment outcome in short-term psychiatric care. A six-month follow-up of a controlled study of patient involvement.

The general trend of avoiding and shortening in-patient treatment raises the question of the stability of treatment gains made during hospitalization. A 6-month follow-up was made for patients treated on a short-term psychiatric ward. The origin was a controlled study of two models of patient involvement in treatment planning. Patients benefiting most from a cooperation procedure during hospitalization were those with socio-psychological treatment objectives and those treated in a Basic Activation Group on the ward. The superior outcome for these patients was not stable during the period of follow-up, resulting in an incongruence between in-hospital and post-hospital adjustment. Furthermore, these patients at time of follow-up showed an increased confidence in the staff of the ward and a decrease in the rated importance of their social network. It is suggested that this is the result of dependency reactions and a separation process from the therapeutic milieu of the ward which were not resolved at time of discharge. Greater concern should be invested in formulating the treatment contract in an out-patient context in order to place the emphasis on the real life situation of the patient.

Adult↗