Biomedical subjects

O Hagnell

Publications and source records attributed to O Hagnell.

At least 19 recordsLinked to original sources

PubMed2005

Does it make sense to do repeated surveys?--the Lundby Study, 1947-1997.

OBJECTIVE: To describe the Lundby Study and the difficulties in doing repeated surveys. METHOD: Best-estimate consensus diagnoses have been used since 1957 together with DSM-IV and ICD-10 in 1997. RESULTS: The Lundby population consisting of 3563 probands was investigated in 1947, 1957 and 1972. Sufficient information was available for 98-99%. In 1997-2000 a fourth field investigation was carried out. Attrition rate for the interviews was 13% (238/1797). About 36% (1030/2827) had died between 1972 and 1997, but data from registers, case notes and key-informants for the period 1972 and 1997 completed the information for 94% (2659/2827). The population has followed the same pattern of development as many rural populations in Sweden since the 1940s. Multiple sources of information are preferable in longitudinal studies in order to tackle the problem of changing diagnostic systems. CONCLUSION: Low attrition rates over 50 years and reasonable diagnostic uniformity make comparisons over time justifiable.

Aged↗

PubMed2000

The course of alcoholism among men in the Lundby Longitudinal Study, Sweden.

OBJECTIVE: The purpose of this study is to describe the course of alcoholism among men in the Lundby community cohort. METHOD: A subset (N = 41) of initially nonalcoholic male subjects were diagnosed by a psychiatrist as first incidence alcoholics (alcohol abuse and/or dependence) during the period 1957-72, all of whom have been followed through four waves of investigation between 1947 and 1993. RESULTS: The proportion of remission of the entire 41 former alcoholic subjects was 39%. Of the 23 survivors, 52% were remitted. The recovery started at age 30-39 and culminated at age 40-49. CONCLUSIONS: In this 40-year follow-up of former alcoholics, stable remissions were shown to occur at a rate of approximately 40% (50% in survivors). Critical variables were severity and the subjects' age at the time of recovery. The results are tentative because of the small number of individuals.

Adult↗

PubMed1998

A 50-year perspective of a family with chromosome-14-linked Alzheimer's disease.

A Swedish family with two generations suffering from presenile dementia with an unusually severe Alzheimer encephalopathy was first reported in 1946. The hypothesis that the disease was inherited through a dominant gene is strongly supported by the follow-up 50 years later of three additional generations and molecular genetic findings of a novel presenilin-1 gene mutation in the family. The pedigree contains six cases with well-documented dementia in four consecutive generations. The Alzheimer encephalopathy was unusually severe in the three cases studied post-mortem, with a pronounced involvement of the central grey structures, such as the claustrum, the nuclei around the third ventricle, the central thalamic nuclei and the brain stem. There were no vascular lesions and little amyloid angiopathy. All six affected cases showed the typical temporoparietal symptom pattern and other core symptoms of Alzheimer's disease, such as logoclonia, myoclonic twitchings and major motor seizures. Other predominant features were psychomotor slowness, increased muscular tension, a stiff stooped gait and a rapid loss of weight. The symptom pattern is convincingly explained by the consistent and severe involvement of cortical and central grey structures and is probably linked to the presenilin-1 gene mutation.

Alzheimer Disease↗

PubMed1998

First-incidence anxiety in the Lundby Study: course and predictors of outcome.

The aim of the present study was to analyse first-incidence anxiety in the Lundby Study with regard to course and predictors of outcome between 1947 and 1972. The Lundby concept of anxiety corresponds broadly to that of anxiety disorders in DSM-III-R. The Lundby Study is a prospective, psychiatric study of a geographically defined total population. The present study includes 124 subjects (46 men and 78 women) who between 1947 and 1972 developed anxiety as their first mental illness in life. The median total duration of illness was 1.6 years in men and 1.4 years in women. In both sexes episodes of mild impairment dominated. In total, 54% of the men and 71% of the women were mentally healthy at the follow-up in 1972. A minority of the probands (27%) received psychiatric treatment. They significantly more often suffered from panic disorder with agoraphobia during their first episode, and from comorbidity of other mental illnesses, than did untreated subjects. They also had a significantly longer total duration of illness, a variable with a negative predictive influence on the probability of being mentally healthy in 1972. Men with anxiety showed a 55% increase in alcoholism compared to standard values. They also displayed an increased risk of relapsing into mental illness compared to female cases, a result which, in the light of earlier findings of increased mortality rates, suggests that further investigations of men with anxiety syndromes in the general population are warranted.

Adult↗

PubMed1998

Mortality in alcoholism among men in the Lundby Community Cohort, Sweden: a forty-year follow-up.

OBJECTIVE: The Lundby Community Cohort has been studied at multiple points in time for more than four decades. The purpose of the present study was to estimate various aspects of mortality among alcoholic men in the cohort. METHOD: The mortality rate was calculated for a defined subset of 41 originally nonalcoholic men, who were diagnosed as first incidence alcoholics during the period 1957-1972, all of whom were followed-up through four waves of investigation between 1947 and 1993. Certified causes of death were obtained from the Swedish National Bureau of Statistics and complemented with information from relatives and hospital records. RESULTS: Of the 41 men, 18 (44%) had died by 1993; 27% before age 60. The average age at death was 56.6 years, (age range 25-86 years). The mortality risk for the group calculated as odds ratio was estimated to be 5.6. The most common causes of death were diseases of the circulatory system (9/18 or 50%). Accidents and suicides were also significant causes (8/18 or 44%), especially in age groups 20-59. The results were compared with those of an earlier published 15-year follow-up of another sample of alcoholics in the Lundby population. CONCLUSIONS: In accordance with the international literature, the study shows a significant reduction in life expectancy for men with alcohol-related disorders compared with matched controls. The data will be used as a basis for forthcoming qualitative analyses of how individual life courses are correlated with alcoholism and heavy drinking.

Adult↗

PubMed1996

Mortality of anxiety syndromes in a normal population. The Lundby Study.

The mortality of anxiety syndromes between 1972 and 1992 was investigated in a prospective study of a normal population, the 1947 Lundby cohort. 121 persons with anxiety according to the Lundby definition (Anx), and 74 persons with panic disorder with/without agoraphobia (PD-Ag) according to the DSM-III-R, all of them developing their first episode between 1947 and 1972, were analyzed with regard to general mortality and special cause of death. Sex- and age-specific mortality rates for these groups were calculated and compared with the corresponding rates of the cohort's 1,877 remaining subjects without first episodes of Anx/PD-Ag. In contrast to the females, the annual rates of general mortality in males with Anx/PD-Ag were 1.9/2.2 times higher in the age group 65-84 years, compared with the rates of the non-Anx/PD-Ag groups. They also had an increase in death due to circulatory disorders, most pronounced in males with PD-Ag before the age of 65. There were no suicides in any of the Anx/PD-Ag groups during the observation period.

Adult↗

PubMed1995

Intelligence and temperament as protective factors for mental health. A cross-sectional and prospective epidemiological study.

The Sjöbring system of personality dimensions measuring intellectual capacity, activity, impulsivity and sociability was used to study possible "salutogenic" (i.e. causes of health) effects. The study comprised 590 subjects investigated in 1947, 1957, 1972 and 1988-1989 in the Lundby project, an epidemiological study in Sweden. Psychiatric diagnoses were made in 1947, 1957 and 1972. Mental health was estimated in 1988-1989 using the concept "love well, work well, play well and expect well". The Sjöbring dimensions were clinically assessed in 1972. Both in the concurrent study in 1972 and in the prospective study in 1988-1989 "super capacity" (high intellectual function), "super validity" (high activity level) and "super solidity" (low impulsivity) were statistically associated with lower frequencies of certain psychiatric diagnoses and a higher frequency of positive mental health. These variables are proposed to increase coping capacity, and therefore increase stress resilience.

Adolescent↗

PubMed1995

Coping with life span crises in a group at risk of mental and behavioral disorders: from the Lundby study.

The subjects belong to a prospective, longitudinal population study on mental health, the Lundby study, performed in 1947, 1957 and 1972. In 1988-1989, 148 individuals, then 42-56 years of age, raised in families with at least 3 risk factors for mental or behavioral disorders, were interviewed about their life span coping style. Twenty-two coping mechanisms were rated; optimism, substitution, wishful thinking, problem-solving, planning, self-reliance, humor, acceptance, resignation, social support, comparison with others, religion, catharsis, self-criticism, value reinforcement, alcohol and drug consumption, professional help, endurance, information-seeking, isolating activity, magic and minimizing. Together they contributed statistically significantly to mental health (explained variance 24%) and quality of life (explained variance 28%). Problem-solving, social support and optimism were frequently used and were statistically associated with positive mental health and lower frequencies of some mental disorders. Sense of coherence, a personal disposition factor, was also statistically associated (explained variance 22%) with the combined coping mechanisms.

Data Collection↗

PubMed1995

Predictors of anxiety in the Lundby study: a prospective study of a normal population during 1947-1972.

The aim of the present study was to search for specific premorbid background factors of 'anxiety' in a normal population, the 1947 Lundby cohort. 2,550 probands were repeatedly examined by psychiatrists during a 25-year period, regardless of medical care. The semi-structured examinations included items referring to the proband's mental and physical health, personality, behaviour and socio-economic background. In the present study, only assessments made before the first onset of anxiety were considered. Very strict criteria of 'healthiness' and anxiety regarding the comparison groups were used. Five out of 50 items considered were significantly predictive. The male features share certain similarities with those observed in earlier predictor studies on anxiety and depressive disorders, while the traits found in women seem to predispose for other mental illness as well.

Adolescent↗

PubMed1994

Salutogenic childhood factors reported by middle-aged individuals. Follow-up of the children from the Lundby study grown up in families experiencing three or more childhood psychiatric risk factors.

This study is salutogenic (= causes of health), focusing on factors which corresponded to good mental health in subjects who had been exposed to at least three child psychiatric risk factors when growing up. The material was drawn from a prospective, longitudinal population study on mental health, the Lundby Study, which was performed in three waves in 1947, 1957 and 1972. In 1988/89, 148 individuals then 42-56 years of age, were re-visited and interviewed about their life span experiences. Factors previously found to increase stress resilience in children and adolescents were identified. The personal dispositions during childhood found to be associated with adult positive mental health were childhood positive self-esteem, successful coping, internal locus of control and intellectual capacity. Childhood family factors, such as trusting relations with a parent and shared values, were also important. Antonovsky's sense of coherence model can be used to explain the mechanisms by which the different variables can lead to health through increasing an individual's capacity for comprehensibility, manageability and meaningfulness, the three concepts of sense of coherence.

Adaptation, Psychological↗

PubMed1994

Prevalence of mental disorders, personality traits and mental complaints in the Lundby Study. A point prevalence study of the 1957 Lundby cohort of 2,612 inhabitants of a geographically defined area who were re-examined in 1972 regardless of domicile.

The Lundby Study is a prospective, psychiatric-epidemiological study of a normal population that has been repeatedly examined over a period of 25 years. Experienced psychiatrists made home visits and collected the basic information through personal examinations adding supplementary data from other relevant sources. The present book contains point prevalence data of mental disorders such as neuroses, psychoses, organic brain syndromes, psychosomatic disorders, psychopathy, mental retardation, alcoholism, mental complaints, and also of various personality traits in a normal population at two points of time, 15 years apart. Together with earlier published incidence studies the present monograph is intended to give as complete a picture as possible of the mental morbidity in a total population. Our most conspicuous finding was the increase over time of the prevalence of neurotic illnesses. Depressive illnesses represented the largest increase. In the male sex the rate of Neurosis trebled from Time 1 to Time 2, although the female preponderance still remained. Psychopathy and Alcoholism, on the other hand, were very markedly male disorders. A description of how the investigations were performed is included and also a list of publications originating from the Lundby Study. This book will be of interest to physicians and psychiatrists interested in epidemiology and also to governmental planners and social scientists.

Adolescent↗

PubMed1993

Mental tiredness in the Lundby study: incidence and course over 25 years.

The Lundby study is a prospective, epidemiological survey of mental health in a total population. When evaluating the material of 2550 individuals followed from 1947 to 1972, we found a large group with mental tiredness as the dominating symptom. Next to depression this was the most frequent diagnosis in the population. According to our concept of Tiredness, one third of the women ran a lifetime risk of developing a first-ever episode of Tiredness, while the risk for men was one fifth. The incidence of Tiredness is described together with the total frequency of episodes. The course of mental illness starting with a first episode of Tiredness within the 25-year investigation period shows that about one third of the men and half of the women relapsed into Tiredness or other mental illnesses, not infrequently with a serious outcome. However, most of the episodes of Tiredness lasted less than 2 years and were of milder impairment. We emphasize the importance of further investigations by means of epidemiological, clinical and neurochemical methods as regards the heterogeneous syndrome of mental fatigue.

Adolescent↗

PubMed1993

Anxiety in the Lundby Study: re-evaluation according to DSM-III-R, incidence and risk.

This study presents the incidence and risk of Anxiety Disorders according to DSM-III-R in the 1947 Lundby cohort. The figures are based on a re-evaluation of 124 first-ever episodes of 'Anxiety' according to the Lundby definition. Panic Disorders without/with Agoraphobia constituted the largest groups, while a proportionally low rate of Generalized Anxiety Disorder was obtained. The incidence rates per 100 person years in Panic Disorders without Agoraphobia were 0.07 for men and 0.20 for women, the female dominance being statistically significant. Corresponding figures in Panic Disorders with Agoraphobia were 0.04 and 0.07. About 20% fell into other diagnostic categories, the most dominating being Mood and Adjustment Disorders and Hypochondriasis. Comparisons with incidence rates from the ECA and Stirling County studies are made and outlines for further research presented.

Adolescent↗

PubMed1993

Premorbid personality traits and psychosomatic background factors in depression: the Lundby Study 1957-1972.

The search for specific predepressive personality factors has a long tradition in psychiatry. Studies in which assessments were made prospectively, before the onset of a first-ever episode of the illness, are, however, rare. In the present report from the Lundby Study we have investigated premorbid, mainly personality-related background factors for first incidences of depressive disorder, diagnosed according to the Lundby criteria for 'Depression proper' and 'Depression plus other psychiatric symptoms'. The items found to be of a predictive value differed between the two diagnostic subgroups and also between men and women. The findings are discussed and compared with earlier predictor studies on depression.

Adolescent↗

PubMed1993

Vascular dementia in the Lundby study. 2. An attempt to identify possible risk factors.

Vascular dementia represents a group of diseases of great medical and social impact. Its etiology is largely unknown but is most likely multifactorial. Factors related to the brain circulation are involved. The aim of the present study was to find out if personality and social background factors might have a clear precipitating or protective value. This study comprises a total population of 2,612 individuals from a geographically delimited area, Lundby, in southern Sweden. In 1957, Hagnell personally examined 99% of the population. A follow-up study of the same individuals, irrespective of domicile, was performed 15 years later. No social background factors proved to be relevant in this study. Personality factors, including psychosomatic reactions, did, however, demonstrate a highly predictive influence on the risk of developing vascular dementia.

Cohort Studies↗

PubMed1992

Senile dementia of the Alzheimer type in the Lundby Study. II. An attempt to identify possible risk factors.

In recent years research on senile dementia of the Alzheimer type (SDAT) has made progress within the field of pathology and to a certain extent in that of heredity. Within epidemiology, the search for risk factors is intensifying but the findings are still inconclusive. The present study of possible risk factors concentrates on environmental and personality factors. The total population of 2612 persons from a geographically delimited area, Lundby, two neighbouring parishes in southern Sweden, was examined in 1957 by one psychiatrist (Hagnell). A follow-up study of the same population, irrespective of domicile, was performed 15 years later, in 1972. Various precipitating as well as protective personality background factors were found to be significant for the outcome of SDAT, but no environmental factors appeared to be statistically significant in this cohort.

Aged↗

PubMed1992

Incidence of dementia in the Lundby Study.

The incidences of senile dementia of Alzheimer type (SDAT) and multi-infarction dementia (MID) were studied in a total Swedish population, the Lundby project. The study is prospective and covers a 25-year period. The incidence rates per year of contracting SDAT or MID and the probability in each 10-year age interval of contracting dementia in the elderly were calculated, as well as the cumulative risk up to a certain age. The lifetime risk of contracting SDAT was for men 25.5% and for women 31.9%. The corresponding figures for MID were 29.8 and 25.1%.

Aged↗

PubMed1992

Vascular dementia in the Lundby study. 1. A prospective, epidemiological study of incidence and risk from 1957 to 1972.

In this study, a total population, the 1957 Lundby cohort, was investigated with regard to the incidence of vascular dementia over a 15-year period, and to provide a succeeding study with basic data concerning the background factors for vascular dementia. The 1957 cohort comprises 2,612 persons who were registered in the geographically delimited Lundby area on July 1, 1957. The lifetime risk of developing vascular dementia was found to be 34.5% in men and 19.4% in women when all degrees of impairment were taken into account, the preponderance for the male sex being very obvious.

Adolescent↗