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At least 505 records · Page 28Linked to original sources
PubMed2005

The long-term cost-effectiveness of clopidogrel plus aspirin in patients undergoing percutaneous coronary intervention in Sweden.

BACKGROUND: The Percutaneous Coronary Intervention-Clopidogrel in Unstable Angina to Prevent Recurrent Events (PCI-CURE) study, which examined the effect of adding clopidogrel to aspirin versus aspirin alone in patients with unstable coronary artery disease (CAD) undergoing PCI, found a relative risk reduction in cardiovascular deaths and myocardial infarction among those treated with clopidogrel. In addition, a within-trial cost-effectiveness analysis showed favorable costs per event avoided. However, to estimate the long-term effects, a modeling approach is necessary. OBJECTIVES: The purpose of this study was to estimate the long-term cost-effectiveness of treating patients undergoing PCI with clopidogrel plus aspirin in Sweden. METHODS: A Markov model was developed. Transition probabilities were estimated based on a register of patients treated in the coronary care units at 74 (out of 78) hospitals throughout Sweden. Patients were assumed to be treated for 1 year with an effect based on data from the PCI-CURE study. Costs were collected from published sources and recalculated to year-2004 Euros (Euro 1.00 = USD 1.24). Life-years gained were used as the measure of effectiveness. The perspective was that of the Swedish society, with a separate analysis using a health care cost perspective. RESULTS: After inclusion and exclusion criteria were applied, 3474 patients were included in the model analysis. The model predicted a net gain in survival of 0.04 year per patient when adding clopidogrel. This yielded a net increase of Euros 449 if only direct costs were included; with indirect costs, the net increase was Euros 332. The resulting cost-effectiveness ratios were Euros 10,993 and Euros 8127 per life-year gained. CONCLUSIONS: The predicted cost-effectiveness ratios were well below the threshold values generally considered cost-effective. Adding clopidogrel to aspirin appeared to be cost-effective in this model analysis of patients with unstable CAD undergoing PCI in Sweden.

Aged↗
PubMedDate not supplied

Doctors' attitudes and end-of-life decisions in the elderly: a comparative study between Sweden, Germany and Russia.

The study was performed in order to determine cross-culturally to what extent various attitudes (legal and ethical concerns, hospital costs, level of dementia, patient's age, patient's wishes, family wishes, doctor's religion) influence the treatment decisions of doctors in face of a critically ill incompetent elderly patient. Convenience samples of doctors in Sweden (n=104), Germany (n=191) and Russia (n=232) were surveyed by means of a self-administered questionnaire comprising a case-vignette of an incompetent elderly patient. The importance of various attitudes attributed to the treatment decision varied between countries. The differences were mostly pronounced for the importance of hospital costs (highest in Russia), patient and family wishes (both highest in Sweden) and level of dementia (highest in Sweden). They reflect diverging clinical practice and underlying societal values. They point to the necessity of the development of uniform standards and training of doctors in ethical issues.

Journal Article↗
PubMed1999

Clonality of Vibrio anguillarum strains isolated from fish from the Scandinavian countries, Sweden, Finland and Denmark.

In order to investigate whether outbreaks of vibriosis in the Baltic region were caused by the spread of certain pathogenic clones, 291 Vibrio anguillarum isolates from Finland (n = 156), Sweden (n = 88) and Denmark (n = 47) were studied with respect to serogroup, ribotype, plasmid content, and biochemical phenotypes as expressed with the PhenePlate (PhP) typing system. For comparison, 54 V. anguillarum serogroup O1 from other countries worldwide were included. Most isolates from Finland, Sweden and Denmark belonged to serogroup O1 (255), followed by O2 (30). Four Finnish isolates cross-reacted strongly with antisera against two new serogroups VaNT2 and VaNT4, whereas two strains were non-typeable. The serogroup O1 isolates displayed ten different ribotype patterns, whereas the other strains were considerably more diverse with respect to ribotypes. Most of the O1 isolates carried the 67 kb virulence plasmid and a group of Finnish isolates, in addition, carried an 86 kb plasmid. Additional plasmids with molecular weights of 63, 76, 135 or 260-290 kb were found in single O1 isolates. With few exceptions, strains of serogroup O2 either had no plasmids or carried one or two small plasmids. PhenePlate typing revealed considerable diversity within the species, serogroup O1 being the most homogeneous. A few PhP types were dominant, whereas other types were observed only in one to four isolates. The prevalence of the different types changed significantly from one year to another but in Finland, one clonal lineage became increasingly important from 1992 (20% of isolates) to 1996 (80%). Remaining clones were mostly restricted to specific geographic areas. By cluster analysis, it was demonstrated that most of the isolates from Finland, Sweden and Denmark belonged to two clusters, and most of the strains from Southern Europe fell into two other, distinct clusters. Most isolates from the UK, North America, Chile and Tasmania grouped together in a distinct cluster. For the typing of V. anguillarum, O-serotyping should be the primary method. For isolates belonging to serogroups other than O1, plasmid profiling in combination with ribotyping gives a very good discrimination between strains, whereas for serogroup O1, another method is required. It is concluded that PhP typing is a tool that provides a good discrimination between O1 isolates.

Animals↗
PubMed2004

Sudden cardiac death in the young in Sweden: electrocardiogram in relation to forensic diagnosis.

OBJECTIVES: To study electrocardiogram (ECG) in relation to forensic diagnosis in young persons who suffered a sudden cardiac death (SCD) in Sweden during 1992-99. DESIGN: A register study of a national database of forensic medicine in Sweden, selecting all cases of SCD 15-35 years of age. In this group, 12-lead ECGs and clinical data were searched for in military conscription and medical records. The ECGs were re-analysed and classified according to the Minnesota code criteria. SETTING: The whole nation of Sweden. SUBJECTS: Sudden cardiac death victims (66 individuals), 15-35 years of age, where it was possible to obtain an ECG recording. RESULTS: We observed major or minor ECG abnormalities in 82% of the subjects. The most common changes were T wave abnormalities (35%), ST segment changes (32%) and conduction defects (20%). The ECGs were evaluated as pathological in 50% of the cases, more often in arrhythmogenic right ventricular cardiomyopathy (88%) and hypertrophic cardiomyopathy (82%). Cardiac-related symptoms were seen in 76% of the total group and there was a family history of a similar cardiac condition in 18%. CONCLUSIONS: Pathological ECGs were common in young SCD victims, in spite of being taken many years before death. An ECG could help identify prospective victims of SCD, and should always be taken in cases with possible cardiac-related symptoms or a family history of SCD. The pathological ECGs were often found in connection with routine screening at military enlistment for men, which raises the question of a routine screening in the young, including women.

Adolescent↗
PubMed2006

The interference of paid work with household demands in different social policy contexts: perceived work-household conflict in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic.

The article explores whether people experiences a lower level of work-household conflict in a context that is characterized by extensive family policies (Sweden and to some extent Hungary and Czech Republic) aimed at facilitating participation in the labour market. This is done by studying perceived work-household conflict among women and men living in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic. The analyses are based on the answers to a questionnaire distributed to nearly 6,000 randomly selected individuals within the framework of the European Union financed 'Household, Work, and Flexibility' (HWF) study. The results show that women in Sweden experience conflicts between work and household demands to a higher degree than any other category in all five countries. The differences between Swedish women and women living in the Netherlands and the UK are explained by variables indicating qualifications and workload in the main job, but the lower degree of work-household conflict among Czech and Hungarian women is still significant when controlling for household composition and working conditions. Data indicate that a possible explanation for this can be found in the interplay between men's and women's attitudes toward gender roles and the actual situation in terms of division of labour.

Employment↗
PubMed1999

Evaluation of human seroreactivity to Bartonella species in Sweden.

Among the species that compose the expanding genus Bartonella, thus far only B. henselae and B. quintana have reportedly been isolated from humans in Europe. To evaluate the prevalence of Bartonella infection in Sweden, we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies to B. henselae, B. quintana, and B. elizabethae. Serum samples from 100 blood donors, who spanned the ages of 20 to 60 and had no apparent clinical signs of illness, were also studied as a control group. An immunoglobulin G indirect fluorescence antibody assay revealed 4 and 8.3% Bartonella positivity rates for the blood donor and patient group, respectively, when a cutoff titer of >/=64 was chosen. Among the blood donors, four were seropositive to B. elizabethae; one of these also had concordant positive titer to B. henselae. In the patient group, 14 serum samples were positive against Bartonella spp. These serum specimens represented nine patients. In three of these seropositive patients, paired serum samples displayed a fourfold increase in antibody titer to at least one of the three antigens. These three patients are discussed. In this report we also present a case study of a 60-year-old Swedish male with fatal myocarditis. Postmortem serological analysis revealed a high titer against B. elizabethae. PCR and nucleotide sequencing of the myocardial tissue from this patient, and of liver tissue from one of the other three patients, showed sequences similar to B. quintana. The age, geographical origin, animal contacts, and serological response pattern to the different Bartonella antigens differed among the four patients. This study substantiates the presence of Bartonella spp. in Sweden, documents the seroreactivity to three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden.

Adolescent↗
PubMed2006

Interocclusal appliances--indications and clinical routines in general dental practice in Sweden.

The aim of this study was to analyse what kind of interocclusal appliances that are used in general dental practice in Sweden, the indications for such treatment, to what extent a clinical status is recorded before treatment, as well as the routines for evaluation of treatment results. The study was a retrospective analysis of patient records from 320 adult patients who had been treated by general dental practitioners in the Public Dental Service in Sweden. For comparison a group of 88 consecutive patients who had received interocclusal appliance therapy at a specialist clinic was used. The most common indication for treatment with hard acrylic stabilisation appliances, as well as with soft appliances, was occlusal wear due to tooth grinding. The second most common indication for treatment with hard acrylic stabilisation appliances was pain from masticatory muscles, while the second most common indication for soft appliances was tension-type headache. Treatment with soft appliances was more often combined with other treatment modalities compared to treatment with hard acrylic stabilisation appliances. Large variations were found between the 3 general dental clinics and the specialist clinic in respect of treatment indications, combinations with other treatment modalities, recording of clinical findings, follow-ups and evaluation of treatment results. General conclusion should, however, be made with caution due to the risk of selection bias. From the results of this study it is obvious that treatment with soft appliances is common in general dental practice in Sweden, despite the lack of scientific support for their efficacy, as well as effectiveness, compared to hard acrylic stabilisation appliances. There is an obvious need for investigations of the decision-making processes among dentists when performing treatment with interocclusal appliances, as well as for randomised controlled studies concerning efficacy and effectiveness of soft appliances.

Adult↗
PubMed2003

Hypertension in diabetes: trends in clinical control in repeated large-scale national surveys from Sweden.

Hypertension in diabetes is an important and treatable cardiovascular risk factor. Treatment targets from guidelines cannot always be achieved in everyday clinical practice. It is therefore of great importance to monitor trends in hypertension control in defined populations. Patients with type I diabetes (range 6685-10,100; treated hypertension 21-29%) or with type II diabetes (range 15,935-22,605; treated hypertension 47-56%) were included in four national samples between 1996 and 1999. This screening was part of the procedures for the National Diabetes Register in Sweden, which monitors trends in clinical practice and risk factors for patients with diabetes, recruited both in primary health care and at the hospital level. A favourable trend in mean and median blood pressure levels was noticed during the 4-year study period, based either on data from repeated surveys or on repeated measures in the same individual, both for type I diabetes (mean: -2/-2 mmHg; P < 0.01) and for type II diabetes (mean: -5/-3 mmHg; P < 0.001). Correspondingly, the proportion of hypertensive patients in acceptable control of blood pressure (< or =140/85 mmHg) increased (P < 0.001) both in type I diabetes (52.0-57.9%) and in type II diabetes (22.4-33.3%). It was concluded that hypertension is a widespread cardiovascular risk factor in patients with diabetes, especially systolic hypertension. A trend for a better systolic blood pressure control during the late 1990s in hypertensive patients with type II diabetes in Sweden could translate into substantial (estimated) clinical benefits in cardiovascular and diabetes-related morbidity. The National Diabetes Register makes a quality assessment of the hypertension treatment possible.

Adult↗
PubMed1993

The disposal of the aborted fetus--new guidelines: ethical considerations in the debate in Sweden.

During the 70s and 80s ethical debate concerning the fetus became intensive. The great advances made in medical technology and research and improvements in prenatal diagnosis as well as in embryological research have led us to believe that the fetus is an individual with recognised claims to protection. In Sweden the aborted fetus has previously been considered merely as a risk-disposal problem, equivalent to dangerous and infected material and there have been no specific guidelines for the treatment of the fetus after abortion. In July 1990 treatment of aborted fetuses was changed with the general guidelines from the National Board of Health and Welfare. The present paper sets out the main contents of the guidelines and discusses the gradually changing views concerning the status of the human fetus in Sweden, as well as the public debate which has been a contributing factor to these changes.

Aborted Fetus↗
PubMed2003

Signs of nephropathy may occur early in young adults with diabetes despite modern diabetes management: results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS).

OBJECTIVE: To estimate the occurrence of early-onset renal involvement in a nationwide population-based cohort of young adults with diabetes in Sweden and relate the findings to glycemic control, type of diabetes, sex, smoking, and blood pressure. RESEARCH DESIGN AND METHODS: The Diabetes Incidence Study in Sweden aims to register all incident cases of diabetes in the age-group 15-34 years. In 1987-1988, 806 patients were reported and invited to participate in a follow-up study focusing on microvascular complications. Of them, 469 subjects participated. The assessment was based on questionnaires (n = 469), blood samples (n = 424), urine samples (n = 251) and, when appropriate, medical records (n = 186). RESULTS: During the follow-up time, median 9 years (range 6-12), 31 of 469 patients (6.6%) with incipient or overt diabetic nephropathy (i.e., micro- or macroalbuminuria) were found, 24 of 426 (5.6%) in type 1 and 7 of 43 (16%) in type 2 diabetic subjects (P = 0.016). Additionally, 24 of 31 patients (77%) had microalbuminuria and 7 (23%) had macroalbuminuria, which mainly occurred in patients with type 2 diabetes. In a Cox regression analysis, high mean HbA(1c) during the follow-up period and high blood pressure at follow-up increased the risk of developing signs of nephropathy (P = 0.020 and P = 0.003, respectively). Compared with patients with type 1 diabetes, those with type 2 diabetes tended to have an increased risk of renal involvement (P = 0.054) when adjusting for sex, tobacco use, glycemic control, and blood pressure. CONCLUSIONS: Despite modern treatment and self-monitoring of blood glucose, young adult patients with diabetes may still develop renal involvement during the first 10 years of diabetes duration. Inadequate HbA(1c), high blood pressure, and type 2 diabetes appear to be risk markers for early occurrence of diabetic nephropathy.

Adolescent↗
PubMed1964

INTERLIBRARY COOPERATION IN SWEDEN AND THE MEDICAL PART OF THE SCANDIA PLAN.

In Sweden, as in Scandinavia generally, the interlibrary loan service is widely extended. The large research libraries traditionally follow a very liberal lending policy. Of fundamental importance to the Swedish interloan system is the maintenance of a union catalog. The free flow of materials from one library to another is facilitated by the franking privilege accorded public institutions. During the fifties, the idea arose of establishing acquisitional cooperation among the research libraries in Sweden. The highly developed interlibrary loan service was of basic significance for the realization of this project. In 1956 the possibilities were investigated of further expanding the acquisitional cooperation to include the greater libraries of Scandinavia. Thus, the so-called Scandia Plan was born. In 1960 the time was ripe to discuss the possibilities of applying the Scandia Plan to medical literature. At a meeting that year it was agreed that such cooperation could apply only to the literature which from a Scandinavian point of view would be considered peripheral. The plan was to include periodicals only, and be restricted to materials which, mainly for language reasons, are infrequently used in Scandinavian research. The task of acquiring such periodicals could be divided between the different libraries of the four countries. Such an arrangement would make it economically possible to increase the common stock of medical periodicals and avoid unnecessary duplication of material least in demand.

Humans↗
PubMed2005

Socioeconomic differences in the burden of disease in Sweden.

OBJECTIVE: We sought to analyse how much of the total burden of disease in Sweden, measured in disability-adjusted life years (DALYs), is a result of inequalities in health between socioeconomic groups. We also sought to determine how this unequal burden is distributed across different disease groups and socioeconomic groups. METHODS: Our analysis used data from the Swedish Burden of Disease Study. We studied all Swedish men and women in three age groups (15-44, 45-64, 65-84) and five major socioeconomic groups. The 18 disease and injury groups that contributed to 65% of the total burden of disease were analysed using attributable fractions and the slope index of inequality and the relative index of inequality. FINDINGS: About 30% of the burden of disease among women and 37% of the burden among men is a differential burden resulting from socioeconomic inequalities in health. A large part of this unequally distributed burden falls on unskilled manual workers. The largest contributors to inequalities in health for women are ischaemic heart disease, depression and neurosis, and stroke. For men, the largest contributors are ischaemic heart disease, alcohol addiction and self-inflicted injuries. CONCLUSION: This is the first study to use socioeconomic differences, measured by socioeconomic position, to assess the burden of disease using DALYs. We found that in Sweden one-third of the burden of the diseases we studied is unequally distributed. Studies of socioeconomic inequalities in the burden of disease that take both mortality and morbidity into account can help policy-makers understand the magnitude of inequalities in health for different disease groups.

Adolescent↗
PubMed2004

Surgery in Sweden at the time of Halsted.

William Stewart Halsted (1852-1922) is one of the most influential persons in the history of US surgery. His surgical career can be divided into the years in New York, NY (1880-1889), and the years in Baltimore, Md (1889-1922). In addition to the important growth and development of surgery that took place in the United States during the late 1800s and early 1900s, an equally impressive growth in surgery took place in many other countries, in particular, in Western Europe. Although a small country, Sweden also saw a strong development of surgery between 1880 and 1920. In this article, some of the surgeons who were prominent in Sweden during this era (Karl Gustav Lennander in Uppsala; John Wilhelm Berg in Stockholm; and Jacques Borelius in Lund) and some of the surgical procedures that were introduced are described. In addition, a few nonsurgeons are discussed because their work significantly influenced surgery. Learning about some of the achievements in surgery during the late 1800s and early 1900s is not only educational but inspiring, and puts today's surgical practice and scientific achievements in an important historical perspective.

General Surgery↗
PubMed2000

Prostate carcinoma trends in three counties in Sweden 1987-1996: results from a population-based national cancer register. South-East Region Prostate Cancer Group.

BACKGROUND: To detect changes in the incidence rate and management of prostate carcinoma, all cases of the disease diagnosed in the southeast region of Sweden between 1987-1996 were recorded. METHODS: The register is based on Swedish personal registration numbers, thereby minimizing the number of dropouts. All cases of prostate carcinoma detected in the southeast region have been recorded according to a defined protocol that has been updated successively to match recent views regarding the disease. To ensure a high number of presented cases, the National Cancer Register was checked for missing cases. RESULTS: Six thousand seven hundred eighty-two cases of prostate carcinoma were registered in the region between 1987-1996. The age-adjusted incidence rate reached a peak in 1993, followed by a slight decrease. The mean age at diagnosis throughout the period was 74.2 years, with a peak age of 74.8 years in 1992. The number of incidental tumors followed the development of the number of transurethral resections of the prostate performed in the region, with a peak in 1991. The percentage of patients receiving gonadotropin-releasing hormone (GnRH) analogues increased from 3.9% to 37.8% whereas the percentage of patients treated with orchiectomy decreased from 40.0% to 12.8% and the percentage of those treated with radical prostatectomy decreased from 11.1% to 2.5%. CONCLUSIONS: A diminishing pool of latent tumors may explain the decreasing incidence rate and lower age at diagnosis observed after 1993. Orchiectomy is rapidly being superseded by GnRH analogues. In contrast to trends reported in the U.S., the percentage of men with prostate carcinoma undergoing total prostatectomy appears to be declining in Sweden.

Age Factors↗
PubMed1996

Iodine supplementation in Sweden and regional trends in thyroid cancer incidence by histopathologic type.

We studied regional patterns of thyroid cancer incidence in relation to iodine intake and iodinization in Sweden using 5,838 incident cases diagnosed in the period 1958-1981. Region was defined either by iodine status, urban-rural status or health-care region (internal controls). Age, period and cohort models were fitted to evaluate trends and regional variation in incidence by histopathologic type. In iodine-deficient areas, the relative risk (RR) of developing thyroid cancer was 0.92 for all histologic types combined, 0.80 for papillary cancer and 0.87 for anaplastic carcinoma. Residence in iodine-deficient regions was associated with a 2-fold increased risk of follicular cancer in men (RR 1.98) and a 17% increase in risk in women (RR 1.17). Regional differences in iodine intake fell after iodinization of the food supply, which was started in 1936 and enhanced in 1966. Nevertheless, incidence of both papillary and follicular carcinoma increased during the study period, with largely similar trends in iodine-deficient and iodine-sufficient areas. Overall, residence in urban or rural areas was not an important determinant of incidence, though trends in the incidence of papillary, follicular and anaplastic cancer did vary between urban and rural areas. The occurrence of thyroid cancer differed only marginally between the 6 health-care regions in Sweden, suggesting that the observations in regions defined by iodine intake were unlikely to be artifactual. Our data suggest that iodinization of the food supply is not associated with adverse trends in the occurrence of thyroid cancer.

Adenocarcinoma, Follicular↗
PubMed1996

Immunohistochemical detection of p53 in non-malignant and malignant oral lesions associated with snuff dipping in the Sudan and Sweden.

Immunohistochemistry was used to examine the expression of p53 in pre-malignant oral lesions and oral squamous-cell carcinomas (SCCs) from Swedish and Sudanese snuff-dippers, as well as in pre-malignant oral lesions and oral SCCs from non-snuff-dippers from the Sudan, Sweden and Norway. Of the 14 SCCs from Sudanese snuff-dippers, 21% (3/14) expressed p53. Of the 14, 60 and 41 SCCs from non-snuff-dippers from the Sudan, Sweden and Norway, 64% (9/14), 65% (39/60) and 68% (28/41) expressed p53, respectively. A statistically significant difference in expression of p53 was found in SCCs from Sudanese snuff-dippers compared to those from non-snuff-dippers from all/or any of the 3 countries. None of the suspected pre-malignant oral lesions from Sudanese snuff dippers or non-snuff-dippers expressed p53. Only 2 out of the 15 oral fibro-epithelial hyperplastic lesions from Swedish snuff-dippers expressed p53. Some of the oral epithelial dysplastic lesions, as well as the carcinoma in situ lesions from Norwegian non-snuff-dippers, expressed p53, while the oral fibro-epithelial hyperplastic lesions did not. The low relative frequency of p53 expression found in oral SCCs from snuff-dippers compared to those from non-snuff-dippers might suggest differences in mechanisms of oncogenic action induced by snuff. Alternatively, the pathogenesis of malignant oral lesions from snuff-dippers may follow a p53-independent pathway. In view of the unusually high levels of the tobacco-specific nitrosamines (TSNA) found in the type of snuff used in the Sudan, investigations of p53 mutations or oncogenes are needed.

Adolescent↗
PubMed1999

hMLH1, hMSH2 and hMSH6 mutations in hereditary non-polyposis colorectal cancer families from southern Sweden.

We have screened 17 Southern Sweden individuals/families with suspected hereditary non-polyposis colorectal cancer (HNPCC) for mutations in the DNA-mismatch repair genes hMLH1, hMSH2 and hMSH6 using denaturing gradient gel electrophoresis, protein truncation test and direct DNA sequencing. The families were selected on the basis of a family history of HNPCC-related tumors or the occurrence of metachronous colorectal cancer/endometrial cancer at young age in an individual with a weak family history of cancer. Furthermore, we required that tumor tissue from at least one individual in the family had to display microsatellite instability. We identified germ-line mutations in 9 individuals from 8 families. Five families had mutations in hMLH1, 4 of which were splice site mutations, 2 had frameshift mutations in hMSH2 and 1 patient with metachronous endometrial and rectal cancer but with a weak family history of cancer had a nonsense mutation in hMSH6. Our results present novel germ-line DNA-repair gene mutations, one of these in hMSH6, and demonstrate the diversified mutation spectrum in Sweden, where no founder mutation has so far been identified.

Adaptor Proteins, Signal Transducing↗
PubMed1999

The medico-legal status of young sex offenders: forensic psychiatric evaluations in Sweden 1988-1995.

Young sex offenders (YSOs) attract significant public and professional concern. YSOs might be perceived as more psychologically deviant or dangerous than other offenders. This study focused on how often YSOs subjected to forensic psychiatric investigation (FPI) were declared medico-legally insane as compared to young non-sex offenders and adult sex offenders. Logistic regression models were applied to data from all major FPIs performed in Sweden between 1988 and 1995 (N=4354) to explore factors affecting the likelihood of receiving a medico-legal insanity declaration. When we adjusted for the statistical effects of age, sex offender status, and psychopathology, YSOs (n=47) were three to four times more likely to be declared insane in the medico-legal sense. The results indicate that YSOs in Sweden constitute a medico-legally distinct subgroup of forensic psychiatric examinees.

Adolescent↗