Research projects in Mental Health | PRIME Health

Research projects in the area mental health conducted by the PRIME Health research group.

Mental health and ill-health in young people ages 16 – 29 years; identity, time-trends and interventions

In Sweden and in other Western countries a remarkable increase in mental health problems has been shown for the age-group 16-24 years since the early 1990's.

This trend is evident for Swedish registered in- and out-patient mental health-data as well as for self-reported health. In contrast to mental ill-health, relatively little is known about young people’s (positive) mental health, as in public mental health more effort is put on prevention rather than on mental health promotion.

The overall aim of this research project is to identify protective and risk factors for mental health and ill-health in the extended group of young people, ages 16-29 years. Further, we want to analyse how mental health and ill-health related to these factors develop over time. The third aim is to test promotive and preventive interventions in the age group 16-29 years.

Collaborators

  • Karin Guldbrandsson, Department of Public Health Sciences, KI
  • Lene Lindberg, Department of Public Health Sciences, KI
  • Frank Lindblad, co-supervisor, Department of Neuroscience, Uppsala University and Stress Research Institute, Stockholm University
  • Anna Sidorchuk, Department of Public Health Sciences, KI
  • Kimmo Sorjonen, co-supervisor, Department of Clinical Neuroscience, KI
  • Regina Winzer, Department of Public Health Sciences, KI

Publications

Positive versus negative mental health in emerging adulthood: a national cross-sectional survey.
Winzer R, Lindblad F, Sorjonen K, Lindberg L
BMC Public Health 2014 Dec;14():1238

Contact

Adjunct senior lecturer

Lene Lindberg

Organizational unit: Social Medicin
E-mail: Lene.Lindberg@ki.se

Labour market position in youth and population health

Most agree that the labour market for young people is not working optimally, but there is less consensus on the exact nature of the problems. To inform this discussion, we use registers to follow up a whole generation of Swedes until mid-adulthood; analysing short and long term health consequences associated with different labour market positions in youth.We also draw on the natural experiment that the Swedish 1990s economic crisis constituted.

While much of the previous literature has been focussed on understanding the consequences of unemployment (i.e. actively seeking employment), we use a population health perspective and additionally follow those that are employed, students and failing students. All the latter exposures are far more common for young people than unemployment, thus possibly driving much more of population health.

Increased understanding of these exposures may inform us about the possible value of different remedies to young people's struggles in the labour market that are being discussed now. While all agree that unemployment is something that we would best do without, less is known about the possible health consequences of e.g. an increased supply of low skill jobs or of expanding the education sector.

Funding from Forte

Collaborators

  • Peter Guban, Centre for Epidemiology and Community Medicine, Stockholm County Council
  • Anton Lager, Department of Public Health Sciences, KI and Centre for Epidemiology and Community Medicine, Stockholm County Council 
  • Josefin Sundin, Department of Public Health Sciences, KI
  • Per Tynelius, Department of Public Health Sciences, KI

Publications

Long-term effects of youth unemployment on mental health: does an economic crisis make a difference?
Thern E, de Munter J, Hemmingsson T, Rasmussen F
J Epidemiol Community Health 2017 Apr;71(4):344-349

Public Engagement

Lager A. Ungdomarna, utbildningssystemet och utanförskapet: den ökande oron är kanske befogad? Invited speaker: Folkhälsomyndighetens seminarie om utbildning, arbete, framtidstro och ungas psykiska hälsa; 2016 Apr 14; Spårvagnshallarna, Stockholm.

Lager A. Ungdomarna, utbildningssystemet och utanförskapet: den ökande oron är kanske befogad? Film clip, 19 minutes.

Contact

Associated

Anton Lager

Organizational unit: ARC (Aging Research Center)
E-mail: Anton.Lager@ki.se

A randomized controlled intervention study to promote mental health and labor market integration of young high school dropouts

Collaborators:

Contact

Postdoc

Michael Wells

Organizational unit: Social Medicin
E-mail: michael.wells@ki.se

Mirror, mirror on the wall. Associations between body dissatisfaction, indoor tanning, smoking, disordered eating and binge drinking in urban adults

Via the Stockholm County health questionnaire of 2014 data will be analysed regarding body dissatisfaction, indoor tanning, smoking, disordered eating and binge drinking in urban adults. Body dissatisfaction is a common phenomenon. Likewise, indoor tanning, smoking, disordered eating and binge drinking are widespread risk behaviours.

The causes of unhealthy body ideals and risk behaviors are multifaceted and may interact which is known from previous research. In particular, this applies to smoking and indoor tanning among adolescents. However, the correlation between body dissatisfaction and the abovementioned risk behaviours is largely unknown and poorly researched.  Each of these risk behaviours separately implies great health risks, but these risks amplify each other if they occur simultaneously.

This study will explore the correlation between body image and smoking, indoor tanning and binge drinking and the strength of these correlations in the adult population.

Collaborators

Contact

Associated

Cecilia Boldemann

Organizational unit: Social Medicin
E-mail: Cecilia.Boldemann@ki.se

Social and mental health outcomes in early adulthood among young people with autism

Although increasing numbers of children and young people are being diagnosed with autism, little is known about their adult outcomes or mental health needs. This study will examine to what extent individuals with autism experience scholastic failure, unemployment, work disability and suicide ideation in early adulthood and help understand potential risk and protective pathways to inform interventions.

Using data from two population-based cohorts in Sweden and England, we propose the largest and most detailed study on this topic conducted to date.

Funding from Stockholm County Council (ALF project)

Collaborators

Publications

Risks for nonaffective psychotic disorder and bipolar disorder in young people with autism spectrum disorder: a population-based study.
Selten J, Lundberg M, Rai D, Magnusson C
JAMA Psychiatry 2015 May;72(5):483-9

Changes in prevalence of autism spectrum disorders in 2001-2011: findings from the Stockholm youth cohort.
Idring S, Lundberg M, Sturm H, Dalman C, Gumpert C, Rai D, et al
J Autism Dev Disord 2015 Jun;45(6):1766-73

Contact

Adjunct professor

Cecilia Magnusson

Organizational unit: Social Medicin
E-mail: Cecilia.Magnusson@ki.se

Early life sex steroids and the risk of autism – a combined bio-sample approach with measurements of steroids in mothers during pregnancy and in new-borns

Autism spectrum disorders (ASD) are becoming increasingly common psychiatric disorders in childhood, but their aetiology remains largely unknown. Perhaps the greatest mystery regarding ASD is that ASD are about four times more prevalent in boys than girls. The sex bias suggests that factors in male versus female sexual development may be important for ASD.

ASD represent a spectrum of impairments in terms of language and social interaction. Neuronal circuits regulating such behavioural domains are influenced by sex hormones. Therefore, it has been hypothesised that an increased androgen exposure during early development (prenatal or neonatal) is a biological link to the development of ASD in both sexes. There is a need to delineate the link between early-life sex steroids and autism by direct measurements of pre- and neonatal sex steroid concentrations in biological samples.

Hence, we are conducting a population-based study on early life sex steroids and risk of ASD that is set in our well-characterized Stockholm Youth Cohort (SYC) and utilises a unique combination of two existing resources: 1) maternal serum samples collected during pregnancy; and 2) neonatal dried blood spots (NDBS) collected on average 4 days after birth.

Funding from Stockholm County Council (ALF project)

Collaborators

Publications

Maternal Polycystic Ovary Syndrome and Risk for Attention-Deficit/Hyperactivity Disorder in the Offspring.
Kosidou K, Dalman C, Widman L, Arver S, Lee B, Magnusson C, et al
Biol. Psychiatry 2017 Nov;82(9):651-659

Maternal polycystic ovary syndrome and the risk of autism spectrum disorders in the offspring: a population-based nationwide study in Sweden.
Kosidou K, Dalman C, Widman L, Arver S, Lee B, Magnusson C, et al
Mol. Psychiatry 2016 Oct;21(10):1441-8

Contact

Adjunct professor

Cecilia Magnusson

Organizational unit: Social Medicin
E-mail: Cecilia.Magnusson@ki.se

Migration, vitamin D-deficiency and risk of autism spectrum disorders

The prevalence of diagnosed autism spectrum disorders (ASD) is rising rapidly. ASDs are neuropsychiatric conditions with early onset, and high burden on affected families and society. The causes of ASD are poorly understood, but environmental factors are important, especially in the aetiology of ASD with comorbid intellectual disability (ASD+ID).

In Western countries, children of immigrants from developing regions have an increased risk of ASD+ID, perhaps because of migration-related environmental factors affecting foetal neurodevelopment. Instead, there is a reduced risk of ASD-ID in this group, which might be explained by poor surveillance and detection of more subtle mental health problems in immigrants. Evidence suggests that early life vitamin D deficiency influences risk of ASD. However, no studies have directly examined whether vitamin D levels are associated with future risk of ASD.

Here, we propose a population based study of migration, early life vitamin D and ASD using: 1) maternal serum samples during pregnancy; 2) neonatal dried blood spots; and 3) health and administrative registers with validated ASD outcomes.

The project will help clarify mechanisms linking migration to the risk of ASD, including any roles of vitamin D deficiency and mental health surveillance, and thus potentially inform preventive actions and other planning of health services. Such information is important in light of the large increase of refugees to Sweden and Europe.

Funding from Vetenskapsrådet

Collaborators

Publications

Maternal vitamin D deficiency and the risk of autism spectrum disorders: population-based study.
Magnusson C, Lundberg M, Lee B, Rai D, Karlsson H, Gardner R, et al
BJPsych Open 2016 Mar;2(2):170-172

Changes in prevalence of autism spectrum disorders in 2001-2011: findings from the Stockholm youth cohort.
Idring S, Lundberg M, Sturm H, Dalman C, Gumpert C, Rai D, et al
J Autism Dev Disord 2015 Jun;45(6):1766-73

Migration and autism spectrum disorder: population-based study.
Magnusson C, Rai D, Goodman A, Lundberg M, Idring S, Svensson A, et al
Br J Psychiatry 2012 Aug;201():109-15

Contact

Adjunct professor

Cecilia Magnusson

Organizational unit: Social Medicin
E-mail: Cecilia.Magnusson@ki.se

Validation of a novel telehealth method for diagnosing Autism Spectrum Disorders.

The aim of the project is to compare the Naturalistic Observation Diagnostic Assessment (NODA), a store-and-forward telehealth approach to ASD diagnosis to current gold-standard, in-person assessment.

Funding Innovationsfonden, Stockholm County Council (public) and Karolinska University Hospital (public)

Collaborators

  • Cecilia Magnusson, Department of Public Health Sciences, KI
  • Behavior Imaging Solutions
  • Neurodevelopmental Unit, Child- and Youth Psychiatry, Stockholm County Council
  • Neuropediatric department at Karolinska University Hospital

Contact

Associated

Selma Idring

Organizational unit: Social Medicin
E-mail: selma.idring@ki.se

Causal effects of education on life-course cognitive ability and dementia

In this project, the causal effect of education on dementia, and possible mediation via intelligence, will be assessed using two Swedish educational reforms during the 20th century as the exposure. The project is predominantly register-based.

Funding from Forte

Collaborators

  • Anton Lager, Department of Public Health Sciences, KI
  • Dominika Seblova, Department of Public Health Sciences, Aging Research Center, KI

Public Engagement

Lager A. Is education causally related to survival? Invited speaker at: The Royal Swedish Academy of Sciences Symposium on Health Inequalities in Modern Welfare States: Do we understand present trends? 2013 Jan 23-24; Stockholm, Sweden.

Lager A. Studera och lev länge. Anton Lager, forskare i folkhälsovetenskap vid Stockholms universitet, har tittat närmare på sambandet mellan utbildning och hälsa. Inledning av Robert Eriksson, professor i sociologi vid Stockholms universitet. Inspelat i januari 2013. Arrangör: Kungliga Vetenskapsakademien.

Bjermo H, Tynelius P, Thern E, Dalman C, Lager A, Rasmussen F. Ökad risk för sjukhusinläggning för psykisk ohälsa, suicidförsök och alkoholrelaterade problem bland unga arbetslösa i Stockholms län. Stockholm: Centrum för epidemiologi och samhällsmedicin; 2015. Faktablad 2015:2. 

Publications

Cognitive and emotional outcomes after prolonged education: a quasi-experiment on 320 182 Swedish boys.
Lager A, Seblova D, Falkstedt D, Lövdén M
Int J Epidemiol 2017 Feb;46(1):303-311

Contact

Associated

Anton Lager

Organizational unit: ARC (Aging Research Center)
E-mail: Anton.Lager@ki.se

At risk for eating disorders

The main purpose of the project is to measure and compare the prevalence of disturbed eating behaviours (DEB), undiagnosed eating disorders (ED), and diagnosed EDs in the Swedish general population with a focus on the family and the social context.

Additionally the project aims to investigate differences between women and men in disordered eating behaviours and assess the co-occurrence with other risk behaviours.

The project draws on data from The Stockholm County Council’s Public Health Surveys (2002, 2006, 2010 and 2014), The Stockholm Public Health Cohort (n=44 494), regional register data from Stockholm County and national register data.

Publications

Ahrén J, Fredlund P, Guban P, Dalman C, Lager A. Anorexia nervosa bland vuxna i Stockholms län. Stockholm: Centrum för epidemiologi och samhällsmedicin, Stockholms läns landsting; 2016. Rapport 2016:4. 

Ahrén, JC., Fredlund, P., Rasmussen., F. & Anton Lager. Tröstätande är kopplat till övervikt och psykisk ohälsa i Stockholms län. Stockholm: Centrum för epidemiologi och samhällsmedicin, Stockholms läns landsting; 2014. Faktablad 2014:18.

Sundin, J, Ahrén JC., Fredlund, P., Guban P., Dalman, D., & Lager., A. (2017). To suffer in silence. Estimating the prevalence of anorexia nervosa among adults in a large Swedish cohort. Manuscript.

Boldeman, C., Ahrén, JC, Guban P., Fredlund, P., & Lager, A. (2017). “Mirror, mirror on the wall”. Associations between body dissatisfaction, indoor tanning, disordered eating, smoking and binge drinking in urban adults. Manuscript.

Psychiatric health in children and adolescents living with over-indebted parents

Over-indebtedness in adults has received increasing attention during the last decade and the negative consequences on these individual’s health have been raised. The knowledge on how this affects children living in families with debt can best be described as non-existent.

The aim of this newly established project is to investigate if over-indebtedness in parents is a risk factor for psychiatric ill-health in children and adolescents. With extensive information from Psychiatry Sweden, an unique database that includes data on psychiatric health and socioeconomic conditions on 10 million individuals born between years 1932-2010 and information from the Swedish Enforcement Authority will be used to identify parents with over-indebtedness.

This project will add important information on a group of young people and children that has received little, or no attention at all in previous research.

Collaborators

  • Jennie Ahrén, Department of Public Health Sciences, KI
  • Cecilia Boldemann, Department of Public Health Sciences, KI
  • Christina Dalman, Department of Public Health Sciences, KI
  • Beata Jablonska, Department of Public Health Sciences, KI
  • Anton Lager, Department of Public Health Sciences, KI
  • Susanna Toivanen, Stockholm University
  • Per-Olof Österberg, Lund University

Contact

Associated

Jennie Ahrén

Organizational unit: Social Medicin
E-mail: jennie.ahren@ki.se

Young entrepreneurs and psychosocial well-being

The general purpose of the planned project is to investigate young entrepreneurs’ working conditions, their psychiatric health and psychological wellbeing. Data consists of Swedish population registries, representative surveys and interviews. In specific parts of the project we aim to explore different ways into entrepreneurship in young individuals and investigate working conditions and psychiatric health among young entrepreneurs.

Public engagement

MIND Advisory Board

Interview with Jennie Ahrén, "Fler män än man trott har anorexia", SVT nyheter, May 23 2016.

Interview with Jennie Ahrén, "Fler än var tionde stockholmare tröstäter", SVT nyheter, December 17 2014.

Contact

Associated

Jennie Ahrén

Organizational unit: Social Medicin
E-mail: jennie.ahren@ki.se

Mental Ill-Health