Eva Serlachius research group - Child and adolescent psychiatry

The overarching goal of the Serlachius research group is to develop and evaluate methods for diagnosing and treating mental disorders in children and adolescents in order to improve early detection and increase availability to evidence-based methods.

Mental disorders are common among children and adolescents and are associated with significant impairment and negative consequences for psychosocial development. The overarching goal of the Serlachius research group is to develop and evaluate methods for diagnosing and treating mental disorders in children and adolescents. The aim is to improve early detection and to increase availability to evidence-based methods. We work mainly with anxiety disorders, obsessive compulsive disorder (OCD) and depression in children and adolescents. 

Research projects 

Internet-delivered CBT 

The research group has extensive experience in developing and evaluating internet-delivered cognitive behavioural therapy (ICBT) for children and adolescents with different disorders (BIP). Our aim is to be able to contribute with evidence based ICBT-programs that can be implemented and disseminated within regular health care. The research group has conducted more than 15 clinical trials, and evaluated programs are being implemented at Region Stockholm’s Unit for Internet Treatment  within the Child and Adolescent Mental Health Services (CAMHS).

  •  Generic internet-delivered CBT for anxiety disorders 

 The generic ICBT programme targets several anxiety disorders (separation anxiety, panic disorder, specific phobias, social anxiety disorder and generalised anxiety disorder) in children 8-12 years of age. The programme has been evaluated in two pilot studies and two randomised controlled trials with good results. The treatment has also been evaluated for children and adolescents in Region Jämtland Härjedalen.

  • Internet-delivered CBT for social anxiety 

This ICBT-programme is specifically targeting social anxiety disorder in children and adolescents  10-17 years of  age. The treatment has been evaluated in a pilot study and a randomised controlled trial with good results.

  •  Internet-delivered CBT for generalised anxiety disorder and excessive worry 

This ICBT-programme is developed to target generalised anxiety disorder and excessive worry  in adolescents aged 13-17 years. The treatment has been evaluated in two smaller trials,  a case series and a multiple baseline study with promising results. The programme is currently being evaluated in a randomised controlled trial comparing ICBT to a waitlist control. 

  • Internet-delivered CBT for obsessive-compulsive disorder

This ICBT-programme is developed for children and adolescents 7-17 years of age with obsessive compulsive disorder (OCD). The treatment has previously been evaluated for adolescents 13-17 years of age in a pilot study and a randomised controlled trial, as well as in a pilot study for children 7-12 years of age. The previous studies showed good results and the programme has subsequently been evaluated in a randomised controlled trial for the age span 7-17 testing the ICBT-programme against face-to-face CBT with good results.  

  • Internet-delivered CBT for mild to moderate depression  

This ICBT-programme is developed for adolescents 13-17 years of age with mild to moderate depression. The treatment has been evaluated in a pilot study comparing guided with unguided ICBT, with promising results. Our next step is to evaluate the programme in a randomised controlled trial comparing the guided and unguided versions of the programme with treatment as usual. 

Can adolescents with depression be effectively treated with guided and self-guided cognitive Behavior Therapy on the Internet? 

  •  Internet-delivered CBT within regular health care

Two of the ICBT-progammes have been evaluated within the regular health care in Sweden:  
•    The generic anxiety programme has been evaluated in Region Jämtland Härjedalen in rural Sweden. 
•    The OCD programme has been evaluated in mental health specialist clinics for OCD in Region Stockholm and Västragötalandsregionen.
   
Programmes that are implemented at Region Stockholm’s Unit for Internet Treatment  within the CAMHS will be evaluated in an effectiveness study. All patients that are offered treatment, regardless of principal disorder, will be asked to participate in the effectiveness study. 

Eye tracking: social attention and reward mechanisms 

The project “Social attention in children and adolescents with social anxiety disorder” consists of several studies that use eye tracking-technology to measure eye movement in youths with psychiatric disorders, such as social anxiety disorder, autism, generalised anxiety disorder and depression. The visual attention in patients is compared to a norm group without any psychiatric disorder. This is studied to understand how social attention and reward processes are expressed in youth with psychiatric disorders and if these mechanisms can be targeted in CBT. The aim is to increase knowledge about how psychiatric disorders develop and are maintained during childhood and adolescence. To date, the project has generated several publications indicating that social attention in youth with social anxiety disorder is different from the norm population. Similar studies will be performed in adolescents with depression.  

Medical education research 

A digital skills-based training programme for medical students in suicide risk assessment of children and adolescents is being developed. Feasibility, acceptability and preliminary effects on medical students’ clinical competencies are planned to be evaluated in a pilot study. 

Research funding 

The research group has received support from the

  • Kavlifondet,
  • Swedish Research Council for Health,
  • Working Life and Wellfare (FORTE),
  • Riksbankens Jubileumsfond,
  • Jane and Dan Olsson Foundations (Jane och Dan Olssons stiftelse för Vetenskapliga ändamål),
  • HSF Region Stockholm, 
  • Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, 
  •  Stockholm Healthcare services, Region Stockholm (for doctoral students), 
  • ALF and PPG project funding,
  • ALF Clinical postdoctoral appointment (Jens Högström), 
  • ALF Clinical research appointment (Eva Serlachius). 

Education  

The research group coordinates courses and modules in child and adolescent psychiatry for medical, speech therapy and doctoral students at Karolinska Institutet.

•    Elective course on the medical programme: Clinical Child and Adolescent Psychiatry – Advanced Course. Twice a year, a five-week advanced course in clinical child and adolescent psychiatry is offered to 10-15 medical students during their final semester. The course consists of lectures, skills-based training, case-based seminars and clinical placements within child and adolescent psychiatric clinics in Stockholm.

•    Module in child and adolescent psychiatry within the medical programme’s course Clinical Medicine- Emphasis on Reproduction and Development. Twice a year, all fourth year medical students are taught early detection and clinical management of common child- and adolescent mental disorders, through lectures and seminars.

•    Module in child and adolescent psychiatry within the speech therapy programme’s course Medicine 3: paediatrics, paediatric neurology and child and adolescent psychiatry. Every year, all second year speech therapy students are taught relevant aspects of child and adolescent psychiatry through lectures and seminars. 

•    Doctoral course: Clinical Research in Child and Adolescent Psychiatry: Methods and Practice
 

Dissertations 

Sarah Vigerland; Internet-delivered CBT for children with anxiety disorders: effect andprerequisites for implementation within public health care 

Fabian Lenhard; Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder

Maral Jolstedt; Internet-delivered cognitive behaviour therapy for paediatric anxiety disorders in clinical settings:increasing access to evidence-based treatments  

Tove Wahlund; Excessive worry in adolescents and adults: development and evaluation of theory-driven treatments

Martina Nordh; Fear and missing out: internet-treatment for social anxiety disorder in youth  

Kristina Aspvall; Novel treatment approaches for children and adolescents with obsessive-compulsive disorder

Lie Åslund; Adolescent sleep: comorbid problems and behavioral treatment of insomnia  

Selected publications 

For a list of publications, see PubMed 

Group members