Viktor Kaldo

Viktor Kaldo

Affiliated to Research | Docent
Visiting address: M46, Internetpsykiatrienheten, Psykiatri Sydväst, Karolinska Universit, 14186 Stockholm
Postal address: K8 Klinisk neurovetenskap, K8 CPF Kaldo, 171 77 Stockholm
Part of:

Selected publications

Articles

All other publications

Grants

  • Swedish Research Council
    1 December 2025 - 31 December 2030
    Self-harm is a serious and growing public health concern among adolescents, strongly associated with suicide risk and mental health problems. It imposes significant societal costs through increased demand for psychiatric and emergency medical care, school absenteeism, and parental sick leave, both short- and long-term. Early interventions, including parental support and psychological treatment focused on emotion regulation may help prevent further deterioration. There is a clear need for brief, accessible treatments tailored to patients within child and adolescent psychiatry services (CAMHS), as well as for effective collaboration models between families and CAMHS. Following a promising feasibility study, we now want to assess the effectiveness of a novel group-based intervention, ERGT-A, for self-harming adolescents and their parents in a single blinded clinical randomized controlled effectiveness study including 166 adolescents (ages 13–18). The control group will receive TAU and cross over to ERGT-A treatment after the primary end-point. This study combines quantitative measures and repeated assessments to identify change processes and long-term effects. This project involves parents, and bridges the gap between research and practice, promoting early intervention and long-term health for a vulnerable and growing patient group.
  • Swedish Research Council
    1 December 2025 - 31 December 2029
    Cognitive behavioural therapy (CBT) is a partly effective treatment for anxiety and depression, yet only around half of patients achieve remission. This project aims to improve precision in psychiatric care by investigating neural variability, the brain’s moment-to-moment fluctuations in activity, as a biomarker for diagnosis, treatment response, and clinical decision-making. Using functional MRI, we will measure neural variability in patients with social anxiety disorder and major depressive disorder undergoing internet-delivered CBT. By combining large-scale imaging with a high-density Single-N design, we will track how and when therapy affects the brain across individuals and time. The project addresses three key questions: (1) Can neural variability distinguish anxiety from depression and both from healthy controls? (2) Can it track symptom change during therapy? (3) Can it predict treatment outcome in new, unseen individuals? Validated using independent datasets and out-of-sample prediction techniques, this project seeks to establish neural variability as a reliable, transdiagnostic biomarker and a foundation for next-generation, neuroscience-informed psychological treatments.
  • Swedish Research Council
    1 December 2025 - 31 December 2029
    Self-harm is a serious and growing public health concern among adolescents, strongly associated with suicide risk and mental health problems. It imposes significant societal costs through increased demand for psychiatric and emergency medical care, school absenteeism, and parental sick leave, both short- and long-term. Early interventions, including parental support and psychological treatment focused on emotion regulation may  help prevent further deterioration. There is a clear need for brief, accessible treatments tailored to patients within child and adolescent psychiatry services (CAPS), as well as for effective collaboration models between families and CAPS.Following a promising feasibility study, we now want to assess the effectiveness of a novel group-based intervention, ERGT-A, for self-harming adolescents and their parents in a single blinded clinical randomized controlled effectiveness study including 166 adolescents (ages 13–18). The control group will receive TAU and cross over to ERGT-A treatment after the primary end-point. This study combines quantitative measures and repeated assessments to identify change processes and long-term effects. This project involves parents, and bridges the gap between research and practice, promoting early intervention and long-term health for a vulnerable and growing patient group.
  • Swedish Research Council
    1 December 2025 - 30 November 2029
    Most young people with autism have comorbid mental disorders, such as obsessive-compulsive disorder (OCD), which can be impairing and difficult to treat. However, the necessary treatments are rarely available because they require access to highly specialised clinics. The families of autistic children demand more access to treatment for OCD. We aim to evaluate a novel digital intervention for OCD in autistic youth aged 7-17. We have previously co-developed and successfully piloted the intervention together with young people with lived experience, their families, and clinicians. We will now evaluate its efficacy and cost-effectiveness in a multicentre randomised controlled trial (N=220) comparing the intervention with an ecologically valid control (stress management training). The primary outcome is OCD symptom severity at the 3-month follow-up (primary endpoint). Secondary outcomes include other clinical symptoms (e.g., mood) and general functioning. Intention-to-treat, mixed-effect regression models will be used for analysis. Costs will be analysed from various perspectives. A subset of participants, therapists, and stakeholders will participate in a process evaluation. The last participant will reach the primary endpoint by the end of 2028. If proven effective, the intervention will be implemented nationally within 2 years after the end of the study. The project is already partially funded
    we seek additional funding to increase national coverage and recruitment pace.
  • Breaking the silence: an integrated treatment of adolescent self-harm through collaboration between psychiatry, school and parents.
    Swedish Research Council for Health Working Life and Welfare
    1 July 2025 - 31 December 2030
    Research problem and specific questions Self-harm in adolescents is a serious and growing concern, inked to increased risk of suicide attempts, psychiatric disorders, substance use, and inpatient care. Early detection and intervention is crucial for improving long-term outcomes and well-being. Although clinical guidelines recommend treatments focusing on emotion regulation, access remains largely restricted to specialist clinics, leaving many adolescents at risk of receiving no or non-specific care. To adress this, we have developed a group-based emotion regulation treatment for self-harming adolescents, showing promising results. The group format integrates well into healthcare structures, fosters social skills training, and reduces stigma – key challenges for this patient group. Schools are primary environments in adolescents' lives and often the first to identify self-harm. However, limited knowledge of appropriate responses and concerns about contagion effects creates barriers to effective management. Strengthening collaboration between healthcare and schools is essential to enhance early detection and support. Data and Method A single-blind randomized controlled trial will be conducted to evaluate the effectiveness of this novel treatment. Adolescents (N=166) age 13–17, will be randomized to emotion regulation treatment plus treatment-as-usual (TAU) or TAU only. The content of TAU will be carefully monitored. Cost-effectiveness, mechanisms of change, and treatment effects up to 12 months post-treatment will be assessed. Focus group interviews with school health professionals will be conducted to identify collaboration needs between schools and healthcare. Societal Relevance and utilization This unique project addresses a critical scientific and clinical challenge by increasing access to treatment for self-harming adolescents. By mitigating the long-term health and social consequences associated with self-harm the project aims to improve outcomes for affected youth. Strengthening collaboration between healthcare, families and schools will enhance early detection and timely interventions. Plan for project realisation The project team consists of researchers with expertise in self-harm, emotion regulation, clinical trials, and child and adolescent psychiatry. Feasibility has been tested, infrastructure is being developed, and recruitment will be carried out through established collaboration with regional and national child and adolescent psychiatry clinics.
  • Swedish Research Council
    1 January 2025 - 31 December 2028
    Self-injury is a growing health crisis among youth, and the strongest risk factor for suicide attempts. Scalable treatments are needed but lacking. We have recently shown that a brief digital treatment, IERITA (Internet-delivered Emotion Regulation Individual Therapy for Adolescents), can be efficacious and cost-effective. However, not all patients respond sufficiently to the standard treatment procedure. Now we aim to implement and evaluate IERITA within regular health services and optimize treatment outcomes. First, we will develop and validate a classification tool to predict non-remission (continued self-injury after treatment). This tool will subsequently be used in the second step: a randomized controlled trial (N=341) between 2025 to 2028, which compares adaptable to standard IERITA. Adolescents allocated to adaptable IERITA and classified as likely non-remission in treatment week four will recieve adapted IERITA (e.g., personalized dose and treatment delivery) for the remaining eight weeks. We will (1) follow participants one- three- and twelve-month post-treatment
    (2) use self-reports and blinded assessments
    (3) study distal effects in national registers
    (4) investigate several clinically relevant outcomes
    and (5) conduct cost-effectiveness analyses. If successful, more patients could receive evidence-based treatment for self-injury, and treatment outcomes could be improved. In extension, queues to care may be reduced, and suicide attempts and suicides prevented.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2025 - 31 July 2026
    Research idea and purposeSelf-injury is a growing and urgent health crisis among youth and the strongest risk factor for suicide attempts. Scalable and evidence-based treatments are needed but lacking. We have recently shown that a brief digital treatment, IERITA (Internet-delivered Emotion Regulation Individual Therapy for Adolescents), can be efficacious compared to treatment as usual only. However, not all patients respond sufficiently to the standard treatment procedure, and established efficacy does not guarantee successful uptake in regular care. This project aims to implement and evaluate IERITA in real-world settings and optimize treatment outcomes. A planning grant creates opportunities to test the project´s feasibility, an essential part of preparation for a large-scale study.Work plan, methods and project realisationFirst, a classification tool to predict continued self-injury after treatment (non-remission) will be developed and subsequently used in a randomized controlled pilot trial (N=30) comparing adaptable to standard IERITA. Adolescents allocated to adaptable IERITA and classified as likely non-remission in treatment week four will change to adapted IERITA (e.g., personalized dose and treatment delivery) for the remaining eight weeks. Feasibility will be evaluated through the number of completed treatment parts, degree of participation in data collection, satisfaction, adherence, and therapist time. Clinically relevant outcomes will also be measured, which include remission (primary clinical outcome), frequency of self-injurious behaviour, suicidality and level of functioning. Participants will be followed up one- and three months post-treatment. The project will be conducted within regular health care services in several regions which we have collaborated with previously. Patient organizations and health professionals will contribute to increasing relevance and feasibility. The budget includes salaries for the project manager and patient organization, and a smaller part for operating costs.Societal relevance and utilisationSelf-injury is rapidly increasing, posing severe risks for youths. The queue to healthcare services is long, and current treatments are costly and not widely or equally accessible. If this project is successful, more youths across the country could receive effective early intervention for self-injury, with the hope of reduced waiting times, equal care, and suicide preventive effects.
  • Emotion Regulation Group Therapy for Adolescents with Deliberate Self-Harm and their caregivers: An open feasibility trial and a qualitative interview study – planning for a randomized controlled trial
    Stiftelsen Sven Jerrings fond
    31 December 2024 - 31 January 2026
  • Affect labeling – experimental evaluation of a behavioral intervention in emotion regulation
    Söderström-Königska fonden
    26 September 2022 - 30 June 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2022 - 31 December 2026
    About 15% of mothers suffer from postpartum depression, which besides their suffering often affects the relation to the child and partner negatively. Depression during pregnancy constitutes a high risk for postpartum depression, and better screening and access to treatment is needed.Mom2B is a mobile application aimed towards all pregnant individuals, and includes screening for depression. If detected, general information regarding health care for depression is presented. We want to randomize half of these indicated risk users to instead receive targeted information about guided, internet-based CBT (ICBT) for depression during pregnancy.Our hypothesis is that more of these will start our evidence-based ICBT and lower their symptom levels and risk for postpartum depression 8-10 weeks after delivery, measured with structured interview and registry data. We also expect the strategy with targeted information and ICBT to be beneficial from a health economic perspective. ICBT is preceded by an assessment, and during the 12-week treatment the participant works with a self-help material while actively supported by a psychologist via text messages. We have evaluated the ICBT-program used in this study with positive results, but in line with other research on ICBT we have seen that more support and adjustments are often asked for. In line with Personalized Care, we will thus randomize some of those seeking ICBT, via Mom2B or other channels, to receive more personalized care by letting them choose type of visits (physical/video/telephone) and get extra visits with a midwife with the purpose of better adjusting the care to their needs. Others will receive no extra visits and are randomized to type of visit. For sub-analyses, some also choose type of visit but receive no extra visits, and vice versa.Our hypothesis is that personalized ICBT will lead to increased treatment engagement and patient empowerment, as well as reduced symptoms and risk for postpartum depression.
  • Affect labeling – experimental evaluation of a behavioral intervention in emotion regulation
    Söderström-Königska stiftelsen
    20 December 2021 - 20 June 2023
  • Swedish Research Council
    1 December 2021 - 30 November 2024
  • Swedish Research Council
    1 December 2021 - 30 November 2024
  • Swedish Research Council
    1 January 2021 - 31 December 2024
  • Affect labeling – experimental evaluation of a behavioral intervention in emotion regulation
    Söderström-Königska foundation
    14 December 2020 - 14 June 2022
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2020 - 31 December 2025
  • Swedish Research Council
    1 January 2019 - 31 December 2021
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2019 - 31 December 2022
  • Swedish Research Council
    1 January 2017 - 31 December 2019
  • Australian Research Council
    8 June 2005 - 31 December 2007

Employments

  • Professor, Clinical Psycholgy, Department of Psycholgy, Linnaeus University, 2018-
  • Affiliated to Research, Department of Clinical Neuroscience, Karolinska Institutet, 2026-2029

Degrees and Education

  • Docent, Karolinska Institutet, 2013

News from KI

Events from KI