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C Allgulander

Publications and source records attributed to C Allgulander.

At least 37 records · Page 2Linked to original sources
PubMed1991

Psychopathology and treatment of 30,344 twins in Sweden. II. Heritability estimates of psychiatric diagnosis and treatment in 12,884 twin pairs.

We estimated the heritability for inpatient psychiatric treatment, treatment with psychoactive medication, and for psychiatric diagnoses in a randomized sample of 12,884 Swedish twin pairs drawn from the general population for a health survey. We found a genetic contribution to treatment and diagnosis, independent of sex and shared environment. The heritability estimate for inpatient treatment was 0.47, for reported treatment with psychoactive medication 0.49, and for an inpatient diagnosis of neurotic or personality disorder 0.60. No statistically significant heritability was found for the diagnoses of alcohol abuse nor for the heterogeneous group of diagnoses of psychoses. This was probably because of the heterogeneity of cases necessary to form large enough groups for analysis, or ascertainment requiring treatment in a psychiatric unit.

Adolescent↗
PubMed1991

Causes of death in a cohort of 50,465 young men--validity of recorded suicide as underlying cause of death.

We studied causes of death in a cohort of all young males (n = 50,465) conscripted for military service in 1969-70. Six hundred eighty three deaths occurred in the cohort during the follow-up through 1983. Injury-related deaths accounted for 75% of all deaths. Of these, 38% were definite suicides, 10% undetermined suicides and 30% motor vehicle accidents. The validity of officially recorded causes of death was studied by scrutinizing all death certificates (n = 683) and forensic reports, including police reports, toxicological and histological data, from a sample (n = 322) of deaths with unclear circumstances. Of 161 officially recorded suicides (E950-959), only one case was reevaluated into poisoning, "undetermined" (E980). Of 47 cases officially recorded "undetermined" (E980-989), 9 were reevaluated into definite suicide (E950-959) although we believe that this is still an underestimation of "true" suicide cases. An alcohol concentration of more than 0.1 g% was found in 45% of all violent deaths (E800-999), 34% of all suicides and 60% of all "undetermined" deaths. We conclude that the causes of death in most cases of injury related death in young age are recorded with high accuracy. Reevaluation of recorded deaths from "undetermined" causes revealed a number of definite suicides, although the "true" number of suicides is difficult to assess even after close scrutiny of the information available.

Accidents↗
PubMed1990

Clinical predictors of completed suicide and repeated self-poisoning in 8895 self-poisoning patients.

The diagnoses of 8895 patients who were admitted for intentional self-poisoning with psycho-active drugs were studied in order to find predictors for subsequent completed suicide and repeated self-poisoning. Automated record linkage by means of the Swedish personal identification numbers was performed between the Stockholm County inpatient registry and the cause-of-death registry. With Cox regression models, several diagnostic predictors were identified although they were generally unspecific and insensitive. This may be due both to the low base rate of suicides, and to the omission of other more powerful non-clinical predictors, such as personality traits, hopelessness and social disruption. It is concluded that secondary psychiatric prevention may still be justified, although it will be applied to large numbers of patients who will not eventually commit suicide or repeat self-poisoning.

Adult↗
PubMed1990

Psychopathology and treatment of 30,344 twins in Sweden. I. The appropriateness of psychoactive drug treatment.

We studied whether regular treatment with tranquilizing and hypnotic drugs among 30,344 twins in Sweden 15-47 years old was associated with robust indicators of poor health. Longitudinal psychiatric diagnoses and subsequent suicides were analyzed with data from cross-sectional health questionnaires. Women were almost twice as likely to report medication, even those with psychiatric inpatient diagnoses. Within each of mental, somatic, and lifestyle domains, medication was more frequent among those with multiple problems. The partial odds for medication for those with a diagnosis of psychosis were 11.81, affective disorder 10.94, neurotic or personality disorder 11.09, alcoholism 5.00, and drug addiction 13.92. We conclude that reported regular treatment with tranquilizing and hypnotic drugs in young Swedish adults was significantly associated with diagnosed and subjective somatic and mental health problems, and thus largely in agreement with current peer guidelines. The reasons why women were more often treated than men requires further study.

Adolescent↗
PubMed1990

Suicide among young men: psychiatric illness, deviant behaviour and substance abuse.

The role of psychiatric illness versus social and behavioural risk factors for suicide in young men was analysed in a longitudinal study of 50,465 conscripts. Data collected in 1969-1970 on social background, personality characteristics, use of alcohol and drugs, psychological assessment and psychiatric diagnosis were linked to records from the national psychiatric case register and the national cause-of-death register through 1983. A total of 247 deaths from suicide occurred in the cohort during the follow-up. By means of multivariate analysis, the role of different social and behavioural characteristics was assessed in relation to that of psychiatric diagnoses, with suicide as dependent variable. A psychiatric diagnosis in inpatient care (n = 2247) was the strongest predictor of suicide, with an odds ratio (OR) of 11.3 (8.3-15.4), controlling for social and behavioural risk factors. Schizophrenia was the diagnosis with the highest suicide risk: OR = 13.3 (8.2-21.6). A psychiatric diagnosis at conscription (n = 5877) was not associated with a significantly increased risk of suicide. Several indicators of poor social background, deviant behaviour, substance abuse and disrupted interpersonal relations were associated with a significantly increased suicide risk, also after controlling for psychiatric illness. Although mental illness requiring inpatient treatment was the most powerful predictor of suicide, less than half the cohort had received such treatment. Social and behavioural risk factors are thus important for prevention on the population level.

Adult↗
PubMed1990

Psychiatric diagnoses as predictors of suicide. A comparison of diagnoses at conscription and in psychiatric care in a cohort of 50,465 young men.

In a cohort of 50,465 Swedish men conscripted for military service in 1969-70, the relative risk for suicide was 3.1 (95% Cl 2.3-4.0) among those who had a psychiatric diagnosis at conscription, and 16.7 (95% Cl 13.8-20.1) among those who had a psychiatric diagnosis in in-patient care during a 13-year follow-up. Of the diagnoses at conscription, only neurotic disorder, personality disorder and drug dependence were associated with a significantly increased risk for future suicide. Among those who were admitted to hospital, almost all in-patient diagnoses were associated with a significantly increased suicide risk. Although a psychiatric diagnosis in in-patient care was a strong predictor of suicide, only 44% of all 247 men who committed suicide had ever been treated in in-patient psychiatric care.

Adolescent↗
PubMed1989

Psychoactive drug use in a general population sample, Sweden: correlates with perceived health, psychiatric diagnoses, and mortality in an automated record-linkage study.

Three person-based computer files were linked to provide a data-set of a random sample of 32,679 Swedes, drawn for interviews regarding perceived health, socioeconomic conditions, and psychoactive drug use. All diagnoses from inpatient psychiatric care in the sample during a 15-year period and the causes of death after the sampling point were combined with the interview responses. Among those admitted for inpatient psychiatric care, substance abuse was an infrequent diagnosis; the majority of schizophrenics and of those with an affective disorder appeared not to medicate regularly; survey non-responders had higher rates of mental disorders than responders. Drug use correlated with both subjective and objective measures of mental ill health. The rate of prescription drug abuse was low. Automated record-linkage is a feasible method to generate hypotheses about mental health in the general population.

Age Factors↗
PubMed1988

Predictors of completed suicide in a cohort of 50,465 young men: role of personality and deviant behaviour.

Suicide seems to be increasing in young people in various countries and causes the greatest loss of years of life under the age of 65 in the Swedish population. Data from a national survey of 50,465 conscripts in Sweden were used in a prospective follow up study to assess personality and behavioural predictors of suicide in young men. Altogether 247 completed suicides occurred in the cohort during 13 years' follow up. Baseline data on social conditions, psychological assessments, and psychiatric diagnoses of the conscripts were entered into a Cox regression model with suicide as the outcome variable. Several early indicators of antisocial personality (poor emotional control, contact with a child welfare authority or the police, and lack of friends) were strongly predictive of suicide. None of the few conscripts who had a diagnosis of schizophrenia or affective psychosis committed suicide. A diagnosis of neurosis was associated with a twofold increase in the suicide rate and personality disorder with a threefold increase. Although the risk of suicide is difficult to assess in an unselected population owing to the low base rate of suicide, the predictors identified in the study may help to identify those at high risk in units where people with deviant behaviour and personality disorders cluster.

Adolescent↗
PubMed1987

Long-term prognosis in addiction on sedative and hypnotic drugs analyzed with the Cox regression model.

The prognosis of 221 patients first admitted in 1941-1954 for dependence on sedative-hypnotic drugs was determined in a record-linkage and interview study concluded in 1984. Different outcomes were related to admission characteristics by means of the Cox proportional hazards regression model. An excess of unnatural deaths was noted; suicides in 11% of the men and 23% of the women. Of those with primary sedative-hypnotic dependence, 46% continued to abuse drugs till death or follow-up, and of those with a primary or concomitant alcohol abuse 72%. An unfavorable outcome was significantly related to primary psychiatric symptoms before the first admission, concomitant alcohol abuse, familial drug and alcohol abuse and health care occupation.

Adult↗
PubMed1986

History and current status of sedative-hypnotic drug use and abuse.

Sedative-hypnotic drug use and abuse increased in Europe after World War II and peaked about 1972. Clinical and follow-up descriptions of abusers support the concept of a psychiatric addiction syndrome, different from a low-dose withdrawal syndrome. Although these drugs may be prescribed unnecessarily, large portions of the general population with pathological psychic distress and insomnia do not receive psychotropic treatment, in spite of findings pointing to genetic and biochemical factors in the genesis of these. Research on underlying mechanisms and the rationale for maintenance therapy is needed.

Anti-Anxiety Agents↗
PubMed1986

Survival analysis (or time to an event analysis), and the Cox regression model--methods for longitudinal psychiatric research.

A multivariate statistical instrument is presented, which combines the life table with regression analysis: the Cox proportional hazards regression model. It is suitable for analyzing longitudinal clinical data, and to find predictors of different outcomes in psychiatric research such as death, relapse or cure. All patient information can be used, since the time to the outcome event is included in the model. Treatments can be compared, and prognostic indices created.

Actuarial Analysis↗
PubMed1984

A 4-6-year follow-up of 50 patients with primary dependence on sedative and hypnotic drugs.

The authors studied 50 of 55 patients originally hospitalized for primary sedative-hypnotic dependence 4-6 years after hospital discharge. Forty-two (84%) of the patients had resumed using sedative-hypnotics, 26 (52%) were abusing drugs at follow-up, and 21 (42%) had been readmitted for drug abuse. Three patients experienced delirious states and six experienced epileptic seizures associated with withdrawal. Physical signs of alcoholism had developed in 11 (22%); four (8%) had committed suicide. Social deterioration was noted in 24 patients. CAT scan results did not deviate from those found in a matched control sample.

Alcoholism↗
PubMed1983

Comparison of quazepam, flunitrazepam and placebo as single-dose hypnotics before surgery.

The hypnotic effect and tolerance of quazepam (Sch 16134) 15 and 30 mg, flunitrazepam 1 and 2 mg and placebo were evaluated in a one-night, randomized, double-blind, parallel group study of 100 hospitalized patients, who were to undergo a planned operation on the following day. All active drugs were rated as superior to placebo by the physician. Subjectively, quazepam 30 mg and flunitrazepam 1 and 2 mg were superior to placebo. Hangover effects were not distinguishable from placebo. Vigilance and ataxia tests were not altered by any of the drugs.

Adolescent↗