Psykologisk flexibilitet hos barn och ungdomar med tvång, ångest och depression

Denna studie syftade till att undersöka hur psykologisk (in)flexibilitet var kopplat till olika vanliga barnpsykiatriska symtom bland barn och ungdomar samt om det fanns en starkare koppling till vissa psykiatriska symtom. Psykologisk flexibilitet kan beskrivas som en “fundamental aspekt” av hälsa eller som en helhetsmodell för mänskligt fungerande (Hayes, Strosahl & Wilson, 1999; Kashdans & Rottenberg, 2010). Vårt urval bestod av 58 barn och ungdomar som sökt vård vid Barn och ungdomspsykiatriska kliniken i Lund. De unga (10-17 år), hade sökt behandling och diagnostiserats med primärt tvångssyndrom (OCD), ångestsyndrom eller depression. Deltagarna fyllde i självskattningsformulär framtagna för att mäta psykologisk flexibilitet, tvångssymtom, ångestsymtom och depressiva symtom. Vid jämförelser av diagnosgrupperna fann vi att de unga med primär diagnos av samsjuklighet mellan depression och ångest uppvisade högst nivåer av psykologisk inflexibilitet, följd av gruppen med primär ångest och slutligen gruppen med primärt tvångssyndrom (OCD). På symtomnivå såg vi signifikanta korrelationer, på så sätt att psykologisk flexibilitet korrelerade signifikant med depression och ångest. En korrelation på låg- till medelnivå framkom mellan psykologisk inflexibilitet och tvång. Dessa korrelationer tydde på att psykologisk flexibilitet kan antas verka på ett transdiagnostiskt sätt för att påverka svårighetsgraden både vad gäller ångest och depression hos unga.The aim of this study was to examine how psychological (in)flexibility was related to the severity of anxiety, depression, and OCD in youth seeking treatment for these disorders, and if there was a stronger connection to some of the psychiatric symptoms. Psychological flexibility can be described as a fundamental aspect of health or as an encompassing model of human functioning (Hayes, Strosahl & Wilson, 1999; Kashdan & Rottenberg, 2010). Participants were 58 treatment-seeking children and adolescents (aged 10-17) who were diagnosed with primary OCD, anxiety disorder or depression. Participants completed self-report measures designed to assess psychological flexibility, OCD, anxiety and depression. In our comparison of the three diagnostic groups, we found that young people with a primary diagnosis of mixed depression and anxiety had the highest levels of psychological inflexibility, followed by those with primary anxiety, and finally those with OCD. On the symptom level, we observed significantly correlations, such that psychological flexibility was strongly and significantly correlated with depression and anxiety. A low to moderate correlation was obtained between psychological flexibility and OCD. These correlations suggest that psychological flexibility may act in a transdiagnostic way to influence the severity of both anxiety and depressive symptoms among children and adolescents

A more frequent disease monitorering but no increased disease activity in patients with inflammatory bowel disease during the first year of the SARS-CoV-2 pandemic : A retrospective study

Background and Aims: The SARS-CoV-2 pandemic abruptly switched the healthcare service for patients with inflammatory bowel disease (IBD) towards a telemedicine dominated approach. The aim of this study was to investigate the impact of this switch on monitoring of patients and on disease activity. Material: The pre-pandemic year included 868 patients and the first year of the pandemic included 891 patients. Medical records were retrospectively checked for contacts, changes in medical treatment, performed fecal calprotectin (FC) tests and colonoscopies. Results: The scheduled follow-up visits to a doctor for patients with IBD shifted from mostly face-to-face pre-pandemic (from 389 to 118 appointments) to mostly telephone-based during the pandemic (from 13 to 423 appointments). There was a 21.3% increase in mean overall scheduled health contacts (p <.001) and a 20.0% increase for the mean number of FC tests (p <.001) in the year of the pandemic compared to the pre-pandemic year. The proportion of patients who had a surveillance colonoscopy was significant lower in the year of the pandemic compared to the pre-pandemic year (12.7% vs 20.1%; p =.002). There were no difference in the proportion of patients with a median FC > 200 mg/kg (18.2% vs 17.1%; p =.767) and in the proportion of patients who changed their medical treatment (24.7% vs 23.9%; p =.713) in the first year of the pandemic compared to the prepandemic year. Conclusions: The shift towards a telemedicine oriented IBD healthcare service in the first year of the pandemic significantly increased the scheduled contacts, as well as the frequency of FC testing. However, there was a significant decrease in performed surveillance colonoscopies. Between the two periods observed, the patients showed no difference in medical treatment or in disease activity