Highlights from the Nordic Journal of Psychiatry, Volume 76

Theme: Nordic Journal of Psychiatry


The Nordic Journal of Psychiatry, formerly “Nordisk Psykiatrisk Tidsskrift”, is an international journal that publishes excellent psychiatric research with a broad scope. It is the official journal for the eight psychiatric associations in the Nordic and Baltic countries. It is a main source of information about current Nordic psychiatry and related fields, The journal is distributed to members of the Nordic and Baltic Psychiatric Associations as well as to members of Associations for Child and Adolescent Psychiatry. This gives access to all articles published in the journal from 1946.

Long acting injectable antipsychotics for bipolar disorder

This study aimed to determine whether the addition of a long-acting injectable antipsychotic (LAI-AP) has a positive effect on prognosis in bipolar disorder. Medical records of patients with bipolar disorder who were using LAI-AP at least for one year in the community mental health center (CMHC) until March 2020 were investigated. Comparisons were made between the period of one year before and after the initiation of LAI-AP. There were 197 patients with bipolar disorder who were attending to the CMHC and 17 of them were under maintenance treatment with LAI-AP for at least one year. The LAI-APs used were aripiprazole (n = 8), paliperidone (n = 5) and risperidone (n = 4). During the one-year period after the LAI-AP initiation, there were fewer days spent in hospital and the number of hospitalizations was lower than the year before the LAI-AP use. The authors conclude that LAI-AP use may have positive effect on course for selected patients with a long history of bipolar disorder.

Yıldızhan E, Uzun E, Tomruk NB. Effect of long acting injectable antipsychotics on course and hospitalizations in bipolar disorder - a naturalistic mirror image study. Nord J Psychiatry. 2021 Jun 14:1-7. doi: 10.1080/08039488.2021.1931714. Online ahead of print. PMID: 34124986

Is aberrant salience a predisposing factor for psychosis?

Aberrant salience (AS) is conceptualized as a potential predisposing factor for psychotic states of mind. The authors aim of this cross-sectional study is to evaluate the AS subjective experience in Ultra-High Risk (UHR) adolescents and young adults compared to help-seeking peers with First Episode Psychosis (FEP) and (2) to assess any significant association of baseline AS with psychopathology and functioning in UHR participants. Participants aged 13-35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS), the Aberrant Salience Inventory (ASI) and the brief version of the Schizotypal Personality Questionnaire (SPQ-B). No difference in baseline AS subjective levels was found between UHR and FEP participants. In UHR individuals, the ASI total score was significantly associated with attenuated positive symptoms, depression and specific schizotypal personality traits. The authors conclude that AS is clinically relevant in UHR subjects, comparable to FEP patients. Moreover, it seems to mutually interact with schizotypy in the clinical manifestation of attenuated positive psychopathology.

Poletti M, Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, Chiri LR, Pupo S, Raballo A. Subjective experience of aberrant salience in young people at Ultra-High Risk (UHR) for psychosis: a cross-sectional study. Nord J Psychiatry. 2021 Jun 29:1-9. doi: 10.1080/08039488.2021.1942547. Online ahead of print. PMID: 34185607

Stability of personality traits in psychotic patients

Personality is an aspect that can affect the symptoms and social function in individuals with psychotic disorders. No study has examined the stability of personality traits exceeding five years in patients with schizophrenia and related disorders. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with schizophrenia and related disorders and healthy individuals and to evaluate case-control differences. At three occasions during 13-year period patients with schizophrenia and related disorders (n = 28) and healthy individuals (n = 57) completed Swedish universities Scales of Personality (SSP). It was found that tests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age, and Physical Trait Aggression, where patients' ratings were stable, whereas controls rated themselves less aggressive at a higher age. Between-subjects correlations showed differences regarding diagnosis, time, age, gender, or age × gender in nine of the 13 subscales as well as in factor Neuroticism. The authors conclude that long-term follow-up showed generally high stability of personality traits measured with SSP. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment.

Fagerberg T Söderman E, Gustavsson JP, Agartz I, Jönsson EG. Thirteen-year follow-up of long-term treated psychotic disorder: personality aspects. Nord J Psychiatry Oct 7;1-8. doi: 10.1080/08039488.2021.1981436. Online ahead of print. PMID: 34620037

Does unipolar mania imply a distinct neurocognitive profile?

Despite a growing number of studies reporting patients with a history of mania without depression have several socio-demographic and clinical differences than bipolar disorder patients, unipolar mania is recognized as bipolar I disorder in the most commonly used classification systems. The aim of this study is to evaluate the neurocognitive differences between unipolar mania, bipolar I disorder and healthy controls, and to reveal the underlying neurocognitive differences. Cambridge Neuropsychological Test Automated Battery was applied to 18 unipolar mania, 19 bipolar I disorder patients and 21 healthy controls matched for age, sex and education levels. Unipolar mania group had worse performance regarding visual memory and executive functions and had specific social cognition deficits compared to both bipolar I disorder and healthy control groups. The authors conclude that the study indicates that unipolar mania might have unique neurocognitive differences compared to bipolar I disorder, which might support the hypothesis that unipolar mania is a distinct neurocognitive disorder within bipolar spectrum disorders.

Sonkurt HO, Altınöz AE, Sonkurt MD, Köşger F. A distinct neurocognitive profile: unipolar mania. Nord J Psychiatry. 2021 Sep 20;1-7. doi: 10.1080/08039488.2021.1977386. Online ahead of print

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