sfriis

• Ingeborgrud, Christine Baalsrud; Oerbeck, Beate; Friis, Svein; Pripp, Are Hugo; Zeiner, Pål & Aase, Heidi [Show all 9 contributors for this article] (2024). Do maternal anxiety and depressive symptoms predict anxiety in children with and without ADHD at 8 years? European Child and Adolescent Psychiatry. ISSN 1018-8827. 33, p. 3169–3178. doi: 10.1007/s00787-024-02374-1. Full text in Research Archive Show summary

  Maternal anxiety and depression during pregnancy and early childhood have been associated with child anxiety and attention-deficit/hyperactivity disorder (ADHD). However, previous studies are limited by their short follow-up, few assessments of maternal symptoms, and by not including maternal and child ADHD. The present study aimed to fill these gaps by investigating whether maternal anxiety and depressive symptoms from pregnancy to child age 5 years increase the risk of child anxiety disorders at age 8 years. This study is part of the population-based Norwegian Mother, Father, and Child Cohort Study. Maternal anxiety and depressive symptoms were assessed by the Hopkins Symptom Checklist (SCL) six times from pregnancy through early childhood, and ADHD symptoms by the Adult Self-Report Scale (ASRS). At age 8 years (n = 781), symptoms of anxiety disorders and ADHD were assessed, and disorders classified by the Child Symptom Inventory-4. Logistic regression models estimated the risk of child anxiety depending on maternal symptoms. The mothers of children classified with an anxiety disorder (n = 91) scored significantly higher on the SCL (at all time points) and ASRS compared with the other mothers. In univariable analyses, maternal anxiety and/or depression and ADHD were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively), remaining significant in the multivariable analysis adjusted for covariates. Our findings link maternal anxiety, depression, and ADHD during pregnancy and early childhood to child anxiety at age 8 years.

• Øvergaard, Kristin Romvig; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Aase, Heidi & Ingeborgrud, Christine Baalsrud [Show all 7 contributors for this article] (2024). Functional Impairment Related to ADHD From Preschool to School Age. Journal of Attention Disorders. ISSN 1087-0547. 29(3), p. 220–230. doi: 10.1177/10870547241301179. Full text in Research Archive Show summary

  Objective: Children with ADHD often experience functional impairments across various aspects of daily life. This study addresses the dearth of longitudinal research on functional impairment trajectories from preschool to school age in children with symptoms of ADHD and comorbid disorders. Methods: We investigated the extent to which functional impairments were associated with ADHD symptoms, along with behavioral and anxiety symptoms, from age 3.5 to 8 years. Utilizing parent- and teacher-reported data, we analyzed associations between global impairment, and dimension scores (e.g., family; child quality of life (QoL); learning; play/leisure activities; and friends) and symptoms at ages 3.5 and 8 years (n = 783). Results: The mean parent global impairment score increased from 0.31 (standard deviation (SD) = 0.40) to 0.83 (SD = 0.63) from 3.5 to 8 years, while the teacher impairment scores slightly decreased. Specific parent impairment dimension scores, particularly QoL, learning, and friends, significantly increased. Preschool ADHD and comorbid behavioral symptoms reported by parents weakly predicted impairment at 8 years. By age 8 years, impairment and symptoms exhibited moderate to strong correlations for all impairment dimensions. Parents reported greater child impairment during school age across settings compared to preschool, while teachers’ impairment profiles remained consistent across ages. Conclusions: These findings suggest that parents perceive impairment as more pronounced at age 8 years and more strongly associated with symptoms of both ADHD and comorbid disorders than at age 3.5 years. Notably, for teachers, a robust correlation between inattention symptoms and learning impairment was observed, with substantially higher impairment scores reported for boys compared to girls.

• Ingeborgrud, Christine Baalsrud; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Aase, Heidi & Biele, Guido [Show all 8 contributors for this article] (2024). Low perceived social support in mothers during pregnancy and early childhood; associations with anxiety and ADHD symptoms in children at 3 and 8 years. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. doi: 10.1007/s00127-024-02792-1. Full text in Research Archive Show summary

  Purpose Low perceived social support is associated with adverse effects on maternal mental health, and often coexists with other risk factors for offspring anxiety and attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether low maternal social support during pregnancy and early childhood predicted anxiety and ADHD symptoms in children at ages 3.5 and 8 years. Methods This study is part of the longitudinal, population-based Norwegian Mother, Father, and Child Cohort Study. Mothers were queried about perceived social support twice during pregnancy, and again at child ages 18 months and 3 years. They were interviewed about their children’s symptoms of anxiety and ADHD at 3.5 years. At 8 years (n = 781), the Child Symptom Inventory-4 was used to identify children who fulfilled the criteria for anxiety disorders and ADHD. Logistic regression models estimated the risk of child anxiety and ADHD, depending on maternal social support. Results Low maternal social support predicted child anxiety symptoms at both ages 3.5 and 8 years as well as ADHD symptoms at 8 years. When including other maternal stressors and child risk factors, low maternal social support remained a significant predictor for child anxiety symptoms at 3.5 years, and there was a trend towards also predicting child anxiety and ADHD symptoms at 8 years. Conclusion The associations between low maternal social support and child symptoms of anxiety and ADHD found in the present study, suggest that focusing on mothers with low social support may hold significance for child symptoms years later.

• Ingeborgrud, Christine Baalsrud; Ørbeck, Beate; Friis, Svein; Zeiner, Pål; Pripp, Are Hugo & Aase, Heidi [Show all 9 contributors for this article] (2023). Anxiety and depression from age 3 to 8 years in children with and without ADHD symptoms. Scientific Reports. 13(1). doi: 10.1038/s41598-023-42412-7. Full text in Research Archive Show summary

  Abstract Childhood anxiety and depressive symptoms may be influenced by symptoms of attention deficit/hyperactivity disorder (ADHD). We investigated whether parent- and teacher-reported anxiety, depressive and ADHD symptoms at age 3 years predicted anxiety disorders and/or depression in children with and without ADHD at age 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. Parents of 3-year-olds were interviewed, and preschool teachers rated symptoms of anxiety disorders, depression and ADHD. At age 8 years (n = 783), Child Symptom Inventory-4 was used to identify children who fulfilled the diagnostic criteria for anxiety disorders and/or depression (hereinafter: Anx/Dep), and ADHD. Univariable and multivariable logistic regression analyses were used. In the univariable analyses, parent-reported anxiety, depressive and ADHD symptoms, and teacher-reported anxiety symptoms at age 3 years all significantly predicted subsequent Anx/Dep. In the multivariable analyses, including co-occurring symptoms at age 3 years and ADHD at 8 years, parent-reported anxiety and depressive symptoms remained significant predictors of subsequent Anx/Dep. At age 3 years, regardless of ADHD symptoms being present, asking parents about anxiety and depressive symptoms, and teachers about anxiety symptoms, may be important to identify children at risk for school-age anxiety disorders and/or depression.

• Gohar, Sherif Mostafa Mohamed Ahmed; Hegelstad, Wenche; Auestad, Bjørn Henrik; Haahr, Ulrik Helt; Joa, Inge & Johannessen, Jan Olav [Show all 13 contributors for this article] (2023). Association between early suicidal trajectories in first-episode psychosis and 10-year follow-up: TIPS registry-linked study. The Lancet Psychiatry. ISSN 2215-0374. 10(7), p. 528–536. doi: 10.1016/S2215-0366(23)00156-6. Full text in Research Archive
• Øvergaard, Kristin; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Aase, Heidi & Biele, Guido [Show all 9 contributors for this article] (2023). Early and repeated screening detects children with persistent attention-deficit/hyperactivity disorder. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-023-02284-8. Full text in Research Archive Show summary

  Abstract Preschool screening of attention-deficit/hyperactivity disorder (ADHD) has been found too inaccurate to be clinically useful. This may be due to the known instability of ADHD symptoms from preschool onwards, and the use of a single screening only. We hypothesized that by identifying a group of children with persistent ADHD from preschool to school age and repeating the screening, the clinical usefulness of screening would increase. This study is part of the prospective longitudinal, population-based Norwegian Mother, Father and Child Cohort Study, with a diagnostic parent interview at 3.5 years and follow-up with parent questionnaires at ages 5 and 8 years ( n  = 707). We identified a group classified with ADHD at all three time points (persistent ADHD). We then used the Child Behavior Checklist ADHD DSM-oriented scale at ages 3.5 and 5 years to investigate the accuracies of single- and two-stage screening at different thresholds to identify children with persistent ADHD. About 30% of the children were classified with ADHD at least once across time (at ages 3.5, 5, and/or 8 years), but only 4% ( n  = 30) had persistent ADHD. At all thresholds, the two-stage screening identified children with persistent ADHD more accurately than single screening, mainly due to a substantial reduction in false positives. Only a small group of children were classified with persistent ADHD from preschool to school age, underlining that future screening studies should distinguish this group from those with fluctuating symptoms when estimating screening accuracies. We recommend a two-stage screening process to reduce false positives.

• Øvergaard, Kristin; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Aase, Heidi & Biele, Guido [Show all 9 contributors for this article] (2022). Attention-deficit/hyperactivity disorder from preschool to school age: change and stability of parent and teacher reports. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-022-02019-1. Full text in Research Archive Show summary

  Abstract Identifying attention-deficit/hyperactivity disorder (ADHD) in pre-schoolers may improve their development if treated, but it is unclear whether ADHD symptoms from this age are stable enough to merit treatment. We aimed to investigate the stability of parent- and teacher-reported ADHD symptoms and ADHD classified above the diagnostic symptom thresholds, including for hyperactivity-impulsivity (HI), inattention and combined presentations from age 3 to 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. At child age 3 years, parents were interviewed and teachers rated ADHD symptoms. At age 8 years, parents ( n  = 783) and teachers ( n  = 335) reported ADHD symptoms by the Child Symptom Inventory-4. We found a significant reduction in the mean number of parent-reported ADHD and HI symptoms from age 3 to 8 years, but otherwise similar mean numbers. Parent-reported ADHD symptoms were moderately correlated between ages, while correlations were low for teachers. A total of 77/108 (71%) of the children classified with parent-reported HI presentation at age 3 years were no longer classified within any ADHD presentation at age 8 years, the only clear trend across time for either informant. There was a low to moderate parent–teacher-agreement in the number of reported symptoms, and very low informant agreement for the classified ADHD presentations. Overall, clinicians should exercise caution in communicating concern about HI symptoms in preschool children. Age 3 years may be too early to apply the ADHD diagnostic symptom criteria, especially if parents and teachers are required to agree.

• Biele, Guido; Øvergaard, Kristin Romvig; Friis, Svein; Zeiner, Pål & Aase, Heidi (2022). Cognitive, emotional, and social functioning of preschoolers with attention deficit hyperactivity problems. BMC Psychiatry. 22. doi: 10.1186/s12888-021-03638-9. Full text in Research Archive
• Biele, Guido; Lekhal, Ratib; Øvergaard, Kristin Romvig; Wang, Mari Vaage; Brandlistuen, Ragnhild Eek & Friis, Svein [Show all 7 contributors for this article] (2022). The effect of special educational assistance in early childhood education and care on psycho-social difficulties in elementary school children. Child and Adolescent Psychiatry and Mental Health (CAPMH). 16. doi: 10.1186/s13034-022-00442-5. Full text in Research Archive Show summary

  Background Three to seven percent of pre-schoolers have developmental problems or child psychiatric disorders. Randomized controlled trials (RCTs) indicate that interventions in early childhood education and care (ECEC) improve long-term outcomes of children from disadvantaged backgrounds. It is unknown if such effects generalize beyond the well-structured context of RCTs and to children who may not have a disadvantaged background but have developmental problems or psychiatric disorders. Methods We used data from the population-based Norwegian Mother, Father and Child Cohort Study, recruiting pregnant women from 1999 to 2009, with child follow-up from ages 6, 18, and 36 months to ages 5, 7, and 8 years. This sub-study included 2499 children with developmental problems or psychiatric disorders at age five. We investigated the effects of special educational assistance at age five on mother-reported internalizing, externalizing, and communication problems at age eight. We analysed bias due to treatment by indication with directed acyclic graphs, adjusted for treatment predictors to reduce bias, and estimated effects in different patient groups and outcome domains with a hierarchical Bayesian model. Results In the adjusted analysis, pre-schoolers who received special educational assistance had on average by 0.1 (0.04–0.16) standardised mean deviation fewer psycho-social difficulties in elementary school. Conclusion In a sample of children from mostly higher socioeconomic backgrounds we estimate a positive effects of special educational assistance during the transition from preschool to the school years. It may therefore be considered as an intervention for pre-schoolers with developmental or behaviour problems. More research with improved measurements of treatment and outcomes is needed to solidify the findings and identify success factors for the implementation of special educational assistance in ECEC.

• Øvergaard, Kristin Romvig; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Aase, Heidi & Zeiner, Pål (2021). Predictive validity of attention-deficit/hyperactivity disorder from ages 3 to 5 Years. European Child and Adolescent Psychiatry. ISSN 1018-8827. 31, p. 1093–1102. doi: 10.1007/s00787-021-01750-5. Full text in Research Archive Show summary

  We investigated to what extent parent-rated attention-deficit/hyperactivity disorder (ADHD) and impairment at age 3 years predicted elevated ADHD symptoms at age 5 years, and whether teacher-rated ADHD symptoms improved these predictions. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. Parents of 3-year-old children (n = 1195) were interviewed about ADHD and impairment, and teachers rated child ADHD symptoms by the Strengths and Difficulties Questionnaire or the Early Childhood Inventory-4. At 5 years of age, the children (n = 957) were classified as ADHD-positive or -negative using Conners’ Parent Rating Scale. Relying solely on parent-rated ADHD or impairment at age 3 years did moderately well in identifying children with persistent elevation of ADHD symptoms, but gave many false positives (positive predictive values (PPVs): .40–.57). A small group of children (n = 20, 13 boys) scored above cut-off on both parent-rated ADHD and impairment, and teacher-rated ADHD symptoms, although adding teacher-rated ADHD symptoms slightly weakened the predictive power for girls. For this small group, PPVs were .76 for boys and .64 for girls. Limiting follow-up to these few children will miss many children at risk for ADHD. Therefore, we recommend close monitoring also of children with parent-reported ADHD symptoms and/or impairment to avoid delay in providing interventions. Clinicians should also be aware that teachers may miss ADHD symptoms in preschool girls.

• Vaskinn, Anja; Sundet, Kjetil; Melle, Ingrid; Andreassen, Ole A. & Friis, Svein (2021). The factor structure of social cognition in schizophrenia: Weak evidence for separable domains. Schizophrenia Research: Cognition. 26, p. 1–4. doi: 10.1016/j.scog.2021.100208. Full text in Research Archive Show summary

  This study examined the factor structure of social cognition in a Norwegian sample of individuals diagnosed with schizophrenia (n = 83). Eight variables from three social cognitive tests from three theoretical domains were included: emotion processing, social perception and theory of mind. Factor analysis with maximum likelihood extraction and oblique rotation resulted in two factors using Kaiser's criterion. Although the two-factor model had better fit than a unifactorial model, it did not represent the data well. Two social cognitive variables did not load on either factor. The two extracted factors did not correspond to an expected distinction between low and high level of processing or between affective and cognitive processes. A non-negligible number of nonredundant residuals between observed and computed correlations suggested poor model fit. In conclusion, this study failed to identify separable dimensions of social cognition in spite of including measures from different theoretical domains.

• Ruud, Torleif & Friis, Svein (2021). Community-based Mental Health Services in Norway. Consortium Psychiatricum. ISSN 2712-7672. 2(1), p. 47–54. doi: 10.17816/CP43. Full text in Research Archive
• Ottesen, Akiah; Hegelstad, Wenche; Joa, Inge; Opjordsmoen, Stein E.; Rund, Bjørn Rishovd & Røssberg, Jan Ivar [Show all 13 contributors for this article] (2021). Childhood trauma, antipsychotic medication, and symptom remission in first-episode psychosis. Psychological Medicine. ISSN 0033-2917. p. 1–10. doi: 10.1017/S003329172100427X. Full text in Research Archive Show summary

  Background: To what extent psychotic symptoms in first-episode psychosis (FEP) with a history of childhood interpersonal trauma (CIT) are less responsive to antipsychotic medication is not known. In this longitudinal study, we compare symptom trajectories and remission over the first 2 years of treatment in FEP with and without CIT and examine if differences are linked to the use of antipsychotics. Methods: FEP (N = 191) were recruited from in- and outpatient services 1997–2000, and assessed at baseline, 3 months, 1 and 2 years. Inclusion criteria were 15–65 years, actively psychotic with a DSM-IV diagnosis of psychotic disorder and no previous adequate treatment for psychosis. Antipsychotic medication is reported as defined daily dosage (DDD). CIT (<18) was assessed with the Brief Betrayal Trauma Survey, and symptomatic remission based on scores from the Positive and Negative Syndrome Scale. Results: CIT (n = 63, 33%) was not associated with symptomatic remission at 2 years follow-up (71% in remission, 14% in relapse), or time to first remission (CIT 12/ no-CIT 9 weeks, p = 0.51). Those with CIT had significantly more severe positive, depressive, and excited symptoms. FEP with physical (N = 39, 20%) or emotional abuse (N = 22, 14, 7%) had higher DDD at 1 year (p < 0.05). Mean DDD did not excerpt a significant between-group effect on symptom trajectories of positive symptoms. Conclusion: Results indicate that antipsychotic medication is equally beneficial in the achievement of symptomatic remission in FEP after 2 years independent of CIT. Still, FEP patients with CIT had more severe positive, depressive, and excited symptoms throughout.

• Overgaard, Kristin Romvig; Ørbeck, Beate; Wagner, Karine; Friis, Svein; Øhre, Beate & Zeiner, Pål (2021). Youth with hearing loss: Emotional and behavioral problems and quality of life. International Journal of Pediatric Otorhinolaryngology. ISSN 0165-5876. 145. doi: 10.1016/j.ijporl.2021.110718. Full text in Research Archive
• Wedervang-Resell, Kirsten; Ueland, Thor; Aukrust, Pål; Friis, Svein; Holven, Kirsten Bjørklund & Johannessen, Cecilie Haggag [Show all 13 contributors for this article] (2020). Reduced levels of circulating adhesion molecules in adolescents with early-onset psychosis. Nature NPJ Schizophrenia. 6, p. 1–8. doi: 10.1038/s41537-020-00112-5. Full text in Research Archive Show summary

  It is suggested that neurodevelopmental abnormalities are involved in the disease mechanisms of psychotic disorders. Although cellular adhesion molecules (CAMs) participate in neurodevelopment, modulate blood–brain barrier permeability, and facilitate leukocyte migration, findings concerning their systemic levels in adults with psychosis are inconsistent. We examined plasma levels and mRNA expression in peripheral blood mononuclear cells (PBMCs) of selected CAMs in adolescents with early-onset psychosis (EOP) aged 12–18 years (n = 37) and age-matched healthy controls (HC) (n = 68). EOP patients exhibited significantly lower circulating levels of soluble platelet selectin (~−22%) and soluble vascular cell adhesion molecule-1 (~−14%) than HC. We found no significant associations with symptom severity. PSEL mRNA expression was increased in PBMCs of patients and significantly negatively correlated to duration of illness. These findings suggest a role for CAMs in the pathophysiology of psychotic disorders.

• Srihari, Vinod H.; Guloksuz, Sinan & Friis, Svein (2020). Natural History, Not Lead Time. American Journal of Psychiatry. ISSN 0002-953X. 177(12), p. 1185–1185. doi: 10.1176/appi.ajp.2020.20040402. Full text in Research Archive
• Ferrara, Maria; Guloksuz, Sinan; Li, Fangyong; Burke, Shadie; Tek, Cenk & Friis, Svein [Show all 12 contributors for this article] (2019). Parsing the impact of early detection on duration of untreated psychosis (DUP): Applying quantile regression to data from the Scandinavian TIPS study. Schizophrenia Research. ISSN 0920-9964. 210, p. 128–134. doi: 10.1016/j.schres.2019.05.035. Full text in Research Archive
• Wedervang-Resell, Kirsten; Friis, Svein; Lonning, Vera Louise Hiorth; Smelror, Runar; Johannessen, Cecilie Haggag & Agartz, Ingrid [Show all 10 contributors for this article] (2019). Lipid alterations in adolescents with early-onset psychosis may be independent of antipsychotic medication. Schizophrenia Research. ISSN 0920-9964. p. 1–7. doi: 10.1016/j.schres.2019.11.039. Full text in Research Archive Show summary

  Background Dyslipidemia and insulin resistance (HOMA-IR) are cardiovascular risk factors prevalent in patients with psychosis. Whether these factors are intrinsic or affected by lifestyle or antipsychotic medication (AP) is unclear. Therefore, we investigated lipid profiles, HOMA-IR, and psychotic phenotypes in patients aged 12–18 years with early-onset psychosis (EOP) with and without AP exposure. Method We measured fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG), insulin, and glucose in patients with EOP (n = 39) and healthy controls (HC) (n = 66). Diet information was not available. Negative symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). We used univariate analysis of variance to compare TC/HDL-C ratios and TG and HOMA-IR values, controlling for body mass index (BMI) and AP exposure. We assessed the explained variance of having EOP using multiple regression analysis. Results Patients with and without AP exposure had significantly higher TC/HDL-C (p = 0.003, p = 0.029) and TG values (p < 0.001, p = 0.021) than HC. Significantly increased HOMA-IR scores were found only in AP-exposed patients (p = 0.037). EOP significantly increased the explained variance for TC/HDL-C and TG, but not for HOMA-IR. Patients with a PANSS negative score > 21 had significantly higher levels of TG than those with low scores (p = 0.032). Conclusion Our results suggest that lipid alterations predate AP treatment in adolescents with EOP. Higher levels of negative symptoms and AP further increase metabolic risk. The preliminary findings propose that subclinical dyslipidemia may be intrinsic to EOP.

• Øvergaard, Kristin Romvig; Ørbeck, Beate; Friis, Svein; Biele, Guido; Pripp, Are Hugo & Aase, Heidi [Show all 7 contributors for this article] (2019). Screening With an ADHD-Specific Rating Scale in Preschoolers: A Cross-Cultural Comparison of the Early Childhood Inventory-4. Psychological Assessment. ISSN 1040-3590. 31(8), p. 985–994. doi: 10.1037/pas0000722. Full text in Research Archive
• Weibell, Melissa Anne E; Johannessen, Jan Olav; Auestad, Bjørn Henrik; Bramness, Jørgen Gustav; Brønnick, Kolbjørn Kallesten & Haahr, Ulrik [Show all 17 contributors for this article] (2019). Early substance use cessation improves cognition-10 years outcome in first-episode psychosis patients. Frontiers in Psychiatry. 10. doi: 10.3389/fpsyt.2019.00495. Full text in Research Archive Show summary

  Background: Cognitive impairment may be a risk factor for, as well as a consequence of, psychosis. Non-remitting symptoms, premorbid functioning, level of education, and socioeconomic background are known correlates. A possible confounder of these associations is substance use, which is common among patients with psychosis and linked to worse clinical outcomes. Studies however show mixed results for the effect of substance use on cognitive outcomes. In this study, the long-term associations of substance use with cognition in a representative sample of first-episode psychosis patients were examined. Methods: The sample consisted of 195 patients. They were assessed for symptom levels, function, and neurocognition at 1, 2, 5, and 10 years after first treatment. Test scores were grouped into factor analysis-based indices: motor speed, verbal learning, visuomotor processing, verbal fluency, and executive functioning. A standardized composite score of all tests was also used. Patients were divided into four groups based on substance-use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users, and nonusers. Data were analyzed using linear mixed effects modeling. Results: Gender, premorbid academic functioning, and previous education were the strongest predictors of cognitive trajectories. However, on motor speed and verbal learning indices, patients who stopped using substances within the first 2 years of follow-up improved over time, whereas the other groups did not. For verbal fluency, the longitudinal course was parallel for all four groups, while patients who stopped using substances demonstrated superior performances compared with nonusers. Persistent users demonstrated impaired visuomotor processing speed compared with nonusers. Within the stop- and episodic use groups, patients with narrow schizophrenia diagnoses performed worse compared with patients with other diagnoses on verbal learning and on the overall composite neurocognitive index. Discussion: This study is one of very few long-term studies on cognitive impairments in first-episode psychosis focusing explicitly on substance use. Early cessation of substance use was associated with less cognitive impairment and some improvement over time on some cognitive measures, indicating a milder illness course and superior cognitive reserves to draw from in recovering from psychosis.

• Wedervang-Resell, Kirsten; Friis, Svein; Lonning, Vera Louise Hiorth; Smelror, Runar; Johannessen, Cecilie Haggag & Reponen, Elina Johanna [Show all 13 contributors for this article] (2019). Increased interleukin 18 activity in adolescents with early-onset psychosis is associated with cortisol and depressive symptoms. Psychoneuroendocrinology. ISSN 0306-4530. 112:104513, p. 1–7. doi: 10.1016/j.psyneuen.2019.104513. Full text in Research Archive Show summary

  <i>Objective</i> - Evidence indicates that the pathophysiology of adult psychosis involves immune dysregulation, but its associations with stress are often not considered. The inflammatory cytokine interleukin (IL)-18, which is elevated in adult schizophrenia, is suggested to be sensitive to stress. We compared the associations of IL-18 with cortisol and clinical variables in adolescents with early-onset psychosis (EOP) aged 12–18 years and age-matched healthy controls (HC).<p> <p><i>Method</i> - We measured serum IL-18, IL-18 binding protein (IL-18BP), IL-18 receptor accessory protein (IL-18RAP), IL-18 receptor 1 (IL-18R1) and cortisol, and calculated the IL-18/IL-18BP ratio in patients (n = 31) and HC (n = 60). Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale and depressive symptoms by the Mood and Feelings Questionnaire-Child version (MFQ-C). Bivariate correlation analysis was used to explore relationships between IL-18/IL-18BP ratio and cortisol, depression and other clinical characteristics. Hierarchical multiple linear regression analysis was used to assess their individual contributions to the variance of the IL-18/IL-18BP ratio.<p> <p><i>Results</i> - Patients had significantly higher IL-18 levels and IL-18/IL-18BP ratios than HC, but similar IL-18BP, IL-18RAP and IL-18R1. Both cortisol (R² change = 0.05) and the MFQ-C score (R² change = 0.09) contributed significantly to the variance in IL-18/IL-18BP ratios after controlling for confounders.<p> <p><i>Conclusion</i> - We found increased IL-18 system activity in adolescents with EOP. Cortisol and depressive symptoms each contributed to the variance in the IL-18/IL-18BP ratio. Our findings support activation of inflammatory pathways in adolescent psychosis and suggest interactions between stress, inflammation and depressive symptoms in EOP.

• Øvergaard, Kristin Romvig; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Biele, Guido & Aase, Heidi [Show all 7 contributors for this article] (2018). Attention-Deficit/Hyperactivity Disorder in Preschoolers: The Accuracy of a Short Screener. Journal of the American Academy of Child and Adolescent Psychiatry. ISSN 0890-8567. 57(6), p. 428–435. doi: 10.1016/j.jaac.2018.03.008. Full text in Research Archive Show summary

  Objective Although early and accurate screening is required for the remediation of attention-deficit/hyperactivity disorder (ADHD), possible gender differences have not been extensively studied. We examined the classification accuracy of the parent and preschool teacher version of the Strengths and Difficulties Questionnaire (SDQ) hyperactivity−inattention (HI) subscale in girls and boys. Method The study was part of the Norwegian Mother and Child Cohort Study (MoBa). Parents and preschool teachers rated a total of 238 girls and 276 boys (mean age 3.5 years) with the SDQ HI subscale. Blinded to the parent and teacher ratings, interviewers classified the children by ADHD diagnoses with the Preschool Age Psychiatric Assessment Interview. Results Areas under the curves for the parent HI subscale scores were good for both girls and boys (0.87 and 0.80, respectively). Preschool teacher classifications were fair (0.76) for girls and poor (0.62) for boys, a significant difference (p = .017). The subscale accurately identified children without ADHD at low parent scores (≤4), and fairly accurately identified ADHD at high scores (≥9), with maximum probabilities of finding true cases of 0.75 in girls and 0.55 in boys. Intermediate scores gave the best balance between sensitivity and specificity with low probabilities of correctly identifying children with ADHD. Conclusion The parental SDQ HI subscale was useful for screening for ADHD in preschool girls and boys. For preschool teachers, the subscale was useful for screening girls.

• Moore, Jennifer; Friis, Svein; Graham, Ian D.; Gundersen, Elisabeth & Nordvik, Jan Egil (2018). Reported use of evidence in clinical practice: A survey of rehabilitation practices in Norway. BMC Health Services Research. 18(379). doi: 10.1186/s12913-018-3193-8. Full text in Research Archive Show summary

  Background The South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway’s population. Physical medicine and rehabilitation services are provided by 9 public hospital trusts and 30 private rehabilitation facilities. The purposes of this study were to conduct a psychometric analysis of the EBP Implementation Scale (EBPIS) and describe rehabilitation clinicians’ self-reported 1) use of evidence-based practices (EBPs), 2) use of EBPs across hospitals, and 3) determine factors associated with use of EBPs in the South Eastern Health Region in Norway. Methods A cross-sectional study using an online survey was conducted with public hospitals and private rehabilitation centers. The survey, which was distributed throughout the region, included the EBPIS, 8 questions related to EBP in the health region, and demographics. Response frequencies were calculated and described. Internal consistency and factor structure of the EBPIS and its subscales were determined. Associations and differences in groups with similar demographics, EBPIS scores, and use of EBPs were identified. Results A total of 316 individuals completed the survey, including allied health clinicians, nurses, psychologists, social workers, and physicians. The EBPIS mean score was 30/72. A factor analysis identified that the EBPIS can be divided into 3 subscales: literature search and critical appraisal (α = .80), knowledge sharing (α = .83), and practice evaluation (α = .74). EBP activities reported were primarily related to literature searches, critical appraisal, and discussing evidence. Approximately 65 and 75% of respondents agreed that the same OMs and evidence based interventions were used within the local clinic respectively. Fewer agreed that the same OMs (13%) and evidence-based interventions (39%) are used regionally. Conclusion The EBPIS and its subscales demonstrated excellent internal consistency. Practice variability exists in rehabilitation throughout Southeastern Norway. An increased emphasis on use of EBP throughout the region is needed.

• Gardsjord, Erlend Strand; Romm, Kristin Lie; Røssberg, Jan Ivar; Friis, Svein; Barder, Helene & Evensen, Julie Horgen [Show all 17 contributors for this article] (2018). Depression and functioning are important to subjective quality of life after a first episode psychosis. Comprehensive Psychiatry. ISSN 0010-440X. 86, p. 107–114. doi: 10.1016/j.comppsych.2018.07.014. Full text in Research Archive
• Øvergaard, Kristin Romvig; Madsen, Kathrine Bang; Ørbeck, Beate; Friis, Svein & Obel, Carsten (2018). The predictive validity of the Strengths and Difficulties Questionnaire for child attention-deficit/hyperactivity disorder. European Child and Adolescent Psychiatry. ISSN 1018-8827. 28(5), p. 625–633. doi: 10.1007/s00787-018-1226-9. Full text in Research Archive
• Gardsjord, Erlend Strand; Romm, Kristin Lie; Røssberg, Jan Ivar; Friis, Svein; Barder, Helene & Evensen, Julie Horgen [Show all 18 contributors for this article] (2017). Is going into stable symptomatic remission associated with a more positive development of life satisfaction? A 10-year follow-up study of first episode psychosis. Schizophrenia Research. ISSN 0920-9964. 193, p. 364–369. doi: 10.1016/j.schres.2017.07.006. Full text in Research Archive
• Furre, Astrid; Falk, Ragnhild Sørum; Sandvik, Leiv; Friis, Svein; Knutzen, Maria & Hanssen-Bauer, Ketil (2017). Characteristics of adolescents frequently restrained in acute psychiatric units in Norway: A nationwide study. Child and Adolescent Psychiatry and Mental Health (CAPMH). 11(1). doi: 10.1186/s13034-016-0136-1. Full text in Research Archive Show summary

  Background The use of restraints in adolescent psychiatric settings requires particular professional, ethical, and legal considerations. The purpose of this study was to investigate whether the number of restraint episodes per patient was related to any of several characteristics of the adolescents. Methods In this nationwide study, we included all adolescents restrained during the period 2008–2010 (N = 267) in Norwegian adolescent acute psychiatric inpatient units. They constitute 6.5% of the adolescents hospitalized in these units in the same period of time. We collected data on the number of restraint episodes they experienced during the study period; Poisson regression was then used to analyze the impact of gender, social, mental health, and treatment characteristics on the frequency of restraint. We developed a risk index for the likelihood of experiencing multiple restraint episodes. Results We found a skewed distribution of restraint episodes in which a small group (18%) of restrained adolescents experienced a majority (77%) of the restraint episodes. A large percentage of the restrained adolescents (36%) experienced only one restraint episode. Risk factors for multiple restraint episodes were female gender, lower psychosocial functioning (Children’s Global Assessment Scale below 35), more and longer admissions, and concomitant use of pharmacological restraint. Except for gender, we used these variables to develop a risk index that was moderately associated with multiple restraint episodes. Conclusions As a small group of patients accounted for a large percentage of the restraint episodes, future research should further investigate the reasons for and consequences of multiple restraint episodes in patients at acute adolescent psychiatric units, and evaluate preventive approaches targeted to reduce their risk for experiencing restraint.

• Falkum, Erik; Klungsøyr, Ole; Lystad, June Ullevoldsæter; Bull, Helen Christine; Evensen, Stig & Martinsen, Egil Wilhelm [Show all 8 contributors for this article] (2017). Vocational rehabilitation for adults with psychotic disorders in a Scandinavian welfare society. BMC Psychiatry. 17:24, p. 1–11. doi: 10.1186/s12888-016-1183-0. Full text in Research Archive Show summary

  Background: This study examined the outcomes of a vocational rehabilitation program (The Job Management Program, JUMP) for persons with psychotic disorders based on close collaboration between health and welfare services. Methods: Participants (N = 148) with broad schizophrenia spectrum disorders (age 18–65) were recruited from six counties in Norway. Three counties were randomized to vocational rehabilitation augmented with cognitive behaviour therapy (CBT), while the remaining three counties were randomized to vocational rehabilitation augmented with cognitive remediation (CR). This paper compares the vocational activity of the total group of JUMP participants with a treatment as usual group (N = 341), and further examines differences between the two JUMP interventions. Employment status (working/not working) was registered at the time of inclusion and at the end of the intervention period. Results: The total number of JUMP participants in any kind of vocational activity increased from 17 to 77% during the intervention. Of these, 8% had competitive employment, 36% had work placements in ordinary workplaces with social security benefits as their income, and 33% had sheltered work. The total number of working participants in the TAU group increased from 15.5 to 18.2%. The JUMP group showed significant improvements of positive (t = −2. 33, p = 0.02) and general (t = −2.75, p = 0.007) symptoms of psychosis. Significant differences between the CBT and CR interventions were not demonstrated. Conclusions: The study supports existing evidence that the majority of persons with broad schizophrenia spectrum disorders can cope with some kind of work, given that internal and external barriers are reduced. Those who wish to work should be offered vocational rehabilitation.

• Weibell, Melissa Anne; Hegelstad, Wenche; Auestad, Bjørn Henrik; Bramness, Jørgen Gustav; Evensen, Julie Horgen & Haahr, Ulrik [Show all 17 contributors for this article] (2017). The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis. Schizophrenia Bulletin. ISSN 0586-7614. 43(4), p. 843–851. doi: 10.1093/schbul/sbw179. Full text in Research Archive
• Melle, Ingrid; Johannessen, Jan Olav; Haahr, Ulrik H.; Hegelstad, Wenche; Joa, Inge & Langeveld, Johannes H. [Show all 15 contributors for this article] (2017). Causes and predictors of premature death in first-episode schizophrenia spectrum disorders. World Psychiatry. ISSN 1723-8617. 16(2), p. 217–218. doi: 10.1002/wps.20431. Full text in Research Archive
• Langeveld, Johannes H.; Bjørkly, Stål; Evensen, Julie Horgen; Joa, Inge; Johannessen, Jan Olav & Larsen, Tor Ketil [Show all 15 contributors for this article] (2017). A 10-year follow-up study of violent victimization in first episode psychosis : risk and protective factors. Psychiatry Research. ISSN 0165-1781. 259(January), p. 545–549. doi: 10.1016/j.psychres.2017.11.013. Full text in Research Archive Show summary

  Violent victimization in persons with severe mental illness has long-term adverse consequences. Little is known about the long-term prevalence of victimization in first episode psychosis, or about factors affecting victimization throughout the course of illness. To assess the prevalence of violent victimization during a 10-year follow-up period in a group of first episode psychosis (FEP) patients, and to identify early predictors and risk factors for victimization. A prospective design was used with comprehensive assessments of violent victimization, treatment variables and functioning at baseline and during 10-year follow-up. A clinical epidemiological sample of FEP patients (n= 298) was studied. FEP patients in our study were at a 3.5 times greater risk of victimization as compared to the normal population. During the 10-year follow-up period, 23% of subjects fell victim to one or more violent assaults. Victimized patients were younger and reported less occupational activity. At 10-year follow-up, victimization was associated with more concomitant drug use, alcohol misuse and violent behavior, but not with a worse clinical or functional outcome. Treatment programs should focus on risk factors for victimization and develop behavioral alternatives to mitigate risk in FEP patients.

• Bendiksen, Bothild; Svensson, Elisabeth; Aase, Heidi; Reichborn-Kjennerud, Ted; Friis, Svein & Myhre, Anne Margrethe [Show all 7 contributors for this article] (2017). Co-Occurrence of ODD and CD in Preschool Children With Symptoms of ADHD. Journal of Attention Disorders. ISSN 1087-0547. 21(9), p. 741–752. doi: 10.1177/1087054714538655. Full text in Research Archive
• Haahr, Ulrik Helt; Larsen, Tor Ketil; Simonsen, Erik; Rund, Bjørn Rishovd; Joa, Inge & Røssberg, Jan Ivar [Show all 16 contributors for this article] (2016). Relation between premorbid adjustment, duration of untreated psychosis and close interpersonal trauma in first-episode psychosis. Early Intervention in Psychiatry. ISSN 1751-7885. 12(3), p. 316–323. doi: 10.1111/eip.12315. Full text in Research Archive
• Gardsjord, Erlend Strand; Romm, Kristin Lie; Friis, Svein; Barder, Helene; Evensen, Julie Horgen & Haahr, Ulrik [Show all 18 contributors for this article] (2016). Subjective quality of life in first-episode psychosis. A ten year follow-up study. Schizophrenia Research. ISSN 0920-9964. 172(1-3), p. 23–28. doi: 10.1016/j.schres.2016.02.034. Full text in Research Archive
• Rund, Bjørn Rishovd; Barder, Helene; Evensen, Julie Horgen; Haahr, Ulrik; Hegelstad, Wenche & Joa, Inge [Show all 17 contributors for this article] (2016). Neurocognition and Duration of Psychosis: A 10-year Follow-up of First-Episode Patients. Schizophrenia Bulletin. ISSN 0586-7614. 42(1), p. 87–95. doi: 10.1093/schbul/sbv083. Full text in Research Archive
• Kvåle, Alice; Bunkan, Berit Heir; Ilner, Stein E. Opjordsmoen & Friis, Svein (2016). The Global Body Examination (GBE): A useful instrument for examination of patients with long-lasting musculoskeletal and/or psychological disorders. European Journal of Physiotherapy. ISSN 2167-9169. 18(2), p. 137–143. doi: 10.3109/21679169.2016.1149217. Full text in Research Archive
• Furre, Astrid; Sandvik, Leiv; Friis, Svein; Knutzen, Maria & Hanssen-Bauer, Ketil (2016). A nationwide study of why and how acute adolescent psychiatric units use restraint. Psychiatry Research. ISSN 0165-1781. 237, p. 60–66. doi: 10.1016/j.psychres.2016.01.067. Full text in Research Archive
• Bjerke, Espen; Solbakken, Ole Andre; Friis, Svein & Monsen, Jon Trygve (2016). Self-Relatedness and Interpersonal Problems in a Large Psychiatric Outpatient Sample. PSYCHOLOGY. ISSN 2152-7180. 7, p. 864–876. doi: 10.4236/psych.2016.76088. Full text in Research Archive
• Hegelstad, Wenche; Brønnick, Kolbjørn Selvåg; Barder, Helene; Evensen, Julie Horgen; Haahr, Ulrik & Joa, Inge [Show all 17 contributors for this article] (2016). Preventing poor vocational functioning in psychosis through early intervention. Psychiatric Services. ISSN 1075-2730. 68(1), p. 100–103. doi: 10.1176/appi.ps.201500451. Full text in Research Archive
• Nilsen, Liv; Norheim, Irene; Frich, Jan C; Friis, Svein & Røssberg, Jan Ivar (2015). Challenges for group leaders working with families dealing with early psychosis: a qualitative study. BMC Psychiatry. 15. doi: 10.1186/s12888-015-0540-8. Full text in Research Archive Show summary

  Background Family work is one of the best researched psychosocial interventions for patients with chronic psychosis. However, family work is less studied for patients with a first episode psychosis and the studies have revealed contradicting results. To our knowledge, no previous studies have examined qualitatively group leaders’ experiences with family work. In the present study we wanted to explore challenges faced by mental health professionals working as group leaders for family interventions with first episode psychosis patients. Method A qualitative exploratory study was carried out based on digitally recorded in-depth interviews and a focus group interview with nine experienced mental health professionals. The interviews were transcribed in a slightly modified verbatim mode and analysed by systematic text condensation. Results Challenges faced by group leaders was classified into six categories: (1) Motivating patients to participate, encouraging potential participants was demanding and time-consuming; (2) Selecting participants by identifying those who can form a functional group and benefit from the intervention; (3) Choosing group format to determine whether a single or multi-family group is best for the participants; (4) Preserving patient independence, while also encouraging them to participate in the intervention; (5) Adherence to the protocol, while customizing adjustments as needed; (6) Fostering good problem-solving by creating a fertile learning environment and choosing the most appropriate problem to solve. Conclusions Group leaders face challenges related to recruitment and selection of participants for family work, as well as in conducting sessions. Awareness of these challenges could help health professionals more specifically to tailor the intervention to the specific needs of patients and their families.

• Bendiksen, Bothild; Aase, Heidi; Diep, Lien My; Svensson, Elisabeth; Friis, Svein & Zeiner, Pål (2015). The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler's Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety. Journal of Attention Disorders. ISSN 1087-0547. doi: 10.1177/1087054715616185. Full text in Research Archive Show summary

  Objective: The objective of this article is to examine the associations between pre- and postnatal maternal distress and preschooler’s symptoms of ADHD, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and anxiety, by timing and gender. Method: Children, aged 3.5 years (N = 1,195), recruited from the Norwegian Mother and Child Cohort Study, were assessed with a semistructured parental psychiatric interview. Perinatal maternal symptoms of distress were assessed by Symptom Checklist (SCL-5); Poisson regression was used to examine the associations. Results: Mid-gestational maternal distress significantly increased the average number of child symptoms, ranging between 3.8% for ADHD hyperactive–impulsive (ADHD-HI) and 8.7% for anxiety. The combination of high maternal scores of distress both pre- and postnatally were associated with increased risk of child symptoms of anxiety (relative risk [RR] = 2.10; 95% confidence interval [CI] = [1.43, 3.07]), CD (RR = 1.83; 95% CI = [1.33, 2.51]), and ODD (RR = 1.30; 95% CI = [1.03, 1.64]), with minor sex differences. Conclusion: Maternal distress during mid-gestation was associated with ADHD, behavioral, and emotional symptoms in preschool children. Continued exposure into the postnatal period may further increase these risk associations .

• Barder, Helene; Sundet, Kjetil Søren; Rund, Bjørn Rishovd; Evensen, Julie Horgen; Haahr, Ulrik & Hegelstad, Wenche [Show all 17 contributors for this article] (2015). Ten year course of IQ in first-episode psychosis: relationship between duration of psychsis and long-term intellectual trajectories. Psychiatry Research. ISSN 0165-1781. 225(3), p. 515–521. doi: 10.1016/j.psychres.2014.11.054. Full text in Research Archive
• Friis, Svein; Melle, Ingrid; Johannessen, Jan Olav; Røssberg, Jan Ivar; Barder, Helene & Evensen, Julie Horgen [Show all 16 contributors for this article] (2015). Early Predictors of Ten-Year Course in First-Episode Psychosis. Psychiatric Services. ISSN 1075-2730. 67(4), p. 438–443. doi: 10.1176/appi.ps.201400558. Full text in Research Archive
• Bendiksen, Bothild; Aase, Heidi; Svensson, Elisabeth; Friis, Svein; Myhre, Anne Margrethe & Reichborn-Kjennerud, Ted [Show all 7 contributors for this article] (2014). Impairment in young preschool children with symptoms of attention-deficit/hyperactivity disorder and co-occurring oppositional defiant disorder and conduct disorder. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. 2(3), p. 95–105. doi: 10.21307/sjcapp-2014-014. Full text in Research Archive
• Sønmez, Nasrettin; Røssberg, Jan Ivar; Evensen, Julie Horgen; Barder, Helene; Haahr, Ulrik & Hegelstad, Wenche [Show all 17 contributors for this article] (2014). Depressive symptoms in first-episode psychosis: A 10-year follow-up study. Early Intervention in Psychiatry. ISSN 1751-7885. 10(3), p. 227–233. doi: 10.1111/eip.12163. Full text in Research Archive
• Nilsen, Liv; Frich, Jan C; Friis, Svein; Norheim, Irene & Røssberg, Jan Ivar (2014). Participants' perceived benefits of family intervention following a first episode of psychosis: A qualitative study. Early Intervention in Psychiatry. ISSN 1751-7885. 10(2), p. 152–159. doi: 10.1111/eip.12153. Full text in Research Archive
• Bull, Helen Christine; Ueland, Toril; Lystad, June; Evensen, Stig; Friis, Svein & Martinsen, Egil Wilhelm [Show all 7 contributors for this article] (2014). Validation of the Work Behavior Inventory. Nordic Journal of Psychiatry. ISSN 0803-9488. 69(4), p. 300–306. doi: 10.3109/08039488.2014.973902. Full text in Research Archive
• Hegelstad, Wenche; Joa, Inge; Barder, Helene; Evensen, Julie Horgen; Haahr, Ulrik & Johannessen, Jan Olav [Show all 16 contributors for this article] (2014). Variation in duration of untreated psychosis in an 18-year perspective. Early Intervention in Psychiatry. ISSN 1751-7885. 8(4), p. 323–331. doi: 10.1111/eip.12057. Full text in Research Archive
• Furre, Astrid; Sandvik, Leiv; Heyerdahl, Sonja; Friis, Svein; Knutzen, Maria & Hanssen-Bauer, Ketil (2014). Characteristics of adolescents subjected to restraint in acute psychiatric units in Norway: A case-control study. Psychiatric Services. ISSN 1075-2730. 65(11), p. 1367–1372. doi: 10.1176/appi.ps.201300429. Full text in Research Archive
• Nilsen, Liv; Frich, Jan C; Friis, Svein & Røssberg, Jan Ivar (2014). Patients’ and family members’ experiences of a psychoeducational family intervention after a first episode psychosis: a qualitative study. Issues in Mental Health Nursing. ISSN 0161-2840. 35(1), p. 58–68. doi: 10.3109/01612840.2013.837992. Full text in Research Archive
• Knutzen, Maria; Bjørkly, Stål; Eidhammer, Gunnar; Lorentzen, Steinar; Mjøsund, Nina Helen & Ilner, Stein E. Opjordsmoen [Show all 8 contributors for this article] (2014). Characteristics of patients frequently subjected to pharmacological and mechanical restraint—A register study in three Norwegian acute psychiatric wards. Psychiatry Research. ISSN 0165-1781. 215(1), p. 127–133. doi: 10.1016/j.psychres.2013.10.024. Full text in Research Archive
• Langeveld, Johannes H.; Bjørkly, Stål; Auestad, Bjørn Henrik; Barder, Helene; Evensen, Julie Horgen & Hegelstad, Wenche [Show all 17 contributors for this article] (2014). Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study. Schizophrenia Research. ISSN 0920-9964. 156(2-3), p. 272–276. doi: 10.1016/j.schres.2014.04.010. Full text in Research Archive Show summary

  Background: First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. Aim: To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior. Method: A prospective design was used with comprehensive assessments of criminal behavior, drug abuse, clinical, social and treatment variables at baseline, five, and 10-year follow-up. Additionally, threatening and violent behavior was assessed at 10-year follow-up. A clinical epidemiological sample of first-episode psychosis patients (n= 178) was studied. Results: During the 10-year follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found to be predictive of violent behavior during the year preceding the 10-year follow-up. Conclusion: After treatment initiation, the overall prevalence of violence in psychotic patients drops gradually to rates close to those of the general population. However, persistent illicit drug abuse is a serious risk factor for violent behavior, even long after the start of treatment. Achieving remission early and reducing substance abuse may contribute to a lower long-term risk for violent behavior in FEP patients.

• Barder, Helene; Sundet, Kjetil Søren; Rund, Bjørn Rishovd; Evensen, Julie Horgen; Haahr, Ulrik & Hegelstad, Wenche [Show all 17 contributors for this article] (2013). Neurocognitive development in first episode psychosis 5 years follow-up: associations between illness severity and cognitive course. Schizophrenia Research. ISSN 0920-9964. 149(1-3), p. 63–69. doi: 10.1016/j.schres.2013.06.016. Full text in Research Archive Show summary

  Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity, as measured by relapses and diagnostic subgroups. The study is an extension of previous findings from the TIPS-project, reporting stability over the first two years. Sixty-two FEP patients (53% male, age 28 ± 9 years) were neuropsychologically examined at baseline and at 1, 2, and 5 year follow-ups. The test battery was divided into five indices; Verbal Learning, Executive Function, Impulsivity, Motor Speed, and Working Memory. To investigate the effect of illness severity, the sample was divided in groups based on number of relapses, and diagnostic subgroups, respectively. Impulsivity and Working Memory improved significantly in the first two years, followed by no change over the next three years. Motor Speed decreased significantly from 2 to 5 years. Number of relapses was significantly related to Verbal Learning and Working Memory, showing a small decrease and less improvement, respectively, in patients with two or more episodes. No significant association was found with diagnostic group. Neurocognitive stability as well as change was found in a sample of FEP-patients examined repeatedly over 5 years. Of potential greater importance for understanding how psychotic illnesses progress, is the finding of significant associations between neurocognition and number of relapses but not diagnostic group, indicating that neurocognition is more related to recurring psychotic episodes than to the descriptive diagnosis per se.

• Hegelstad, Wenche; Haahr, Ulrik; Larsen, Tor Ketil; Auestad, Bjørn Henrik; Barder, Helene & Evensen, Julie Horgen [Show all 17 contributors for this article] (2013). Early detection, early symptom progression and symptomatic remission after ten years in a first episode of psychosis study. Schizophrenia Research. ISSN 0920-9964. 143(2-3), p. 337–343. doi: 10.1016/j.schres.2012.10.027. Full text in Research Archive
• Færden, Ann; Barrett, Elizabeth Ann; Nesvåg, Ragnar; Friis, Svein; Finset, Arnstein & Marder, Stephen R. [Show all 10 contributors for this article] (2013). Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis. Psychiatry Research. ISSN 0165-1781. 210(1), p. 55–61. doi: 10.1016/j.psychres.2013.02.007. Full text in Research Archive
• Jónsdóttir, Halldóra; Ilner, Stein E. Opjordsmoen; Birkenæs, Astrid Brate; Simonsen, Carmen Elisabeth; Engh, John & Ringen, Petter Andreas [Show all 10 contributors for this article] (2013). Predictors of medication adherence in patients with schizophrenia and bipolar disorder. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 127(1), p. 23–33. doi: 10.1111/j.1600-0447.2012.01911.x. Full text in Research Archive
• Barder, Helene; Sundet, Kjetil Søren; Rund, Bjørn Rishovd; Evensen, Julie Horgen; Haahr, Ulrik & Hegelstad, Wenche [Show all 17 contributors for this article] (2013). Ten year neurocognitive trajectories in first-episode psychosis. Frontiers in Human Neuroscience. 7. doi: 10.3389/fnhum.2013.00643. Full text in Research Archive Show summary

  Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP subjects (51% male, 28 ± 9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. Results: The four neurocognitive indices showed overall stability over the 10 year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year [F(4, 38) = 5.8, p = 0.001, η2 = 0.40]. Conclusions: Main findings are long-term stability in neurocognitive functioning in FEP patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed.

• Kvåle, Alice; Bunkan, Berit Heir; Ilner, Stein E. Opjordsmoen & Friis, Svein (2013). Development of the Palpation Domain for Muscle and Skin in the Global Body Examination. Journal of Musculoskeletal Pain. ISSN 1058-2452. 21(1), p. 9–18. doi: 10.3109/10582452.2012.762821. Full text in Research Archive Show summary

  Objectives: To develop new scales within palpation of muscle and skin domains based on 16 items from the Global Physiotherapy Examination and 46 items from the Comprehensive Body Examination [CBE], and to investigate how well these new scales would discriminate between healthy individuals and different groups of patients, when compared with the original methods. Methods: Two physiotherapists independently examined 132 persons [34 healthy, 32 with localized pain, 32 with widespread pain, and 34 with psychoses]. Muscle and skin domains were studied separately. The numbers of items were reduced by omitting items with too high a correlation and by exploratory factor analysis [EFA]. Internal consistency was examined with Cronbach’s α. Discriminative validity was examined using the Mann–Whitney U-test and the area under the curve. Results: Only items from the left body half was included in the EFA, as very high correlation [mean r = 0.90] was found in the 23 bilateral palpation pairs in CBE. The initial 62 items were reduced to 11 for palpation of muscle and 5 for palpation of skin. Cronbach’s α was 0.88 for the subscales for Muscle and Skin. The new Palpation domain in the Global Body Examination showed excellent discriminative ability between healthy persons and the different patient groups [P < 0.001; area under the curve 0.81–0.94]. Patients with localized pain had significantly less muscular and skin aberration than patients with widespread pain. Conclusions: A new Global Body Examination Palpation domain with acceptable psychometric properties was developed. It had fewer items than the Global Physiotherapy Examination and CBE, but with almost the same discriminating ability.

• Knutzen, Maria; Bjørkly, Stål; Eidhammer, Gunnar; Lorentzen, Steinar; Mjøsund, Nina Helen & Ilner, Stein E. Opjordsmoen [Show all 8 contributors for this article] (2013). Mechanical and pharmacological restraints in acute psychiatric wards - why and how are they used? Psychiatry Research. ISSN 0165-1781. 209(1), p. 91–97. doi: 10.1016/j.psychres.2012.11.017. Full text in Research Archive Show summary

  Restraint use has been reported to be common in acute psychiatry, but empirical research is scarce concerning why and how restraints are used. This study analysed data from patients' first episodes of restraint in three acute psychiatric wards during a 2-year study period. Logistic regression analyses were used to identify predictors for type and duration of restraint. The distribution of restraint categories for the 371 restrained patients was as follows: mechanical restraint, 47.2%; mechanical and pharmacological restraint together, 35.3%; and pharmacological restraint, 17.5%. The most commonly reported reason for restraint was assault (occurred or imminent). It increased the likelihood of resulting in concomitant pharmacological restraint. Female patients had shorter duration of mechanical restraint than men. Age above 49 and female gender increased the likelihood of pharmacological versus mechanical restraint, whereas being restrained due to assault weakened this association. Episodes with mechanical restraint and coinciding pharmacological restraint lasted longer than mechanical restraint used separately, and were less common among patients with a personality disorder. Diagnoses, age and reason for restraint independently increased the likelihood for being subjected to specific types of restraint. Female gender predicted type of restraint and duration of episodes.

• Evensen, Julie Horgen; Røssberg, Jan Ivar; Barder, Helene; Haahr, Ulrik; Hegelstad, Wenche & Joa, Inge [Show all 16 contributors for this article] (2012). Apathy in first episode psychosis patients: A ten year longitudinal follow-up study. Schizophrenia Research. ISSN 0920-9964. 136(1-3), p. 19–24. doi: 10.1016/j.schres.2011.12.019. Full text in Research Archive
• Friis, Svein (2012). Kan man bli frisk av schizofreni. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. p. 847–848. doi: 10.4045/tidsskr.12.0270. Full text in Research Archive
• Evensen, Julie Horgen; Røssberg, Jan Ivar; Barder, Helene; Haahr, Ulrik; Hegelstad, Wenche & Joa, Inge [Show all 15 contributors for this article] (2012). Flat affect and social functioning: A 10 year follow-up study of first episode psychosis patients. Schizophrenia Research. ISSN 0920-9964. 139(1-3), p. 99–104. doi: 10.1016/j.schres.2012.04.019. Full text in Research Archive
• Langeveld, Johannes H.; Joa, Inge; Friis, Svein; Hegelstad, Wenche; Melle, Ingrid & Johannessen, Jan Olav [Show all 12 contributors for this article] (2012). A Comparison of Adolescent and Adult Onset First-Episode Non Affective Psychosis: 2-year Follow-up:. European Archives of Psychiatry and Clinical Neuroscience. ISSN 0940-1334. 262, p. 599–605. doi: 10.1007/s00406-012-0308-9. Full text in Research Archive
• Kvåle, Alice; Bunkan, Berit Heir; Ilner, Stein E. Opjordsmoen & Friis, Svein (2012). Development of the Movement domain in the Global Body Examination. Physiotherapy Theory and Practice. ISSN 0959-3985. 28(1), p. 41–49. doi: 10.3109/09593985.2011.561419. Full text in Research Archive
• Friis, Svein; Kvåle, Alice; Ilner, Stein E. Opjordsmoen & Bunkan, Berit Heir (2012). The Global Body Examination (GBE). A useful instrument for evaluation of respiration. Advances in Physiotherapy. ISSN 1403-8196. 14(4), p. 146–154. doi: 10.3109/14038196.2012.704943. Full text in Research Archive Show summary

  Background and aims: Assessment of respiration is important in medicine and physical therapy. As respiration is multifaceted, we need several specific examination methods. The purpose of this study was to develop a method for examination of visible respiratory movements, by extracting from two examinations the items with best ability to discriminate among healthy controls, patients with pain disorders and patients with psychotic disorders. Methods: Two physiotherapists independently examined 132 individuals (34 healthy persons, 32 with localized pain, 32 with widespread pain and 34 with psychoses). Items were assigned to subscales by explorative factor analysis. Internal consistency of subscales was examined with Cronbach's alpha. To examine validity, one-way analysis of variance and the area under the curve (AUC) were used. Results: We identified four subscales: Tension, Position of Thorax, Basal respiration and Thoracic movements. Cronbach's alpha ranged from 0.75 to 0.86. The subscales’ discriminating ability was excellent between healthy controls and patients, and fair between patients with localized pain and the two other patient groups. Conclusions: The respiration domain of the new Global Body Examination has 21 items, which comprise four subscales with high internal consistency and good ability to discriminate between healthy persons and patients with pain disorders or psychosis.

• Haahr, Ulrik; Simonsen, Erik; Røssberg, Jan Ivar; Johannessen, Jan Olav; Larsen, Tor Ketil & Melle, Ingrid [Show all 11 contributors for this article] (2012). Patient satisfaction with treatment in first-episode psychosis. Nordic Journal of Psychiatry. ISSN 0803-9488. 66(5), p. 329–335. doi: 10.3109/08039488.2011.644808. Full text in Research Archive
• Bakken, TL; Røssberg, Jan Ivar & Friis, Svein (2012). The use of the Ward Atmosphere Scale for intellectually disabled psychiatry inpatients: A pilot study. Advances in Mental Health and Intellectual Disabilities. ISSN 2044-1282. p. 265–272. Full text in Research Archive
• Hegelstad, Wenche; Larsen, Tor Kjetil; Auestad, Bjørn Henrik; Evensen, Julie Horgen; Haahr, Ulrik & Joa, Inge [Show all 17 contributors for this article] (2012). Long-Term Follow-Up of the TIPS Early Detection in Psychosis Study: Effects on 10-Year Outcome. American Journal of Psychiatry. ISSN 0002-953X. 169(4), p. 374–380. doi: 10.1176/appi.ajp.2011.11030459. Full text in Research Archive
• Bakken, Trine Lise; Røssberg, Jan Ivar & Friis, Svein (2012). The used of the Ward Atmosphere Scale for intellectually disabled psychiatric inpatients: A pilot study. Advances in Mental Health and Intellectual Disabilities. ISSN 2044-1282. p. 265–272. doi: 10.1108/20441281211261159. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Sundet, Kjetil Søren; Vaskinn, Anja; Birkenæs, Astrid Brate; Engh, John & Færden, Ann [Show all 12 contributors for this article] (2011). Neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends on history of psychosis rather than diagnostic group. Schizophrenia Bulletin. ISSN 0586-7614. 37(1), p. 73–83. doi: 10.1093/schbul/sbp034. Full text in Research Archive
• Tandberg, Marte; Ueland, Toril; Sundet, Kjetil Søren; Haahr, Ulrik; Joa, Inge & Johannessen, Jan Olav [Show all 15 contributors for this article] (2011). Neurocognition and occupational functioning in patients with first-episode psychosis: a 2-year follow-up study. Psychiatry Research. ISSN 0165-1781. 188(3), p. 334–342. doi: 10.1016/j.psychres.2011.04.021. Full text in Research Archive
• Nesvold, Helle; Ormstad, Kari & Friis, Svein (2011). Sexual assault centres and police reporting - an important arena for medical/legal interaction. Journal of Forensic Sciences. ISSN 0022-1198. 56(5), p. 1163–1169. doi: 10.1111/j.1556-4029.2011.01880.x. Full text in Research Archive
• Johannessen, Jan Olav; Joa, Inge; Auestad, Bjørn; Haahr, Ulrik; Larsen, Tor Ketil & Melle, Ingrid [Show all 13 contributors for this article] (2011). First-episode psychosis patients recruited into treatment via early detection teams versus ordinary pathways: course and health service use during 5 years. Early Intervention in Psychiatry. ISSN 1751-7885. 5(1), p. 70–75. doi: 10.1111/j.1751-7893.2010.00201.x. Full text in Research Archive

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• Hem, Erlend; Kirkevold, Marit; Friis, Svein & Vaglum, Per Jørgen Wiggen (2021). Innføring i klinisk forskning og fagutvikling. Universitetsforlaget. ISBN 9788215056593. 218 p. Full text in Research Archive

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• Ruud, Torleif & Friis, Svein (2022). Continuity of care and therapeutic relationships as critical elements in acute psychiatric care. World Psychiatry. ISSN 1723-8617. 21(2), p. 241–242. doi: 10.1002/wps.20965. Full text in Research Archive
• Friis, Svein; Melle, Ingrid & McGlashan, Thomas H. (2019). Symptom remission at 12-weeks is a strong predictor for long term outcome. Psychological Medicine. ISSN 0033-2917. 50(14). doi: 10.1017/S0033291719003465. Full text in Research Archive
• Øvergaard, Kristin Romvig; Ørbeck, Beate; Friis, Svein; Biele, Guido; Aase, Heidi & Zeiner, Pål (2018). Inattention in pre-School ADHD- are there gender differences? Full text in Research Archive
• Øvergaard, Kristin Romvig; Ørbeck, Beate; Friis, Svein; Pripp, Are Hugo; Biele, Guido & Aase, Heidi [Show all 7 contributors for this article] (2018). Dr Øvergaard et al. Reply. Journal of the American Academy of Child and Adolescent Psychiatry. ISSN 0890-8567. 57(9), p. 701–702. doi: 10.1016/j.jaac.2018.05.021. Full text in Research Archive
• Guloksuz, Sinan; Li, Fangyong; Tek, Cenk; Woods, Scott W.; McGlashan, T.H. & Friis, Svein [Show all 7 contributors for this article] (2016). Analyzing the duration of untreated psychosis: Quantile regression. JAMA psychiatry. ISSN 2168-6238. 73(10), p. 1094–1095. doi: 10.1001/jamapsychiatry.2016.2013. Full text in Research Archive
• Dahl, Hanne-Sofie Johnsen; Ulberg, Randi; Friis, Svein; Perry, John Christopher & Høglend, Per Andreas (2016). Therapists' inadequate feelings and long-term effect of transference work. Psychotherapy and Psychosomatics. ISSN 0033-3190. 85(5), p. 309–310. doi: 10.1159/000444647. Full text in Research Archive
• Kvåle, Alice; Bunkan, Berit Heir; Opjordsmoen, Stein & Friis, Svein (2015). The Global Body Examination (GBE) - a useful instrument for examination of patients with long-lasting musculoskeletal and/or psychological disorders. Full text in Research Archive
• Friis, Svein (2015). How to help clinically relevant research survive? Acta Psychiatrica Scandinavica. ISSN 0001-690X. 132(6), p. 439–440. doi: 10.1111/acps.12515. Full text in Research Archive
• Friis, Svein (2015). Skjerming – straff eller støtte? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(1), p. 8–8. doi: 10.4045/tidsskr.14.1271. Full text in Research Archive
• Friis, Svein (2014). Prediction of outcome in schizophrenia depends on the sample. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 130(4), p. 241–242. doi: 10.1111/acps.12288. Full text in Research Archive
• Nilsen, L; Frich, Jan C; Friis, Svein; Norheim, Irene & Røssberg, Jan Ivar (2014). Psychosocial intervention. Patients and Family members perceived benefits from psychoeducational Family work in first-episode psychosis. Full text in Research Archive
• Knutzen, Maria; Bjørkly, Stål; Eidhammer, Gunnar; Lorentzen, Steinar; Mjøsund, Nina Helen & Opjordsmoen, Stein [Show all 8 contributors for this article] (2014). Corrigendum to "Characteristics of patients frequently subjected to pharmacological and mechanical restraint - A register study in three Norwegian acute psychiatric wards" [Psychiatry Res. 215 (2014) 127-133]. Psychiatry Research. ISSN 0165-1781. 219(3), p. 714–714. doi: 10.1016/j.psychres.2014.03.013. Full text in Research Archive
• Norheim, Irene; Nilsen, Liv; Frich, Jan C; Friis, Svein & Røssberg, Jan Ivar (2014). Psychosocial intervention - Challenges With Family work in early psychosis: a qualitative study of Professionals' experiences. Full text in Research Archive
• Nilsen, Liv; Frich, Jan C; Friis, Svein; Norheim, Irene & Røssberg, Jan Ivar (2014). C91 Psychosocial intervention patients and family members perceived benefits from psychoeducational family work in first-episode psychosis. Early Intervention in Psychiatry. ISSN 1751-7885. 8, p. 156–156. Full text in Research Archive
• Norheim, Irene; Nilsen, Liv; Frich, Jan C; Friis, Svein & Røssberg, Jan Ivar (2014). B90 Psychosocial intervention – challenges with family work in early psychosis: a qualitative study of professionals ’ experiences. Early Intervention in Psychiatry. ISSN 1751-7885. 8, p. 121–121. Full text in Research Archive
• Friis, Svein; Barder, Helene; Evensen, Julie Horgen; Haahr, Ulrik; Hegelstad, Wenche ten Velden & Joa, Inge [Show all 17 contributors for this article] (2012). The TIPS study and bias: Replies to Dr Amos. Australian and New Zealand journal of psychiatry (Print). ISSN 0004-8674. 46(9), p. 905–907. doi: 10.1177/0004867412451344. Full text in Research Archive
• Melle, Ingrid; Johannessen, Jan Olav; Joa, Inge; Haahr, Ulrik; Rossberg, Jan Ivar & Evensen, Julie [Show all 12 contributors for this article] (2012). Suicide and accidental death in first-episode schizophrenia spectrum psychosis. Early Intervention in Psychiatry. ISSN 1751-7885. 6(Supp. 1), p. 23–23. Full text in Research Archive
• Hegelstad, Wenche; Larsen, Tor Ketil; Evensen, Julie Horgen; Friis, Svein; Haahr, Ulrick & Joa, Inge [Show all 12 contributors for this article] (2012). Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome. Early Intervention in Psychiatry. ISSN 1751-7885. 6, p. 15–15. Full text in Research Archive
• Barder, Helene; Sundet, Kjetil Søren; Rund, Bjørn Rishovd; Haar, Ulrik; Johannessen, Jan Olav & Larsen, Tor Ketil [Show all 12 contributors for this article] (2012). Neurocognitive development in first-episode psychosis 5-year follow-up: associations between illness severity and cognitive course. Early Intervention in Psychiatry. ISSN 1751-7885. 6, p. 27–27. Full text in Research Archive
• Langeveld, Johannes H.; Joa, Inge; Johannessen, Jan Olav; Friis, Svein; Hegelstad, Wenche & Melle, Ingrid [Show all 12 contributors for this article] (2012). Characteristic of first-episode psychosis patients reporting violent/threatening behavior. Early Intervention in Psychiatry. ISSN 1751-7885. 6, p. 51–51. Full text in Research Archive
• Haahr, Ulrik; Larsen, Tor Ketil; Simonsen, Erik; Joa, Inge; Melle, Ingrid & Rossberg, Jan Ivar [Show all 12 contributors for this article] (2012). The relation between trauma and clinical factors in first-episode psychosis: Results from the TIPS study. Early Intervention in Psychiatry. ISSN 1751-7885. 6, p. 82–82. Full text in Research Archive
• Melle, Ingrid; Joa, Inge; Larsen, T.K.; Haahr, Ulrik; Friis, Svein & Johannesen, Jan O. [Show all 10 contributors for this article] (2012). Shortening the duration of untreated psychosis: experiences from the TIPS study. Early Intervention in Psychiatry. ISSN 1751-7885. 6, p. 5–5. Full text in Research Archive
• McGlashan, Thomas H.; Evensen, Julie Horgen; Haahr, J.; Hegelstad, Wenche; Joa, Inge & Johannessen, Jan Olav [Show all 16 contributors for this article] (2011). EARLY DETECTION AND INTERVENTION (EDI) IN FIRST EPISODE PSYCHOSIS: CAN IT IN CREASE THE CHANCE FOR FULL RECOVERY? TIPS 10 YEAR FINDINGS. Schizophrenia Bulletin. ISSN 0586-7614. 37, p. 273–274. Full text in Research Archive
• Friis, Svein; Evensen, Julie Horgen; Haahr, Ulrik; Hegelstad, Wenche; Joa, Inge & Johannessen, O [Show all 16 contributors for this article] (2011). Early Detection and Intervention(EDI) in first episode psychosis: Can it reduce the risk for poor outcome? Tips 10 years findings. Schizophrenia Bulletin. ISSN 0586-7614. 37, p. 98–98. Full text in Research Archive
• Nilsen, Liv; Røssberg, Jan Ivar; Frich, Jan C & Friis, Svein (2015). Participants and health professionals’ experiences with family work in first episode psychosis. Universitetet i Oslo. Full text in Research Archive Show summary

  In the present study we wanted to examine psycho educational family work as experienced by patients suffering from first episode psychosis, their family members and health professionals’ conducting the same intervention. A qualitative explorative study was conducted in a natural setting. Twelve patients, fourteen family members and nine mental health professionals were interviewed and data was analyzed by systematic text condensation. Both patients and family members highlighted the importance of the relationship with the group leaders and to meet others in similar situations. Patients experienced a high level of anxiety and tension during the group meetings and the group format was demanding immediately after a psychotic episode. Real lifetime stories told by patients were experienced as essential and helped family members understand the nature of psychosis. The group leaders described an intervention where the participants experienced a milieu suitable for growth and recovery. However, patients still suffering from distressing symptoms and social skills deficits need time to recover before participating. The overall impression is that group leaders must have a considerable amount of knowledge, about the intervention, combined with clinical competence and experience in order to plan, recruit and provide psycho educational family work.

• Engh, John & Friis, Svein (2011). Cognitive insight and clinical insight in schizophrenia : methodological, neurocognitive and psychopathological aspects and comparison to bipolar disorder. Universitetet i Oslo. Full text in Research Archive Show summary

  Poor clinical insight (i.e. insight of illness) is considered a characteristic feature of schizophrenia. It is central for determining the presence of mental disorder and its prognosis, as well as for prescribing appropriate treatment and management. Patients with schizophrenia and other psychotic disorders suffer markedly from distorted beliefs. Yet, insight of illness does not specifically address the patient’s capacity to evaluate these disruptions. Evaluation of own anomalous beliefs and recognition of incorrect conclusions can be conceptualized as cognitive insight and assessed with Beck Cognitive Insight Scale (BCIS).<br> Lack of clinical insight may also be a major problem in psychotic disorders other than schizophrenia. Studies comparing levels of insight across diagnostic groups have not found substantial differences between patients with bipolar disorder and schizophrenia. Notably, the insight questionnaires used in these studies were not validated for patients with bipolar disorders. This also applies to the scale measuring clinical insight in this study, the Birchwood Insight Scale (IS). The first part of this thesis focuses on methodological issues regarding these questionnaires. In study I acceptable psychometric properties were found for the IS when applied to patients with schizophrenia and bipolar I disorder. However, for patients with bipolar II disorder the scale seemed to work poorly. Findings in the original BCIS study (Beck et al., 2004) suggested that the scale was able to differentiate between depressive patients with and without psychosis. We found that the psychometric properties were acceptable for the bipolar disorder group as well as the schizophrenia group. The scores of healthy controls, however, cannot be compared to patient scores without excluding items referring to psychotic experiences. Furthermore, the two BCIS subscales, self-reflectiveness and self-certainty, showed low or moderate correlation for all the three groups, indicating that they represent two different dimensions of cognitive insight. High scores on selfreflectiveness and low scores on self-certainty were considered as normal.<br> In the second part of the thesis the relationships between cognitive insight and clinical characteristics were explored. An association was found between self-certainty and delusions, in line with findings in the few previous studies. Furthermore, we explored the relationship between cognitive insight and different constellations of psychotic symptoms (delusions and/or hallucinations). Delusions irrespective of the presence or absence of hallucinations were associated with low self-reflectiveness and high self-certainty, reflecting low cognitive insight. In contrast, a subgroup of patients with solitary hallucinations showed high cognitive insight, which is quite interesting for understanding hallucinations but needs replication. The relationship between cognitive insight and neurocognition was also studied within the framework of this thesis. Consistent with a study on patients with first episode psychosis we found that low self-certainty is associated with high IQ and verbal learning. Verbal learning made a specific contribution in explaining self-certainty also when potential confounders were taken into account.<br> Taken together, the present thesis suggests that both clinical and cognitive insight could be measured with self-report questionnaires in schizophrenia and bipolar I disorder. Further, it suggests that hallucinations are related to better cognitive insight, and delusions with worse cognitive insight, and that low cognitive insight is associated with high IQ and low verbal learning. This indicates that cognitive insight is an important concept in understanding the psychopathology of psychotic symptoms.

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