Steinn Steingrimsson

Sahlgrenska University Hospital · Psychiatry

Background Modern lithium management guidelines were introduced to improve the renal prognosis of lithium patients. Aims To examine whether prospects for severe renal impairment (defined as chronic kidney disease at least stage 4 (CKD4)), in long-term lithium patients, have changed over time after the introduction of lithium monitoring guidelines....

Background: Interest in sensory rooms or so-called “calm rooms” in psychiatric inpatient care has increased significantly. In a hospital setting, their purpose is to introduce a relaxing environment to increase well-being as well as to decrease anxiety and aggressive behaviors. Calm rooms can also be used as a tool to provide self-help through a co...

This paper explores the potential for a system to be a co-author on an academic paper based on the criteria proposed by the International Committee of Medical Journal Editors (ICMJE). We used a third generation generative pretrained transformer (GPT-3) to write a review paper on the topic of its choice: The Effects of Sleep Deprivation on Cognitive...

Background: Borderline personality disorder (BPD) is considered a disorder of emotion regulation resulting from the expression of a biologically determined emotional vulnerability (that is, heightened sensitivity to emotion, increased emotional intensity/reactivity and a slow return to emotional baseline) combined with exposure to invalidating envi...

BACKGROUND Nonadherence to pharmaceutical antidepressant treatment is common among patients with depression. Digitalized follow-up (ie, self-monitoring systems through mobile apps) has been suggested as an effective adjunct to conventional antidepressant treatment to increase medical adherence, improve symptoms of depression, and reduce health care...

BACKGROUND The use of chatbots in mental health support has increased exponentially in recent years, with studies showing that they may be effective in treating mental health problems. More recently, the use of voice-controlled visual avatars called digital humans has been introduced, which use machine learning and mimicry of facial emotions to bui...

Background: Psychiatric patients may refer to concepts neither medically accepted nor easily understood to describe their experiences when seeking medical care. These concepts may lie outside the clinician’s cultural references and consequently hinder the diagnostic consultation. In the fifth version of the Diagnostic and Statistical Manual of Ment...

Introduction Major depressive disorder (MDD) is a common and severe mental disorder. Although inpatient care may be needed in some cases, little is known on which factors are associated with risk for readmission. Objectives To identify risk factors associated with an increased risk of readmission within 90 days, after being discharged from psychia...

Background Nonadherence to pharmaceutical antidepressant treatment is common among patients with depression. Digitalized follow-up (ie, self-monitoring systems through mobile apps) has been suggested as an effective adjunct to conventional antidepressant treatment to increase medical adherence, improve symptoms of depression, and reduce health care...

This paper explores the potential for a system to be a co-author on an academic paper based on the criteria proposed by the International Committee of Medical Journal Editors (ICMJE). We used a third generation generative pretrained transformer (GPT-3) to write a review paper on the topic of its choice: The Effects of Sleep Deprivation on Cognitive...

BACKGROUND Interest in sensory rooms or so-called “calm rooms” in psychiatric inpatient care has increased significantly. In a hospital setting, their purpose is to introduce a relaxing environment to increase well-being as well as to decrease anxiety and aggressive behaviors. Calm rooms can also be used as a tool to provide self-help through a con...

Background: Weighted blankets (WBs) have been suggested as a treatment option for insomnia and are commonly prescribed despite lack of evidence of efficacy. Aim: To investigate prescription pattern, return rate and cost of WBs. Material and methods: This observational cohort register-based study in western Sweden included every individual who,...

Background Caution is generally advised when starting lithium treatment in patients with impaired renal function. We aimed to study the risk of developing severe chronic kidney disease (CKD) among patients with impaired renal function treated with lithium. Methods The risk of developing severe CKD was calculated from a register-based cohort of 83...

The COVID-19 pandemic has caused societal restrictions and public fear whichmay have impacted the pattern of seeking psychiatric care. There has generally been a decrease in the numbers seeking acute psychiatric care. It is important to investigate which groups seeking psychiatric treatment have decreased in number. The aim of our investigation was...

Background Immersive virtual reality (VR) games are increasingly becoming part of everyday life. Several studies support immersive VR technology as a treatment method for mental health problems. There is however little insight into the prevalence of commercially available VR games for treatment of mental health problems on commercial platforms such...

Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures. Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PH...

From around 1800 to the end of the twentieth century, mental healthcare grew from unorganized, improvised home care and, more rarely, ecclesiastical care to being one of the basic public services. During this period, the practice of psychiatry professionalized and psychiatric symptoms were medicalized. A turning point in this development was the ex...

Background Ambient particulate matter is a leading risk factor for disease globally. Particulate matter 10 (PM10) and particulate matter 2.5 (PM2.5) are derived from different sources, including operating motor vehicles as well as from industrial activities. In this study we investigate the association between increased concentrations of PM and tot...

Background Transcutaneous vagus nerve stimulation (tVNS) has been suggested as a treatment method for depression. Methods A systematic review to systematically evaluate the efficacy of tVNS for the treatment of depression was conducted according to PRISMA guidelines. Primary outcomes were mortality, self-harm, depressive symptoms, and health-relat...

Background: Total sleep deprivation (TSD) combined with bright light therapy (BLT) has been suggested as a valuable add-on to standard treatment for rapid relief of depression. However, there is a lack of randomized controlled trials in real-life clinical settings. The aim of this pragmatic randomized clinical trial was to investigate the effective...

Objective To measure rate of subscription of common sleep medication and diagnoses of substance use disorder (SUD) before and after receiving a prescribed weighted blanket (WB) among patients with psychiatric diagnoses. Materials and methods Using register-based data of health-related factors in a Swedish region, a total of 1785 adult individuals...

Background: Depression is a common mental illness associated with significant disability and suffering. Current treatment strategies include psychopharmacological therapy, psychotherapy, and in certain cases electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS). However, further treatment options are needed. Vagus n...

Objective: To systematically review evidence on the efficacy and safety of sleep deprivation (SD) as a treatment option for patients with unipolar or bipolar depression. Methods: A systematic review according to PRISMA-guidelines was conducted. The certainty of evidence was assessed using the GRADE approach. Controlled trials were included in effi...

Background: Personality traits, such as self-directedness (SD) and cooperativeness (CO), may be indicative of problematic alcohol and/or drug use. Objectives: The aim of this study was to quantify the association of substance use with SD and CO in a large cohort of adolescents. Method: A total of 6,917 individuals (58% women) at the age of 18...

Providing health services through remote communications for sub-acute health issues during emergencies may help reduce the burden of the health care system and increase availability of care. This study aimed to investigate the attitudes of the public towards receiving medical services and providing medical information through remote communication i...

Background Little is known of the risks involved for patients who, at the start of lithium treatment, already have compromised renal function. Aims To assess the risk of developing severe renal impairment (chronic kidney disease (CKD) 4–5) among those patients and to explore predictors for the progression. Methods A retrospective longitudinal coh...

BACKGROUND Immersive virtual reality (VR) games are increasingly becoming part of everyday life. Several studies support immersive VR technology as a treatment method for mental health problems. There is however minimal research into the feasibility, prevalence, and quality of commercially available VR games on commercial platforms as tools for tre...

Background Post-traumatic stress disorder (PTSD) is debilitating for patients and society. There are a number of treatment methods albeit not all patients respond to these and an interesting method using electroencephalography-based neurofeedback (EEG-NF) has become more prominent in recent years. This systematic review aimed to assess whether EEG-...

OBJECTIVE:The perinatal period can be destabilizing for patients with bipolar disorder (BD). A specialized BD outpatient clinic was established in 2013 in Gothenburg and since 2015, an individualized perinatal care plan has systematically been implemented for female patients prior to pregnancy. The aim of this is study was to examine the outcome of...

High or low ambient temperatures pose a risk factor for the worsening or onset of psychiatric disorders. The aim of this study was to investigate the association between ambient temperature and psychiatric emergency visits in an urban region in a temperate climate. The daily number of visits to a psychiatric emergency room (PEVs) at Sahlgrenska Uni...

Objective: Determine sickness absence recommendation (SAR) prevalence for treatment-seeking patients with ADHD depending on comorbidity. Method: Population-based patient chart review of ADHD outpatients aged 19 to 29 years. The outcome, SAR, included both available financial benefit forms; activity compensation and sickness benefit. Latent class...

Background: Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psyc...

Background and Aims Methylphenidate (MPH) is a prescription stimulant used to treat attention-deficit hyperactivity disorder. MPH is currently the preferred substance among most intravenous (i.v.) substance users in Iceland. Four types of MPH preparations were available in Iceland at the time of study: Immediate-release (IR), sustained-release (SR)...

Introduction The concept of “highly sensitive person” is a cultural concept, which has become popular in western societies including Sweden. A highly sensitive person (HSP) is usually described as having hypersensitivity to external stimuli, different cognitive processing and high emotional reactivity. Although the concept lacks diagnostic validity...

Introduction Subclinical symptoms of depression or mania, present prior to clinical manic or depressive episodes in individuals with bipolar disease. Mobile applications that measure habitual behavioral patterns such as mobility, physical activity level and social engagement present an opportunity to identify state transitions preceding relapse. Th...

Purpose: Identify risk factors of death or imprisonment within classes defined by demographic factors and diagnoses within one year of first psychiatric admission. Methods: Nationwide data was obtained from hospital registers from psychiatric hospitals in Iceland 1983-2007. Mortality and cause of death as well as information about imprisonments...

Background/aims: Methylphenidate (MPH) has been the most commonly used intravenous (i.v.) substance in Iceland in recent years. In Iceland, MPH is available in 3 forms: immediate-release (IR) tablets (MPH IR, short-acting), sustainable-release (SR) capsules (MPH SR, long-acting) and osmotic-release (OROS) tablets (MPH OROS, long-acting). The aims...

Surgical site infections (SSIs) are common complications after open heart surgery. Fortunately, most are superficial and respond to minor wound debridement and antibiotics. However, 1-3% of patients develop deep sternal wound infections that can be fatal. Late infections with sternocutaneous fistulas, are encountered less often, but represent a com...

Background: Mood Spectrum Self Report (MOODS-SR) is an instrument that assesses mood spectrum symptomatology including subthreshold manifestations and temperamental features. There are different versions of the MOODS-SR for different time frames of symptom assessment: lifetime (MOODS-LT), last-month and last-week (MOODS-LW) versions. Objective:...

Introduction The MOODS-SR is a self-report instrument consisting of 161 dichotomous items. It is designed to assess lifetime presence of mood spectrum psychopathology. Recently, it has been proposed that a subset of 33 items can be used to distinguishing bipolar disorder. Aim To evaluate psychometric properties of a 33-item subset and to propose a...

Introduction Wake-therapy (or “Sleep deprivation”) has the potential of providing a fast anti-depressive response as add-on treatment to pharmaceutical intervention. Agitation in a depressive state is well known and is often associated with interrupted sleep. Although hypomanic symptoms have been reported following a single nights wake, agitation h...

Surgical site infection is a common complication following cardiac surgery. Triclosan-coated sutures have been shown to reduce the rate of infections in various surgical wounds, including wounds after vein harvesting in coronary artery bypass grafting patients. Our purpose was to compare the rate of infections in sternotomy wounds closed with tricl...

Patients with severe mental illness have a shortened lifespan, and substance use disorder (SUD) is an especially important diagnosis in this respect. There have been no studies comparing directly SUD to other diagnoses in a nationwide cohort. To directly compare differences in mortality rates of psychiatric inpatients with a discharge diagnosis of...

Studies of the overlap between severe mental disorder and criminality tend to focus on prison populations rather than psychiatric populations. Our aims were to establish the prevalence of previous imprisonment among female psychiatric inpatients and test relationships between diagnoses, mortality and imprisonment. A nationwide cohort of 18-65-year-...

Prescription rates of methylphenidate (MPH) are sharply rising in most Western countries. Although it has been reported that MPH has abuse potential, little is known about the prevalence of intravenous (IV) abuse of MPH. The aim of the study was to investigate the prevalence of IV MPH abuse among treatment-seeking IV substance abusers in Iceland. T...

Introduction Admission to a psychiatric hospital is a strong predictor for future adverse outcome such as imprisonment and death. There exists a large gender gap for this relationship for men and women. Aim To study sex difference in the time from admission to psychiatric hospital and time to imprisonment or death. Methods All patients over 18 ye...

Introduction Mood Spectrum Self Report (MOODS-SR) is an innovative instrument to assess mood spectrum symptomatology. This may provide a better way of conceptualizing the psychopathology of affective disorders. Aim Psychometric evaluation of the Swedish adaptation of MOODS-SR, lifetime version. Methods Patients with affective disorders were recru...

Introduction Several effective treatment alternatives exist for depression, however, not everyone responds to antidepressants and the time lag to response can be long. Bright light therapy (BLT) has successfully been used as an adjuvant treatment to antidepressants in severe depression among inpatients. Aim The aim of this study was to evaluate th...

Introduction Wake therapy, during a whole night, followed by bright light therapy for 6 days has been shown in a number of studies to be effective in quickly alleviating depressive symptoms. Aim To evaluate the implementation of wake therapy followed by bright light treatment among inpatients with depression as an adjunct to treatment as usual. M...

Background Diagnosis at first admission is an important variable in epidemiological studies but concerns regarding stability need to be adressed. Aims To investigate the persistence of diagnosis at first admission within 10 years in a nationwide cohort of psychiatric inpatients with 25 year follow-up. Methods A cohort was established from a datab...

There is a strong correlation between severe mental illness and criminality, but little is known about how these two problem areas together may affect health outcomes. The objective of this paper is to compare survival rates of male psychiatric inpatients over a 25-year period who have and have not been subject to imprisonment, allowing for nature...

Background Personality traits are important factors in predicting both development as well as remission of substance use disorders (SUDs). Self-directedness (SD) and cooperativeness (CO) are character personality traits on the Temperament-Character Inventory (TCI) that are modifiable and correlate with substance use. This association has not been s...

Background The most studied outcomes in mental illness are suicide and psycho-social functioning. However, outcomes such as all-cause mortality, imprisonment and repeated admissions to psychiatric facilities could also be appropriate to study as hard endpoints in epidemiological studies. In this nationwide cohort register study of psychiatric inp...

Negative pressure wound therapy (NPWT) is a new therapeutic option in wound healing and was first described in its present form in 1997. A vacuum source is used to create sub-atmospheric pressure in the local wound environment to promote healing. This is achieved by connecting a vacuum pump to a tube that is threaded into a wound gauze or foam fill...

Infections of the sternal wound are among the most serious complications after open heart surgery. These infections result in increased morbidity for patients, can sometimes be fatal, and are associated with increased costs. Deep sternal wound infections (DSWIs) are the most common and serious of these infections. Late infections, which can result...

Aims: To study how general practitioners diagnose and treat adult patients with community acquired pneumonia (CAP) and evaluate outcomes. Method: Retrospective chart review for one year on patients 18 years and older diagnosed with CAP in three different primary care centers in Iceland. Results: A total of 215 patients were diagnosed with CAP....

To evaluate the outcome of treatment for deep sternal wound infection (DSWI) in a nationwide patient cohort, before and after the introduction of negative-pressure wound therapy (NPWT). This was a population-based cohort of all patients treated for DSWI in Iceland out of 2446 open heart operations performed between 2000 and 2010. Length of hospital...

To study changes over a 25-year period in the gender gap in discharge diagnoses of alcohol use disorder (AUD) and other substance use disorder (SUD) in psychiatric in-patients.  A register-based study of all admissions to psychiatric hospitals in Iceland between January 1983 and December 2007. Annual rate of admissions to psychiatric hospitals, adj...

We studied the incidence and characteristics of surgically treated sternocutaneous fistulas in a nationwide cohort of patients undergoing open heart surgery in Iceland. Between 2000 and 2010, sternocutaneous fistulas were treated surgically in 6 out of 2446 patients undergoing open heart surgery (incidence 0.25%, 95% confidence interval 0.11-0.53%)...

Negative pressure wound therapy (NPWT) is a recent therapeutic option in wound healing, where a vacuum source is used to create sub-atmospheric pressure in the wound bed with airtight dressings. The aims were to study the indications for the use of NPWT in a whole country and evaluate the outcome of treatment. This was a retrospective study that in...

Sternocutaneous fistulas (SCFs) after cardiac surgery represent a complex surgical problem involving multiple hospital admissions, prolonged antibiotic treatment, and repeated debridements. Our objective was to identify the incidence of and risk factors for SCF, and to evaluate long-term survival. A total of 12,297 patients underwent sternotomy for...

The aim of this nationwide case-control study was to study the epidemiology and identify risk factors of deep sternal wound infections (DSWI) in Iceland. Between 1997-2004, 1 650 adults underwent open cardiac surgery in Iceland. For every infected patient four control subjects were chosen (n =163), matched for time of operation. The groups were com...