Rücklab – Psychiatry research at Karolinska Institutet

Today, Seena Fazel, world-leading researcher in suicide prediction, from Oxford University held an intriguing seminar on risk assessment models for suicide. In the seminar, he talked about the OxSATS risk predictor model for suicide. The OxSATS is a part of OxRisk, a project by the Forensic Psychiatry and Psychology group at the University of Oxford that has developed a number of web-based risk calculators. The risk calculators are supposed to complement clinical decision-making.

Check out the OxRisk project here.

And read more about Seena Fazel and his research here.

We would like to highlight the fact that Manne Sjöstrand has become a Docent!

Manne’s research focuses on ethical questions in clinical psychiatry, specifically on the ethics of suicide prediction and ethical questions related to involuntary treatment. He also serves as a Consultant Psychiatrist at the Consultation Liaison Psychiatric Unit at Psykiatri Sydväst.

Congratulations, Manne! 👏

Members of our Modelling Team got no less than five abstracts accepted for presentation at the World Congress of Epidemiology in Capetown, South Africa later this year. The following three presentations will be oral presentations:

Leoni Grossman

Suicide in the compulsory mental care population in Sweden: a descriptive nationwide registry study

Fredrik Johansson

Early change in individual depression symptoms and later symptom severity during internet-delivered cognitive behavioural therapy: preliminary findings

Björn Bråstad

Predictors of labour market marginalization in psychiatric patients following internet-delivered psychotherapy: A MULTI-PSYCH study with clinical, registry, and genetic data

The Modelling Team is led by John Wallert and these presentations will showcase our most recent pre-publication findings from the ongoing team projects MULTI-PSYCH and Compulsory Mental Care and Suicide.

The Bergen 4-Day Treatment Trial has successfully recruited the required number of participants. This marks a significant step towards evaluating the effectiveness of the treatment in relation to standard treatment and brings us closer to potentially implementing it.

The study aims to assess the non-inferiority, speed of recovery, and cost-effectiveness of the Bergen 4-Day Treatment (B4DT) for obsessive-compulsive disorder in comparison to the gold-standard cognitive-behavioral therapy with exposure and response prevention through a randomized controlled trial (RCT). CBT, while effective, typically spans 3-4 months with approximately half of patients remaining impaired post-treatment. B4DT, a concentrated treatment developed by Gerd Kvale and Bjarne Hansen from Bergen, entails four consecutive days of ERP at a clinic. Previous uncontrolled trials and one RCT have shown B4DT to achieve remission in about 70% of patients. However, direct comparison with gold-standard CBT is lacking, prompting the current study to address this gap.

The Bergen team from the Rück group and OCD-programmet has done an outstanding job by successfully recruiting 120 participants 👏👏

A warm welcome to Sim Jamil, our new PhD student!

Sim will be working with the intensive exposure-based treatment RCT for post-traumatic stress disorder (PTSD). A thrilling project that will evaluate the effect, speed of recovery, and cost-effectiveness of a PTSD treatment delivered daily for five consecutive days. Preliminary research shows intensive trauma focused treatment (I-PE) to be as effective as when the treatment is delivered by weekly sessions, but with the advantage that the recovery rate is faster and the proportion of patients who drop out decreases. 

Maria Bragesjö is Sim’s principal supervisor.

Hear Max in the latest episode of OCD-podden talking about the current randomized controlled non-inferiority trial examining Bergen 4-day treatment (B4DT), an intensive treatment compared to gold standard psychological treatment delivered weekly.

Max Sannemalm is a lic. psychologist at OCD-programmet at Psykiatri Sydväst and also a PhD student working with the B4DT-study.

Read more about the project and the rest of the team here.

Congratulations Mia and the tricho-derma community!

Today, incredible Mia Asplund successfully defended her thesis Development of novel and accessible treatments for Trichotillomania and Skin-picking disorder in Erna Möllersalen at Karolinska Institutet (KI), Flemingsberg. Opponent was Michael Twohig, Professor at Utah State University.

Also present were principal supervisor Volen Ivanov and co-supervisors Christian Rück and Fabian Lenhard (KI). Examination board consisted of Monica Buhrman, Associate Professor (Uppsala University), Ida Flink, Professor (Karlstad University) and Victoria Blom, Associate Professor (The Swedish School of Sports and Health).

What is trichotillomania and skin-picking disorder?
Trichotillomania (TTM) and Skin-picking disorder (SPD) are psychiatric conditions characterized by recurrent and excessive hair-pulling and skin-picking, respectively. These behaviors result in significant hair loss or skin lesions and often consume substantial amounts of time, leading to significant distress and functional impairment. Prevalence rates vary across studies but have been demonstrated to be as high as 3.5% for TTM and 5% for SPD.

Click here to read more about the project, or here to enjoy the full thesis.

The Rück research group are proud of you and your important contribution to advancing research on how to treat these debilitating conditions! 💐🥂

Although trauma-focused cognitive behavioral therapy such as prolonged exposure is considered the first choice in the treatment of post-traumatic stress disorder (PTSD), it is rarely available in regular health care. In a new feasibility trial, Maria Bragesjö et al. test digital therapy (Huddinge Online Prolonged Exposure; HOPE) to bridge this gap.

Results in short: HOPE proved feasible and effective. The treatment was well tolerated by patients and significant reductions in PTSD symptoms were found at end of treatment and were robust to the 6-month follow-up.

Read the full article here.

Next step: A randomized controlled study is currently underway by Maria and her team at Psykiatri Sydväst, testing two different digital cognitive behavioral treatments for PTSD. Link to registration here.

Fresh as a spring sign, we have a new postdoc in the group!

Fredrik Johansson starts as the new postdoc in the Wallert statistical modeling team. He describes his research as follows:

“My research within Rücklab focuses on causal and predictive modeling of suicide, both for people in closed psychiatric compulsory care but also in the general population. Based on a combination of registry data and genetic data, we try to improve the possibilities to predict who is at high risk of suicide, but also to understand what lies behind suicide in these different groups. Another research focus is treatment outcomes after internet-mediated CBT. Again, we are using registry data and genetic data, but also clinical data collected during treatment to better predict various relevant treatment outcomes and to understand processes that lead to successful treatment outcomes.”

Welcome, Fredrik!

Today, Mia Asplund nailed her thesis at the KI library in Flemingsberg. Also present, of course, was supervisor Volen Ivanov. Well hammered and congratulations!