Kent Nilsson

Uppsala University | UU · Centre for Clinical Research, County of Västmanland

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 9...

Background Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of t...

Aim The aim of this study is to investigate the extent to which school-related factors, such as school liking, participation in decision-making, school-related parental support, teachers’ support, and school physical environment, explain trends in mental health problems. The problems considered are psychosomatic symptoms (PSS), depressive symptoms...

Introduction The COVID-19 pandemic led to a surge in mental health issues and psychological distress, disruption to work/studying conditions, and social isolation particularly among young adults. Changes in these factors are differentially associated with alcohol use. Moreover, the relationship between these factors are bidirectional and may have f...

Background Adolescent mental health problems are on the rise globally, including in Sweden. One indicator is an increase in psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the trends in PSS. However, we found limited research on such associations. Method...

The prevalence of depressive symptoms in adolescents is 12–18% and is twice as frequent in females. Sleep problems and thoughts of death are depressive symptoms or co-occurrent phenomena. Family maltreatment is a risk factor for later depressive symptoms and the period circadian regulator (PER) has been studied in relation to neurotransmitters, ada...

Introduction Impairments in decision-making processes are believed to play an important role in both substance use disorders and behavioral addictions. Clinical and pre-clinical experimental testing provide complimentary insights on the psychobiological mechanisms of decision-making. The IOWA Gambling Task (IGT) assesses decision-making under ambig...

Background: Initiation of use/co-use of nicotine and alcohol, commonly occurring in an episodic manner during adolescence, can imprint vulnerability to the developing brain and lead to addiction. The ventral tegmental area (VTA) is a key heterogeneous region of the mesocorticolimbic circuit involved in the binge-drinking and intoxication step of t...

Aims: This study aims to investigate trends in four types of adolescent mental health problems; that is, psychosomatic symptoms, depressive symptoms, suicidal ideations, and suicide attempts 2004-2020. A second aim is to investigate the moderating roles of socioeconomic status and sex in these trends. Methods: The analysis is based on repeated c...

Background Alcohol consumption among adolescents has declined considerably during the last two decades. However, it is unknown if these adolescents’ alcohol consumption will remain low as they grow older. To our knowledge, this is one of the first studies that uses longitudinal data to examine if non-drinking adolescents have a lower alcohol consum...

Physical activity (PA) and sedentary behavior (SB) affect people’s physical and mental health. The aim was to examine changes in PA and SB in a Swedish population: at three time points: 2019, 2020, and 2022, i.e., before and during the COVID-19 pandemic. Pre-pandemic PA and SB, i.e., 2019, were assessed retrospectively in 2020. Associations between...

Aim: To study the prevalence and patterns of problematic gaming and gambling during the COVID-19 pandemic and the association with psychiatric traits and major types of anxiety categories. Method: 1067 young adults participated in both wave 3 (2018) and wave 4 (2021) of the SALVe Cohort. Associations with psychiatric symptoms and anxiety were exami...

Background Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at...

Decision-making requires that individuals perceive the probabilities and risks associated with different options. Experimental human and animal laboratory testing provide complimentary insights on the psychobiological underpinnings of decision-making. The Iowa gambling task (IGT) is a widely used instrument that assesses decision-making under uncer...

Background Provoked vestibulodynia (PVD) is a common pain disorder afflicting primarily young women, and botulinum toxin A (BTA) has been to a limited extent tested as a treatment. Aim Evaluate outcome 12 months after injection with BTA as a treatment for PVD. Methods We conducted a double-blinded, placebo-controlled trial of twice repeated injec...

Introduction Autonomic arousal is believed to be an underlying reinforcer for problematic gambling behavior. Theories suggests that near-misses (outcomes falling just short of a true win) are structural characteristics affecting emotion and motivation while increasing gambling persistence. Objectives Psychophysiological responses to different outc...

Depression affects one in five persons at 18 years of age. Allele A of the brain-derived neurotrophic factor (BDNF) rs6265 is considered to be a risk factor for depression. Previous studies of the interaction between BDNF rs6265, early adversity, and/or physical activity have shown mixed results. In this study, we explored the relation between BDNF...

Psychological theories consider autonomic arousal to be a reinforcer for problem gambling. Structural characteristics such as near-misses, which are non-win events that come close to a real win, have been shown to elicit win-like responses while increasing motivation and gambling persistence. This study investigated the autonomic and subjective res...

Background. Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether adolescents with high levels of psychosomatic symptoms are at risk of develo...

Epigenome-wide studies report higher methylation among women than men with decreasing levels with age. Little is known about associations of sex and age with methylation of monoamine oxidase A ( MAOA ). Methylation of the first exonic and partial first intronic region of MAOA has been shown to strengthen associations of interactions of MAOA-uVNTR g...

Background Studies in Sweden and elsewhere have shown that mental health problems have increased among adolescents in recent decades. Unlike the previous studies, we extend the investigation to the trends of various mental health problems, namely: psychosomatic symptoms, suicide attempts, depressive symptoms, and suicide ideations in the last two d...

FKBP5 gene–environment interaction (cG × E) studies have shown diverse results, some indicating significant interaction effects between the gene and environmental stressors on depression, while others lack such results. Moreover, FKBP5 has a potential role in the diathesis stress and differential susceptibility theorem. The aim of the present study...

Aim Examination of psychometric properties and diagnostic accuracy of the Depression Self-Rating Scale for Adolescents (DSRS-A) as well as development and evaluations of a shorter version, DSRS-A-Screener. Methods Analyses of component structure and internal consistency were performed in a community-based sample of adolescents N = 4,506 and among...

Objective Breastfeeding, which is important for early growth, is a possible moderator of genetic influence, such as the effect of the fat mass and obesity-associated gene (FTO) on body mass index (BMI). The aim of this study was to assess the moderating effect of breastfeeding duration on the relationship between FTO rs9939609 and BMI in a Caucasia...

DNA methylation and gene expression can be altered by early life stress (ELS) and/or ethanol consumption. The present study aimed to investigate whether DNA methylation of the Vesicular Glutamate Transporters ( Vglut ) 1-3 is related to previously observed Vglut1-3 transcriptional differences in the ventral tegmental area (VTA), nucleus accumbens (...

Background: Assessment of disability is part of the psychiatric diagnostic process, and validated scales are needed for the assessment of functioning. The Swedish translations of the Child Sheehan Disability Scale (CSDS) for adolescents and parents (CSDS-P) have been adapted for use in psychiatric settings. Objective: The purpose of the study was t...

Depression is a common mental health problem that is thought to develop through a combination of genetic, psychological, and environmental factors, including parental behaviours and parental mental health. The present study investigated the potential interaction between oxytocin receptor (OXTR) single nucleotide polymorphisms (SNPs) (rs53576, rs237...

Aim The bidirectional association between obesity and depression seen in adults is not clearly established in adolescents. The aim of this study was to investigate the longitudinal association between body mass index (BMI), depressive symptoms and interactions between bullying victimization and BMI, taking gender differences into account. Subjects...

DNA methylation and gene expression can be altered by early life stress (ELS) and/or ethanol consumption. The present study aimed to investigate whether DNA methylation of the Vesicular Glutamate Transporters ( Vglut ) 1–3 is related to previously observed Vglut1-3 transcriptional differences in the ventral tegmental area (VTA), nucleus accumbens (...

Abstract Background Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requ...

Background Depression often emerges during early adolescence and is one of the most common mental health problems. The present study investigated the influence of parenting styles and parental depression on depressive symptoms during adolescence and young adulthood, using both a cross-sectional and a longitudinal approach. Methods Data were obtain...

Background: Physical activity (PA) during adolescence is associated with a wide range of health benefits, including lower levels of internalizing and externalizing problems. Although the association between PA and mental health has been established, there are few prospective studies investigating if the association between PA and internalizing/ext...

Objective: To evaluate pain reduction after two injections of 50 units botulinum toxin A compared with placebo for provoked vestibulodynia. Methods: We conducted a double-blinded, placebo-controlled randomized trial of 50 units botulinum toxin A or placebo injected in the bulbocavernosus muscles twice, 3 months apart, in women with provoked vest...

The relationship between a parent and an adolescent is dynamic. A parent may do better in certain areas or during certain phases of the adolescent’s life, and the adolescent’s needs or demands on the parent may vary accordingly. Parental dimensions have been used to evaluate the quality of a parent–child relationship. The present study explored the...

Background: The Montgomery–Åsberg Depression Rating Scale – Self Assessment (MADRS-S) is used to assess symptom severity in major depressive disorder (MDD) among adolescents, but its psychometric properties and diagnostic accuracy are unclear. Aim: The aim of this study was to explore psychometric properties, including diagnostic accuracy, of the M...

Background: The association between childhood maltreatment and subsequent aggressive behaviour is modified by monoamine oxidase A (MAOA) functional polymorphism (MAOA-uVNTR) genotype, MAOA-Long (MAOA-L) in females, MAOA-Short (MAOA-S) in males. Childhood maltreatment is associated with differential DNA methylation in several genes. Consistent with...

The importance of Vesicular Glutamate Transporter 2 (VGLUT2)-mediated neurotransmission has been highlighted in studies on addiction-related phenotypes. The single nucleotide polymorphism rs2290045 in VGLUT2 has been associated with alcohol dependence, but it is unknown whether or how this association is affected by environmental factors. The prese...

Psychotic-like experiences (PLEs), such as delusions and hallucinations, are risk markers for psychiatric symptoms and functional impairment. However, the unique contribution of PLEs to psychiatric symptoms remains unclear. Thus, the aim of this study was to investigate the effect of PLEs on psychiatric symptoms, adjusting for the baseline of such...

The rank-ordered logit (rologit) model was recently introduced as a robust approach for analysing continuous outcomes, with the linear exposure effect estimated by scaling the rank-based log-odds estimate. Here we extend the application of the rologit model to continuous outcomes with ties and ordinal outcomes treated as imperfectly-observed contin...

Attention‐deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by impairments in attention, hyperactivity and impulsivity. A higher proportion of boys than girls are diagnosed with ADHD, although girls seek care for ADHD at an older age, and almost to the same extent as men by adulthood (1). The sex difference in pre...

Background Childhood maltreatment interacts with a functional polymorphism in the monoamine oxidase A (MAOA) gene promoter region to modify the risk of aggressive behaviour. In females, the high-expressing variant (MAOA-L) interacts with maltreatment, whereas in males it is the low-expressing variant (MAOA-S) that interacts with maltreatment, highl...

Background: The aims of this longitudinal study were to identify predictors for continued pornography consumption and to investigate pornography consumption in relation to psychosomatic and depressive symptoms among a group of adolescents in Sweden. Methods and materials: A longitudinal study in classroom environment in 53 randomly selected senior...

Since the pioneering finding of Caspi and co-workers in 2002 that exposure to childhood maltreatment predicted later antisocial behaviour (ASB) in male carriers of the low-activity MAOA-uVNTR allele, frequent replication studies have been published. Two meta-analyses, one in 2006 and the other in 2014, confirmed the original findings by Caspi and c...

Early life stress (ELS) or alcohol consumption can influence DNA methylation and affect gene expression. Monoamine oxidase A (Maoa) encodes the enzyme that metabolizes monoaminergic neurotransmitters crucial for the stress response, alcohol reward, and reinforcement. Previously, we reported lower Maoa expression in the nucleus accumbens and dorsal...

Introduction: The role of parenting behavior is often highlighted in the development of anxiety in youth. However, previous reports are limited in terms of the specificity of relationships between different types of anxiety and parenting behaviors, informant effects on these relationships, and direction of effects. Methods: This study investigat...

Background: Recently, an increased trend toward non-drinking among adolescents has been observed in several countries. The aim of the present study is to evaluate a common suggestion in literature, that adolescents do not drink alcohol because they spend more time on the internet, monitored at home, by examining associations between internet activ...

Childhood physical abuse (PA) and sexual abuse (SA) interact with monoamine oxidase A (MAOA) gene polymorphism to modify risk for mental disorders. In addition, PA and SA may alter gene activity through epigenetic mechanisms such as DNA methylation, thereby further modifying risk for disorders. We investigated whether methylation in a region spanni...

The gene–environment interaction research field in psychiatry has traditionally been dominated by the diathesis–stress framework, where certain genotypes are assumed to confer increased risk for adverse outcomes in a stressful environment. In later years, theories of differential susceptibility, or biological sensitivity, suggest that candidate gen...

The oxytocin receptor gene (OXTR) influences human behavior. The G allele of OXTR rs53576 has been associated with both prosocial and maladaptive behaviors but few studies have taken account of environmental factors. The present study determined whether the association of childhood maltreatment with conduct problems was modified by OXTR rs53576 gen...

Aim The aims of this study were to investigate the long‐term stability of problematic gaming among adolescents and whether problematic gaming at wave 1 (W1) was associated with problem gambling at wave 2 (W2), three years later. Methods Data from the SALVe cohort, including adolescents in Västmanland born in 1997 and 1999, were accessed and analyz...

Genetic and environmental interactive influences on predisposition to develop alcohol use disorder (AUD) account for the high heterogeneity among AUD patients and make research on the risk and resiliency factors complicated. Several attempts have been made to identify the genetic basis of AUD; however, only few genetic polymorphisms have consistent...

Background: The diagnostic accuracy of the parent report of the Montgomery–Åsberg Depression Rating Scale (MADRS-P) for the screening of major depressive disorder (MDD) in adolescents has not been evaluated. Aim: The aim was to explore the psychometric properties and diagnostic accuracy of the MADRS-P in general child and adolescent psychiatric out...

Background Epigenetic mechanisms are candidate moderators of the effect of maltreatment on brain and behavior. Interactions between maltreatment and the monoamine oxidase A upstream variable number tandem repeat genotype (MAOA‐uVNTR) are associated with alcohol‐related problems. However, presently it is not known whether DNA methylation moderates t...

Introduction and aims: Traditionally, non-drinking adults or young adults have been associated with health deficits rather than health benefits. However, as the proportion of Swedish non-drinking adolescents has doubled since 2000, their health profiles are of interest. The aim of the present study is to examine whether social relations, school ch...

Alcohol misuse has been linked to dysregulation of stress, emotion, and reward brain circuitries. A candidate key mediator of this association is the FK506-binding protein (FKBP5), a negative regulator of the glucocorticoid receptor. The aim of the present study was to further understand the Fkbp5/FKBP5-related genetic underpinnings underlying the...

Background The total number of cardiovascular (CVD) deaths accounted for almost a third of all deaths globally in 2013. Population based randomised controlled trials, managed within primary care, on CVD risk factor interventions are scarce. The aim of the study was to evaluate the effects of a health dialogue intervention in a primary care setting...

Social anxiety is one of the most commonly reported mental health problems among adolescents, and it has been suggested that parenting style influences an adolescent's level of anxiety. A context-dependent effect of oxytocin on human social behavior has been proposed; however, research on the oxytocin gene ( OXT ) has mostly been reported without c...

The young brain is highly sensitive to environmental influences that can cause long-term changes in neuronal function, possibly through altered gene expression. The endogenous opioid system continues to mature after birth and because of its involvement in reward, an inadequate maturation of this system could lead to enhanced susceptibility for alco...

Aim: To investigate the associations between gambling frequency, attention-deficit hyperactivity disorder (ADHD) symptoms, and problem gambling among adolescent boys and girls. One hypothesis was that adolescents with increased ADHD symptoms have a higher frequency of gambling compared to adolescents with fewer ADHD symptoms. Method: A population-b...

The hypothesis that the S allele of the 5-HTTLPR serotonin transporter promoter region is associated with increased risk of depression, but only in individuals exposed to stressful situations, has generated much interest, research and controversy since first proposed in 2003. Multiple meta-analyses combining results from heterogeneous analyses have...

Introduction The candidate gene-environment interaction (cG × E) research field in psychiatry has traditionally been dominated by the diathesis–stress framework, where certain genotypes are assumed to confer increased risk for adverse outcomes in a stressful environment. In later years, theories of differential susceptibility or biological sensitiv...

Aim The aims of the present study was to investigate the long-term stability of problematic gaming among adolescents, and whether problematic gaming at wave 1 (W1) were associated with problematic gambling at wave 2 (W2), three years later. Methods Data from the SALVe-Cohort, including adolescents in Västmanland born in 1997 and 1999, at two waves...

To understand parent and child relations researchers have used three bipolar dimensions (warmth and rejection, structure and chaos, autonomy support, and coercion). These dimensions are not necessarily bipolar but could work as unipolar dimensions. The Parents as Social Context Questionnaire (PASCQ) has been used in parenting studies but needs to b...

Introduction Adolescence is a period of increasing demands in independent social functioning where parenting style may have an impact on social anxiety. A context-dependent effect of oxytocin on human social behavior has been suggested, however research on the gene coding for oxytocin (OXT) has mostly been reported without considering contextual fa...

The aim of the study was to examine whether online social network chatting (OSNC) is related to any of three peer-related pathways to alcohol use among adolescents including a stress-exposure pathway, a peer status pathway and a social context pathway. A survey was distributed to a Swedish population-based sample of 2,439 boys and girls 15–16 years...

The gene that encodes the FK506-binding protein 5 (FKBP5) is regarded as a candidate for investigating how negative life events interact with a genetic predisposition to stress-related disorders, such as depression and anxiety. Given the role of FKBP5 as an important regulator of stress responses, we aimed to investigate if single-nucleotide polymo...

Objectives: The aims of this study were to describe patterns of pornography consumption, investigate differences between consumers and non-consumers of pornography regarding sexual experiences, health and lifestyle and determine associations between pornography consumption and sexual experiences, health and lifestyle among adolescent girls. The hy...

The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N = 1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N = 24...

Aims: This study examined whether social capital and a sense of coherence are associated with hazardous alcohol use in a large population-based Swedish sample. In particular, the objectives were (a) to examine which of five subdimensions of social capital is associated with hazardous alcohol use, (b) to investigate the moderating role of sense of...

Background Reports of anxiety disorder characteristics among youth in clinical settings typically include descriptions of patients who have been specifically referred for anxiety treatment. At odds with a large body of evidence which demonstrates these disorders to be most common among young people, prevalence studies in samples referred to general...

Catechol-O-methyltransferase (COMT) genotype has been implicated as a vulnerability factor for several psychiatric diseases as well as aggressive behavior, either directly, or in interaction with an adverse environment. The present study aimed at investigating the susceptibility properties of COMT genotype to adverse and favorable environment in re...

The neurobiological basis of early life stress (ELS) impact on vulnerability to alcohol use disorder is not fully understood. The effect of ELS, adult ethanol consumption and single housing, on expression of stress and DNA methylation regulatory genes as well as blood corticosterone levels was investigated in the hypothalamus and pituitary of adult...

Objective: The objective of this study is to investigate the discriminative validity of neuropsychological tests and diagnostic assessment instruments in diagnosing adult ADHD in a clinical psychiatric population. Method: Of 108 patients, 60 were diagnosed with ADHD. The Diagnostic Interview for ADHD in adults (DIVA 2.0) and Adult ADHD Self-Repo...

Discordant associations between monoamine oxidase A (MAOA) genotype and high alcohol drinking have been reported in human and non-human primates. Environmental influences likely moderate genetic susceptibility. The biological basis for this interplay remains elusive, and inconsistencies call for translational studies in which conditions can be cont...

Alcohol use disorder is the outcome of both genetic and environmental influences and their interaction via epigenetic mechanisms. The neurotransmitter glutamate is an important regulator of reward circuits and implicated in adaptive changes induced by ethanol intake. The present study aimed at investigating corticolimbic and corticostriatal genetic...

The objective of the study is to evaluate the psychometric properties of the Gaming Addiction Identification Test (GAIT) and its parent version (GAIT-P), in a representative community sample of adolescents and parents in Västmanland, Sweden. Self-rated and parent-rated gaming addictive symptoms identified by GAIT and GAIT-P were analyzed for freque...

Alcohol use disorder is the outcome of both genetic and environmental influences and their interaction via epigenetic mechanisms. The neurotransmitter glutamate is an important regulator of reward circuits and implicated in adaptive changes induced by ethanol intake. The present study aimed at investigating corticolimbic and corticostriatal genetic...