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  1. Article ; Online: Acceptance and willingness-to-pay for oocyte cryopreservation in medical versus age-related fertility preservation scenarios among Swedish female university students.

    Gambadauro, Pietro / Bränn, Emma / Hadlaczky, Gergö

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 5325

    Abstract: Oocytes can be effectively cryopreserved and stored for future use in in-vitro fertilisation. Oocyte cryopreservation (OC) can therefore mitigate different threats to female fertility, but attitudes and policies often seem more favourable in medical ... ...

    Abstract Oocytes can be effectively cryopreserved and stored for future use in in-vitro fertilisation. Oocyte cryopreservation (OC) can therefore mitigate different threats to female fertility, but attitudes and policies often seem more favourable in medical rather than age-related fertility preservation scenarios. The value of OC for potential candidates may be perceived differently depending on the indications, although relevant empirical data are lacking. An adequately powered sample of Swedish female university students (n = 270; median age 25; range 19-35) were randomly delivered a medical (n = 130) or age-related (n = 140) fertility preservation scenario within an online survey. Sociodemographic factors, reproductive experiences, and awareness about OC were not significantly different between the groups. Differences in four outcomes were studied: proportions of respondents (1) positive to the use of OC, (2) positive to public funding for OC, or (3) open to considering OC; and (4) willingness-to-pay (WTP) for OC, measured in thousand Swedish krona (K SEK) through contingent valuation. There were no significant differences in the proportions of respondents positive to the use of OC (medical: 96%; age-related: 93%) or open to consider it (medical: 90%; age-related: 88%) in each scenario. However, public funding had significantly greater support in the medical scenario (85%) than in the age-related one (64%). The median WTP (45 K SEK ≈ 4.15 K EUR) approximated the current Swedish market price for a single elective cycle and was not significantly different between the scenarios (Cliff's delta - 0.009; 95%CI - 0.146, 0.128). These findings suggest that it may be inappropriate to justify counselling and priority policies only on the assumption that fertility preservation with OC for medical indications is more beneficial to women than when the same technique is used for age-related reasons. However, it would be interesting to investigate further why public funding appears more debatable than the treatment itself.
    MeSH term(s) Female ; Humans ; Cryopreservation/methods ; Fertility Preservation/methods ; Oocytes ; Students ; Sweden ; Universities
    Language English
    Publishing date 2023-04-01
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-32538-z
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  2. Article ; Online: Menstrual symptoms and subjective well-being among postmenarchal adolescents.

    Gambadauro, Pietro / Hadlaczky, Gergö / Wasserman, Danuta / Carli, Vladimir

    AJOG global reports

    2023  Volume 4, Issue 1, Page(s) 100304

    Abstract: Background: Menstrual symptoms are predominantly studied among adults but may occur directly after menarche. Adolescent menstrual healthcare, however, faces specific obstacles and more research into menstrual symptoms as a determinant of adolescent well- ...

    Abstract Background: Menstrual symptoms are predominantly studied among adults but may occur directly after menarche. Adolescent menstrual healthcare, however, faces specific obstacles and more research into menstrual symptoms as a determinant of adolescent well-being is therefore advocated.
    Objective: This study aimed to investigate menstrual symptoms and their impact on everyday life and well-being among postmenarchal adolescents.
    Study design: A survey was delivered to a random sample of 1644 schoolgirls, drawn from a population-based project involving 116 lower secondary education schools (7th and 8th grade) in Stockholm, Sweden. Menstrual symptoms (ie, dysmenorrhea, heavy bleeding, irregular periods, mood disturbance, other general symptoms) were investigated through multiple choice questions and defined according to their impact on everyday life as mild (seldom affected), moderate (affected but possible to cope) and severe (affected and difficult to cope). Subjective well-being was measured with the World Health Organization Five Well-Being index. Postmenarchal respondents were eligible for analysis; those with incomplete outcome data or using hormonal contraception were excluded. The frequency and severity of symptoms across different postmenarchal years (1st, 2nd, 3rd, 4th, or 5th+ year after menarche) were studied with Chi-square and Kendall's tau statistics. Analysis of variance was used to study the association between menstrual symptoms and World Health Organization Five Well-Being index scores. A composite menstrual health index variable was obtained through principal component analysis and used to study the overall impact of menstrual symptoms on well-being in regression analyses.
    Results: Of 1100 postmenarchal girls (mean age, 14.1±0.7 years), 93.2% reported menstrual symptoms, 81.3% had at least 1 moderate symptom and 31.3% had at least 1 severe symptom. The most frequent symptoms were dysmenorrhea (80.4%) and mood disturbance (81.1%), followed by irregular periods (67.9%), heavy bleeding (60.4%), and other general symptoms (60.4%). Throughout postmenarchal years, there was a significant increase in frequency and severity (
    Conclusion: Despite growing awareness about the relevance of menstruation to women's health, unmet menstrual health needs are a potential threat to the well-being of adolescents. Education, screening, and clinical competence are important tools to reduce the burden of menstrual symptoms during adolescence and to prevent long-term consequences. The development of novel person-centered strategies should be a priority for clinical practice and research in adolescent menstrual health.
    Language English
    Publishing date 2023-12-26
    Publishing country United States
    Document type Journal Article
    ISSN 2666-5778
    ISSN (online) 2666-5778
    DOI 10.1016/j.xagr.2023.100304
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  3. Article ; Online: Associations between sleep habits, quality, chronotype and depression in a large cross-sectional sample of Swedish adolescents.

    Lemke, Theresa / Hökby, Sebastian / Wasserman, Danuta / Carli, Vladimir / Hadlaczky, Gergö

    PloS one

    2023  Volume 18, Issue 11, Page(s) e0293580

    Abstract: Objective: To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents.: Method: Questionnaire data were obtained from ... ...

    Abstract Objective: To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents.
    Method: Questionnaire data were obtained from a representative sample of Swedish adolescents (n = 8449; 50.8% girls; aged 12-16). Depression was defined as >13 BDI-II scores. Logistic regression modelling estimated the effects of sleep duration, sleep quality, and chronotype on depression, adjusted for socio-demographic factors.
    Results: On weekdays, approximately 46% of adolescents slept less than the recommended length of eight hours per night (depressed: 68%, non-depressed: 40%). On weekends, however, only 17% slept shorter than recommended. Short weekday sleep duration was more common among girls than boys (53% vs. 38%) and girls reported worse sleep quality. The regression model showed that depression was predicted by weekday sleep duration (OR = 0.773, p < .0001), sleep quality (OR = 0.327, p < .0001), and late chronotype (OR = 1.126, p = .0017), but not by weekend sleep duration. A 30-minute increase in weekday sleep duration was associated with about 10% lower odds of depression.
    Conclusions: A substantial proportion of Swedish adolescents do not seem to meet the sleep recommendations of eight hours per night. Short sleep duration on weekdays, poor sleep quality, and late chronotype were associated with increased risk of depression. Interventions promoting longer weekday sleep duration (e.g., later school start times) seem relevant in this context, but further research is needed to investigate the directionality and underlying mechanisms of these associations.
    MeSH term(s) Male ; Female ; Humans ; Adolescent ; Circadian Rhythm ; Chronotype ; Sweden/epidemiology ; Cross-Sectional Studies ; Depression/epidemiology ; Sleep ; Surveys and Questionnaires ; Sleep Wake Disorders
    Language English
    Publishing date 2023-11-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0293580
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  4. Article ; Online: Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior.

    Hökby, Sebastian / Westerlund, Joakim / Alvarsson, Jesper / Carli, Vladimir / Hadlaczky, Gergö

    International journal of environmental research and public health

    2023  Volume 20, Issue 4

    Abstract: Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion- ... ...

    Abstract Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months;
    MeSH term(s) Male ; Humans ; Adolescent ; Female ; Depression/psychology ; Screen Time ; Sweden ; Adaptation, Psychological ; Emotions
    Language English
    Publishing date 2023-02-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20043771
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  5. Article ; Online: A pilot study evaluating the preventive effects of platform-end lengthwise fencing on trespassing, person struck by train and traffic delays.

    Fredin-Knutzén, Johan / Hadlaczky, Gergö / Wigren, Anders / Sokolowski, Marcus

    Journal of safety research

    2023  Volume 88, Page(s) 78–84

    Abstract: Background: Trespassing at train tracks and "person under train" (PUT) incidents are serious health, societal and transportation concerns. There is a need for developing different measures to prevent these events. Here, we hypothesized that platform-end ...

    Abstract Background: Trespassing at train tracks and "person under train" (PUT) incidents are serious health, societal and transportation concerns. There is a need for developing different measures to prevent these events. Here, we hypothesized that platform-end lengthwise fences (PLF) reduce trespassing, the number of PUT incidents (suicides and accidents), and train traffic delays.
    Method: PLFs were installed as the intervention at one station in Stockholm in 2020. The number of trespassers detected using CCTV-cameras was compared before and after at the intervention station over a total period of 29 months (using incidence rate ratio, IRR). The reduction in the number of PUT (over 20 years) and train traffic delays (over 9 years) was also investigated by IRR, and by using three control groups.
    Results: After installation of PLF there was a significant ∼90% reduction in trespasses (IRR = 0.10, 95%CI 0.04-0.23; one-sided exact p < 0.0001). No PUT incident occurred at the intervention station after the installation, compared to 1.11 per year before installation (IRR = 0.32, 95%CI 0-1.82; one-sided exact p = 0.1216). There was a significant reduction in delay minutes post installation compared to before the installation (Mann Whitney U = 0, upper one-sided exact p = 0.0357). The effect of the PLF was also observable in comparison to the three control groups, suggesting that the preventive effect was not due to wider societal events affecting all stations.
    Conclusion: PLF had a large effect on reducing the number of trespasses and the number of delay minutes due to trespasses and PUT incidents. PLF may also have an effect of reducing PUT incidents.
    Practical applications: PLF is deemed to be relatively easy and cheap to install and thus scalable (as compared to full barriers, e.g., platform screen doors) and may be considered at platform-ends having an exit, provided there is enough space to install them.
    MeSH term(s) Humans ; Suicide ; Suicide Prevention ; Pilot Projects ; Railroads ; Transportation
    Language English
    Publishing date 2023-11-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2015321-1
    ISSN 1879-1247 ; 0022-4375
    ISSN (online) 1879-1247
    ISSN 0022-4375
    DOI 10.1016/j.jsr.2023.10.010
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  6. Article ; Online: A pilot study evaluating the effectiveness of preventing railway suicides by mid-track fencing, which restrict easy access to high-speed train tracks.

    Fredin-Knutzén, Johan / Hadlaczky, Gergö / Andersson, Anna-Lena / Sokolowski, Marcus

    Journal of safety research

    2022  Volume 83, Page(s) 232–237

    Abstract: Background: Suicides in the railway system is a serious health, societal, and transportation concern. Restriction of the access to suicide methods in the form of different physical barriers is a promising approach for suicide prevention.: Method: Mid- ...

    Abstract Background: Suicides in the railway system is a serious health, societal, and transportation concern. Restriction of the access to suicide methods in the form of different physical barriers is a promising approach for suicide prevention.
    Method: Mid-track fencing, which is fencing placed in-between the high-speed and commuter train tracks, was installed at one out of seven stations along a train line outside of Stockholm in the years 2013/2014. The number of suicides at the intervention station was compared to six other stations used as controls, over a total period of 20 years (2002-2021).
    Results: Suicides at high-speed tracks occurring at stations was the major cause of death on the investigated railway line. Prior to the year 2014, the intervention and control stations displayed similar time trends in the number of suicides. After installation of the mid-track fencing in 2014, there was a 62.5% reduction in the rate of suicides occurring at the intervention station. Compared to the six other control stations, the intervention station displayed a significant reduction in the number of suicides during the years 2014-2021 (OR = 0.14, 95%CI 0.013-0.95). Suicides at the railway lines in-between stations were not increased post-intervention. However, nearby control stations showed a 162% increase in suicides after the intervention, suggesting the induction of transfer effects.
    Conclusion: Mid-track fences restricting access to high-speed train tracks may have a large effect on reducing the number of railway suicides at intervention stations, but may also induce an increase in suicides at nearby stations without mid-track fences.
    Practical applications: Partial physical barriers such as mid-track fencing is deemed to be relatively easy and cheap to install (as compared to full barriers; e.g., full height platform screen doors) and should be considered at all stations on railway lines that have high-speed trains passing by.
    MeSH term(s) Humans ; Suicide ; Pilot Projects ; Suicide Prevention
    Language English
    Publishing date 2022-09-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2015321-1
    ISSN 1879-1247 ; 0022-4375
    ISSN (online) 1879-1247
    ISSN 0022-4375
    DOI 10.1016/j.jsr.2022.08.019
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  7. Article ; Online: Suicides during the Swedish midsummer holiday: analysis of cause of death data 1980-2018.

    Hökby, Sebastian / Westerlund, Joakim / Blazevska, Bianca / Hadlaczky, Gergö

    Nordic journal of psychiatry

    2021  Volume 75, Issue 7, Page(s) 487–493

    Abstract: Introduction: Previous studies have demonstrated increased suicide rates on holidays such as New Year, nationally and internationally. Comparable to New Year's Eve, Swedish Midsummer is a major holiday, linked to high levels of alcohol consumption in ... ...

    Abstract Introduction: Previous studies have demonstrated increased suicide rates on holidays such as New Year, nationally and internationally. Comparable to New Year's Eve, Swedish Midsummer is a major holiday, linked to high levels of alcohol consumption in the population. We, therefore, hypothesized that suicides and deaths with undetermined intent would increase during the Midsummer celebration.
    Methods: We used a retrospective death registry design to investigate all suicides that occurred on Midsummer's Eve (ME), Midsummer's Day (MD) and 28 adjacent days (AD) during 1980-2018. Data were stratified by diagnosis type, sex and age, and was analyzed with paired
    Results: During the 30-day investigation period, the observed average was 4.3 deaths per day (23.3% cases with undetermined intent). ME, but not MD, was associated with significantly fewer suicides compared to AD (-1.08 deaths,
    Discussion: The study found that suicide decreases and deaths with undetermined intent increases on ME. The findings are interpreted considering that substance use may affect both suicidal intentions and diagnosis classifications. Social and cultural support and holiday anticipations might also account for suicidal behaviors on ME.
    MeSH term(s) Cause of Death ; Holidays ; Humans ; Retrospective Studies ; Suicide ; Sweden/epidemiology
    Language English
    Publishing date 2021-04-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1104974-1
    ISSN 1502-4725 ; 0803-9488 ; 0029-1455
    ISSN (online) 1502-4725
    ISSN 0803-9488 ; 0029-1455
    DOI 10.1080/08039488.2021.1900388
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  8. Article: Suicidal Thoughts and Behaviors Among Swedish Suicide-Bereaved Women: Increased Risk Associated With the Loss of a Child, Feelings of Guilt and Shame, and Perceived Avoidance From Family Members.

    Westerlund, Michael / Hökby, Sebastian / Hadlaczky, Gergö

    Frontiers in psychology

    2020  Volume 11, Page(s) 1113

    Abstract: Previous studies have shown that suicide-bereaved individuals may suffer increased risk of suicidal thoughts and behaviors (STBs) due to traumatic grief. In this paper, we present the self-reported rate of STB among Swedish suicide-bereaved women ( ...

    Abstract Previous studies have shown that suicide-bereaved individuals may suffer increased risk of suicidal thoughts and behaviors (STBs) due to traumatic grief. In this paper, we present the self-reported rate of STB among Swedish suicide-bereaved women (
    Language English
    Publishing date 2020-06-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2020.01113
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  9. Article ; Online: Measuring Attitudes toward Suicide Prevention among Occupational Staff Frequently Exposed to Suicidal Individuals: Psychometric Evaluation and Validation.

    Ramberg, Inga-Lill / Hökby, Sebastian / Karlsson, Linda / Hadlaczky, Gergö

    International journal of environmental research and public health

    2021  Volume 18, Issue 8

    Abstract: As the attitudes of healthcare staff are thought to influence the quality and effectiveness of interventions targeting patients' suicide risk, attitudes are often used as an outcome in the evaluation of suicide-preventive training. Due to various ... ...

    Abstract As the attitudes of healthcare staff are thought to influence the quality and effectiveness of interventions targeting patients' suicide risk, attitudes are often used as an outcome in the evaluation of suicide-preventive training. Due to various problems related to the validity and reliability of commonly used scales, there is a lack of overall agreement on how to measure these attitudes. Confirmatory factor analysis (CFA) was used to cross-validate previously used models and to investigate new models to measure professionals' attitudes toward work with suicidal individuals and to test the longitudinal stability of the models by analyzing new sets of data. The population in the first study consisted of a heterogenous group of 1350 professionals who managed suicidal individuals relatively frequently. The second study included 640 professionals. The results of the cross-validation of previous models were described and a new questionnaire measuring attitudes toward suicide prevention, suicidal individuals, and organizational-facilitated self-efficacy (OSAQ-12) was presented. The three presented models retained a good fit and were stable over time. Valid and reliable measurement models that measure aspects of attitudes toward suicide are a prerequisite for conducting both cross-sectional and intervention studies.
    MeSH term(s) Attitude ; Cross-Sectional Studies ; Humans ; Psychometrics ; Reproducibility of Results ; Suicidal Ideation ; Suicide/prevention & control ; Surveys and Questionnaires
    Language English
    Publishing date 2021-04-10
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph18084001
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  10. Article ; Online: Increased suicide risk among younger women in winter during full moon in northern Europe. An artifact or a novel finding?

    Plöderl, Martin / Westerlund, Joakim / Hökby, Sebastian / Hadlaczky, Gergö / Hengartner, Michael Pascal

    Molecular psychiatry

    2022  Volume 28, Issue 2, Page(s) 901–907

    Abstract: Available evidence suggests that there is no effect of moon phases on suicidal behavior. However, a Finnish study recently reported elevated suicide rates during full-moon, but only among premenopausal women and only in winter. This could not be ... ...

    Abstract Available evidence suggests that there is no effect of moon phases on suicidal behavior. However, a Finnish study recently reported elevated suicide rates during full-moon, but only among premenopausal women and only in winter. This could not be replicated in an Austrian study and stirred a discussion about whether the Finnish finding was false-positive or if there are unaccounted moderator variables differing between Finland and Austria. The goal of the present study was to provide another replication with data from Sweden, which is geographically more comparable to Finland than Austria. We also investigated the discussed moderator variables latitude and nightly artificial brightness. There were 48,537 suicides available for analysis. The fraction of suicides during the full-moon quarter in winter did not differ significantly from the expected 25% among premenopausal women (23.3%) and in the full sample (24.7%). The incidence risk ratios for full moon quarter in Poisson regression models were 0.96 (95% CI: 0.90-1.02) for premenopausal women and 1.01 (95% CI: 0.99-1.04) for the full sample. According to Bayes-factor analysis, the evidence supports the null-hypothesis (no association) over the alternative hypothesis (some association). We found similar results when we split the data by latitude and artificial nightly brightness, respectively. In line with the Austrian study, there was no increase of suicides in Sweden among premenopausal women in winter during full-moon. The results from the Finnish study are likely false positive, perhaps resulting from problematic but common research and publication practices, which we discuss.
    MeSH term(s) Humans ; Female ; Suicide ; Moon ; Artifacts ; Bayes Theorem ; Europe/epidemiology
    Language English
    Publishing date 2022-10-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1330655-8
    ISSN 1476-5578 ; 1359-4184
    ISSN (online) 1476-5578
    ISSN 1359-4184
    DOI 10.1038/s41380-022-01823-0
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