In English
In January 2000 we have opened a Stress Research Clinic with a grant from the insurance company Alecta, which noted a sharp increase in stress-related sick leave among white-collar workers in Sweden. We conducted a study in which 80 consecutive patients with stress-related diagnoses and sick-leave above 3 months' duration (the majority over six months) were randomly assigned to a 6-months intervention or to a waiting list control condition for the same amount of time. The treatment included stress-management training in a group format, individual medical, acupuncture and short-term psychotherapeutic interventions if necessary, group physiotherapy and psychosocial counseling geared at work resumption.
In this project (the first of its kind in Sweden - see Perski & Grossi, 2004) we have shown a return to work rate of 62% after one year. In the unpublished three-year follow-up of this group the return rate is 75%. Since this first project, we have seen over 600 patients in our clinic. The majority was on sick-leave for at least a year and the return rate to work (employment, work training or education) is currently around 80% at completion of our treatment. We have now several ongoing projects concerning treatment issues.
We are currently one of the few clinics in Europe which has a systematic research program on treatment and rehabilitation issues and we feel that we deserve systematic support in our effort if one considers that estimated 25% of all work-related sickness leave in Europe is stress related!
Sickness mechanisms
The line of our work here is to show that stress-related disorders are due to distinct biological disturbances, which might, in turn, be treatable. One of our main hypotheses is that long-term imbalance between demands and resources (stress) leads to disturbance in the restitution and the regeneration of the organism, which in turn gravely reduces its' adaptability and resistance to external factors.
In co-operation with Prof. Torbjörn Åkersted and his research group at our Institute (world renowned for their studies of sleep mechanisms), we have conducted a study on the sleep function of our patients. The sleep patterns of 32 patients on sick-leave for at least 3 months due to stress related disorders were compared those of 16 healthy control subjects. In the analysis of the data (Ekstedt et al, 2004) we were able to show a severe disturbance of the sleep pattern, characterised by a significant reduction of slow wave sleep and increases in micro-arousals throughout the night. It is believed that during slow wave sleep the regeneration of the nervous and immune system is at its' maximum, as evidenced by peak releases of growth hormone and absence of catabolic hormones, e.g. cortisol. We are continuing studies around sleep disturbances and biological processes which follow in our patients. Another study is the role of sleep enhancement treatments, with the evaluation of behavioral group methods we currently employ in our clinic in combination with placebo or pharmacological agents, which supposedly enhance slow-wave sleep.
Another line of study concerns the cognitive impairments, i.e. problems with memory and concentration, which are reported by the great majority of our patients. In co-operation with Ass. Prof Ivanka Savic, an expert on MR and PET techniques at Karolinska Institute, we conduct a series of cognitive tests in our patients, both before and after our treatment program.
Our group
Our group has been active in the basic stress-research in the last 20 years, but in the last five years we started to reorient our research effort toward intervention studies. We have gathered a team of researchers, therapists, physicians and related professionals around our Stress Research Clinic (Stressmottagningen), mainly affiliated to Stress Research Institute at Stockholm University and at the Karolinska Institute. Members of the group are:
- Ass. Prof at Karolinska Institute, Ph.D. psychologist Aleksander Perski who is a research team leader at Stress Research Institute as well as affiliated researcher at Karolinska Institute. He is recognised specialist in the area of treatment of stress-related diseases.
- Ass. Prof at Karolinska Institute Giorgio Grossi, Ph.D., behavioral sciences, research leader in our group with the main interest in psycho physiological and endocrine mechanisms of stress disorders.
- Prof. at Sundsvall University Örjan Sundin, Ph.D., psychologist with the interest in stress-prevention interventions at individual and organisational level.
- Karin Schraml, psychologist, research assistant at Stress Research Institute, Stockholm University.
- Merja Hellenius, MD, responsible for medical follow-up of our patients as well as medical responsibility of intervention studies.
We also have a team of associated therapists, physical therapists, nurses, rehabilitation specialists as well as administrators who constitute a team of our stress clinic - presently about 20 people. The clinic is located at the Karolinska Institute campus and consists of three group rooms and administrative space. We also have access to gym at Karolinska Institute campus. Beside access to Stress Research Institute endocrine lab and sleep lab, we have our own biofeedback equipment mainly used to improve breathing function. We also have psycho physiological equipment to monitor EKG, activities and blood pressure during 24-hours.
Collaboration
The Stress Research Institute is a leading research organisation for stress research in Sweden, and gives us numerous opportunities for co-operation between various research teams. There is a particularly extensive collaboration with the Sleep research group headed by Prof. Torbjörn Åkerstedt, a world leading specialist in the biology of sleep function. We have currently two research projects together and are planning one large intervention study around sleep normalisation in exhausted patients next year.
We also have intensive collaboration with the group around Prof. Töres Theorell, a world-renowned specialist on work and health, around the work-place intervention projects. We have collaboration with Ass. Prof Ivanka Savic, Karolinska Institute, who is involved in our study of exhaustion and cognitive function impairments. Collaboration with Ass.prof. Joachim Soares at the Stockholm County Social Medicine Centre - epidemiology of stress disorders. We collaborate with Dr. Kristina Glise at the Stress Centre, Gothenburg - about prevention strategies and treatment of stress disorders.
International collaboration Prof. Manfred Schaufeli at the Department of Health Psychology, Utrecht University, Holland around the issues of burnout, job-related stress and prevention interventions. Prof. Giovanni Fava, Department of Psychology, Bologna University as above Prof. Barbara Weigl, School of Social Psychology, Warsaw, Poland Prof. Samuel Melamed , Tel Aviv University, Israel - biology of burnout studies.
Click here for a list of our publications.
If you want to reach us please don't hesitate to contact Aleksander Perski:
Phone: (+46) 08-524 820 71
e-mail: perski@stressmottagningen.com
