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Subglacial lakes form beneath ice sheets and ice caps if water is available and if bedrock and surface topography are able to retain the water. On a regional scale, the lakes modulate the timing and rate of freshwater flow through the subglacial system to the ocean by acting as reservoirs. More than 100 hydrologically active subglacial lakes that drain and recharge periodically have been documented under the Antarctic Ice Sheet, while only approximately 20 active lakes have been identified in Greenland. Active lakes may be identified by local changes in ice topography caused by the drainage or recharge of the lake beneath the ice. The small size of the Greenlandic subglacial lakes puts additional demands on mapping capabilities to resolve the evolving surface topography in sufficient detail to record their temporal behaviour. Here, we explore the potential for using CryoSat-2 swath-processed data, together with TanDEM-X digital elevation models, to improve the monitoring capabilities of active subglacial lakes in Greenland. We focus on four subglacial lakes previously described in the literature and combine the data with ArcticDEMs to obtain improved measurements of the evolution of these four lakes. We find that with careful tuning of the swath processor and filtering of the output data, the inclusion of these data, together with the TanDEM-X data, provides important information on lake activity, documenting, for example, that the ice surface collapse basin on Flade Isblink Ice Cap was 50 % (30 m) deeper than previously recorded. We also present evidence of a new, active subglacial lake in southwestern Greenland, which is located close to an already known lake. Both lakes probably drained within 1 month in the summer of 2012, which suggests either that they are hydrologically connected or that the drainages were independently triggered by extensive surface melt. If the hydrological connection is confirmed, this would to our knowledge be the first indication of hydr

Background: Offspring of parents with a mental disorder are at high risk of developing a mental disorder and experiencing other adverse outcomes, highlighting the need for preventive interventions. However, it remains uncertain to what extent these interventions are effective in reducing offspring’s risk of developing mental disorders and other important outcomes. The main objective of this systematic review will be to assess the effects of preventive interventions versus any control intervention for parents with a mental disorder on offspring outcomes. Methods/design: A systematic review with meta-analysis will be performed and reported as recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), bias will be assessed with the Cochrane Risk of Bias tool-version 2 (ROB2), an eight-step procedure will be used to assess if the thresholds for clinical significance are crossed, trial sequential analysis will be conducted to control for random errors, and the certainty of the evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. To identify relevant trials, we will search for published trials in several electronic databases from their inception to the present. We will also search for unpublished trials and grey literature. Two review authors will independently screen the articles, extract data, and perform a risk of bias assessment. We will include any published or unpublished randomized clinical trial comparing a psychological preventive intervention versus any control intervention for parents with any mental disorder. The primary outcomes, which will be assessed in the offspring only, will be quality of life and incidence of a mental disorder. Secondary outcomes will include internalizing symptoms, externalizing symptoms, serious adverse events, out-of-home placement, and absence from school or daycare. Exploratory outcomes include trauma, socioemotional develop

The Ross Ice Shelf, West Antarctica, experienced an extensive melt event in January 2016. We examine the representation of this event by the HIRHAM5 and MetUM high-resolution regional atmospheric models, as well as a sophisticated offline coupled firn model forced with their outputs. The model results are compared with satellite-based estimates of melt days. The firn model estimates of the number of melt days are in good agreement with the observations over the eastern and central sectors of the ice shelf, while the HIRHAM5 and MetUM estimates based on their own surface schemes are considerably underestimated, possibly due to deficiencies in these schemes and an absence of spin-up. However, the firn model simulates sustained melting over the western sector of the ice shelf, in disagreement with the observations that show this region as being melt-free. This is attributed to deficiencies in the HIRHAM5 and MetUM output, and particularly a likely overestimation of nighttime net surface radiative flux. This occurs in response to an increase in nighttime downwelling longwave flux from around 180–200 W m-2 to 280 W m-2 over the course of a few days, leading to an excessive amount of energy at the surface available for melt. Satellite-based observations show that this change coincides with a transition from clear-sky conditions to clouds containing both liquid-water and ice-water. The models capture the initial clear-sky conditions but seemingly struggle to correctly represent the ice-to-liquid mass partitioning associated with the cloudy conditions, which we suggest is responsible for the radiative flux errors.

Introduction: Prevalence rates and correlates of personality disorders (PD) are relevant to health care policy and planning. Objectives: To present normative data for self-reported ICD-11 personality disorder (PD) features including tentative cut-off scores and prevalence rates for severity levels along with psychosocial correlates. Methods: The Personality Disorder Severity ICD-11 (PDS-ICD-11) scale and criterion measures of impairment were administered to a social-demographically stratified sample of Danish citizens (N = 8,941) of which 3,044 delivered complete data. Item-Response Theory (IRT) was employed to indicate cut-offs based on standard deviations from the latent mean. Results: The unidimensionality of the PDS-ICD-11 score was supported and IRT analysis suggested norm-based thresholds at latent severity levels. Expected associations with criterion measures were found. Conclusion: The normative data portray ICD-11 PD features in the general population and allow for interpretation of PDS-ICD-11 scores (e.g., scores of 12, 16, and 19 may indicate mild, moderate, and severe dysfunction), which may inform health care policy and planning. A total weighted prevalence of 6.9 % of the Danish general population is estimated to have clinically significant personality dysfunction, proportionally composed of Mild (4.8 %), Moderate (1.2 %), and Severe (0.9 %) levels. Future research should corroborate these findings using relevant clinical samples and methods.

The Level of Personality Functioning Scale–Brief Form 2.0 is a frequently used self-report inventory that may be used to screen for self- and interpersonal dysfunction according to the DSM-5 Alternative Model for Personality Disorders (AMPD) and the ICD-11 Classification of Personality Disorders. Nevertheless, reliable norms and cut-off scores to aid interpretation and clinical decision making are still lacking. The LPFS-BF and relevant impairment measures were administered to a sociodemographically stratisfied sample of 2,002 adults from the general Danish population of whom 713 individuals eventually delivered data for inclusion in the present study. The unidimensionality of the LPFS-BF scores was established using Confirmatory Factor Analysis (CFA). Item-Response Theory (IRT) analysis indicated satisfactory item functioning for all 12 items and suggested normative observed score thresholds at different latent severity levels. Meaningful associations were found between the LPFS-BF norm-based cut-off scores, quality of life, and social and occupational functioning. This study presented the first normative data for LPFS-BF, which specifically applies to Denmark but likely also other socioeconomically comparable Nordic and Western societies. These results allow for interpretation of LPFS-BF scores and clinical decision-making. Future research should corroborate these findings and compare them to scores obtained in other general population samples.

Ice losses from the Greenland and Antarctic ice sheets have accelerated since the 1990s, accounting for a significant increase in the global mean sea level. Here, we present a new 29-year record of ice sheet mass balance from 1992 to 2020 from the Ice Sheet Mass Balance Inter-comparison Exercise (IMBIE). We compare and combine 50 independent estimates of ice sheet mass balance derived from satellite observations of temporal changes in ice sheet flow, in ice sheet volume, and in Earth's gravity field. Between 1992 and 2020, the ice sheets contributed 21.0±1.9 mm to global mean sea level, with the rate of mass loss rising from 105 Gt yr−1 between 1992 and 1996 to 372 Gt yr−1 between 2016 and 2020. In Greenland, the rate of mass loss is 169±9 Gt yr−1 between 1992 and 2020, but there are large inter-annual variations in mass balance, with mass loss ranging from 86 Gt yr−1 in 2017 to 444 Gt yr−1 in 2019 due to large variability in surface mass balance. In Antarctica, ice losses continue to be dominated by mass loss from West Antarctica (82±9 Gt yr−1) and, to a lesser extent, from the Antarctic Peninsula (13±5 Gt yr−1). East Antarctica remains close to a state of balance, with a small gain of 3±15 Gt yr−1, but is the most uncertain component of Antarctica's mass balance. The dataset is publicly available at https://doi.org/10.5285/77B64C55-7166-4A06-9DEF-2E400398E452 (IMBIE Team, 2021).

Impaired parental reflective functioning (PRF), i.e. difficulties in understanding one’s child in terms of mental states, may constitute a risk for children’s development and wellbeing. Impaired PRF has been linked to parental psychopathology, however no study has investigated PRF in adult patients with personality disorders (PDs). We examined PRF in a sample of adult outpatients with diagnosed PDs compared with healthy controls (HCs), and explored associations between PRF and symptoms of psychopathology and interpersonal problems in parents with PD. A convenience sample of treatment-seeking outpatients with PDs (n = 34) were assessed with questionnaires measuring PRF (The Parental Reflective Functioning Questionnaire (PRFQ)), symptoms of psychopathology (Symptom Checklist Revised (SCL-90-R)) and interpersonal problems (Inventory of Interpersonal Problems (IIP)). PRF scores were compared with reported means of HCs (n = 156) pooled from a previous study. Parents with PD reported higher levels of pre-mentalizing and lower levels of certainty about mental states compared with HCs. Both groups reported high levels of interest and curiosity and did not differ significantly in this regard. Exploratory analyses showed that low levels of certainty about mental states was associated with high levels of depressive and psychotic symptoms and submissive types of interpersonal problems (social-avoidance and non-assertiveness). Our findings provide preliminary evidence that patients with PD have impairments in PRF compared with HCs. The findings stress the importance of assessing the multidimensional nature of PRF in parents with PD., Impaired parental reflective functioning (PRF), i.e. difficulties in understanding one’s child in terms of mental states, may constitute a risk for children’s development and wellbeing. Impaired PRF has been linked to parental psychopathology, however no study has investigated PRF in adult patients with personality disorders (PDs). We examined PRF in a sample of adult outpatients with diagnosed PDs compared with healthy controls (HCs), and explored associations between PRF and symptoms of psychopathology and interpersonal problems in parents with PD. A convenience sample of treatment-seeking outpatients with PDs (n = 34) were assessed with questionnaires measuring PRF (The Parental Reflective Functioning Questionnaire (PRFQ)), symptoms of psychopathology (Symptom Checklist Revised (SCL-90-R)) and interpersonal problems (Inventory of Interpersonal Problems (IIP)). PRF scores were compared with reported means of HCs (n = 156) pooled from a previous study. Parents with PD reported higher levels of pre-mentalizing and lower levels of certainty about mental states compared with HCs. Both groups reported high levels of interest and curiosity and did not differ significantly in this regard. Exploratory analyses showed that low levels of certainty about mental states was associated with high levels of depressive and psychotic symptoms and submissive types of interpersonal problems (social-avoidance and non-assertiveness). Our findings provide preliminary evidence that patients with PD have impairments in PRF compared with HCs. The findings stress the importance of assessing the multidimensional nature of PRF in parents with PD.

Background: Mentalization-Based Therapy (MBT) was originally developed as a structured psychotherapy approach developed to treat borderline personality disorder (BPD) lasting up to 18 months in outpatient settings. However, a short-term (5 months) MBT program has recently been developed. No studies have investigated how MBT therapists experience the shift towards conducting short-term MBT for BPD. Objective: The objective of this study was to explore therapist experiences with conducting short-term MBT for outpatients with BPD in the Danish mental health services. Methods: Semi-structured qualitative interviews were conducted with seven therapists about their experiences with short-term MBT after a one-year pilot phase. The interviews were verbatim transcribed and analyzed using thematic analysis. Results: The following four major themes from the therapists’ experiences with short-term MBT were found in the qualitative analysis: (1) The longer the better, (2) Change processes can be intellectual or experiential, (3) Short-term therapy is hard work, and (4) Termination is more challenging in short-term MBT. Conclusion: Most therapists were overall reluctant towards changing from long-term to short-term MBT. These therapist experiences could inform implementation of short-term MBT in mental health settings in the future.

Background The optimal psychotherapy duration for mental health disorders is unclear. Our aim was to assess the beneficial and harmful effects of shorter- versus longer-term psychotherapy for adult mental health disorders. Method We searched relevant databases and websites for published and unpublished randomised clinical trials assessing different durations of the same psychotherapy type before June 27, 2022. Our methodology was based on Cochrane and an eight-step procedure. Primary outcomes were quality of life, serious adverse events, and symptom severity. Secondary outcomes were suicide or suicide-attempts, self-harm, and level of functioning. Results We included 19 trials randomising 3,447 participants. All trials were at high risk of bias. Three single trials met the required information size needed to confirm or reject realistic intervention effects. One single trial showed no evidence of a difference between 6 versus 12 months dialectical behavioral therapy for borderline personality when assessing quality of life, symptom severity, and level of functioning. One single trial showed evidence of a beneficial effect of adding booster sessions to 8 and 12 weeks of internet-based cognitive behavioral therapy for depression and anxiety when assessing symptom severity and level of functioning. One single trial showed no evidence of a difference between 20 weeks versus 3 years of psychodynamic psychotherapy for mood- or anxiety disorders when assessing symptom severity and level of functioning. It was only possible to conduct two pre-planned meta-analyses. Meta-analysis showed no evidence of a difference between shorter- and longer-term cognitive behavioural therapy for anxiety disorders on anxiety symptoms at end of treatment (SMD: 0.08; 95% CI: -0.47 to 0.63; p = 0.77; I2 = 73%; four trials; very low certainty). Meta-analysis showed no evidence of a difference between shorter and longer-term psychodynamic psychotherapy for mood

Introduction: Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, and several countries offer treatment programs for BPD lasting for years, which is resource demanding. No previous trial has compared short-term with long-term MBT. Objective: The aim of the study was to assess the efficacy and safety of short-term versus long-term MBT for outpatients with BPD. Methods: Adult outpatients (≥18 years) with subthreshold or diagnosed BPD were randomly assigned (1:1) to short-term MBT (5 months) or long-term MBT (14 months). The primary outcome was BPD symptoms assessed with the Zanarini Rating Scale for Borderline Personality Disorder. Secondary outcomes were functional impairment, quality of life, global functioning, and severe self-harm. All outcomes were primarily assessed at 16 months after randomization. Results: Between October 4, 2018, and December 3, 2020, we randomly assigned 166 participants to short-term MBT (n = 84) or long-term MBT (n = 82). Regression analyses showed no evidence of a difference when assessing BPD symptoms (MD 0.99; 95% CI: -1.06 to 3.03; p = 0.341), level of functioning (MD 1.44; 95% CI: -1.43 to 4.32; p = 0.321), quality of life (MD -0.91; 95% CI: -4.62 to 2.79; p = 0.626), global functioning (MD -2.25; 95% CI: -6.70 to 2.20; p = 0.318), or severe self-harm (RR 1.37; 95% CI: 0.70-2.84; p = 0.335). More participants in the long-term MBT group had a serious adverse event compared with short-term MBT (RR 1.63; 95% CI: 0.94-3.07; p = 0.088), primarily driven by a difference in psychiatric hospitalizations (RR 2.03; 95% CI: 0.99-5.09; p = 0.056). Conclusion: Long-term MBT did not lead to lower levels of BPD symptoms, nor did it influence any of the secondary outcomes compared with short-term MBT.

Purpose: Research has shown that schizophrenia augments the risk for criminal behaviour and variables both defining- and related to schizophrenia, increase criminal offending. Premeditated criminal offending is considered a severe form of criminal offending, however, very little is known about what predicts future premeditated criminal offending in schizophrenia. Method and materials: In this 6-year follow-up study we explored which factors underlie future premeditated criminal behaviour in a sample of patients diagnosed with schizophrenia (N = 116). We also investigated if a specific mentalizing profile underlie part of the variance of premeditated criminal offending. Results: Results showed that psychopathy underlie future premeditated crime in schizophrenia, and that a specific mentalizing profile, comprised of a dysfunctional emotional and intact cognitive mentalizing profile in relation to others, mediated parts of the relation between psychopathy and premeditated criminal offending. Finally, our results indicated that patients with schizophrenia with a specific mentalizing profile (see above) engaged in premeditated criminal behaviour earlier during the 6-year follow-up period compared to patients with other mentalizing profiles. Conclusions: Our findings suggest that mentalization should carefully be inspected in patients with schizophrenia in relation to future premeditated offending.

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Denne bog indfører læseren i at anvende ICD-11’s klassifikation af personlighedsforstyrrelser og relaterede træk. Ved hjælp af kliniske eksempler forklares aspekter af personlighedsfunktion, diagnosticering af sværhedsgrad og specifikation af trækdomæner. Med ICD-11 er der særlig fokus på personlighedens almenmenneskelige egenskaber, hvad angår aspekter af selvet og interpersonel funktion, som kan være mere eller mindre forstyrrede hos de fleste personer. Bogen kan således være anvendelig på tværs af de fleste kliniske sammenhænge. Der indgår konkrete vejledninger til diagnosticering og klinisk håndtering af henholdsvis let, moderat og svær personlighedsforstyrrelse såvel som subdiagnostiske personlighedsvanskeligheder. Herudover vejledes læseren i at tolke specifikke kombinationer af trækdomæner. Der indgår også vejledning til differentialdiagnostiske overvejelser, klinisk beslutningstagning, individualiseret behandlingsplanlægning, behandlingsintensitet og psykoterapeutisk fokus. Det er forfatternes mål at give læseren et overblik over alt det, man bør vide, for at komme godt i gang med at bruge denne fundamentalt nye måde at diagnosticere og forstå personlighedsforstyrrelser på. Bogen henvender sig først og fremmest til psykologer, psykiatere og beslægtede faggrupper i enten offentlig eller privat praksis, sekundært til studerende inden for de sundhedsfaglige områder. I bogens appendiks findes henvisninger til instrumenter samt inspiration til at “oversætte” de traditionelle ICD-10 og DSM-5 personlighedsforstyrrelser til ICD-11’s nye diagnostiske tilgang.

Introduction: To facilitate interpretation and clinical utility of patient-reported outcomes, normative data provide a reference for a person’s score on a particular outcome in relation to the general population. This study reports Danish general population norms for four mental health indicators, assessing social functioning (Sheehan Disability Scale, SDS) personal recovery (Brief INSPIRE-O), symptom burden (Symptom Check List-10, SCL-10) and subjective well-being (WHO-5).Methods: The study was a cross-sectional survey study organized by the State’s statistical authority among the general population of adult Danish residents in Denmark, ranging in age between 18 to 79 years.Results: A total of 8003 citizens were contacted including reminders from 2 March 2019 to 11 April 2019 by electronic letters, resulting in 2819 (35%) citizens providing complete responses. Female gender, higher age, Danish origin and living with a partner were associated with increased participation, and decreased participation was observed in male immigrants. We found a mean score of subjective well-being slightly lower than the population norm typically found in Danish general population studies. Elderly persons, Danes, and persons living with a partner reported better subjective mental health. Subjective well-being and personal recovery were positively correlated with social contacts and self-reported general health rating, and negatively correlated with social functioning and symptoms of depression and anxiety.Conclusion: This normative data provides a reference for interpreting mental health status. Our findings indicate slightly poorer subjective mental health than previously found. There is a need for special attention to engaging male immigrants in studies on mental health in the general population.