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Biomedical subjects

E L Mortensen

Publications and source records attributed to E L Mortensen.

At least 19 recordsLinked to original sources
PubMed2002

Pain in somatoform disorders: is somatoform pain disorder a valid diagnosis?

OBJECTIVE: Investigate the validity of DSM-IIIR somatoform pain disorder (SPD) by comparing subgroups of somatoform disorder patients on several measures of psychopathology. METHOD: A total of 144 patients with unexplained physical symptoms were referred from non-psychiatric departments. Among these, 127 patients with somatoform disorders were identified, classified according to the Structured Clinical Interview for DSM (SCID) diagnostic interview, and rated with scales for somatization, anxiety, depression and personality traits. RESULTS: Patients presenting pain did not differ significantly from patients presenting non-pain symptoms on measures of symptoms and personality traits. Correspondingly, patients with SPD did not differ significantly from patients with conversion disorder (CD), while patients with Somatization disorder (SD) had higher scores on most scales for psychopathology and personality disorder. CONCLUSION: Significant diagnostic and symptomatic overlap was found between SPD and CD, and although the statistical power of the study was modest, the study questions the validity of the current definition of SPD.

Adolescent↗
PubMed2002

Cerebral perfusion and cerebrovascular reactivity are reduced in white matter hyperintensities.

BACKGROUND AND PURPOSE: There is growing evidence that white matter hyperintensities (WMH) should not be considered as benign age-dependent changes on MR images but indicate pathological changes with clinical consequences. Previous studies comparing subjects with WMH to normal controls have reported global reductions in cerebral blood flow (CBF) and cerebral vascular reactivity. In this study, we examined localized hemodynamic status to compare WMH to normal appearing white matter (NAWM). METHODS: A group of 21 normal 85-year-old subjects were studied using dynamic contrast-enhanced MRI together with administration of acetazolamide. From a combination of anatomic images with different signal weighting, regions of interest were generated corresponding to gray and white matter and WMH. Localized measurements of CBF and cerebral blood volume (CBV) and mean transit time were obtained directly within WMH and NAWM. RESULTS: When comparing WMH to NAWM, measurements showed significantly lower CBF (P=0.004) and longer mean transit time (P< 0.001) in WMH but no significant difference in CBV (P=0.846). The increases in CBF and CBV induced by acetazolamide were significantly smaller in WMH than in NAWM (P=0.026, P<0.001). CONCLUSION: These results show that a change in the hemodynamic status is present within the WMH, making these areas more likely to be exposed to transient ischemia inducing myelin rarefaction. In the future, MRI may be used to examine the effect of therapeutic strategies designed to prevent or normalize vascular changes.

Acetazolamide↗
PubMed2001

A gender difference in the association between APOE genotype and age-related cognitive decline.

OBJECTIVE: To determine whether the APOE epsilon4 allele is associated with age-related intellectual decline in a community-dwelling sample of Danes. METHODS: A sample of 189 subjects who did not have dementia was tested with the Wechsler Adult Intelligence Scale (WAIS) at the ages of 50 and 80 years. Of these subjects, 163 (84 women and 79 men) completed all WAIS subtests at both assessments and 139 completed the digit symbol and block design subtests at the ages of 50, 60, 70, and 80 years. RESULTS: Cognitive decline from the age of 50 to the age of 80 years was substantial and larger for the performance subtests than for the verbal subtests (the declines were 18.40 for the performance IQ and 8.39 for the verbal IQ). APOE genotype was unrelated to the observed WAIS results of the 80-year assessment, but there was a significant interaction between APOE genotype and sex for decline scores in the performance IQ and three performance subtests (digit symbol, block design, and object assembly). In women, 26 epsilon4 carriers showed larger decline than 58 noncarriers, whereas there was no significant relation between APOE genotype and cognitive decline in men. The association in women between APOE genotype and cognitive decline was significant only for decline in the decade from age 70 to age 80 years. The interaction between sex and APOE genotype remained significant when education was included as a covariate. CONCLUSION: The APOE epsilon4 allele is associated with normal age-related decline in cognitive functions in women only. This finding may be supportive of recent evidence suggesting sex differences in APOE-associated risk for AD. Thus, the sex difference in the risk of sporadic AD may partly be explained by a sex-specific impact of the APOE epsilon4 allele on age-related cognitive decline.

Aged↗
PubMed2001

A longitudinal study of gender differences in depressive symptoms from age 50 to 80.

The Obvious Depression Scale was administered to 739 community residents at ages 50, 60, and 80 years, with 151 present at all waves. Although selective attrition influenced the level of depressive symptoms in cross-sectional vs. longitudinal samples, both sets of analyses revealed higher scores in women than in men at ages 50 and 60, but not at age 80. Men showed increases in depressive symptoms from age 60 to 80, but women did not (interaction p < .002). This interaction was not present in somatic symptoms, which increased across time in both genders. Potential explanations include differential changes in social roles with aging.

Age Distribution↗
PubMed2001

The Danish National Birth Cohort--its background, structure and aim.

BACKGROUND: It is well known that the time from conception to early childhood has importance for health conditions that reach into later stages of life. Recent research supports this view, and diseases such as cardiovascular morbidity, cancer, mental illnesses, asthma, and allergy may all have component causes that act early in life. Exposures in this period, which influence fetal growth, cell divisions, and organ functioning, may have long-lasting impact on health and disease susceptibility. METHODS: To investigate these issues the Danish National Birth Cohort (Better health for mother and child) was established. A large cohort of pregnant women with long-term follow-up of the offspring was the obvious choice because many of the exposures of interest cannot be reconstructed with sufficient validity back in time. The study needs to be large, and it is aimed to recruit 100,000 women early in pregnancy, and to continue follow-up for decades. The Nordic countries are better suited for this kind of research than most other countries because of their population-based registers on diseases, demography and social conditions, linkable at the individual level by means of the unique ID-number given to all citizens. Exposure information is mainly collected by computer-assisted telephone interviews with the women twice during pregnancy and when their children are six and 18 months old. Participants are also asked to fill in a self-administered food frequency questionnaire in mid-pregnancy. Furthermore, a biological bank has been set up with blood taken from the mother twice during pregnancy and blood from the umbilical cord taken shortly after birth. Data collection started in 1996 and the project covered all regions in Denmark in 1999. By August 2000. a total of 60,000 pregnant women had been recruited to the study. It is expected that a large number of gene-environmental hypotheses need to be based on case-control analyses within a cohort like this.

Cohort Studies↗
PubMed2000

Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study.

BACKGROUND: White-matter hyperintensities are commonly found on magnetic resonance imaging (MRI) of elderly people with or without dementia. Studies of the relation between severity of white-matter hyperintensities and cognitive impairment have had conflicting results. We undertook a longitudinal study of age-related decline in intellectual function and MRI at age 80 years. METHODS: From a cohort of 698 people born in 1914 and living in seven municipalities in Denmark, 68 healthy non-demented individuals had been tested with the Wechsler adult intelligence scale (WAIS) at ages 50, 60, and 70, and they agreed to further WAIS testing at age 80, and cerebral MRI at age 80-82 (mean age 82.3 years). We scored separately the numbers of periventricular and deep white-matter hyperintensities. FINDINGS: Scores for periventricular hyperintensities in this sample included all possible degrees of severity, but no participant scored more than 75% of maximum for deep white-matter hyperintensities. Neither type was related to the WAIS IQs of the 80-year assessment, but both were significantly associated with decline in performance IQ from age 50 to age 80 years (bivariate correlation coefficients 0.32, p=0.0087, and 0.28, p=0.0227, respectively). An analysis based on two WAIS subtests showed that the association between white-matter hyperintensities and cognitive impairment was significant only for cognitive decline in the decade 70-80 years. INTERPRETATION: Both periventricular and deep white-matter hyperintensities are related to decline in intelligence but, in healthy octogenarians, the cumulative effect of these features alone explains only a small part of the large differences among individuals in age-related decline in intelligence. Interpretation of the presence and severity of white-matter hyperintensities in a diagnostic context must be done cautiously.

Aged↗
PubMed2000

A randomized trial assessing the impact of written information on outpatients' knowledge about and attitude toward randomized clinical trials. The INFO trial group.

To improve the patient education process in clinical research, three information materials describing general aspects of design and conduct of randomized clinical trials were developed. The materials varied in length, reading ability level, and reader appeal. Their influence on knowledge about and attitude toward randomized clinical trials was assessed in a randomized, parallel group, evaluator-blinded trial among 415 outpatients. The patients were randomized to the following groups: control (no intervention), leaflet, brochure, or booklet. Knowledge was assessed by a 17-item multiple-choice questionnaire and attitude was assessed by a 32-item Likert questionnaire at entry and 2 weeks after the intervention. The interventions and the questionnaires were pilot tested and power calculations were performed. At entry, the mean knowledge score was 7.9 points. At follow-up, the knowledge scores increased by 0.5 for the control, 1.0 for the leaflet, 1.6 for the brochure, and 1.4 for the booklet. The brochure and the booklet improved the knowledge score significantly compared with the control. The general attitude was positive at entry (mean 71.5 points). Only the booklet significantly increased the total attitude score (4.8 points) and the randomized clinical trials attitude subscale score (1.8 points). In conclusion, written information significantly improved outpatients' knowledge about and attitude toward randomized clinical trials. Detailed rather than brief information was more effective. Control Clin Trials 2000;21:223-240

Attitude to Health↗
PubMed1999

Psychopathy and psychopathological profiles in prisoners on remand.

A total of 178 Danish male remand prisoners were examined using comprehensive interviews and questionnaires on psychopathological, personality and social measures, and file data. These data were compared with scores on the Hare Psychopathy Checklist - Revised (PCL-R). Subjects were divided into four groups according to quartile PCL-R scores. In general there were high rates of psychiatric morbidity in all PCL-R quartile groups. The medium-high scorers represent a more vulnerable group with a high prevalence of dependence disorders, relatively high neuroticism score and relatively high prevalence of neurotic and stress-related disorders. The high scorers were more psychosocially maladjusted, had more often made previous suicidal attempts, and had a higher psychoticism score. Chronic psychotic disorders did occur, mostly in the high-scoring group. The population had lower scores on the PCL-R than in most previous studies, suggesting a lower prevalence of psychopathic features among Danish criminals and possibly a lower cut-off point when using the PCL-R as a categorical measure. Both findings are consistent with the results of other European studies. Further studies on cross-cultural differences with regard to PCL-R psychopathic features and on psychic vulnerability related to PCL-R scores and factor 1/factor 2 of the PCL-R are suggested.

Adolescent↗
PubMed1999

Beer, wine, spirits and subjective health.

STUDY OBJECTIVE: To examine the association between intake of different types of alcoholic beverages and self reported subjective health. DESIGN: Cross sectional health survey with assessment of intake of beer, wine and spirits (at last non-weekend day), smoking habits, social networks, physical activity, body mass index, educational level, presence of chronic disease, and self reported health. SETTING: WHO Copenhagen Healthy City Survey, Denmark. PARTICIPANTS: 4113 men and 7926 women aged 18 to 100 years. MAIN RESULTS: Of the 12,039 subjects, 8680 reported their health as optimal, and 3359 reported a suboptimal health. After controlling for the covariates, the relation between total alcohol intake and the proportion reporting suboptimal health was J shaped. Heavy drinkers of any of the three types of alcoholic beverages had a higher prevalence of suboptimal health than non-drinkers. However, only light (1-2 glasses of wine yesterday) and moderate (3-5) wine drinkers had significantly lower odds ratios for suboptimal health--0.72 (95% confidence limits; 0.56 to 0.92) and 0.65 (0.49 to 0.87), respectively--when compared with non-wine drinkers. Moderate beer or spirits drinkers did not differ significantly from non-drinkers of these beverages with regard to prevalence of suboptimal health. Consistently, beer preference drinkers had an odds ratio of 1.50 (1.25 to 1.80) for suboptimal health compared with wine preference drinkers. CONCLUSIONS: A light to moderate wine intake is related to good self perceived health, whereas this is not the case for beer and spirits. The causal relations creating this association are unknown and should be considered when interpreting the relation between different types of alcoholic beverages and subsequent morbidity and mortality.

Adolescent↗
PubMed1999

Active life in old age. Combining measures of functional ability and social participation.

UNLABELLED: This paper describes a new measure of Active Life Expectancy, called Active Life Classification (ALC) in which the criterion for successful aging is a combination of good functional ability and high social participation. OBJECTIVES: 1) to describe the distribution of ALC among 75-year-old men and women, 2) to investigate the association between ALC and life satisfaction and 3) to describe how ALC is determined by socio-demographic, psycho-social, and health factors. DESIGN: A cross-sectional population survey. SETTING: Eleven municipalities in the Western part of Copenhagen County in 1989. SUBJECTS: A random sample of 75-year-old people who were invited to participate in the study (participation rate: 89, n = 477). MAIN OUTCOME MEASURE: ALC is a combination of two dichotomized variables: functional ability (dependent vs not dependent of help) and social participation (low vs. high). RESULTS: For both men and women an active life (measured by ALC) was significantly associated with life satisfaction. For men only good self-rated health was related to ALC in the multivariate analysis. Among women high income, many social contacts, good self-rated health, good memory and lack of chronic diseases were associated with ALC. CONCLUSIONS: It is an advantage to combine functional ability and social participation in the description of quality of life in old age, as 1) a high social participation may compensate for a poor functional ability, and vice versa, 2) the combined measure is meaningful for both sexes, and 3) it gives more information than the two concepts used as separate outcome measures.

Aged↗
PubMed1998

Outpatients' knowledge about and attitude towards clinical research and randomized clinical trials. The INFO Trial Group.

OBJECTIVES: To investigate the knowledge about randomized clinical trials and the attitude towards clinical research among Danish outpatients and to examine the relationships between outpatient demographic variables and knowledge and attitude. SETTING: Outpatients (n = 415) were recruited from four departments at a university hospital in Copenhagen. METHODS: The participants answered an 18 item multiple choice test evaluating knowledge about randomized clinical trials and a 32 item Likert format questionnaire evaluating attitudes towards clinical research in general and randomized clinical trials. Assessment of scales for knowledge and attitudes was performed using Rasch analysis and Cronbach's alpha. Associations between demographic variables, knowledge score and attitude score were examined using analysis of variance. RESULTS: Mean age for all outpatients was 46 years (range 18-88 years); 251 (60%) were females. A total of 27 outpatients (7%) had previously participated in a randomized clinical trial. Mean knowledge score (number of correct answers out of a maximum of 17) was 7.9 (SD 3.1). Patients in the younger age groups and patients with longer education had significantly higher knowledge scores (p < 0.001). The effect of age group (estimated increase in knowledge score relative to the group 60-89 years) was: 18-29 years 1.2 (SE 0.4); 30-39 years 2.0 (SE 0.4); and 40-59 years 1.6 (SE 0.4). The effect of education (estimated decrease in knowledge score relative to patients with > 12 years of education) was: < 7 years 3.4 (SE 0.4); and 8-11 years 2.0 (SE 0.3). Mean total attitude score was 74.8 (SD 14.8) on a scale from 0-128. Compared to female patients, male patients had an estimated 5.1 points (SE 1.5) higher attitude score (p < 0.001). There was a weak but significant positive association (r = 0.38; p < 0.001) between the knowledge score and the total attitude score. CONCLUSION: Among Danish outpatients knowledge about randomized clinical trials is better in the younger age groups and in individuals with longer education. Overall, better knowledge was associated with a more positive attitude towards clinical research. The question is whether it is possible by simple means to increase knowledge about clinical research and whether an increase in knowledge may positively affect the attitude towards clinical research in individual patients.

Adolescent↗
PubMed1997

Coping strategies among the long-term mentally ill: categorization and clinical determinants.

The aim of this study was to explore strategies for coping with symptoms in 98 long-term mentally ill patients. The following characteristics of the strategies were investigated: level, effectiveness, target symptom and problem orientation. In addition, we studied the association between measures of coping and psychopathology. An average of 3.8 coping strategies per patient was reported, and strategies involving behavioural change were most common (48%), followed by changes in socialization (24%) and in cognitive control (15%). Coping efforts were most commonly directed towards non-psychotic symptoms. A high load of general and affective symptoms, few negative symptoms and a high level of illness awareness predicted the total number of coping strategies. Separate analysis of active and passive strategies, including increased and decreased socialization, respectively, revealed very different patterns of clinical predictors. These results are discussed with reference to community-care programmes.

Activities of Daily Living↗
PubMed1996

[Delayed effects of prenatal exposure to phenobarbital on intelligence--Phenemal].

Two double-blind studies were conducted on two independent samples of adult men prenatally exposed to phenobarbital and matched control samples using two different measures of general intelligence (WAIS and a draft board test (BPP)). The two studies included 33 and 81 exposed adult men respectively, and the two control groups included 52 and 101 unexposed men matched on a wide spectrum of maternal variables recorded pre- and perinatally. Based on data from control subjects, regression models were built relating intelligence scores to relevant pre-exposure matching variables. Models generated predicted scores for each exposed subject. Men exposed prenatally to phenobarbital had significantly lower verbal intelligence scores than predicted. Lower socioeconomic status and being the offspring of an unwanted pregnancy increased the magnitude of the negative effects. Exposure which includes the last trimester was the most detrimental. Physicians are urged to use increased caution in prescribing such medications during pregnancy or to premature neonates.

Adult↗
PubMed1996

Aggression and personality: association with amino acids and monoamine metabolites.

Associations in 52 normal individuals were examined between plasma and cerebrospinal fluid (CSF) concentrations of tryptophan (Trp) and tyrosine, and concentrations of monoamine metabolites in the CSF, and scores on an aggression questionnaire, the Kinsey Institute Reaction List II, and the Eysenck Personality Questionnaire. There was a significantly positive correlation between CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and extroverted aggression scores, and a significantly negative correlation between CSF 5-HIAA levels and introverted aggression scores. Males showed higher plasma Trp concentrations than females, and significantly positive correlations between plasma Trp concentrations and scores on extroverted aggression and the Eysenck E scale. Males, furthermore, showed a significantly negative correlation between CSF Trp levels and scores on the Eysenck P scale, and a significantly positive correlation between concentrations of 3-methoxy-4-hydroxy-phenylglycol in CSF and scores on moral aggression. These results suggest that central serotonin influences aggression in normal individuals through effects on personality.

Adult↗
PubMed1996

Psychometric properties of the Danish 16PF and EPQ.

A Danish translation of the Cattell's 16PF has been used in studies evaluating the effects of prenatal drug exposure. This paper reports a psychometric analysis of the 16PF and Eysenck's EPQ based on a sample of 558 young Danes. Many 16PF scales had unacceptable psychometric properties (as indicated by coefficient alpha and item--total score correlations), but more satisfactory results were obtained with the EPQ N and E scales. A factor analysis of all 16PF and EPQ scales suggested a six factor solution that roughly corresponds to the second-order factor structure obtained by Krug and Johns (1986). It is concluded that the second-order factor structure should be the basis of interpretation of the 16PF in both practical and research contexts.

Adult↗
PubMed1995

In utero exposure to phenobarbital and intelligence deficits in adult men.

OBJECTIVE: To test whether exposure to phenobarbital in utero is associated with deficits in intelligence scores in adult men and whether the magnitude of the postnatal effect is mediated by exposure parameters and/or postnatal environmental factors. DESIGN: Two double-blind studies were conducted on independent samples of adult men prenatally exposed to phenobarbital and matched control samples using different measures of general intelligence. Based on data from control subjects, regression models were built relating intelligence scores to relevant pre-exposure matching variables and age at testing. Models generated predicted scores for each exposed subject. Group mean differences between the individually predicted and observed scores estimated exposure effects. SETTING: Copenhagen, Denmark. PARTICIPANTS: Exposed subjects were adult men born at the largest hospital in Copenhagen between 1959 and 1961 who were exposed to phenobarbital during gestation via maternal medical treatment and whose mothers had no history of a central nervous system disorder and no treatment during pregnancy with any other psychopharmacological drug. Study 1 included 33 men and study 2, 81 men. Controls were unexposed members of the same birth cohort matched on a wide spectrum of maternal variables recorded prenatally and perinatally. Controls for studies 1 and 2 included 52 and 101 men, respectively. MAIN OUTCOME MEASURES: In study 1: Wechsler Adult Intelligence Scale (Danish version); in study 2: Danish Military Draft Board Intelligence Test (Børge Priens Prøve). RESULT: Men exposed prenatally to phenobarbital had significantly lower verbal intelligence scores (approximately 0.5 SD) than predicted. Lower socioeconomic status and being the offspring of an "unwanted" pregnancy increased the magnitude of the negative effects. Exposure that included the last trimester was the most detrimental. CONCLUSION: Phenobarbital exposure during early development can have long-term deleterious effects on cognitive performance. Detrimental environmental conditions can interact with prenatal biological insult to magnify negative outcomes. Physicians are urged to use increased caution in prescribing such medications during pregnancy.

Adult↗