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Biomedical subjects

O Lingjaerde

Publications and source records attributed to O Lingjaerde.

At least 19 recordsLinked to original sources
PubMed2001

Personality structure in patients with winter depression, assessed in a depression-free state according to the five-factor model of personality.

BACKGROUND: Depressive disorders are often associated with abnormalities of personality. This has also been found in Seasonal Affective Disorder, Winter Depression type (W-SAD), although relatively few and small studies have been done on this disorder so far, and mainly in the depressed phase. The aim of this study was to explore the personality structure and its possible background and clinical correlates in a larger group of patients with W-SAD, assessed in a non-depressed state, in the Five-Factor (or "Big Five") model of personality paradigm. METHODS: 82 persons (87% of those asked) with diagnosed W-SAD, most of them originally self-referred, who had previously received light treatment at our unit, completed a Norwegian version of an inventory yielding the personality factors Agreeableness, Surgency, Conscientiousness, Emotional stability, and Openness to experience. RESULTS: Compared to a Norwegian reference group, the mean scores of the W-SAD patients were significantly lower on the factors agreeableness, surgency and emotional stability, and significantly higher on conscientiousness. However, very few patients had scores outside the reference range. The personality factors do not seem to be associated with the core physiological manifestations of winter depression, but rather with the psychic aspects, and are poor predictors of response to light treatment. LIMITATIONS: Some reservations should be made as to the generalisability of the findings to SAD patients in general. Thus, increased conscientiousness may reflect help-seeking behaviour. CONCLUSIONS: Personality structure does not seem to predict occurrence of physiological reactions to lack of adequate daylight in autumn/winter, and is a poor predictor of improvement after light treatment, but may predict the associated psychic symptomatology.

Adult↗
PubMed2001

Relatives' distress and patients' symptoms and behaviours: a prospective study of patients with schizophrenia and their relatives.

OBJECTIVE: The aim of this study is to explore the relationship between relatives' distress and patients' symptoms and behaviours. METHOD: Fifty relatives in close contact with 36 patients with schizophrenia DSM-III-R filled in the General Health Questionnaire (GHQ) and the Perceived Family Burden Scale (PFBS) at the patient's hospital admission, 4.5 and 9 months post-discharge. The patients were assessed by means of the Positive and Negative Syndrome Scale (PANSS). RESULTS: The PFBS anxiety-depression cluster was at all three assessments positively correlated with relative's distress (GHQ), not with PANSS anxiety and depression measurements. In multiple regression analysis PFBS, but not PANSS, was related to relatives' distress. CONCLUSION: Relatives' distress was related to their reports of problematic patient behaviours, especially anxiety-depressive behaviour, not to symptoms as measured by clinical interviews. High distress is related to high expressed emotion, suggesting that relatives' report of patient's behaviour should be addressed to improve patient's outcome.

Adolescent↗
PubMed2000

Effects of various anions on serotonin transport in human platelets.

A survey is given of some results from the author's studies on serotonin (5HT) uptake in human blood platelets in vitro. These findings are relevant also for serotonin reuptake at serotonergic synapses, since it has been shown that the serotonin transporter (5HTT) in platelets is identical to that in the brain. The main findings: 5HT uptake is dependent on the presence of Cl-, which shows simple saturation kinetics in relation to 5HT uptake rate, probably by acting on a hypothetical "anion site". Chloride can, however, be partly replaced by other small anions like bromide, iodide and nitrite. Unexpectedly, increasing concentrations of nitrite gives a sigmoidal 5HT uptake curve, indicating a double effect: being able to replace chloride in the "anion site", and exerting an allosteric effect by being bound to a separate "activating site". It was later found that the monocarboxylic acids acetate, lactate and pyruvate, which can not replace chloride, have an allosteric stimulatory effect on 5HT uptake in the presence of chloride, presumably by acting at the same activating site as shown for nitrite. The chloride concentration, as well as lactate and puruvate, may exert a regulatory effect on serotonin reuptake in the brain.

Binding Sites↗
PubMed1999

What predicts the course of expressed emotion in relatives of patients with schizophrenia or related psychoses?

The expressed emotion (EE) index may not be as stable as it was once believed to be. The aim of this study was to identify variables associated with spontaneous change from low to high and from high to low levels of EE and EE subscales--critical comments (CC), hostility (H), emotional overinvolvement (EOI). Using a longitudinal, prospective study design, of 59 relatives having at least weekly face-to-face contact with 40 patients with an acute episode or relapse into schizophrenia (DSM-III-R) were interviewed by means of the Camberwell Family Interview (CFI) at admission and at 4 1/2 months after discharge. The results showed that high-high or unstable levels of CC, H or EE were associated with the patient not working or studying prior to admission. Relatives with low-high and high-high EOI patterns had more weekly face-to-face contact with the patient prior to admission than relatives with a low-low EOI pattern. Patients whose relatives had low-high CC and EE patterns were less ill at admission than patients whose relatives had low-low patterns. Higher perceived family burden was associated with, at admission, an unstable pattern of CC, and at follow-up, high-high EOI or EE patterns rather than low-low patterns. Our study suggests that it is possible to identify which relatives will have a stable and which a changing EE level, allowing for more focused intervention.

Adolescent↗
PubMed1999

Characteristics of patients with otherwise typical winter depression, but with incomplete summer remission.

BACKGROUND: Seasonal affective disorder, winter depression type (WD-SAD), is characterized by recurring autumn/winter depression with full remission or hypomania/mania in summer. However, some patients have an otherwise typical WD but with incomplete summer remission. We wanted to elucidate in what other respects such patients differ from typical WD-SAD patients. METHODS: 14 patients meeting DSM-III-R criteria for Seasonal Pattern except for incomplete summer remission (ISR), were compared with 144 patients meeting the full criteria, including complete summer remission (CSR), with regard to demography, illness history, clinical symptoms, and response to light treatment. RESULTS: In comparison with the CSR group, the ISR group had a longer duration of illness, more often used antidepressants, and improved significantly less after treatment with bright light for 6 days, whereas the symptomatology in winter (Montgomery-Asberg Depression Rating Scale plus hypersomnia, hyperphagia, and carbohydrate craving) was similar in the two groups. LIMITATIONS: The ISR group was small, and the severity of their summer depression could only be assessed retrospectively. CONCLUSIONS: Patients with otherwise typical WD but with incomplete summer remission respond poorly to light treatment. Full summer remission should be retained as a criterion for WD-SAD.

Appetite↗
PubMed1998

Direct assessment of improvement in winter depression with a visual analogue scale: high reliability and validity.

Reliability and validity of direct visual analogue scale (VAS) ratings of improvement were assessed in 162 patients with Seasonal Affective Disorder, Winter Depression type (W-SAD), after light treatment for 6 consecutive days. The patients were rated with the Montgomery-Asberg Depression Rating Scale (MADRS) and a scale for the 'atypical' symptoms hypersomnia, hyperphagia and carbohydrate craving (the ATYP scale) before and after treatment. After treatment the patients also self-rated their global improvement on a 10-cm VAS, with anchoring points of 'No improvement' and 'Complete improvement'. VAS ratings were repeated several times, with 1-4 weeks between assessments, in a follow-up period, always referring to improvement in relation to baseline, and accompanied by a statement whether there had been any change since the former VAS rating. Shortly after treatment there was a mean reduction of 59.8% on the MADRS and 57.1% on the ATYP score, and 58.4% improvement as measured by the VAS. VAS rating correlated highly with percentage reduction of MADRS scores (r=0.85) and somewhat less with reduction of ATYP scores (r=0.64). VAS ratings in the follow-up period showed an extremely high test-retest reliability (r=0.96) for two consecutive ratings between which the patient stated that there had been no definite change. The results support the use of VAS ratings for assessment of global improvement after light treatment in patients suffering from W-SAD; use in other kinds of depression and with other types of treatment remains to be explored.

Adult↗
PubMed1998

[Local monitoring center for clozapine (Leponex) treatment].

A local centre for monitoring clozapine therapy has been in operation in the Pharmacy Department at Asgård Hospital in Tromsø since 1994. The centre utilizes an electronic reporting system and is available to clozapine-prescribers in the three northernmost countries in Norway: Nordland, Troms and Finnmark. The system fosters early detection of poor compliance with frequent blood tests and for signs of white blood cell suppression. This is a new concept in Norway and one way of assuring the quality of clozapine treatment. The purpose of the centre is to improve patient safety by facilitating early detection of potentially dangerous white blood cell suppression, thereby avoiding fatal consequences.

Adverse Drug Reaction Reporting Systems↗
PubMed1998

Criticism and hostility in relatives of patients with schizophrenia or related psychoses: demographic and clinical predictors.

Relatives' criticism and hostility are important risk factors for relapse in schizophrenia. In order to explain these attitudes, we examined a Norwegian sample of 47 recently hospitalized patients (with schizophrenia or related psychoses) and 72 relatives. Relatives' expressed emotion was assessed by means of the Camberwell Family Interview. Demographic and clinical data were used as predictor variables in confirmatory regression analyses. The most robust predictors of high levels of criticism were, on the part of the patient, lack of paid employment, more than 3 previous hospital admissions, more troublesome behaviours reported by relatives, especially anxiety/depression, and better cognitive functioning at admission. Robust predictors of hostility were lack of employment and more than 3 previous hospitalizations. Interventions to reduce criticism should include employing patients and working with relatives' unrealistic expectations.

Adolescent↗
PubMed1998

Relatives' emotional warmth towards patients with schizophrenia or related psychoses: demographic and clinical predictors.

Despite the importance of relatives' emotional warmth for outcome in schizophrenia, no studies to date have addressed demographic and clinical predictors of warmth. We examined a Norwegian sample of 47 recently hospitalized patients (with schizophrenia or schizophreniform disorder) and 72 key relatives. Relatives' emotional warmth was assessed by means of the Camberwell Family Interview. Regression analyses showed that no substance abuse (especially amphetamines), better premorbid adjustment (12-15 years), a chronic social security status, and the relative not being a parent were the strongest predictors of emotional warmth. Emotional warmth was not related to patients' symptoms.

Adolescent↗
PubMed1998

Dawn simulation vs. lightbox treatment in winter depression: a comparative study.

Dawn simulation, with gradually increasing bedside light in the morning, has shown promising results as an alternative to bright light treatment for winter depression. To compare these treatments, 61 out-patients with winter depression (20-70 years of age, 80% women) were randomized to receive either lightbox treatment with 1500-2500 lux white light for 2 h in the morning for 6 days on an out-patient basis (n=34), or dawn simulation treatment in their homes, with 60 or 90 min of light augmentation time to 100-300 lux, for 2 weeks (n=27). Patients' ratings of improvement on a visual analogue scale (correlating strongly with percentage reduction in an extended Montgomery-Asberg Depression Rating Scale (MADRS) score) at the end of treatment showed a mean of 40.0% (SD 27.7%) in the dawn simulation group and 57.4% (SD 29.9%) in the lightbox group (P=0.02). The majority of the patients in both groups maintained their improvement during a 9-week follow-up. Age, sex, current major depression or current use of antidepressants did not predict outcome in either group. No serious side-effects were observed.

Adult↗
PubMed1998

Guilt proneness and expressed emotion in relatives of patients with schizophrenia or related psychoses.

OBJECTIVE: Knowledge of what predicts relatives' expressed emotion (EE) may contribute to improved family work in schizophrenia. In the present study we examined guilt proneness as a determinant of EE components. METHOD: In a Norwegian sample of 46 recently hospitalized patients (schizophrenia or schizophreniform disorder) and 69 relatives, relatives' expressed emotion was assessed by means of the Camberwell Family Interview, and guilt proneness by means of the Revised Mosher Guilt Inventory. (RMGI). RESULTS: Confirmatory multiple regression analyses showed that hostility-guilt (RMGI) was negatively related to high levels of criticism and hostility and, for men, positively related to emotional overinvolvement. There was a strong positive relationship between relatives' guilty conscience (RMGI) and emotional overinvolvement if the patient had a diagnosis of schizophrenia. CONCLUSIONS: Our analyses indicate that relatives' guilt proneness may be a determinant of their criticism, hostility and emotional overinvolvement towards a schizophrenic family member. This personality trait should be taken into account in family work which aims at modifying relatives' expressed emotion.

Adolescent↗
PubMed1997

Relatives' locus of control and expressed emotion in schizophrenia and related psychoses.

OBJECTIVES: Knowledge of what predicts relatives' expressed emotion (EE) may contribute to improved family work in schizophrenia. In the present study we examined locus of control (LOC) beliefs as determinants of EE components. DESIGN: This study is observational, prospective and partly cross-sectional, partly longitudinal (stability of LOC). METHODS: In a Norwegian sample of 47 recently hospitalized patients (schizophrenia or schizophreniform disorder) and 70 relatives, the relatives' EE was assessed by the Camberwell Family Interview and LOC by Levenson's Internality, Powerful Others and Chance scales. RESULTS: Confirmatory multiple regression analyses showed that Chance LOC was positively related to emotional overinvolvement (p < .005). Powerful Others LOC, especially 'wish to ingratiate' items, were positively linked to criticism and, among workers/lower grade employees only, to emotional overinvolvement. Internal LOC was not linked to any EE scale. CONCLUSIONS: This study indicates that LOC beliefs may be determinants of emotional overinvolvement and criticism, and should be taken into account in family work that aims at modifying relatives' EE.

Adult↗
PubMed1996

Response to light therapy in seasonal affective disorder: personality disorders and temperament as predictors of outcome.

Outcome after 6 days of morning light therapy in subjects fulfilling criteria for winter seasonal affective disorder (SAD) was examined. Responders had significantly fewer previous episodes of SAD. Patients with a diagnosis of any DSM-III-R, axis II personality disorder, were significantly less likely to respond to light therapy than patients without axis II pathology. Poor treatment outcome was also significantly associated with: one or more personality disorders in cluster C, avoidant personality disorder, high number of positive criteria for self-defeating personality disorder and high score on the harm avoidance scale of the Tridimensional Personality Questionnaire. Temperament accounted for 25% of the variance in treatment outcome.

Adult↗
PubMed1996

Platelet monoamine oxidase activity in patients with winter seasonal affective disorder.

The aim of the present study was to examine whether high or low levels of platelet monoamine oxidase (MAO) activity were associated with an increased risk of winter seasonal affective disorder (SAD) or of developing characteristic vegetative symptoms during episodes of the disorder. We also investigated the relationship between MAO activity and the Global Seasonality Scale (GSS), a measure of seasonal variation in sleep length, social activity, mood, weight, appetite, and energy level. Patients with SAD (n = 49), patients with subsyndromal SAD (n = 11), and normal volunteers (n = 25) participated in the study. We found significantly higher levels of platelet MAO activity in females but did not observe significant differences across age groups or between groups of patients tested in different seasons or mood states. MAO activity (whether high or low) was not associated with a significant increase in risk of SAD or of developing hypersomnia, hyperphagia, or carbohydrate craving during episodes of winter depression. We found no significant relationship between GSS and MAO activity. Patients who had made suicide attempts during an episode of SAD had significantly lower mean levels of platelet MAO activity than other patients.

Adult↗
PubMed1996

Inter-rater reliability of expressed emotion ratings based on the Camberwell Family Interview.

High expressed emotion in relatives has been shown to predict a poorer outcome in a range of disorders and cultures. However, variation in predictive power is considerable, and this could partly be due to low inter-rater reliability. Sixty-nine relatives of 47 acutely admitted schizophrenic patients were interviewed using the Camberwell Family Interview. Audiotapes were assessed by pairs of raters drawn from a group of seven approved raters. Inter-rater reliability was good for criticism, hostility, emotional over-involvement (as a six level scale) and expressed emotion index (EOI cut-off score 2-3); and it was fair, but unsatisfactory, for emotional over-involvement (binary scales), warmth, positive remarks and expressed emotion (EOI cut-off score 3-4). These findings suggest that the warmth scale and the dichotomized versions of the EOI scale should be used with caution. The influence of warmth on the outcome in schizophrenia may have been underestimated because of low reliability.

Adult↗
PubMed1996

Emotional overinvolvement in parents of patients with schizophrenia or related psychosis: demographic and clinical predictors.

BACKGROUND: Parental emotional overinvolvement (EOI) may entail a worse outcome in schizophrenia. In the present study we examined demographic and clinical predictors of EOI. METHOD: The predictors were examined in a Norwegian sample of 41 recently admitted patients (schizophrenia or schizophreniform disorder) and 66 parents. Parents' expressed emotion was assessed by the Camberwell Family Interview. RESULTS: Regression analyses showed that higher EOI was significantly related, on the part of the parent, to being a mother, single, spending more time with the patient; and, on the part of the patient, to no substance misuse, more anxiety-depression, and less uncritical and aggressive behaviour. EOI was not linked to previous hospital admissions. CONCLUSION: Our analyses indicate that characteristics of the parent and of the parent-patient dyad seem to be the most important determinants of EOI. EOI is probably not linked to psychotic relapse, but rather to affective disturbances in the patient.

Anxiety↗