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Biomedical subjects

O S Dalgard

Publications and source records attributed to O S Dalgard.

At least 19 recordsLinked to original sources
PubMed2000

Symptoms of anxiety and depression among mothers of pre-school children: effect of chronic strain related to children and child care-taking.

BACKGROUND: Factors that affect maternal mental health were studied when the children were 30 and 50 months old, and changes in the importance of these factors over time were analyzed. A specific aim was to elucidate the role of chronic strain related to children and child care-taking. This study follows up previous work on the influence of social class, strain and social support on maternal mental distress when the children were 18 months old. METHODS: The sample is population based, and 1,081 parents were invited to fill out questionnaires. Maternal mental distress was measured by the Hopkins Symptom Checklist (SCL-25). Multiple regression analyses were conducted at each time point and chi-square tests were used to analyze the changes between the estimated regression coefficients over time. RESULTS: Chronic strain related to children and child care-taking consistently predicted maternal mental distress. Among the specific child related strains, problems with child care-taking were significantly associated with maternal symptom levels at all time points. The importance of two specific child problem behaviors (activity level and the child being a worrier) on maternal mental health changed over time. LIMITATIONS: Conclusions about causality can not be drawn based on cross-sectional analyses. The self-report measures used here may be biased by the current mood state. CONCLUSIONS: Problems with child care arrangements and combining work and child care-taking are predictive of maternal mental health when the children are 18, 30 and 50 months old. The risk and protective factors found here may have implications for prevention and intervention.

Adult↗
PubMed1999

Life stress, social support and psychological distress in late adolescence: a longitudinal study.

Questionnaire data from 211 adolescents and follow-up data recorded 18 months later were employed to test main effects and stress-buffering effects of negative life events, on-going stressors and social support from family and friends on mental health. Negative life events, change from baseline level of on-going adversities and social support all contributed significantly to subsequent symptom scores, although negative life events only reached borderline significance among boys. There was evidence in favour of the buffer hypothesis for boys: negative life events had a significantly stronger effect when social support from peers was low, and long-lasting adversities had a significantly stronger effect when social support from parents was low. Both these two-way interaction effects among boys were significantly different from the corresponding trends among girls. Since the scores on both the independent and dependent variables are based on subjective self-reports, the results may have been affected by various types of response bias. The probabilities of such bias effects are discussed.

Adaptation, Psychological↗
PubMed1999

The meaning and significance of caseness: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview. II.

In previous analyses of data from the present general population study we found that screening of anxiety and depression symptoms by the Hopkins Symptom Checklist-25 (HSCL-25) and diagnostic classification by the Composite International Diagnostic Interview (CIDI) identified the same amount of cases, but agreed in only half of them. In this paper we compared and validated the screening cases with the classificatory cases by the use of medication, loss of functioning and help seeking (illness indicators). We thought that the CIDI cases would have more illness indicators, because they reflected diagnoses, "true illness", in contrast to the HSCL-25, which was a more unspecific measure of distress. The HSCL-25 and the illness indicators data were collected in a stage I random individual population sample above 18 years during 1989-1991 (N = 1879, response rate 74%), the CIDI data were collected in a selected stage II, (N = 606, response rate 77%). The stage II data were weighted to represent the population sample. Screening cases by the HSCL-25 had significantly more illness indicators than diagnostic cases by the CIDI. Cases agreed upon with both instruments had the most illness indicators, cases agreed upon only by the CIDI had the least. Diagnoses give information about help eventually needed, the HSCL-25 distress measure expresses more the urgency with which it is needed. The choice between the HSCL-25 and the CIDI would depend on the aim and the resources of the study. If evaluation of needs is involved, using an instrument picking up both classification and distress would be the best choice. Given our positive experience with interviewing with the CIDI, a CIDI improved to be more sensitive to how much distress a certain diagnosis exerts on the individual would be a good choice.

Adolescent↗
PubMed1999

The influence of social class, strain and social support on symptoms of anxiety and depression in mothers of toddlers.

BACKGROUND: The aim of the study was to identify risk and protective factors for anxiety and depression among mothers of toddlers. METHODS: A population-based sample of 921 Norwegian mothers with 18-month-old children completed a questionnaire designed to examine the impact of socioeconomic and demographic factors, somatic health problems, negative life events, chronic strain and social support on symptoms of anxiety and depression (HSCL-25). RESULTS: There was a moderate aversive effect of negative life events and chronic strain and a moderate protective effect of social support on the symptom level, but no interaction effects were found between the risk and protective factors. Behaviour problems among the children clearly seemed to affect the mothers' symptom level. The symptom level varied with background factors like the mothers' education, employment status and age even after controlling for the effect of strain and social support. The largest effect of the background factors seemed to be indirect, however, mediated through their effect on the risk and protective factors. CONCLUSIONS: Although problems with the children's behaviour and child care arrangements were observed to have a strong impact on the mothers' symptom level, the frequencies of such problems appeared to be less dependent on socioeconomic conditions than did other types of strain.

Adult↗
PubMed1999

Mental disorders and referrals to mental health specialists by general practitioners.

In a population study we analysed psychiatric help-seeking directed to general practitioners (GPs) and looked at who was referred to and received treatment from psychiatrists or psychologists. A random sample of 2015 persons were interviewed on a large number of variables, of which five groups were used in logistic regression analysis to find what accounted for (1) help-seeking addressed to GPs, (2) prior (not during the last 12 months) referral from GPs to, and treatment from, a psychiatrist or psychologist, and (3) current specialist referral/treatment (referral to/treatment from a psychiatrist/psychologist in the last 12 months). A total of 38 variables were covered in the areas of demographics, social support, life events and general well-being, and mental health (HSCL-25), with six personality-related variables. The conclusions are: (1) The strongest predictor of former and current help-seeking was high current symptom rating (HSCL-25). (2) Demographic variables played a limited role in explaining help-seeking. (3) Personality-related variables played a more important role in the referral/treatment groups than most demographic variables. Compared with those not being referred, people currently seeing or having seen a psychiatrist/psychologist described themselves as easily worried, but at the same time having an attitude of speaking out and of not accepting a below-par life situation.

Adolescent↗
PubMed1999

Prevalence, incidence and age at onset of psychiatric disorders in Norway.

BACKGROUND: Increased demands for psychiatric services and increased rates of sickness absence for depression have raised the question of the occurrence of psychiatric disorders in Norway, and whether there is in fact a rising incidence rate. METHODS: Between 1989-1991, 2015 and 617 persons participated in a two-phase population study. Phase I comprised screening by the Hopkins Symptom Check List 25 items (HSCL-25), and phase II a diagnostic interview by the Composite International Diagnostic Interview (CIDI), including report of date (year) of the first occurrence of any symptoms, and any consequent diagnosis: RESULTS: A symptom score of 1.75 or more was found in 19.8% of the women and 9.3% of the men by the HSCL-25. Depression, anxiety or somatoform disorder by CIDI was found in 21.5% of the women and 11.5% of the men. The incidence rate increased significantly from 3.3 to 12.8 per 1000 person years from 1930 to 1991. The incidence rate in the year before the interview was 42.6 per 1000 person years. Age of onset became lower. More women became ill, but the illness seemed to last longer in men. A major problem in comparing results between studies is the different concepts and operationalisations of psychiatric illness, and the varying time periods given for estimates. CONCLUSION: The findings provide evidence of psychiatric illness being a rising and major health problem, but the role of recall bias must be further investigated.

Adult↗
PubMed1999

Organizing ODIN: a case study in European academic co-operation. The ODIN Group.

The European Commission is an increasingly important source of funding for international research projects and is due to announce its Framework 5 program early in 1999. The Outcomes of Depression International Network (ODIN), funded from the current EC Biomed 2 program, is a case study in European academic co-operation. Its organization has three key elements. First, engaging the principal investigators: this has involved identifying potential partners, ensuring reciprocity of interests, effective co-ordination, 'dividing the spoils' in advance, and setting up good personal and electronic communication systems. Second, an esprit de corps has been created amongst the researchers, maintaining contact and consistency, and promoting higher degrees. Third, ongoing problems including difficulties in negotiations with the EC, divergence of detailed study methods, and isolation and demoralization amongst researchers, have been addressed. ODIN may provide a useful model for researchers wishing to set up international collaborative groups.

Academic Medical Centers↗
PubMed1998

Concordance between symptom screening and diagnostic procedure: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview I.

The definition of case is a core issue in psychiatric epidemiology. Psychiatric symptom screening scales have been extensively used in population studies for many decades. Structured diagnostic interviews have become available during recent years to give exact diagnoses through carefully undertaken procedures. The aim of this article was to assess how well the Hopkins Symptom Checklist-25 (HSCL-25) predicted cases by the Composite International Diagnostic Interview (CIDI), and find the optimal cut-offs on the HSCL-25 for each diagnosis and gender. Characteristics of concordant and discordant cases were explored. In a Norwegian two-stage survey mental health problems were measured by the HSCL-25 and the CIDI. Only 46% of the present CIDI diagnoses were predicted by the HSCL-25. Comorbidity between CIDI diagnoses was found more than four times as often in the concordant cases (case agreed upon by both instruments) than in the discordant CIDI cases. Concordant cases had more depression and panic/generalized anxiety disorders. Neither the anxiety nor the depression subscales improved the prediction of anxiety or depression. The receiver operating characteristic (ROC) curves confirmed that the HSCL-25 gave best information about depression. Except for phobia it predicted best for men. Optimal HSCL-25 cut-off was 1.67 for men and 1.75 for women. Of the discordant HSCL-25 cases, one-third reported no symptoms in the CIDI, one-third reported symptoms in the CIDI anxiety module, and the rest had symptoms spread across the modules. With the exception of depression, the HSCL-25 was insufficient to select individuals for further investigation of diagnosis. The two instruments to a large extent identified different cases. Either the HSCL-25 is a very imperfect indicator of the chosen CIDI diagnoses, or the dimensions of mental illness measured by each of the instruments are different and clearly only partly overlapping.

Adult↗
PubMed1998

Psychosocial risk factors and mortality: a prospective study with special focus on social support, social participation, and locus of control in Norway.

STUDY OBJECTIVE: The objective is to investigate the effect on mortality of psychosocial variables, with special focus on social support, social participation, and locus of control. DESIGN: The study is designed as a prospective study with a 17 year follow up period, using univariate and multivariate proportional hazards regression analysis to estimate the predictive power of psychosocial variables, when controlling for sociodemographic and biological factors. SETTING: The study is based on a population sample randomly drawn from different neighbourhoods of Oslo in 1975/76, for the purpose of surveying health, in particular mental health, in relation to various social and psychosocial variables. The initial data were gathered by structured interviewing, whereas the data about mortality and cause of death, was gathered from the Central Bureau of Statistics. PARTICIPANTS: The initial sample included 1010 persons above the age of 18 years, with no upper age limit. The follow up with respect to mortality covered the whole sample, with the exception of a very few who had left the country. MAIN RESULTS: When controlling for socio-demographic and biological factors, low social participation, and to a lesser extent, few close relationships and external locus of control, were associated with increased mortality. CONCLUSION: The effect of social participation and locus of control may indicate that life style, and individual psychological resources, are at least as important for survival as support from others in stressful life situations.

Adult↗
PubMed1997

Psychiatric morbidity in primary public health care: a multicentre investigation. Part II. Hidden morbidity and choice of treatment.

A total of 1,281 patients were examined during consultation with their GP in a Nordic multicentre study focusing on the prevalence of psychiatric illness, hidden psychiatric morbidity, treatment and pathways to specialized care. The methodology and prevalence were reported in an accompanying paper. The present paper presents results concerning the variables hidden psychiatric morbidity, treatment and pathways to specialized care. The GPs detected 44% of the psychiatric cases compared with the result of a diagnostic interview (PSE). The distinction between psychosis and non-psychosis did not influence the GPs' ability to detect a mental illness. According to the GPs' assessment the majority of patients suffering from a mental disorder consulted their GP about physical complaints. The GPs treated the patients themselves, and only a limited number of cases were referred to psychiatrists or psychologists.

Adolescent↗
PubMed1997

Urban environment and mental health. A longitudinal study.

BACKGROUND: In a follow-up survey from Oslo, 503 persons were re-interviewed using the same questionnaire after 10 years. METHOD: The questionnaire includes questions about social support, social characteristics of the neighbourhood and mental health. Information about the neighbourhood was also gathered from key informants. RESULTS: Of the five types of neighbourhoods surveyed, only one showed marked change over time with respect to social characteristics. This was an initially poorly functioning neighbourhood with poor mental health among the residents, where substantial improvements took place as part of the further development of the area. Parallel with the improvement in social environment there was a significant improvement in mental health among those who continued to live in the same area, as opposed to those who continued to live in the other areas. Selective migration could not explain this finding. CONCLUSIONS: The findings support the environment stress hypothesis, implying that the quality of a neighbourhood has an impact on mental health. The implications for psychiatric prevention are discussed.

Age Factors↗
PubMed1996

Religiosity and help-seeking in a rural and an urban area.

Help-seeking for emotional problems addressed to priests was compared with help-seeking addressed to general practitioners (GPs), psychiatrists and psychologists in two demographically different areas of Norway. Only small differences were found between the rural and the urban area, and a substantial proportion of people contacted priests for personal/emotional problems. This contact was not related to dissatisfaction with the mental health system, and we found no evidence for a "religiosity gap" between mental health professionals, on the one hand, and people contacting priests, on the other. People contacting priests also had a stronger general willingness to seek help from other professionals compared to the general population. In both the rural and urban areas, seeking help from priests because of mental problems was related to having experienced a personal loss (death of a spouse, separation, divorce), in addition to having a religious commitment.

Female↗
PubMed1996

Psychiatric interventions for prevention of mental disorders. A psychosocial perspective.

Technology for psychiatric prevention is poorly developed, and knowledge about the causes of mental illness is difficult to apply to practical preventive work. As it would take many years before the effects of primary preventive efforts would be visible, secondary and tertiary prevention are essential to reducing the prevalence of mental illness. Recent studies on reducing the negative health consequences of acute stress seem to justify some optimism that psychosocially-oriented prevention is possible. Experience with the preventive benefits of social support at times of crisis suggests that active social support can prevent social disintegration at the community level and mental health problems for individuals.

Aged↗
PubMed1995

Psychiatric morbidity in primary public health care: a Nordic multicentre investigation. Part I: method and prevalence of psychiatric morbidity.

The prevalence of mental illness in five different Scandinavian primary care populations was investigated in this study. Patients consecutively consulting their general practitioner a particular week-day were included in the study. Initially the SCL-25 was applied and next the high scores and a sample of the low scores were interviewed by the PSE. In the analysis the screening procedure was first validated. The internal validity of the SCL was tested by means of Rasch latent structure analysis and the external validity tested by ROC/QROC analysis. Based on this, a short 8-item version of the SCL was developed. The prevalence of mental illness in all centres was 0.26 with a minimum of 0.14 in Nacka and a maximum of 0.34 in Turku.

Adolescent↗
PubMed1995

Social support, negative life events and mental health.

BACKGROUND: In a 10-year follow-up of a survey from Oslo, 503 persons were reinterviewed using the same questionnaire. METHOD: The questionnaire includes information about social support, 'locus of control' and mental health as well as negative life events and long-lasting mental strain during the year prior to the follow-up. RESULTS: The study confirms the "buffer hypothesis", that social support protects against the development of mental disorder only when the individual is exposed to stressors, like negative life events. This buffering effect was especially strong for depression. CONCLUSIONS: The buffering effect only applies to the 'externals'--those who have personality-related feelings of powerlessness and lack of control over their own lives. The 'internals' do not have the same need for social support to cope with life stressors, and have low symptom scores even when negative life events are combined with relative weak social support.

Adaptation, Psychological↗
PubMed1992

[Social network, alcohol drinking habits and injuries caused by violence among women and men in the county of Akershus. Results from anonymous questionnaires among persons aged 40-42 years. 1990-91].

All residents aged 40-42 in Akershus county were invited to screening for cardiovascular risk factors in 1990-91 as part of a prevention programme. Of the 13,607 attendants, 8,960 answered an anonymous questionnaire about social network, drinking habits, and injuries due to violence. Compared with data from the Central Bureau of Statistics, our material included a high percentage of persons with a higher education, a high percentage of married persons, and a low percentage of persons living alone. Results in respect of social network and drinking habits roughly agreed with those of other studies. Of the males, 15.7% had been injured at least once as a result of violence, most often assault and robbery. Of the females, the corresponding percentage was 18.1. Here the dominating forms of violence were maltreatment, threats and sexual assault. Females were more often exposed than males to repeated violence and more often suffered persisting problems as a result of maltreatment. Compared with other studies, we found a high prevalence of injuries from violence among females, suggesting underreporting of experiences of violence by females in studies based on personal interview or the hospitals' injury register.

Adult↗