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Biomedical subjects

Odd Steffen Dalgard

Publications and source records attributed to Odd Steffen Dalgard.

16 recordsLinked to original sources
PubMed2006

Return of depressed men: changes in distribution of depression and symptom cases in Norway between 1990 and 2001.

BACKGROUND: Women's elevated risk of depression compared to men is a common finding in psychiatric epidemiology. Studies conducted in the 1950s and 1970s, however, documented approximately equal prevalence of sex rates. AIM: This study investigated changes in depression rates between 1990 and 2001 in Norway. Further, differences in severity were examined between men and women. METHOD: A study population (later to be called OsLof) was established in 1990, supplemented in 2001, and analysed as two cross-sectional datasets to compare sex and age differences in ICD-10 diagnoses and HSCL-25> or =1.75 caseness. Organic depression and the DSM-IV Major Depressive Episode were also examined in 2001. RESULTS: There was no significant change in the prevalence of depression or HSCL-25 caseness from 1990 to 2001. However, a major shift in prevalence occurred over time within the 18-34 year old age category with significantly higher rates among younger men (1% to 10%) and lowered rates among younger women (10% to 4%). Among persons depressed, no significant differences were found for severity between the sexes. LIMITATIONS: A selection of healthier participants than found in the source population might have resulted in lower prevalence than real. CONCLUSION: There was no indication of an overall increase in depression from 1990 to 2001, neither by diagnosis nor by symptom checklist scores. However, a major shift in prevalence occurred within the 18-34 year old age category with significantly higher rates among younger men and lowered rates among younger women. No sex differences existed in terms of severity of depression.

Adolescent↗
PubMed2006

Psychosocial factors and distress: a comparison between ethnic Norwegians and ethnic Pakistanis in Oslo, Norway.

BACKGROUND: In the Norwegian context, higher mental distress has been reported for the non-Western immigrants compared to the ethnic Norwegians and Western immigrants. This high level of distress is often related to different socio-economic conditions in this group. No efforts have been made earlier to observe the impact of changed psychosocial conditions on the state of mental distress of these immigrant communities due to the migration process. Therefore, the objective of the study was to investigate the association between psychological distress and psychosocial factors among Pakistani immigrants and ethnic Norwegians in Oslo, and to investigate to what extent differences in mental health could be explained by psychosocial and socioeconomic conditions. METHOD: Data was collected from questionnaires as a part of the Oslo Health Study 2000-2001. 13581 Norwegian born (attendance rate 46%) and 339 ethnic Pakistanis (attendance rate 38%) in the selected age groups participated. A 10-item version of Hopkins Symptom Checklist (HSCL) was used as a measure of psychological distress. RESULTS: Pakistanis reported less education and lower employment rate than Norwegians (p < 0.005). The Pakistani immigrants also reported higher distress, mean HSCL score 1.53(1.48-1.59), compared to the ethnic Norwegians, HSCL score 1.30(1.29-1.30). The groups differed significantly (p < 0.005) with respect to social support and feeling of powerlessness, the Pakistanis reporting less support and more powerlessness. The expected difference in mean distress was reduced from 0.23 (0.19-0.29) to 0.07 (0.01-0.12) and 0.12 (0.07-0.18) when adjusted for socioeconomic and social support variables respectively. Adjusting for all these variables simultaneously, the difference in the distress level between the two groups was eliminated CONCLUSION: Poor social support and economic conditions are important mediators of mental health among immigrants. The public health recommendations/interventions should deal with both the economic conditions and social support system of immigrant communities simultaneously.

Adult↗
PubMed2006

Inequalities in health: a comparative study between ethnic Norwegians and Pakistanis in Oslo, Norway.

BACKGROUND: The objective of the study was to observe the inequality in health from the perspective of socio-economic factors in relation to ethnic Pakistanis and ethnic Norwegians in Oslo, Norway. METHOD: Data was collected by using an open and structured questionnaire, as a part of the Oslo Health Study 2000-2001. Accordingly 13581 ethnic Norwegians (45% of the eligible) participated as against 339 ethnic Pakistanis (38% of the eligible). RESULTS: The ethnic Pakistanis reported a higher prevalence of poor self-rated health 54.7% as opposed to 22.1% (p < 0.001) in ethnic Norwegians, 14% vs. 2.6% (p < 0.001) in diabetes, and 22.0% vs. 9.9% (p < 0.001) in psychological distress. The socio-economic conditions were inversely related to self-rated health, diabetes and distress for the ethnic Norwegians. However, this was surprisingly not the case for the ethnic Pakistanis. Odd ratios did not interfere with the occurrence of diabetes, even after adjusting all the markers of socio-economic status in the multivariate model, while self-reported health and distress showed moderate reduction in the risk estimation. CONCLUSION: There is a large diversity of self-rated health, prevalence of diabetes and distress among the ethnic Pakistanis and Norwegians. Socio-economic status may partly explain the observed inequalities in health. Uncontrolled variables like genetics, lifestyle factors and psychosocial factors related to migration such as social support, community participation, discrimination, and integration may have contributed to the observed phenomenon. This may underline the importance of a multidisciplinary approach in future studies.

Journal Article↗
PubMed2006

A randomized controlled trial of a psychoeducational group program for unipolar depression in adults in Norway (NCT00319540).

BACKGROUND: Coping with Depression Course (CWD) has shown to be effective in the treatment of depression. However, there are very few randomized controlled trials on unipolar depression in adults. AIMS: To test the effect of a modified CWD on unipolar depression in a randomized controlled trial design in adults. METHODS: Participants were recruited through mass media, tested by BDI and clinical interview, and randomized into intervention group (N = 81) and control group (N = 74). The program was mainly conducted by nurses with background in psychiatry and primary health care, and the intervention encompassed 8 weekly sessions of 2 1/2 hours, with 3 booster sessions. RESULTS: By "intention-to-treat" analysis a statistically significant effect on depressive symptoms at follow up at 6 months was found, and the level of symptoms was sustained after 12 months. CONCLUSION: The study shows that the intervention is effective in the treatment of unipolar depression, and suitable for specialized psychiatric services as well as primary health care.

Journal Article↗
PubMed2006

Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study.

OBJECTIVE: To explore if differences in negative life events, vulnerability and social support may explain the gender difference in depression. METHODS: Cross-sectional, multinational, community survey from five European countries (n = 8,787). Depression is measured by Beck Depression Inventory, whereas negative life events and social support are measured by various questionnaires. RESULTS: Women report slightly more negative life events than men do, mainly related to the social network, but more social support in general and in connection with reported life events. This trend is the same in all participating countries except Spain, where there is no gender difference in the reported support. In general, women are not more vulnerable to negative life events than men are. However, women with no social support, who are exposed to life events, are more vulnerable than men without support. CONCLUSION: The higher rate of depression in women is not explained by gender differences in negative life events, social support or vulnerability.

Adult↗
PubMed2006

[Economic evaluation of a course in coping with depression].

BACKGROUND: A course in coping with depression was reported to have documented effects in terms of shortening periods of depression. An economic evaluation of the course was conducted. MATERIALS AND METHODS: The estimate of medical effect derives from a randomized controlled trial in 155 subjects with depression. On average subjects in the intervention group improved 3-4 points more on the Beck Depression Inventory than subjects in the control group. A value estimate is provided for this effect given what is known about the weight that society places on severity of illness and effect of treatment when prioritising among patient groups. The value estimate is compared with the costs of the course. RESULTS AND INTERPRETATION: It is estimated that if 200 people take the course, the improvements in quality of life for all these people taken together may be regarded as equally valuable and worthy of priority as an intervention that provides an extra life year to one person. The cost of giving the course to 200 people is estimated at USD 45,000-60,000. This is within the limits of what society is generally willing to pay in order to gain life years. Because of possible reductions in sick leave, societal net costs may be modest.

Adaptation, Psychological↗
PubMed2006

Immigration, lack of control and psychological distress: findings from the Oslo Health Study.

The aims of this study are to compare the level of psychological distress between Norwegian born and immigrants from countries with different income levels and culture, and to investigate the explanatory effect of socioeconomic and psychosocial factors, with special emphasis on lack of control (powerlessness and self-efficacy). A cross-sectional survey with self-administered questionnaire was conducted in 2000-2001 in a sample of 15,723 adults living in Oslo. Psychological distress was measured by a ten-item shortened version of Hopkins Symptom Checklist-25 items, whereas psychosocial variables were measured by various instruments. The results show that the level of psychological distress is significantly higher in immigrants from low- and middle-income countries than in the Norwegian born and the immigrants from high-income countries. They also report more powerlessness, more negative life events, less social support, less income and less paid work. It is concluded that negative life events, mainly related to social network, somatic health and economic situations, as well as lack of social support, are important mediators between immigration from low- and middle-income countries to Norway and psychological distress. Powerlessness also plays a role, but this is mainly because of a concept overlap between psychological distress and powerlessness.

Adult↗
PubMed2006

Health service use by adults with depression: community survey in five European countries. Evidence from the ODIN study.

BACKGROUND: Little is known about patterns of healthcare use by people with depression in Europe. AIMS: To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors. METHOD: People aged 18-65 years with depressive or adjustment disorders (n=427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services. Outcome measures were self-reported use Client Services Receipt Interview and costs of general practice, generic, psychiatric or social services in the past 6 months. RESULTS: Less frequent use was made of generic services in Norway and psychiatric services in the UK. Severity of depression, perceived health status, social functioning and level of social support were significant predictors of use; the number of people able to provide support was positively associated with greater health service use. CONCLUSIONS: Individual participant factors provided greater explanatory power than national differences in healthcare delivery. The association between social support and service use suggests that interventions may be needed for those who lack social support.

Adolescent↗
PubMed2004

[An educational programme for coping with depression: a randomized controlled trial].

BACKGROUND: Depression is a serious health problem, with lifetime prevalence in the western world of 20-30%. Only a relatively small proportion of depressed people receive treatment; hence there is a great need for further development of feasible treatment programmes. MATERIAL AND METHODS: A psycho-educative group-based treatment programme was tested in a randomized controlled study of unipolar depression. The size of the intervention group was 81 as against 74 in the control group. The programme lasted 8 weeks with weekly sessions of 2(1/2) hours and booster sessions after 1, 2 and 4 months. Each group had 8 to 10 participants; psychiatric nurses acted as facilitators. RESULTS: The rate of improvement after 6 months was significantly higher in the intervention group than in the control group. In the intervention group, 69% of participants showed significant improvement (reduction in the Beck Depression Inventory score of 6 points or more), compared to 37% in the control group. Improvement in the intervention group mainly took place during the first 8 weeks. INTERPRETATION: The treatment programme turned out to have a significant effect on unipolar depression and seems feasible in primary health care as well as in specialized psychiatric care.

Adaptation, Psychological↗
PubMed2004

Estimating depression prevalence from the Beck Depression Inventory: is season of administration a moderator?

The existence of winter seasonal affective disorder (SAD) and its milder population variants implies that depression estimates in a given population may tend to be higher in winter than at other times of the year. The aim of this study was therefore to test whether depression prevalence estimates based on the Beck Depression Inventory (BDI) are systematically moderated by season of administration. Existing information from the screening phase of a multicentre investigation of depression prevalence provided the data for the study. Repeated cross-sectional BDI data from samples in the United Kingdom (n=1299), Finland (n=1352), Norway (n=2711) and Spain (n=1246) were analysed for month- and season-of-administration effects. Whether data were measured continuously or as a dichotomous variable (BDI cutoff >/=13), there was no evidence of a systematic seasonal pattern in depression estimates across the four sites. No seasonal effects reached statistical significance at any single site, and trends in the association between winter and elevated BDI scores were positive in two sites (UK and Norway) and negative in two (Finland and Spain). Although limited by a post hoc analysis of existing data, this study provides the strongest evidence to date that season of administration is not a moderator of depression prevalence as estimated by the BDI.

Adolescent↗
PubMed2003

[Increasing psychological stress among young adults in Norway, 1990-2000].

BACKGROUND: Between 1990 and 2000, the number of disability benefit recipients in Norway increased by 19.3%. We wanted to examine changes in the way people cope with society's demands, our hypothesis being that changing demands increase psychological stress; this again leads to increasing numbers of disability benefit recipients with a psychiatric diagnosis. MATERIAL AND METHODS: We examined the ability to support oneself financially among the 20 to 39-year-olds, traditionally the period in people's lives when they are at their most adaptive. We used data for the 1990-2000 period on sickness absence of one year or more, medical or occupational rehabilitation, long-term unemployment, welfare payments without entitlement, and disability benefits. We examined the diagnoses used for one-year sickness absence, medical rehabilitation and disability benefit status. Data were obtained from the relevant public-sector registers. RESULTS: The prevalence of social security clients in the 20-39 age group was up from 6.4% in 1994 to 7.7% in 2000, an increase of 20%. The biggest increases (1992 to 2000 data) were related to minor psychiatric disorders, 152%, and milder forms of musculoskeletal disorders, 111%. INTERPRETATION: Changing demands in the workplace have increased the load of psychological stress in society, but changing demands in people's private lives are a contributing factor. The results imply an increasing mismatch between the adaptation required in our society and people's resources for coping with what is expected of them. Our health care and social security systems in their present form cannot properly come to grips with this situation; they may even exacerbate it by demanding too little of patients and thereby socialising them into the patient role.

Adaptation, Psychological↗
PubMed2003

Urban-rural differences in the occurrence of female depressive disorder in Europe--evidence from the ODIN study.

BACKGROUND: In an earlier paper of the European multi-centre ODIN study (Ayuso-Mateos et al. 2001) we found remarkable urban preponderance in comparison to the corresponding rural site in the female prevalence of depressive disorder in the UK and Ireland. The aim of this paper is to analyse the possible reasons for this finding. METHOD: A representative sample of 12,702 people aged between 18 and 64 residing in specified urban and rural areas were screened by the Beck Depression Inventory (BDI) for depressive disorder in four European countries (Finland, Ireland, Norway and the UK). Those over cut-off (BDI score < 12) and a 5 % random sample of those under cut-off underwent diagnostic interview including the SCAN version 2.0, and completed a battery of additional research instruments. RESULTS: The estimated 1-month prevalence of depressive disorder according to ICD-10 was 9 % in the total ODIN sample. A large between-country variation was found in female urban prevalence, with Ireland (Dublin) and the UK (Liverpool) having a remarkably high rate. The women in these same countries showed a significant urban/rural difference, whereas in men and in the total sample this difference was non-significant. Logistic regression analysis including some selected risk factors of depression showed still higher risk of depressive disorder both in Dublin and Liverpool compared with the Finnish urban site (Turku), which had the lowest urban prevalence. In addition, also such factors as lack of confidant and having difficulties in getting practical help from neighbours were important predictors of depressive disorder. Similarly, when analysing the different countries separately, the significance of the urban/rural difference in women remained for Ireland and the UK, indicating that the other risk factors studied could not totally explain the difference. CONCLUSIONS: ODIN is the first European study on occurrence of depressive disorder in both urban and rural settings allowing closer analysis of the urban/rural differences. The most striking result was the large urban/rural difference in women in the two countries from the British Isles which could not be totally explained by the socio-demographic factors included in this study.

Adolescent↗
PubMed2003

Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36).

A great number of questionnaires and instruments have been developed in order to measure psychological distress/mental health problems in populations. The Survey of Level of Living in 1998 conducted by Statistics Norway used both Hopkins Symptom Checklist (SCL-25) and the Short Form 36 (SF-36), including the five-item mental health index (MHI-5). Five-item and 10-item versions of the SCL-25 have also been used in Norwegian surveys. The purpose of this study was to investigate the correlation between the various instruments, and to assess and to compare psychometric characteristics. A random sample of 9735 subjects over 15 years of age drawn from the Norwegian population received a questionnaire about their health containing SCL-25 and SF-36. Response rate was 71.9%. Reliability of the SCLs and MHI-5 were assessed by Cronbach alpha. The scores from full and abbreviated instruments were compared regarding possible instrument-specific effects of gender, age and level of education. The correlations between the instruments were calculated. The capacity of the various instruments to identify cases was assessed in terms of sensitivity, specificity, predictive values, receiver operating characteristics (ROC) and area under the curve (AUC). The reliabilities were high (Cronbach alpha>0.8). All instruments showed a significant difference in the mean scores for men and women. The correlation between the various versions of SCL ranged from 0.91 to 0.97. The correlation between the MHI-5 and the SCLs ranged from -0.76 to -0.78. The prevalence rate was 11.1% for SCL-25 scores above 1.75 and 9.7% for scores below 56 in MHI-5. AUC values indicated good screening accordance between the measures (AUC>0.92). The results suggest that the shorter versions of SCL perform almost as well as the full version. The corresponding cut-off points to the conventional 1.75 for SCL-25 are 1.85 for SCL-10 and 2.0 for SCL-5. MHI-5 correlates highly with the SCL and the AUC indicate that the instruments might replace each other in population surveys, at least when considering depression. An operational advantage of the MHI-5 over the SCL instruments is that it has been widely used not only in surveys of mental health, but also in surveys of general health.

Adolescent↗
PubMed2002

The ability of general practitioners to detect mental disorders among primary care patients in a stressful environment: Gaza Strip.

BACKGROUND: The aim of the present study was to investigate the detection rate by general practitioners (GPs) of mental disorders in a primary health care setting and relating the findings to selected GP characteristics and the patient sociodemographic characteristics. METHODS: The patients were assessed with respect to mental disorders by Hopkins Symptom Checklist 25 (HSCL-25), and the GPs were independently asked to fill in the Goldberg checklist II to assess the patient after consultation. The sample consisted of 10 primary health care clinics in the Gaza Strip, which were randomly selected from the five regions that form the Gaza Strip (Northern, Southern region, Gaza City, Middle region, Khan-Younis and Rafah). Thirty-two GPs and 661 patients participated in the study. RESULTS: The study showed that the GPs detected only 11.6 per cent of patients with mental disorders at HSCL-25 score >1.75, and that the GP's assessment was not significantly associated with the HSCL-25 scores. GPs with postgraduate psychiatric training performed better in detecting mental disorders, likewise female GPs and those who were more than 40 years old. The results also revealed that the GPs were more able to detect mental disorders among patients older than 25 years, and in female patients. CONCLUSIONS: The GPs' poor detection rate of mental disorders indicates the importance of mental health training for GPs working in primary health care clinics.

Adult↗