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Biomedical subjects

T Theorell

Publications and source records attributed to T Theorell.

At least 145 records · Page 8Linked to original sources
PubMed1987

Psychosocial work conditions before myocardial infarction in young men.

All male patients in the greater Stockholm area who had survived a myocardial infarction below the age of 45 were examined with regard to medical and psychosocial risk factors 3-6 months after the onset of the infarction. For each patient, a male control subject was randomly selected after matching with regard to age and residence area. In the patient group, coronary angiograms were performed and rated with regard to degree of coronary atherosclerosis. The psychosocial variables were not correlated with degree of coronary atherosclerosis. Excessive work demands combined with boredom at work ("variety" and "intellectual discretion") were significantly more often reported by the patients after adjustment had been made for life style factors. In the multivariate analysis a high LDL/HDL cholesterol ratio, a high cumulative tobacco consumption, high demands in relation to variety at work as well as high demands in relation to influence over work and finally a low alcohol consumption were significant independent predictors of case status. Excessive work demands in themselves did not differentiate cases from controls.

Adult↗
PubMed1987

Coping and social activity patterns among relatives of cancer patients.

In this study we have examined how relatives of cancer patients change their social patterns when they are offered increased possibilities to take active part in the care of the patient. Relatives who were offered such an activation programme were compared with relatives who were offered the usual routine programme ('comparison group'). The instrument used for the present study was a modified version of the 'coping wheel' introduced by Shalit. Fifty relatives in the activation group and 45 in the comparison group were followed at repeated occasions approximately once a month during the patient's treatment. Twenty-two in the activation group and 19 in the comparison group were followed 1 and 2 month(s) after the patient's death. Relatives in the activation group reported a significantly higher proportion of activities concerning friends and relatives (P less than 0.04) during the treatment period. At the last observation occasion preceding death, relatives in the comparison group reported significantly more areas dealing with 'own feelings' (P less than 0.04). Relatives in the activation group reported a significantly greater increase in number of 'own activities' from the last observation preceding the patient's death to 1 month after death (P less than 0.04) compared to the comparison group.

Adaptation, Psychological↗
PubMed1987

Maternal opinion of psychosocial support: evaluation of an antenatal programme.

The aim of the study was to investigate the significance of psychosocial screening and psychosocial support in antenatal care. Different methods were used. Three hundred and sixty-four pregnant women participated. There was no increase in obstetrical complications, premature births or growth retardation among the infants born to mothers with a high life stress score. A correlation between smoking and reduced birth weight was noted. Most women claimed that they had reduced their alcohol intake already before their first visit to the antenatal clinic. Those women who attended the most extensive psychosocial care had the most favourable attitudes towards the antenatal care. There was a positive correlation between intensive psychosocial support and sickness allowance. The question is raised whether all pregnant women should have the right to be out of work during the last 2 months of pregnancy without reduction of parent's allowance benefit.

Absenteeism↗
PubMed1987

Suicide patterns among physicians related to other academics as well as to the general population. Results from a national long-term prospective study and a retrospective study.

In the present study, we have followed a national cohort of physicians, academics and the general population (part of the compulsory census in 1960) for a period of 10 years and identified all cases of suicide during the period 1961-1970. Furthermore, we have carried out a retrospective study of suicides among the four major medical specialist groups (general practitioners, internists, psychiatrists and general surgeons) and compared these rates with other medical specialists. Results show an elevated standardized mortality ratio (SMR) for suicide among female physicians compared to other academics as well as to the general population. Furthermore, male doctors exhibit an elevated suicide rate only when compared to other academics. Among the various specialists, general surgeons alone exhibited a significantly elevated suicide rate. The study clearly shows that female physicians are more prone to suicide than most other women, but that male physicians are also at risk compared to other male academics. Furthermore, at least in Sweden, general surgeons, not psychiatrists, have the highest suicide rate of all physicians.

Adult↗
PubMed1987

Psycho-endocrinological reactions in female relatives of cancer patients. Effects of an activation programme.

Psychiatric grief reactions after the loss of a close relative are associated with endocrinological reactions, in particular elevated plasma cortisol. In the present study it was tested if a psychosocial intervention programme for relatives to cancer patients affects the reaction patterns. Thirty-six female relatives in the intervention programme were compared with 36 relatives only subjected to a routine programme. Eighteen of the relatives in the intervention programme and 17 in the routine programme experienced the death of the patient during the study period. Systematic psychiatric observations and analyses of the plasma levels of cortisol and prolactin were made approximately once a month. During the treatment period the psychiatric scores did not differ between the groups, but the prolactin levels tended to be lower in the intervention group (p = 0.06). During the terminal phase preceding the patient's death the plasma cortisol levels were significantly elevated in the intervention group but not in the routine group. At examination one and two months after the death of the patient the mental exhaustion scores were significantly lower in the intervention group. The findings are consistent with the hypothesis that grief is activated by the intervention and that the active mourning may have prophylactic value to the relatives after the death of the patient.

Adult↗
PubMed1987

Relationships between critical life events, job stress and cardiovascular illness.

The relationship between critical life events and the state of health has become the subject of a growing number of studies. Starting with a review of recent studies centered on coronary heart disease the paper gives an outline of the present state of research in this field. Methodological aspects are discussed and special emphasis is laid on the longitudinal approach which is illustrated by several studies conducted by the author. The use of life event information could play an important role in preventive action. There are by now psychophysiological and clinical findings to support this pathway, namely as regarding secondary prevention, e.g. after a first myocardial infarction, but an efficient application requires further exploration of this field.

Coronary Disease↗
PubMed1987

Stress syndromes.

Some methodological problems in epidemiological research on stress syndromes are reviewed. It is pointed out that syndromes defined on the basis of physiological findings may be difficult to relate to psychosocial problems. This is exemplified by the early asymptomatic stages of hypertension. Men with this syndrome seem to report fewer life problems than other men. This could be due to systematic underreporting. It is shown that different illnesses may have different psychosocial correlates. Research has shown that early endocrinological response patterns during stress periods may be beneficial in the long-term perspective.

Epidemiologic Methods↗
PubMed1986

Young men with high blood pressure report few recent life events.

Men who had high, medium and low blood pressure at age 18 (compulsory screening for military service in Stockholm) were examined ten years later at age 28. Interviewers, having had no information regarding past or present blood pressure, interviewed them about life events experienced during the year preceding the examination. Men with high blood pressure at rest reported fewer life events for the past year than other men. Furthermore, high plasma adrenaline levels at rest were associated with few reported life events.

Adolescent↗
PubMed1986

Type A behaviour, education and psychosocial work characteristics in relation to ischemic heart disease--a case control study of young survivors of myocardial infarction.

The interaction of Type A behaviour, psychosocial work environment and education in relation to medical risk factors for IHD was analyzed in a case-control study of male and female post-MI-patients under age 45. In multivariate analysis LDL/HDL-cholesterol ratio and smoking (explaining 27 and 6% of the variance) emerged as the two most important discriminators of patients from control subjects. The third factor, variety of work tasks, explained 5% of the variance. Type A behaviour ranked as factor no. 7, explaining only 2% of the variance and educational level did not reach statistical significance as an independent explanatory factor. When the sample was divided into men and women with high and low education, most of the patient-control difference in Type A and psychosocial work characteristics was found among highly educated men on one hand and women with a low level of education on the other. Thus Type A behaviour seems to be less important and psychosocial work environment more important in adding psychosocial risk to the medically established risk of IHD.

Achievement↗
PubMed1986

Stress management in the treatment of essential hypertension in primary health care.

The present study was a pilot project to determine the feasibility of a stress management program for treatment of hypertension in the Swedish primary health care system. Those patients in the catchment area of the primary health care center at Tumba hospital who were under 45 years old and diagnosed with primary hypertension during 1979-1981, were chosen to participate if they had had at least one measurement of 150 mmHg systolic and/or 95 mmHg diastolic during 1981. Patients on diuretic medication were included but those being medicated with beta-blockers were excluded for ethical reasons. Of the 21 people who fulfilled these criteria, 13 took part in the treatment, which lasted ten weeks. Both systolic and diastolic blood pressure decreased significantly (151.1 to 124.7 and 96.4 to 89.3, respectively). The conclusions drawn were that stress management may offer a viable alternative to medication of mild hypertension in primary health care and that it should be tested on a larger scale with systematic blood pressure measurements performed during daily activities, serving as a basis for baseline determination.

Adult↗
PubMed1985

The relation of social support and working environment to medical variables associated with elevated blood pressure in young males: a structural model.

The object of the present study was to examine the interaction of working environment factors and the individual social support network with medical variables related to blood pressure elevations in young (mean age = 28 years) hypertensives. The results of path analyses reveal that the medical variables which explained a significant amount of the variation in systolic blood pressure were blood hemoglobin, plasma adrenaline and relative weight. High relative weight was associated with a low level of employment security and high plasma adrenaline with a poor self-reported social network as well as a job providing few possibilities for learning new things. High levels of diastolic pressure were associated with elevated hemoglobin levels, increased heart rate and low plasma renin activity. Increased heart rate was influenced by a lack of 'anger' coping in conflict situations at work and a low number of contacts with acquaintances. Working environment and social support are hypothesized to assert their influence through increased sympathetic stimulation mediated by limbic-hypothalamic discharge.

Adaptation, Psychological↗
PubMed1985

Blood pressure variations during a working day at age 28: effects of different types of work and blood pressure level at age 18.

During an ordinary work day blood pressure was self-monitored once every hour in two samples of asymptomatic nonmedicating 28-year-old men. They were selected on the basis of previous compulsory blood pressure recordings made at the age of 18 when they had been drafted for military service. Subjects in the "original hypertensive sample" with "strain" occupations (hectic and uncontrollable, such as waiter, driver and cook) had more marked elevations of systolic blood pressure during work hours than other subjects.

Adult↗
PubMed1985

Type of occupation and near-future hospitalization for myocardial infarction and some other diagnoses.

Using three different registers a cohort study was undertaken to describe the relationship between type of occupation and hospitalization. A total of 958 096 subjects aged 20-64 years were followed-up for one year regarding inpatient care. Several significant associations between type of occupation and incidence of hospitalization for different diagnoses were observed. Male subjects employed in occupations where a high proportion reported a combination of hectic work and few possibilities to learn new things were more frequently hospitalized for myocardial infarction than other working men. The relative 'hospitalization' ratio for men 20-54 years of age in these strenuous occupations was estimated as 1.6 with a 95% confidence interval of 1.3-1.9. For women, the relative 'hospitalization' ratio in the ages 20-64 in occupations where a high proportion reported a combination of hectic and monotonous work was estimated as 1.6 with a 95% confidence interval of 1.1-2.3. Both these associations were statistically significant even after controlling for 12 possible confounding factors.

Adult↗
PubMed1985

Psychosocial and physiological factors in relation to blood pressure at rest--a study of Swedish men in their upper twenties.

The interrelationships between psychosocial factors, several physiological variables and blood pressure (BP) were investigated in 88 young men (aged 26-32 years) in whom high, intermediate or low BP had been recorded at the age of 18 years. In the original high BP group, venous plasma noradrenaline was normal but adrenaline levels elevated. At the follow-up adrenaline correlated with systolic blood pressure (SBP), and this was also so after controlling for overweight and serum gamma-glutamyltranspeptidase [gamma-GT, a marker for alcohol consumption, which showed an independent association with diastolic blood pressure (DBP)]. Low assertiveness (low scores of verbal and indirect aggression) correlated with high BPs, even after controlling for other psychosocial variables. Several associations between psychosocial job variables and physiological variables were found. Among self-reported job variables, excessive 'demands' and 'bossing others' (but not 'decision latitude' or 'psychosocial conflict') were associated with high SBP. Habitual smoking of cigarettes was not associated with BP at rest, but influenced several associations between psychosocial and physiological variables. Men with high BP at rest and low plasma renin activity (PRA) reported more psychosocial problems at work and lower assertiveness than other groups.

Adult↗