Biomedical subjects

A A Dahl

Publications and source records attributed to A A Dahl.

At least 19 recordsLinked to original sources

PubMed2006

Migraine with and without aura: association with depression and anxiety disorder in a population-based study. The HUNT Study.

Some data indicate that migraine with aura (MA) is more strongly associated with anxiety disorder and depression than migraine without aura (MoA), but the evidence is not conclusive. In the Nord-Trøndelag Health study 1995-1997, a total of 49 205 (75% of the participants) subjects gave valid answers to both HADS (Hospital Anxiety and Depression Scale) and a validated headache questionnaire. Associations between anxiety disorder/depression and MA/MoA were evaluated by multiple logistic regression analysis. Depression (DEP) [odds ratio (OR) 1.7; 95% confidence interval (CI) 1.2, 2.6] and depression with comorbid anxiety disorder (COM) (OR 1.6; 95% CI 1.2, 2.1) were more likely in women having MA than in those with MoA. No stronger association was found for pure anxiety disorder (ANX) in MA vs. MoA (OR 0.9; 95% CI 0.7, 1.5). Among men, we found no difference in prevalence of depression and anxiety disorders between MA and MoA. This is a new finding that might have relevance for both research and clinical treatment.

Adult↗

PubMed2006

Outcomes in adulthood for children with foetal growth retardation. A linkage study from the Nord-Trøndelag Health Study (HUNT) and the Medical Birth Registry of Norway.

OBJECTIVE: The aims were to examine the long-term functional outcome and risk of mood disorders in adulthood in individuals with foetal growth retardation. METHOD: In a prospective cohort study of 7806 individuals aged 20-30 years, using linked data from the Health Survey of Nord-Trøndelag (HUNT-2) and the Medical Birth Registry of Norway, we studied the long-term effects of being born with a birth weight below the 10th percentile for gestational age (SGA). RESULTS: SGA individuals had lower educational level (OR: 1.33), lower socioeconomic functioning level (OR: 1.77) and more frequent reported mood disorder in adulthood (OR: 1.26). Analyses of a substratum of infants born at term showed almost identical results. CONCLUSION: Foetal growth retardation measured as SGA shows a moderate risk for lower education and socioeconomic level and for anxiety and/or depression in young adulthood. Issues concerning interventions for children at risk should be considered.

Adult↗

PubMed2006

Cardiorespiratory fitness in relation to self-reported physical function in cancer patients after chemotherapy.

AIM: The aim of this study was to estimate the association between objective cardiorespiratory fitness (CRF) and subjective self-reported physical function, taking into account the influence of mental distress. We hypothesized an association between these parameters, since they might be thought to measure parts of the same phenomenon. METHODS: Approximately 1 month after discontinuation of all primary treatment, 90 cancer patients aged 18-50 years treated with chemotherapy were surveyed. CRF was determined by the Astrand-Ryhming indirect cycle ergometer test, which indicate peak VO2 in mL x kg(-1) x min(-1) (predicted VO2max). Self-reported physical function was assessed by The European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). The relation between VO2max and self-reported physical function was estimated by multiple linear regression. Mental distress (assessed by The Hospital Anxiety and Depression scale), age, gender, body mass index (BMI), time from treatment to physical test and diagnoses were included as potential confounders. RESULTS: There was no association between predicted VO2max and self-reported physical function. Mental distress was negatively associated with self-reported physical function (P<0.001), but is not associated with predicted VO2max. CONCLUSIONS: The results suggest that predicted VO2max does not reflect self-reported physical function and vice versa in cancer patients after chemotherapy. If information about cardiac and/or pulmonary status is required, direct or indirect measures of VO2max should be used.

Adolescent↗

PubMed2005

Neonatal outcomes in offspring of women with anxiety and depression during pregnancy. A linkage study from The Nord-Trøndelag Health Study (HUNT) and Medical Birth Registry of Norway.

BACKGROUND: The presence of mental disorder during pregnancy could affect the offspring. AIMS: To examine the effects of anxiety disorder and depression in pregnant women on neonatal outcomes, and to compare neonatal outcomes between offspring of attendees and non-attendees in a general population-based health survey. METHOD: Pregnant women (n = 680) were identified from the population-based health study of Nord-TrØndelag County (HUNT-2) by linkage with the Medical Birth Registry of Norway. The women rated themselves on the Hospital Anxiety and Depression Rating Scale (HADS). Outcome variables were gestational length, birth weight, and Apgar scores. RESULTS: HADS-defined anxiety disorder during pregnancy was associated with lower Apgar score at one minute (score < 8; odds ratio = 2.27; p = .03) and five minutes (score < 8; odds ratio = 4.49; p = .016). No confounders were identified. Anxiety disorder and depression during pregnancy was not associated with low birth weight or preterm delivery. Offspring of non-attendees had a lower birth weight (77 g; t = 3.27; p = 0.001) and a shorter gestational length (1.8 days; t = 2.76; p = 0.006) than that of offspring of attendees, a difference that may be explained by a higher load of psychosocial risk factors among the non-attendees. CONCLUSION: In our study that may be biased towards the healthier among pregnant women, anxiety disorder or depression during pregnancy were not strong risk factors for adverse neonatal outcomes although low Apgar score in offspring of women with anxiety disorder may indicate poor neonatal adaptation.

Adult↗

PubMed2005

Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase.

BACKGROUND: Limited research has been done on mental health and health-related quality of life (QOL) of primary caregivers (PCs) to patients staying at home with advanced cancer. This study examines anxiety, depression, and QOL in PCs of patients with cancer in the late palliative phase. PATIENTS AND METHODS: The sample consisted of 49 PCs of women with breast cancer and 47 PCs of men with prostate cancer. QOL was rated with the Medical Outcome Study Short Form (SF-36), and mental health with the Hospital Anxiety and Depression Scale (HADS). The findings were compared with age-adjusted norm data (norm). RESULTS: Physical QOL was significantly higher than norm in both genders, while mental QOL was significantly lower in male PCs. The level of anxiety was significantly higher than norm in both genders. No significant difference for level of depression was found in either gender, while caseness of HADS-defined depression was significantly more prevalent in female PCs compared with norm. CONCLUSION: PCs of both genders had significantly more anxiety than norm samples. Health care personnel in contact with PCs should consider screening them for mental symptoms and QOL and, if necessary, recommend further evaluation by their doctors.

Aged↗

PubMed2005

Help-seeking behaviour in patients with anxiety disorder and depression.

OBJECTIVE: The objective of this study was to investigate help-seeking behaviour among persons with anxiety disorder and depression based on self-rating in a Norwegian population (the HUNT study). METHOD: Of the 92 100 inhabitants aged 20-89 years invited, 65 648 (71.3%) took part. Among them 60 869 (66.1%) persons delivered valid ratings on hospital anxiety and depression scale, and had answered the requested help for mental problems question. RESULTS: Among HUNT attenders 13% of those with depression and 25% with anxiety disorders had been help seekers. Help seeking was only non-significantly associated with demographic or other variables. CONCLUSION: Most persons with anxiety disorder and/or depression in the population had not sought help for their mental disorders, but the disparity between use and need of health service must not be overassessed. Improvement of the help-seeking rate for common mental disorder should have high priority in mental health politics.

Adult↗

PubMed2005

Sertraline in generalized anxiety disorder: efficacy in treating the psychic and somatic anxiety factors.

OBJECTIVE: The objective was to study the efficacy of sertraline on symptoms of psychic and somatic anxiety in patients suffering from moderate-to-severe generalized anxiety disorder (GAD). METHOD: Out-patients with DSM-IV GAD were randomized to 12 weeks of double-blind treatment with placebo. The psychic and somatic anxiety factors of the Hamilton Anxiety Rating Scale (HAM-A) and the Quality of Life, Enjoyment, and Satisfaction Questionnaire were analyzed. RESULTS: Treatment with sertraline resulted in significantly greater last observation carried forward (LOCF)-endpoint improvement than placebo on both the HAM-A psychic and somatic anxiety factors. At LOCF-endpoint, all items on the HAM-A psychic factor were more improved on sertraline than placebo, as were three of seven items on the somatic factor. Reduction of secondary depressive symptoms was more correlated with endpoint improvement in quality of life than either psychic- or somatic anxiety. CONCLUSION: Sertraline treatment demonstrated efficacy for both the psychic and somatic anxiety symptoms of GAD.

Adult↗

PubMed2004

Farmers are at risk for anxiety and depression: the Hordaland Health Study.

AIMS: To examine whether, and why, farmers and non-farmers differ regarding levels of anxiety and depression. METHODS: The study encompassed 17 295 workers age 40-49 years, including 917 farmers, from the population-based Hordaland Health Study 1997-99 (HUSK). Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively). Self-reported information on various work-related factors, demographics, lifestyle and somatic health problems was included. The main analytical methods were univariate analysis of variance (ANOVA)/Kruskal-Wallis test, chi(2)/Fisher's exact test and logistic regression. RESULTS: Compared with non-farmers, farmers had higher levels and prevalences of depression, particularly the male farmers, who also had higher anxiety levels. Among men, farmers reported longer work hours, lower income, higher psychological job demands and less decision latitude compared with non-farmers. Farmers had physically heavier work and a lower level of education than non-farmers. Generally, the differences were largest between full-time farmers and non-farmers. Differences in anxiety and depression levels between male full-time farmers and non-farmers could be explained by the farmers' longer work hours, physically harder work and lower income. CONCLUSIONS: Farming is associated with increased levels of anxiety and increased levels and prevalences of depression. As regards depression, preventative measures and screening for cases in need of treatment should be strongly considered.

Adult↗

PubMed2003

Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression.

OBJECTIVE: The Edinburgh Postnatal Depression Scale (EPDS) is a self-rating scale developed to screen for postnatal depression. The aim of this study was to validate a Norwegian translation of the EPDS, study its psychometric properties, and identify risk factors for postnatal depression. METHOD: EPDS was filled in by 411 women at 6-12 weeks postpartum. Of these, 100 were interviewed using the Mini International Neuropsychiatric Interview for DSM-IV major and minor depressive disorders. RESULTS: When using a cut-off of 11 on the EPDS, 26 of 27 women with major depression were identified (sensitivity 96%, specificity 78%). An aggregate point prevalence of 10.0% of major and minor depression was found. A one-factor model accounted for 46.6% of the variance. Strongest risk factors for postpartum depression were previous depression, depression in current pregnancy, and current somatic illness. LIMITATIONS: Women screened using the EPDS who had a score above threshold, yet did not attend the diagnostic interview could cause the point prevalence of depression to be higher than indicated here. CONCLUSION: The Norwegian translation of EPDS functions equally well as other translations as a screening tool for postnatal depression. The risk factors that were found are compatible with other studies.

Adult↗

PubMed2003

The association between age and depression in the general population: a multivariate examination.

OBJECTIVE: In a large general population study we found a close to linear rise with age in the mean score and prevalence of self-reported symptoms of depression. The aim of this study was to examine if this linear relation prevailed when controlled for multiple variables and to examine factors that eventually explained the association. METHOD: Among individuals aged 20-89 years living in Nord-Trøndelag County of Norway, 60 869 filled in valid ratings of the Hospital Anxiety and Depression Scale as well as many other variables. Covariates were grouped into a multivariate model with six blocks. Logistic regression was used to model the blocks and variables with caseness of depression as the dependent variable. RESULTS: The model explains a considerable part of the age-related pattern on depression. The pattern became less distinct in the age groups above 50 years. Variables within the blocks of somatic diagnoses and symptoms, as well as impairment, had most explanatory power. CONCLUSION: Because of our large sample we were able to control for more relevant variables than earlier studies. In contrast to most other studies, we found that an age-related increase of the prevalence of depression persisted after control for multiple variables.

Adult↗

PubMed2003

Change of immunoglobulins and complement factors in patients with self-injurious behaviour.

OBJECTIVE: As stress activates the inflammatory response system, and attempted suicide is connected with severe stress, we hypothesized that patients hospitalized for self-injurious behaviour have changed immunocompetence. METHOD: The concentration of immunoglobulins IgG, IgA, IgM, and the complement components C3 and C4 in 73 patients hospitalized for self-injurious behaviour was compared with those of 122 healthy controls. The immunoglobulins and complement were quantified by nephelometric technique. RESULTS: The levels of IgG and IgM were significantly lower, and the complement C3 and C4 were significantly higher in self-injurious patients compared with controls. This was valid in both genders and the effects did not interact with gender. CONCLUSIONS: This controlled study showed that the concentrations of immunoglobulins were reduced and complement components were increased in patients who are admitted to hospital for self-injurious behaviour.

Adult↗

PubMed2003

When adolescents disagree with their mothers: CBCL-YSR discrepancies related to maternal depression and adolescent self-esteem.

OBJECTIVE: To facilitate understanding of disagreement between mothers and adolescents when they report on adolescents' mental symptoms, discrepancy of reports were studied in relation to depressive symptoms of mothers and self-esteem of adolescents. PARTICIPANTS: Sixty-eight mother-adolescent pairs participated. All the adolescents (11-17 years) were referred to child and adolescent psychiatric outpatient clinics in Norway for emotional or behavioural disorders. METHODS: The adolescents completed the questionnaire Youth Self Report (YSR), and mothers completed the corresponding Child Behaviour Checklist (CBCL). Maternal depression was measured with the Hospital Anxiety and Depression Scales and adolescent self-esteem was measured with Self-Perception Profile for Adolescents. RESULTS: Mothers' level of depression emerged as a significant variable (P < 0.001) predicting CBCL-YSR discrepancy on internalizing disorders, explaining 41% of the variance. With increased levels of depression mothers tended to report more internalizing problems compared to the adolescents. For mother-adolescent discrepancy on externalizing problems, adolescents' age was the most significant variable. With increasing age the adolescents were more in agreement with their mothers when reporting their externalizing problems. But also self-esteem problems concerning their looks made adolescents inclined to admit more externalizing problems, thus being more in agreement with their mothers. CONCLUSIONS: Subjective, psychological variables such as mothers' level of depression and self-esteem of adolescents may be useful to consider when interpreting informant discrepancy concerning the mental problems of adolescents.

Adolescent↗

PubMed2003

Depression and anxiety disorders associated with headache frequency. The Nord-Trøndelag Health Study.

The aim of this large cross-sectional population-based study was to examine the association between migraine, non-migrainous headache and headache frequency with depression, and anxiety disorders. From 1995 to 1997, all 92 566 inhabitants aged 20 years and above in Nord-Trøndelag County in Norway were invited to participate in the Nord-Trøndelag Health Study ('Helseundersøkelsen i Nord-Trøndelag' = HUNT-2). A total of 64 560 participated, whereof 51 383 subjects (80%) completed a headache questionnaire that was included. Of these 51 383 individuals, 47 257 (92%) completed the depression subscale items and 43 478 (85%), the anxiety subscale items of the Hospital Anxiety and Depression Scale (HADS). Associations were assessed in multivariate analyses, estimating prevalence odds ratios (OR) with 95% confidence intervals (CI). Depression and anxiety disorders as measured by HADS, were significantly associated with migraine (OR = 2.7, 95% CI 2.3-3.2; OR = 3.2, 95% CI 2.8-3.6) and non-migrainous headache (OR = 2.2, 95% CI 2.0-2.5; OR = 2.7, 95% CI 2.4-3.0) when compared with headache-free individuals. The association was stronger for anxiety disorders than for depression. The ORs for depression and anxiety disorders amongst both migraine and non-migrainous sufferers increased with increasing headache frequency. Depression and anxiety disorders are associated with both migraine and non-migrainous headache, and this association seems more dependent on headache frequency than diagnostic category.

Adult↗

PubMed2002

The influence of definitions on the prevalence of eating problems in an adolescent population.

OBJECTIVE: The definitions of eating problems vary widely as they integrate cognitive, behavioural and physiological components to different degrees. The aim of this study was to show how much these differences affect the prevalence of eating problems in an adolescent population. METHOD: All of the 9131 adolescents in a Norwegian county participated in a health study, 8042 (88.1%) of whom gave valid responses to a questionnaire covering various aspects of eating problems, and had their weight and height measured. RESULTS: The prevalence of eating problems ranged from 0.3 to 47.0% depending on the definitions used. The various definitions also gave different gender ratios, although the prevalences increased with age in females only. CONCLUSIONS: The various definitions of eating problems had a low degree of correlation and led to quite variable prevalences. All of them showed that the prevalence of eating problems was higher in females, but their prevalence in males was also considerable.

Adolescent↗

PubMed2002

Short Form 36 and Hospital Anxiety and Depression Scale. A comparison based on patients with testicular cancer.

BACKGROUND: The aim of this study was to compare the scorings of anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS-A [Anxiety] and HADS-D [Depression]) with the scorings on the eight subscales of Short Form 36 (SF-36) and the Physical (PCS) and Mental Component Summary (MCS) assessed by the same patients. METHOD: In a cross-sectional study 736 long-term survivors after treatment for testicular cancer (TC) completed HADS and SF-36. Pearson's correlation coefficients were calculated on item and scale level to assess the associations between the HADS and the SF-36 scales and, in particular, between HADS and PCS and MCS, respectively. Independent predictors for PCS and MCS were identified by linear regression analysis. RESULTS: HADS-A and HADS-D were significantly associated with the SF-36 summary scales. HADS-A explained 5% of the variance of PCS and 49% of the variance of MCS. The comparable figures for HADS-D were 10% and 45%, respectively. In the multivariate analysis the HADS-D scoring independently predicted the level of PCS together with the patients' educational level, long-lasting working disability and age (variance: 30%). Both HADS-D and HADS-A remained independent parameters for MCS (variance: 58%) together with the patient's civil status. HADS-D item D4 ("slowed down") was similarly associated with both PCS and MCS. CONCLUSION: In univariate analyses HADS-D and HADS-A were statistically associated with PCS and MCS. The highest r values were observed for the associations between HADS and MCS, in particular between HADS-A and MCS. In the multivariate analyses HADS-D, but not HADS-A, contributed to PCS, whereas both HADS-A and HADS-D were associated with MCS. This pattern of different predictions of the summary scales of SF-36 supports a clinical practice that anxiety and depression should be assessed separately. Additional use of a self-rating instrument for depression and anxiety, such as HADS, is recommended when SF-36 is used for quality of life (QL) assessment.

Adolescent↗

PubMed2002

Are anxiety and depression related to gastrointestinal symptoms in the general population?

BACKGROUND: In clinical studies there is a strong relationship between gastrointestinal symptoms, anxiety and depression. The results may be biased, however, since anxiety and depression will influence the decision to consult a doctor. The aim of this study was to investigate the relationship between these symptoms in the population. METHODS: In the Health Study of Nord-Trøndelag County of Norway (HUNT) a questionnaire concerning physical and mental health, demographic and life-style factors was sent to all inhabitants aged 20 years and above (a total of 94,197 persons). Valid questionnaires were returned by 62,651 persons (66.5%). Presence of nausea, heartburn, diarrhoea and constipation during the last year was self-reported. Anxiety disorders and depression were based on self-ratings of the Hospital Anxiety and Depression Scale (HADS). RESULTS: 48% of the population reported one or more of the four gastrointestinal symptoms. Based on the HADS ratings, 15.3% of the population had an anxiety disorder and 10.4% a depression. Anxiety disorder was most strongly associated with nausea (OR 3.42). Anxiety was also associated with heartburn, diarrhoea and constipation, but weaker than with nausea. Depression was less strongly associated with the four gastrointestinal symptoms. Demographic factors, life-style factors and extra-gastrointestinal complaints could not explain the effect of anxiety disorders and depression on these gastrointestinal symptoms. CONCLUSIONS: In this population study there was a strong relationship between gastrointestinal symptoms, anxiety disorders and depression. These findings suggest that mental disorders in patients with gastrointestinal symptoms are not merely a consequence of selection bias in patient materials but connected to the symptoms themselves.

Adult↗

PubMed2001

[Depression--socioeconomic perspectives].

BACKGROUND: Depression is a major health problem, and there is a growing awareness of the economic burden imposed by depressive disorders. MATERIAL AND METHODS: A review of the literature on the societal cost of depression is presented in a comparison of the two major studies on the topic and a discussion of the feasibility of reducing costs. RESULTS: Estimating the societal cost of depression is complicated and estimates differ a great deal. The costs are, however, considerable with morbidity costs constituting the largest component. Depression is underdiagnosed and undertreated, but the majority of patients can be effectively treated; thus, in theory, cost reductions should be feasible. After the controversial Gotland study it was claimed that improving the skills of general practitioners in diagnosing and treating the disorder might reduce its societal costs considerably. However, these results were not reproduced in the randomized controlled Hampshire study. INTERPRETATION: It is uncertain to what degree it is possible to reduce the societal costs of depression. Research on the health economics of depressive disorders should be given priority.

Controlled Clinical Trials as Topic↗

PubMed2001

Depression in relation to age and gender in the general population: the Nord-Trøndelag Health Study (HUNT).

OBJECTIVE: Previous sample studies of depression have shown a higher prevalence of depression in women, and an inconsistent relation to age has been found for both genders. The aim of the present study was to investigate depression in relation to gender and age in the general adult population. METHOD: Of the total population of 92,100 individuals aged 20-89 years and living in Nord-Trøndelag county of Norway, 62,344 (67.7%) filled in valid ratings of depression on the Hospital Anxiety and Depression Scale (HADS). RESULTS: Minimal gender difference was found in dimensional depression scores and in prevalence rates of depression. Both these measures were found to increase continuously with age in both genders. CONCLUSION: Our results of this population-based study differ from most sample studies reported, and these discrepancies are discussed with focus on study design, self-rating, and the concept of depression covered by HADS.

Adult↗