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Biomedical subjects

Bo Netterstrøm

Publications and source records attributed to Bo Netterstrøm.

8 recordsLinked to original sources
PubMed2007

[Experiences from a stress clinic. A pilot study].

INTRODUCTION: The aim of the study was to develop a multi-disciplinary stress management program for employees with long-term stress. METHODS: In a two-year period, 66 people active in the labour market were referred to the stress clinic at an occupational medicine clinic. All but 10 went through the program for four months and were further evaluated after one year regarding employment, symptoms and salivary cortisol. The program consisted of 1) an evaluation of symptoms of depression and stress, 2) stress management consultations, 3) introduction to relaxation techniques and physical exercise and 4) in some cases contact to the work place for adjustments or referral to psychiatric evaluation. Physiological measures such as maximal oxygen uptake, blood pressure, cholesterol, HDL, TSH, HbA1C, fasting glucose and fibrinogen were carried out at baseline and after four months. Salivary cortisol was measured at baseline, after four months and one year. As a control group 24 people with similar symptoms referred to the Clinic of Occupational Medicine were used. RESULTS: A significantly larger number of people in the study group (82%) than in the control group (42%) were employed after one year. There was no difference between the two groups regarding the prevalence of stress symptoms during the follow-up period, even though the prevalence decreased significantly. However, the prevalence of depression was significantly lower after one year in the study group (4%) compared to the control group (40%). Maximum oxygen uptake increased and fibrinogen decreased significantly in four months. The rise in salivary cortisol from awakening until 30 minutes later increased significantly during one year and correlated with symptoms of depression.

Adult↗
PubMed2006

Psychosocial factors at home and at work and levels of salivary cortisol.

BACKGROUND: Salivary cortisol as a physiological measure of stress has attracted great interest in recent years. METHOD: A 55 women and 28 men, all healthy volunteers, were included in a study on psychosocial factors at work and at home and salivary cortisol. General linear models, univariate and repeated measures, respectively, were used to evaluate the associations between psychosocial factors and cortisol excretion measured six times during a working day. Age, physical activity, tobacco use and the time of the first saliva sample were used as covariates. RESULTS: In the women, high degrees of time pressure, effort and effort reward imbalance were significantly associated with higher levels of cortisol. In the men, high degrees of effort, effort reward imbalance and overcommitment were significantly associated with higher levels of cortisol. CONCLUSION: Psychosocial factors are of significance to the level of salivary cortisol. The study emphasises the benefits of taking physiological measurements of stress in epidemiological studies.

Activities of Daily Living↗
PubMed2006

[Self-reported stress and risk of breast cancer--a secondary publication].

A possible association between stress and risk of breast cancer has been assessed in different study designs with conflicting results. We prospectively followed 6,689 women from the Copenhagen City Heart Study for 18 years for a first-time diagnosis of primary breast cancer. The women were asked about stress intensity and frequency at baseline in 1981-83. Women reporting high levels of stress were at lower risk of breast cancer (hazard ratio = 0.60; 95% CI: 0.37-0.97) than women reporting low levels of stress. This association was most pronounced among women who received hormone therapy.

Aged↗
PubMed2006

Psychological job demands increase the risk of ischaemic heart disease: a 14-year cohort study of employed Danish men.

AIMS: To test the relationship between job strain and the incidence of ischaemic heart disease (IHD) prospectively in the Danish working population. METHODS AND RESULTS: In 1986, a clinical examination was undertaken of 659 men, all employed and without known IHD, together with a questionnaire-based evaluation of living conditions and psychosocial factors at work, including items identified in the job strain model. This study was part of the World Health Organization-initiated MONICA II study. In the job strain model, job strain is defined as the combination of high psychological demands and a low degree of control in the work situation. An objective classification of the components in the job strain model was made by imputation by utilizing the participants' job title and the principles guiding the payment of their salaries/wages. In addition, a questionnaire-based subjective classification was undertaken. All participants were followed until the end of 1999 with regard to hospitalization and death as a result of IHD. Stepwise analyses were made, adjusting for age, social class, social network and established behavioural and physiological coronary risk factors. Self-reported job strain was significantly associated with IHD independently of standard coronary risk factors. Of the two components in the job strain model only high demands contributed significantly to this result. The study did not support the job strain hypothesis when an imputed, objective classification of the components in the job strain model was applied. This is in accordance with the majority of other studies in this area. An unexpected finding was that the incidence of IHD was highest among employers and managers. CONCLUSION: High psychological demands at work are a risk factor for IHD, a fact that should affect the primary and secondary prevention of IHD.

Adult↗
PubMed2005

[Psychosocial factors at work and ischemic heart disease].

We reviewed the epidemiologic research on the relationship between psychosocial factors at work and ischemic heart disease (IHD). A literature search identified 35 longitudinal English-language studies published in peer-reviewed journals. Nine out of 18 cohort studies and 14 out of 17 case control studies showed a significant association between psychosocial factors at work and IHD. In three of the studies, the results showed the expected association without it being significant, and in nine of the studies no association was found. Twenty-nine of the studies achieved a satisfactory quality score of at least 16 points out of a possible 25. Among these, 19 found a positive association between psychosocial factors at work and IHD. Nineteen of the studies had used the job strain model suggested by Karasek and Theorell as the model of exposure. Eleven of these found a clear association between job strain and IHD, three found a partial association, and five showed negative results. Three of the negative studies had used the ecological method as the measure of exposure. None of the five American studies found any association between job strain and IHD. The 11 positive studies were carried out in the UK, Sweden, the Czech Republic, and Denmark. An imbalance between efforts rendered and rewards, as well as long working hours, was also found to increase the risk of IHD in the six studies which had looked into these exposures. The results of this literature review ought to have consequences for the prevention of IHD and affect the advice offered to IHD patients.

Case-Control Studies↗
PubMed2005

Self reported stress and risk of breast cancer: prospective cohort study.

OBJECTIVE: To assess the relation between self reported intensity and frequency of stress and first time incidence of primary breast cancer. DESIGN: Prospective cohort study with 18 years of follow-up. SETTING: Copenhagen City heart study, Denmark. PARTICIPANTS: The 6689 women participating in the Copenhagen City heart study were asked about their perceived level of stress at baseline in 1981-3. These women were followed until 1999 in the Danish nationwide cancer registry, with < 0.1% loss to follow-up. MAIN OUTCOME MEASURE: First time incidence of primary breast cancer. RESULTS: During follow-up 251 women were diagnosed with breast cancer. After adjustment for confounders, women with high levels of stress had a hazard ratio of 0.60 (95% confidence interval 0.37 to 0.97) for breast cancer compared with women with low levels of stress. Furthermore, for each increase in stress level on a six point stress scale an 8% lower risk of primary breast cancer was found (hazard ratio 0.92, 0.85 to 0.99). This association seemed to be stable over time and was particularly pronounced in women receiving hormone therapy. CONCLUSION: High endogenous concentrations of oestrogen are a known risk factor for breast cancer, and impairment of oestrogen synthesis induced by chronic stress may explain a lower incidence of breast cancer in women with high stress. Impairment of normal body function should not, however, be considered a healthy response, and the cumulative health consequences of stress may be disadvantageous.

Adult↗
PubMed2005

Progression in intima media thickness--the significance of hormonal biomarkers of chronic stress.

OBJECTIVE: The pathophysiological pathways from stress caused by psychosocial stress to IHD has not been dealt with very extensively. The objective of this study was to analyse the association between cortisol levels and progression in intima media thickness (IMT). METHODS AND RESULTS: In 1998 and 2002, 95 participants went through a clinical investigation including ultrasound of the artery carotis communis. Progression in IMT was analysed in relation to levels of salivary cortisol in 1998 and the average levels of salivary cortisol in 1998/2002. Further, the significance of conventional coronary risk factors, testosterone and dehydro-epiandrosterone sulphate (DHEAS) were evaluated. Among the men, only age and HDL-cholesterol (negative) were significantly correlated with progression in IMT. Among the women, awakening cortisol response was significantly correlated with progression in IMT. Testosterone and DHEAS were borderline significantly associated (negatively) with progression in IMT in both genders. CONCLUSION: Progression in atherosclerosis were determined by different risk factors in women and men. The awakening cortisol response was of great importance to IMT progression in women but not in men.

Adult↗