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Biomedical subjects

E L Mortensen

Publications and source records attributed to E L Mortensen.

At least 37 records · Page 2Linked to original sources

Psychopathy and psychopathological profiles in prisoners on remand.

A total of 178 Danish male remand prisoners were examined using comprehensive interviews and questionnaires on psychopathological, personality and social measures, and file data. These data were compared with scores on the Hare Psychopathy Checklist - Revised (PCL-R). Subjects were divided into four groups according to quartile PCL-R scores. In general there were high rates of psychiatric morbidity in all PCL-R quartile groups. The medium-high scorers represent a more vulnerable group with a high prevalence of dependence disorders, relatively high neuroticism score and relatively high prevalence of neurotic and stress-related disorders. The high scorers were more psychosocially maladjusted, had more often made previous suicidal attempts, and had a higher psychoticism score. Chronic psychotic disorders did occur, mostly in the high-scoring group. The population had lower scores on the PCL-R than in most previous studies, suggesting a lower prevalence of psychopathic features among Danish criminals and possibly a lower cut-off point when using the PCL-R as a categorical measure. Both findings are consistent with the results of other European studies. Further studies on cross-cultural differences with regard to PCL-R psychopathic features and on psychic vulnerability related to PCL-R scores and factor 1/factor 2 of the PCL-R are suggested.

Adolescent↗

Beer, wine, spirits and subjective health.

STUDY OBJECTIVE: To examine the association between intake of different types of alcoholic beverages and self reported subjective health. DESIGN: Cross sectional health survey with assessment of intake of beer, wine and spirits (at last non-weekend day), smoking habits, social networks, physical activity, body mass index, educational level, presence of chronic disease, and self reported health. SETTING: WHO Copenhagen Healthy City Survey, Denmark. PARTICIPANTS: 4113 men and 7926 women aged 18 to 100 years. MAIN RESULTS: Of the 12,039 subjects, 8680 reported their health as optimal, and 3359 reported a suboptimal health. After controlling for the covariates, the relation between total alcohol intake and the proportion reporting suboptimal health was J shaped. Heavy drinkers of any of the three types of alcoholic beverages had a higher prevalence of suboptimal health than non-drinkers. However, only light (1-2 glasses of wine yesterday) and moderate (3-5) wine drinkers had significantly lower odds ratios for suboptimal health--0.72 (95% confidence limits; 0.56 to 0.92) and 0.65 (0.49 to 0.87), respectively--when compared with non-wine drinkers. Moderate beer or spirits drinkers did not differ significantly from non-drinkers of these beverages with regard to prevalence of suboptimal health. Consistently, beer preference drinkers had an odds ratio of 1.50 (1.25 to 1.80) for suboptimal health compared with wine preference drinkers. CONCLUSIONS: A light to moderate wine intake is related to good self perceived health, whereas this is not the case for beer and spirits. The causal relations creating this association are unknown and should be considered when interpreting the relation between different types of alcoholic beverages and subsequent morbidity and mortality.

Adolescent↗

Active life in old age. Combining measures of functional ability and social participation.

UNLABELLED: This paper describes a new measure of Active Life Expectancy, called Active Life Classification (ALC) in which the criterion for successful aging is a combination of good functional ability and high social participation. OBJECTIVES: 1) to describe the distribution of ALC among 75-year-old men and women, 2) to investigate the association between ALC and life satisfaction and 3) to describe how ALC is determined by socio-demographic, psycho-social, and health factors. DESIGN: A cross-sectional population survey. SETTING: Eleven municipalities in the Western part of Copenhagen County in 1989. SUBJECTS: A random sample of 75-year-old people who were invited to participate in the study (participation rate: 89, n = 477). MAIN OUTCOME MEASURE: ALC is a combination of two dichotomized variables: functional ability (dependent vs not dependent of help) and social participation (low vs. high). RESULTS: For both men and women an active life (measured by ALC) was significantly associated with life satisfaction. For men only good self-rated health was related to ALC in the multivariate analysis. Among women high income, many social contacts, good self-rated health, good memory and lack of chronic diseases were associated with ALC. CONCLUSIONS: It is an advantage to combine functional ability and social participation in the description of quality of life in old age, as 1) a high social participation may compensate for a poor functional ability, and vice versa, 2) the combined measure is meaningful for both sexes, and 3) it gives more information than the two concepts used as separate outcome measures.

Aged↗

Outpatients' knowledge about and attitude towards clinical research and randomized clinical trials. The INFO Trial Group.

OBJECTIVES: To investigate the knowledge about randomized clinical trials and the attitude towards clinical research among Danish outpatients and to examine the relationships between outpatient demographic variables and knowledge and attitude. SETTING: Outpatients (n = 415) were recruited from four departments at a university hospital in Copenhagen. METHODS: The participants answered an 18 item multiple choice test evaluating knowledge about randomized clinical trials and a 32 item Likert format questionnaire evaluating attitudes towards clinical research in general and randomized clinical trials. Assessment of scales for knowledge and attitudes was performed using Rasch analysis and Cronbach's alpha. Associations between demographic variables, knowledge score and attitude score were examined using analysis of variance. RESULTS: Mean age for all outpatients was 46 years (range 18-88 years); 251 (60%) were females. A total of 27 outpatients (7%) had previously participated in a randomized clinical trial. Mean knowledge score (number of correct answers out of a maximum of 17) was 7.9 (SD 3.1). Patients in the younger age groups and patients with longer education had significantly higher knowledge scores (p < 0.001). The effect of age group (estimated increase in knowledge score relative to the group 60-89 years) was: 18-29 years 1.2 (SE 0.4); 30-39 years 2.0 (SE 0.4); and 40-59 years 1.6 (SE 0.4). The effect of education (estimated decrease in knowledge score relative to patients with > 12 years of education) was: < 7 years 3.4 (SE 0.4); and 8-11 years 2.0 (SE 0.3). Mean total attitude score was 74.8 (SD 14.8) on a scale from 0-128. Compared to female patients, male patients had an estimated 5.1 points (SE 1.5) higher attitude score (p < 0.001). There was a weak but significant positive association (r = 0.38; p < 0.001) between the knowledge score and the total attitude score. CONCLUSION: Among Danish outpatients knowledge about randomized clinical trials is better in the younger age groups and in individuals with longer education. Overall, better knowledge was associated with a more positive attitude towards clinical research. The question is whether it is possible by simple means to increase knowledge about clinical research and whether an increase in knowledge may positively affect the attitude towards clinical research in individual patients.

Adolescent↗

Coping strategies among the long-term mentally ill: categorization and clinical determinants.

The aim of this study was to explore strategies for coping with symptoms in 98 long-term mentally ill patients. The following characteristics of the strategies were investigated: level, effectiveness, target symptom and problem orientation. In addition, we studied the association between measures of coping and psychopathology. An average of 3.8 coping strategies per patient was reported, and strategies involving behavioural change were most common (48%), followed by changes in socialization (24%) and in cognitive control (15%). Coping efforts were most commonly directed towards non-psychotic symptoms. A high load of general and affective symptoms, few negative symptoms and a high level of illness awareness predicted the total number of coping strategies. Separate analysis of active and passive strategies, including increased and decreased socialization, respectively, revealed very different patterns of clinical predictors. These results are discussed with reference to community-care programmes.

Activities of Daily Living↗

[Delayed effects of prenatal exposure to phenobarbital on intelligence--Phenemal].

Two double-blind studies were conducted on two independent samples of adult men prenatally exposed to phenobarbital and matched control samples using two different measures of general intelligence (WAIS and a draft board test (BPP)). The two studies included 33 and 81 exposed adult men respectively, and the two control groups included 52 and 101 unexposed men matched on a wide spectrum of maternal variables recorded pre- and perinatally. Based on data from control subjects, regression models were built relating intelligence scores to relevant pre-exposure matching variables. Models generated predicted scores for each exposed subject. Men exposed prenatally to phenobarbital had significantly lower verbal intelligence scores than predicted. Lower socioeconomic status and being the offspring of an unwanted pregnancy increased the magnitude of the negative effects. Exposure which includes the last trimester was the most detrimental. Physicians are urged to use increased caution in prescribing such medications during pregnancy or to premature neonates.

Adult↗

Aggression and personality: association with amino acids and monoamine metabolites.

Associations in 52 normal individuals were examined between plasma and cerebrospinal fluid (CSF) concentrations of tryptophan (Trp) and tyrosine, and concentrations of monoamine metabolites in the CSF, and scores on an aggression questionnaire, the Kinsey Institute Reaction List II, and the Eysenck Personality Questionnaire. There was a significantly positive correlation between CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and extroverted aggression scores, and a significantly negative correlation between CSF 5-HIAA levels and introverted aggression scores. Males showed higher plasma Trp concentrations than females, and significantly positive correlations between plasma Trp concentrations and scores on extroverted aggression and the Eysenck E scale. Males, furthermore, showed a significantly negative correlation between CSF Trp levels and scores on the Eysenck P scale, and a significantly positive correlation between concentrations of 3-methoxy-4-hydroxy-phenylglycol in CSF and scores on moral aggression. These results suggest that central serotonin influences aggression in normal individuals through effects on personality.

Adult↗

Psychometric properties of the Danish 16PF and EPQ.

A Danish translation of the Cattell's 16PF has been used in studies evaluating the effects of prenatal drug exposure. This paper reports a psychometric analysis of the 16PF and Eysenck's EPQ based on a sample of 558 young Danes. Many 16PF scales had unacceptable psychometric properties (as indicated by coefficient alpha and item--total score correlations), but more satisfactory results were obtained with the EPQ N and E scales. A factor analysis of all 16PF and EPQ scales suggested a six factor solution that roughly corresponds to the second-order factor structure obtained by Krug and Johns (1986). It is concluded that the second-order factor structure should be the basis of interpretation of the 16PF in both practical and research contexts.

Adult↗

In utero exposure to phenobarbital and intelligence deficits in adult men.

OBJECTIVE: To test whether exposure to phenobarbital in utero is associated with deficits in intelligence scores in adult men and whether the magnitude of the postnatal effect is mediated by exposure parameters and/or postnatal environmental factors. DESIGN: Two double-blind studies were conducted on independent samples of adult men prenatally exposed to phenobarbital and matched control samples using different measures of general intelligence. Based on data from control subjects, regression models were built relating intelligence scores to relevant pre-exposure matching variables and age at testing. Models generated predicted scores for each exposed subject. Group mean differences between the individually predicted and observed scores estimated exposure effects. SETTING: Copenhagen, Denmark. PARTICIPANTS: Exposed subjects were adult men born at the largest hospital in Copenhagen between 1959 and 1961 who were exposed to phenobarbital during gestation via maternal medical treatment and whose mothers had no history of a central nervous system disorder and no treatment during pregnancy with any other psychopharmacological drug. Study 1 included 33 men and study 2, 81 men. Controls were unexposed members of the same birth cohort matched on a wide spectrum of maternal variables recorded prenatally and perinatally. Controls for studies 1 and 2 included 52 and 101 men, respectively. MAIN OUTCOME MEASURES: In study 1: Wechsler Adult Intelligence Scale (Danish version); in study 2: Danish Military Draft Board Intelligence Test (Børge Priens Prøve). RESULT: Men exposed prenatally to phenobarbital had significantly lower verbal intelligence scores (approximately 0.5 SD) than predicted. Lower socioeconomic status and being the offspring of an "unwanted" pregnancy increased the magnitude of the negative effects. Exposure that included the last trimester was the most detrimental. CONCLUSION: Phenobarbital exposure during early development can have long-term deleterious effects on cognitive performance. Detrimental environmental conditions can interact with prenatal biological insult to magnify negative outcomes. Physicians are urged to use increased caution in prescribing such medications during pregnancy.

Adult↗

[Symptoms of depression in cancer patients undergoing chemotherapy].

Symptoms of depression and anxiety were measured in a prospective follow-up study of 36 cancer patients before and during chemotherapy by means of the Hamilton rating scales and the Melancholia Scale. These scales proved useful in the examined population. Moderate or severe depression was seen in almost half of the patients before chemotherapy, but this figure decreased during follow-up. The symptomatology resembled that of primary depression, and the brief rating scales for depression seemed suitable for screening purpose. Problems in identifying morbid states of anxiety and depression are discussed.

Adult↗

Depressive symptoms in cancer patients undergoing chemotherapy: a psychometric analysis.

Depressive psychopathology was measured in a prospective follow-up study of 36 cancer patients. The psychometric properties of the Hamilton rating scales for depression and anxiety and the Melancholia Scale were examined. The scales proved useful, indicating that the symptomatic structure of depression in cancer patients is rather identical to that seen in primary depression. Depressive states were found in about 40% of patients before the start of chemotherapy. The frequency of intermediate and high scores on the depression scales showed a low to moderate decrease after 6 months. Aspects of depression in the medically ill are discussed, and screening routines suggested.

Adaptation, Psychological↗

The interrelationship of weight loss, dietary intake, and quality of life in ambulatory patients with cancer of the lung, breast, and ovary.

One hundred four consecutive patients with newly diagnosed small cell lung cancer, metastatic breast cancer, and ovarian cancer in good physical functional condition (performance rating 0-1 on Eastern Cooperative Oncology Group scale) were divided into a weight-losing group (> or = 5% unintentional weight loss within 3 mo; n = 48) and a weight-stable group (n = 56). Dietary intakes in relation to fat-free mass were not different in the two groups. According to the Quality of Life index and the General Health Questionnaire, weight-losing patients had significantly lower quality of life than weight-stable patients. In patients with weight loss, daily intakes of energy and protein correlated significantly with scores on the General Health Questionnaire. This study has shown that many ambulatory cancer patients do not eat enough to maintain weight and that even a moderate weight loss is associated with psychological distress and lower quality of life.

Adult↗

The Prenatal Development Project.

The primary aim of the Prenatal Development Project (PDP) is to evaluate the developmental effects of prenatal exposure to steroid hormones and psychoactive drugs, particularly synthetic progestin, corticosteroids and barbiturates. Data collection has taken place at the Psykologisk Institut, now the Institute of Preventive Medicine, since 1981. The PDP database is unique for its breadth and depth as well as its combination of prospective longitudinal and cross-sectional perspectives. This article describes the database, including subject selection, perinatal information, the comprehensive contemporary evaluation and archival information from Danish registers. The unique matching procedures designed specifically for these projects and data analytic strategies are explained. The value of the PDP database is discussed both in relation to specific project aims (evaluating effects of prenatal drug exposure) and in relation to developmental and psychological research in general.

Adult↗

Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomized study.

PURPOSE: This study examined the effect of frequent nutritional counseling on oral intake, body weight, response rate, survival, and quality of life in patients with cancer of the lung (small-cell), ovary, or breast undergoing cyclic chemotherapy. PATIENTS AND METHODS: Of 105 assessable patients, 57 were randomized to receive nutritional counseling, and 48 to receive no nutritional counseling and consumption of an ad lib oral intake. The intervention group was counseled to achieve a daily energy and protein intake according to recommended dietary allowances. Counseling was standardized and performed by a trained dietitian, and took place twice monthly during a 5-month period from start of chemotherapy. RESULTS: Dietary counseling increased daily energy intake by approximately 1 MJ and protein intake by 10 g over the entire study period. There was no change in the control group. Counseling led to an insignificant increase in body weight, but triceps skinfold measurement increased significantly after 5 months. Response rate and overall survival did not differ between the groups. Quality of life measured by the Quality-of-Life index (QL-index) increased significantly in both groups, but did not differ between groups. CONCLUSION: No clinical benefit could be demonstrated despite long-term and continuous improved food intake in cancer patients with solid tumors undergoing aggressive chemotherapy.

Adult↗

Linear versus normalized T scores as standardized neuropsychological test scores.

In this paper we present and discuss standardized T score systems for neuropsychological test data. Both linear and normalized T scores were calculated for 141 normal subjects and a group of 141 patients with diffuse or focal brain damage. Many standard neuropsychological tests have skewed raw score and linear T score distributions, and we argue that normalized T scores have practical advantages because they permit simple descriptions of both patient groups and individual test score distributions. We also argue that skewness can be partially explained by ceiling effects and other test construction artefacts and that skewed raw score distributions do not necessarily reflect skewed distributions of the underlying mental abilities. Consequently, use of normalized T scores seems appropriate in many research and clinical contexts.

Adult↗

A critical note on Lezak's 'best performance method' in clinical neuropsychology.

A fundamental problem in clinical neuropsychology is the estimation of premorbid levels of cognitive functioning. Lezak (1983) described the so-called 'best performance method' of estimating premorbid abilities. Essentially, this method consists in using the highest test scores or the best performance in everyday tasks as the best estimate of premorbid ability. This paper describes three studies of the empirical consequences of using the 'best performance method': The first study demonstrates that application of this method on WAIS subtests leads to a gross overestimation of intelligence as measured by the IQ. The second study corroborates this finding and also shows that overestimation of intelligence leads to systematic errors in the expected performance in neuropsychological tests in normal subjects. Finally, the third study shows that this is also the case in patients with diffuse cerebral atrophy.

Adult↗

Temporal gradient in the remote memory impairment of amnesic patients with lesions in the basal forebrain.

Recall and recognition of premorbid public events were studied in four groups of subjects. Dementia patients showed equal losses from all time periods compared to normal controls. In contrast, two groups of amnesic patients showed extensive remote memory losses, which were most marked for the last few years prior to onset. The difference between recall and recognition was similar in the groups. The results indicate that the retrograde amnesia associated with aneurysms of the anterior communicating artery cannot be distinguished from that of amnesia with other etiologies. Implications of the finding of a temporal gradient in the retrograde amnesia of non-alcoholic amnesics are discussed.

Adult↗