Biomedical subjects
H Saelan
Publications and source records attributed to H Saelan.
Extroversion and neuroticism and the associated risk of cancer: A Danish cohort study.
The authors have investigated the effect of personality, as measured with the Eysenck Personality Inventory, on the incidence of cancer among 1,031 persons participating in a Danish health survey in 1976-1977 and followed up for 20 years. They thereby accrued a total of 19,993 person-years. The expected number of cancer cases was estimated on the basis of age-, sex-, and site-specific incidence rates in Copenhagen County, DENMARK: Overall, 113 malignancies were observed among the cohort members between the date of interview and December 31, 1996. Since 114.3 were expected from county incidence rates, the standardized incidence ratio was 0.99 (95% confidence interval: 0.81, 1.19). No statistically significant deviation of the relative risk from unity was seen for any measure of personality, and no excess risk was seen for any particular type of cancer. A regression model, in which adjustment was made for age, sex, calendar period, alcohol consumption, tobacco smoking, psychiatric illness as rated by the interviewing doctor, marital status, and social class, showed no excess risk of cancer among persons considered to be in medium- or high-risk groups according to the Eysenck Personality INVENTORY: The authors' data provide no support for the hypothesis of an association between personality and the risk of cancer.
Copenhagen Community Psychiatric Project (CCPP): characteristics and treatment of homeless patients in the psychiatric services after introduction of community mental health centres.
The main purpose of the study was to describe the characteristics of homeless psychiatric patients, and to compare the treatment they are offered to that offered to domiciled patients by the psychiatric services. Another purpose was to analyse the prevalence of homelessness among psychiatric patients before and after the introduction of community mental health centres in Copenhagen. Cross-sectional studies were conducted in two intervention and two control districts before and after introduction of the new treatment modalities. In 1991, 80 of 1008 patients (8%) were homeless. Male sex, young age, living on general welfare, schizophrenia and alcohol or substance abuse were the factors that most markedly differentiated homeless from domiciled patients. Compared with the treatment of domiciled patients, the homeless were more likely to be offered no further treatment after consultation in a psychiatric emergency and, if admitted, they were more likely to be placed in locked wards, given compulsory medication, and medicated with depot neuroleptics. The homeless were also less likely to be offered psychotherapy and consultation with a social worker. Schizophrenia and alcohol or substance abuse characterised the majority of the patients discharged homeless. In the intervention districts, the number of homeless patients in contact with the psychiatric services was found to increase at the same rate as the number of all patients in contact with the psychiatric services. In the control districts, no changes in prevalence of homeless patients or other patients in contact with the psychiatric services occurred. It is concluded that homeless psychiatric patients comprise a difficult patient group, with problems of schizophrenia, substance abuse and lack of motivation for treatment. It is recommended that special efforts be made to create housing facilities that fit the needs of different types of homeless patients, and that the homeless mentally ill are assisted in obtaining and maintaining an acceptable housing situation.
CCPP-Copenhagen Community Psychiatric Project. Implementation of community mental health centres in Copenhagen: effects of service utilization, social integration, quality of life and positive and negative symptoms.
Deinstitutionalization of psychiatry in Denmark has been extensive and the number of psychiatric beds per 1,000 inhabitants is among the lowest in Europe. The effect of supplementing hospital treatment with treatment in community mental health centres was evaluated in a quasi-experimental design. The patient group examined consisted of patients with long-term contact with psychiatric services. When development in intervention and control districts was compared, the only significant difference was that the total patient group in the intervention district had an increased number of day attendances per year. Comparison of patients from intervention districts who attended day-centres regularly with patients from control districts before and after implementation of community mental health centres indicated that patients from intervention districts had a reduction in the use of inpatient services, a significant increase in quality of life and a significant decrease in the presence of the negative symptom, alogia. We concluded that implementation of community mental health centres can increase the quality of life for the patients and decrease the frequency of the negative symptom, alogia.
[Alcohol consumption in a Danish cohort study over a period of 11 years].
A cohort living in Copenhagen County, originally consisting of 1198 persons, 577 men and 621 women, who were 40 years old in 1976, was reexamined in 1981 and again in 1987, 1052 (88%) participated in 1976, 922 (84%) in 1981, and 965 (85%) in 1987. The purpose of this study was to describe alcohol consumption changes in the cohort, with a view to identifying subgroups who significantly change their alcohol consumption behaviour. The same questionnaire was employed all three times to measure the alcohol consumption level and frequency. Alcohol consumption peaked in 1981 (45-years old) with 10.4 drinks on average a week. Men increased 8% and women 37%. There is an overall downward tendency in the consumption frequency among men whereas the opposite is the case among women. The two groups are converging toward a weekly consumption level. It seems now that the women are leading the change in the content of consumption with relatively more wine consumption. Therefore it is concluded that female consumption should be considered a target in future preventive programs.
[Extent of HIV infection and AIDS among drug addicts].
The purpose of this study was to review the extent of the HIV-epidemic and to make a prognosis about the number of AIDS-cases among drug addicts in the community of Copenhagen. In the public institutions for treatment of drug addicts, 191 HIV-positive individuals were known by January 1991. In the period August 1990-November 1991, 33 newly recognized cases of seropositivity were registered among drug addicts in the area of Copenhagen, but the time of infection was unknown. By October 1991, 53 cases of AIDS among drug addicts in Denmark were recorded. Based upon the knowledge of incubation period and mortality of AIDS, it was possible to set up a mathematical model, from which the number of expected AIDS-cases could be estimated. This model showed that the number of living drug addicts with AIDS in the community of Copenhagen probably not will exceed 20 during the coming years. It was also showed, that the number of drug addicts, who were infected with HIV in the primary spread of the virus in 1985-1986, was probably lower than 250. The actual prevalence and incidence of HIV-infection among drug addicts is uncertain, and there is a need for better surveillance of the epidemic.
Patients in the care of private psychiatric practitioners. Comparison with public hospital patients and the background districts' population.
In Western societies, the number of psychiatric hospital beds has decreased markedly in the past decades. The reduction in hospital beds has resulted in a relatively large number of mentally ill individuals residing in the community. They experience varying degrees of success. One form of treatment available to such patients is private psychiatric consultation. In Denmark and England (two countries with public supported health care systems) the number of psychiatrists in private practice (PPPs) has increased in recent years. These private practioners may offer a mode of treatment which may meet the needs of a subgroup of the psychiatric patients in the community. The fees of the PPPs are paid by the National Health Service. In this study we report on the characteristics of the patients attending the consultation of private psychiatrists and the treatment which they are offered. We compare the patients of the PPPs with 1. psychiatric patients residing in the same districts who are cared for by the public hospital system and 2. the background populations of these same districts. The results suggest that the patients in private psychiatric practice are distinct in a number of ways. Neurosis is the dominant diagnosis. Of the patients, 71% are women; the patients tend to be younger than the background districts population; after controlling for age, the marital status of the patients in PPPs' care does not differ significantly from that of the background population, and they are comparable to the background population in level of employment. These patients are more able to care for themselves than the psychiatric patients treated in the public hospital system. The results suggest that PPP is a means of caring for a subgroup of the psychiatric patients in urban settings.
Alcohol consumption in a Danish cohort during 11 years.
A cohort living in Copenhagen County, originally consisting of 1198 persons, 577 men and 621 women, 40-years of age in 1976, was reexamined in 1981, and again in 1987. Of the original cohort 1052 (88%) participated in 1976, 992 (84%) in 1981, and 965 (85%) in 1987. The purpose of this study was to describe changes in alcohol consumption in the cohort, with the view of identifying subgroups, who have changed their alcohol consumption behaviour to a certain extent. Alcohol consumption was measured by the same questionnaire all three times as to the level of consumption and frequency. Alcohol consumption peaked in 1981 (45-year olds) with 10.4 drinks on average a week. Men increased their consumption by 8% and women by 37%. There was an overall downward tendency in the consumption frequency among men, whereas the opposite was the case among women. The two groups are converging toward a weekly consumption frequency. It seems now that women are leading the change toward a greater wine consumption in relative and absolute terms. It is therefore concluded that female consumption should be considered as a target in future preventive programmes.
Prevalence of hypertension in type 1 (insulin-dependent) diabetes mellitus.
The prevalence of hypertension in a representative sample (n = 10202) of the Danish general population aged 16-59 years was assessed to 4.4% based on three blood pressure readings. In Type 1 (insulin-dependent) diabetic patients of similar age (n = 1703) the prevalence was determined in a similar way to 14.7% (p less than 0.00001). The excess prevalence in Type 1 diabetic patients was due to hypertension in patients with incipient and clinical nephropathy as the prevalence of hypertension among diabetic patients with normal urinary albumin excretion (essential hypertension) was 3.9%, similar to that observed in the general population. The patients with Type 1 diabetes and essential hypertension had higher systolic (146 +/- 19 vs 133 +/- 18 mm Hg, p less than 0.00001) and diastolic blood pressure (87 +/- 12 vs 79 +/- 7 mm Hg, p less than 0.00001), but less changes in the eye background than patients with incipient nephropathy (urinary albumin excretion 30-300 mg/24 h) (p less than 0.03), indicating that the two groups were also different with respect to other microangiopathic lesions. Patients with essential hypertension were defined as having a normal urinary albumin excretion before and during antihypertensive treatment (if any). They were followed-up for a 58 (6-234) month period. We confirmed that hypertension is more common among Type 1 diabetic patients than in the general population and found the prevalence of essential hypertension similar in Type 1 diabetic patients to the non-diabetic population. This supports our hypothesis that hypertension is very unlikely to be the cause of diabetic nephropathy.
[Occurrence of psychiatric disease in a Danish population group aged 40].
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Symptoms and signs of polyneuropathy and their relation to alcohol intake in a normal male population.
In a normal population of 468 45-year-old males symptoms and signs of polyneuropathy were investigated and related to self-reported alcohol consumption and associated problems. Sensory disturbances in the feet were claimed by 3.4%, 5.8% had abolished Achilles tendon reflexes, and 7.7% increased vibratory perception thresholds. Significant correlations were found between persons with signs of neuropathy and persons with physical or social consequences of alcohol abuse.
[The group practice project in Naestved. Assessment of a research activity in the light of community medicine].
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[The concept of representativity in epidemiological studies. Examples from population study of 40 year olds in Glostrup].
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[Experimental activity in primary health care. A questionnaire study among the participants in a preventive program].
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[Distribution of alcohol consumption in a group of 40-year-old Danes].
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[Prevention of ischemic heart diseases in primary health care. Distribution of risk factors in a risk group].
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[Social-psychiatric factors in a Danish population group aged 40 years. Description of the population and study of the methods].
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[Community medicine in the primary health sector. I. The group practice project in Naestved: methods and population].
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