Biomedical subjects

Odd Steffen Dalgard

Publications and source records attributed to Odd Steffen Dalgard.

6 recordsLinked to original sources

PubMed2004

[An educational programme for coping with depression: a randomized controlled trial].

BACKGROUND: Depression is a serious health problem, with lifetime prevalence in the western world of 20-30%. Only a relatively small proportion of depressed people receive treatment; hence there is a great need for further development of feasible treatment programmes. MATERIAL AND METHODS: A psycho-educative group-based treatment programme was tested in a randomized controlled study of unipolar depression. The size of the intervention group was 81 as against 74 in the control group. The programme lasted 8 weeks with weekly sessions of 2(1/2) hours and booster sessions after 1, 2 and 4 months. Each group had 8 to 10 participants; psychiatric nurses acted as facilitators. RESULTS: The rate of improvement after 6 months was significantly higher in the intervention group than in the control group. In the intervention group, 69% of participants showed significant improvement (reduction in the Beck Depression Inventory score of 6 points or more), compared to 37% in the control group. Improvement in the intervention group mainly took place during the first 8 weeks. INTERPRETATION: The treatment programme turned out to have a significant effect on unipolar depression and seems feasible in primary health care as well as in specialized psychiatric care.

Adaptation, Psychological↗

PubMed2004

Estimating depression prevalence from the Beck Depression Inventory: is season of administration a moderator?

The existence of winter seasonal affective disorder (SAD) and its milder population variants implies that depression estimates in a given population may tend to be higher in winter than at other times of the year. The aim of this study was therefore to test whether depression prevalence estimates based on the Beck Depression Inventory (BDI) are systematically moderated by season of administration. Existing information from the screening phase of a multicentre investigation of depression prevalence provided the data for the study. Repeated cross-sectional BDI data from samples in the United Kingdom (n=1299), Finland (n=1352), Norway (n=2711) and Spain (n=1246) were analysed for month- and season-of-administration effects. Whether data were measured continuously or as a dichotomous variable (BDI cutoff >/=13), there was no evidence of a systematic seasonal pattern in depression estimates across the four sites. No seasonal effects reached statistical significance at any single site, and trends in the association between winter and elevated BDI scores were positive in two sites (UK and Norway) and negative in two (Finland and Spain). Although limited by a post hoc analysis of existing data, this study provides the strongest evidence to date that season of administration is not a moderator of depression prevalence as estimated by the BDI.

Adolescent↗

PubMed2003

[Increasing psychological stress among young adults in Norway, 1990-2000].

BACKGROUND: Between 1990 and 2000, the number of disability benefit recipients in Norway increased by 19.3%. We wanted to examine changes in the way people cope with society's demands, our hypothesis being that changing demands increase psychological stress; this again leads to increasing numbers of disability benefit recipients with a psychiatric diagnosis. MATERIAL AND METHODS: We examined the ability to support oneself financially among the 20 to 39-year-olds, traditionally the period in people's lives when they are at their most adaptive. We used data for the 1990-2000 period on sickness absence of one year or more, medical or occupational rehabilitation, long-term unemployment, welfare payments without entitlement, and disability benefits. We examined the diagnoses used for one-year sickness absence, medical rehabilitation and disability benefit status. Data were obtained from the relevant public-sector registers. RESULTS: The prevalence of social security clients in the 20-39 age group was up from 6.4% in 1994 to 7.7% in 2000, an increase of 20%. The biggest increases (1992 to 2000 data) were related to minor psychiatric disorders, 152%, and milder forms of musculoskeletal disorders, 111%. INTERPRETATION: Changing demands in the workplace have increased the load of psychological stress in society, but changing demands in people's private lives are a contributing factor. The results imply an increasing mismatch between the adaptation required in our society and people's resources for coping with what is expected of them. Our health care and social security systems in their present form cannot properly come to grips with this situation; they may even exacerbate it by demanding too little of patients and thereby socialising them into the patient role.

Adaptation, Psychological↗

PubMed2003

Urban-rural differences in the occurrence of female depressive disorder in Europe--evidence from the ODIN study.

BACKGROUND: In an earlier paper of the European multi-centre ODIN study (Ayuso-Mateos et al. 2001) we found remarkable urban preponderance in comparison to the corresponding rural site in the female prevalence of depressive disorder in the UK and Ireland. The aim of this paper is to analyse the possible reasons for this finding. METHOD: A representative sample of 12,702 people aged between 18 and 64 residing in specified urban and rural areas were screened by the Beck Depression Inventory (BDI) for depressive disorder in four European countries (Finland, Ireland, Norway and the UK). Those over cut-off (BDI score < 12) and a 5 % random sample of those under cut-off underwent diagnostic interview including the SCAN version 2.0, and completed a battery of additional research instruments. RESULTS: The estimated 1-month prevalence of depressive disorder according to ICD-10 was 9 % in the total ODIN sample. A large between-country variation was found in female urban prevalence, with Ireland (Dublin) and the UK (Liverpool) having a remarkably high rate. The women in these same countries showed a significant urban/rural difference, whereas in men and in the total sample this difference was non-significant. Logistic regression analysis including some selected risk factors of depression showed still higher risk of depressive disorder both in Dublin and Liverpool compared with the Finnish urban site (Turku), which had the lowest urban prevalence. In addition, also such factors as lack of confidant and having difficulties in getting practical help from neighbours were important predictors of depressive disorder. Similarly, when analysing the different countries separately, the significance of the urban/rural difference in women remained for Ireland and the UK, indicating that the other risk factors studied could not totally explain the difference. CONCLUSIONS: ODIN is the first European study on occurrence of depressive disorder in both urban and rural settings allowing closer analysis of the urban/rural differences. The most striking result was the large urban/rural difference in women in the two countries from the British Isles which could not be totally explained by the socio-demographic factors included in this study.

Adolescent↗

PubMed2003

Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36).

A great number of questionnaires and instruments have been developed in order to measure psychological distress/mental health problems in populations. The Survey of Level of Living in 1998 conducted by Statistics Norway used both Hopkins Symptom Checklist (SCL-25) and the Short Form 36 (SF-36), including the five-item mental health index (MHI-5). Five-item and 10-item versions of the SCL-25 have also been used in Norwegian surveys. The purpose of this study was to investigate the correlation between the various instruments, and to assess and to compare psychometric characteristics. A random sample of 9735 subjects over 15 years of age drawn from the Norwegian population received a questionnaire about their health containing SCL-25 and SF-36. Response rate was 71.9%. Reliability of the SCLs and MHI-5 were assessed by Cronbach alpha. The scores from full and abbreviated instruments were compared regarding possible instrument-specific effects of gender, age and level of education. The correlations between the instruments were calculated. The capacity of the various instruments to identify cases was assessed in terms of sensitivity, specificity, predictive values, receiver operating characteristics (ROC) and area under the curve (AUC). The reliabilities were high (Cronbach alpha>0.8). All instruments showed a significant difference in the mean scores for men and women. The correlation between the various versions of SCL ranged from 0.91 to 0.97. The correlation between the MHI-5 and the SCLs ranged from -0.76 to -0.78. The prevalence rate was 11.1% for SCL-25 scores above 1.75 and 9.7% for scores below 56 in MHI-5. AUC values indicated good screening accordance between the measures (AUC>0.92). The results suggest that the shorter versions of SCL perform almost as well as the full version. The corresponding cut-off points to the conventional 1.75 for SCL-25 are 1.85 for SCL-10 and 2.0 for SCL-5. MHI-5 correlates highly with the SCL and the AUC indicate that the instruments might replace each other in population surveys, at least when considering depression. An operational advantage of the MHI-5 over the SCL instruments is that it has been widely used not only in surveys of mental health, but also in surveys of general health.

Adolescent↗

PubMed2002

The ability of general practitioners to detect mental disorders among primary care patients in a stressful environment: Gaza Strip.

BACKGROUND: The aim of the present study was to investigate the detection rate by general practitioners (GPs) of mental disorders in a primary health care setting and relating the findings to selected GP characteristics and the patient sociodemographic characteristics. METHODS: The patients were assessed with respect to mental disorders by Hopkins Symptom Checklist 25 (HSCL-25), and the GPs were independently asked to fill in the Goldberg checklist II to assess the patient after consultation. The sample consisted of 10 primary health care clinics in the Gaza Strip, which were randomly selected from the five regions that form the Gaza Strip (Northern, Southern region, Gaza City, Middle region, Khan-Younis and Rafah). Thirty-two GPs and 661 patients participated in the study. RESULTS: The study showed that the GPs detected only 11.6 per cent of patients with mental disorders at HSCL-25 score >1.75, and that the GP's assessment was not significantly associated with the HSCL-25 scores. GPs with postgraduate psychiatric training performed better in detecting mental disorders, likewise female GPs and those who were more than 40 years old. The results also revealed that the GPs were more able to detect mental disorders among patients older than 25 years, and in female patients. CONCLUSIONS: The GPs' poor detection rate of mental disorders indicates the importance of mental health training for GPs working in primary health care clinics.

Adult↗