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Biomedical subjects

Per Vaglum

Publications and source records attributed to Per Vaglum.

29 records · Page 2Linked to original sources
PubMed2004

Help-seeking for mental health problems among young physicians: is it the most ill that seeks help? - A longitudinal and nationwide study.

OBJECTIVES: The aims of this study were to assess the prevalence of self-reported mental health problems and help-seeking among young physicians, and identify predictors of seeking help. METHODS: A prospective cohort sample of Norwegian medical students (N = 631) were assessed in their final semester (T1), and in the first (T2) and fourth (T3) postgraduate year. The average observation period was 3.6 years. RESULTS: The prevalence of mental health problems that needed treatment over the preceding year was observed to have increased from 11% at T2 to 17% at T3. There was no increase in help-seeking. Longitudinally, 34% reported that they needed treatment on one or several occasions. Adjusted predictors of help-seeking were perceived level of mental health problems and a reality weakness personality trait. CONCLUSION: Those who sought help had higher levels of emotional distress than those who did not. However, higher reality weakness scores predicted lower help-seeking and, therefore, may be a risk factor for avoiding necessary care.

Adult↗
PubMed2004

The process of suicidal planning among medical doctors: predictors in a longitudinal Norwegian sample.

BACKGROUND: The suicidal process is a common underlying perspective on suicidal behaviour, but the process has hardly been empirically studied. This study investigates the process from suicidal thoughts to suicidal planning among physicians; an occupational group with a raised risk of suicide. The process is studied in two ways: First, predictors at medical school of postgraduate suicidal planning are identified. Second, the transition from suicidal thoughts to planning over three to four years is explored. METHODS: A nationwide cohort of Norwegian medical students (N=631) were approached initially in their final semester (T1), and then again in the first (T2) and fourth (T3) postgraduate years. The average observation time was 3.6 years. RESULTS: Twenty-eight participants (6%) reported suicidal planning in the postgraduate years. Adjusted predictors at T1 were vulnerability trait (neuroticism), severe depressive symptoms, and negative life events. Among those with previous suicidal thoughts at T1, 13 (8%) reported suicidal planning at T2 or T3. Adjusted predictors of transition from thoughts to planning were reality weakness trait, severe depressive symptoms, and a low level of perceived medical school stress. A minority of the postgraduate planners had sought professional care. LIMITATIONS: The effect of severe depressive symptoms may be overestimated, and the sample size is relatively small. CONCLUSIONS: Common predictors for both postgraduate suicidal planning and transition from thoughts to planning were depressive symptoms and personality traits. Reality weakness was the most decisive trait for aggravation in suicidal ideation, and this personality trait needs further study in suicidal research and clinical awareness.

Adult↗
PubMed2004

Neurocognitive dysfunction in first-episode psychosis: correlates with symptoms, premorbid adjustment, and duration of untreated psychosis.

OBJECTIVE: The authors examined the relationship of neurocognitive function with duration of untreated psychosis, premorbid illness factors, and clinical symptoms to determine whether long duration of untreated psychosis independently compromises cognitive function. METHOD: Patients recruited to a study of the effect of an early detection program on the duration of untreated first-episode psychosis in two catchment areas were compared to patients in a similar treatment program in two other catchment areas without an early detection program. The median duration of untreated psychosis was 10.5 weeks for all patients. A total of 301 patients entered the study, and 207 completed a comprehensive neuropsychological test battery that assessed working memory/fluency, executive function, verbal learning, impulsivity, and motor speed. The median time from start of treatment to neuropsychological testing was 108 days; all patients were tested within 9 months. RESULTS: No significant association was found between duration of untreated psychosis and any of the cognitive measures. Strong associations were demonstrated between poorer premorbid school functioning and neurocognitive deficits, especially in verbal learning and working memory. No relationship was found between neurocognitive functions and clinical measures, except for an inverse correlation of Positive and Negative Syndrome Scale negative symptoms and working memory and a positive correlation between positive symptoms and motor speed. CONCLUSIONS: The data contribute to a disconfirmation of the hypothesis of an association between duration of untreated psychosis and neurocognitive performance at baseline.

Adult↗
PubMed2004

Personality traits and drinking to cope as predictors of hazardous drinking among medical students.

OBJECTIVE: The purpose of this study was to describe the prevalence and development of drinking to cope and hazardous drinking among medical students and to examine whether various personality traits and drinking to cope predict hazardous drinking. METHOD: In a 6-year prospective study of a nationwide sample of medical students (N = 421) assessments were made by questionnaire at the beginning (T1) and at the end (T2) of each participant's tenure at medical school. A cohort of 272 medical students (56% women) from all medical schools in Norway participated at both T1 and T2. The questionnaires encompassed measures of personality characteristics (Basic Characteristic Inventory) and alcohol-use (hazardous drinking and drinking to cope). RESULTS: The levels of drinking to cope and hazardous drinking were not significantly different between T1 and T2, rising from 9.2% to 11.8% and from 17.7% to 19.2%, respectively. Hazardous drinking at T1 (odds ratio [OR] = 7.0; 95% confidence interval [CI]: 3.2-15.4) and level of control (personality trait) at T1 (OR = 0.7; 95% CI: 0.6-0.9) predicted hazardous drinking at T2 among all the students. Hazardous drinking (OR = 3.5; 95% CI: 1.4-9.0), control (OR = 0.7; 95% CI: 0.6-0.9) and drinking to cope at T1 (OR = 5.0; 95% CI: 1.0-24.1) independently predicted hazardous drinking at T2 among the men, whereas the only predictor among the women was hazardous drinking at T1 (OR = 42.1; 95% CI: 8.1-218.2). CONCLUSIONS: Drinking to cope should be targeted for preventive measures against hazardous drinking, particularly among men. The effects of personality and drinking to cope differ by gender and should be studied further.

Adaptation, Psychological↗
PubMed2003

[Teaching clinical communication to medical students in Norway].

BACKGROUND: Clinical communication as part of the doctor-patient relationship has gained increased attention in the undergraduate medical education in Norway. Such teaching programmes require considerable resources, as much of the instruction has to be carried out in small groups, and they should be subjected to a thorough assessment from a cost-benefit perspective. MATERIALS AND METHODS: A working group representing the four medical faculties in Norway initiated EKKO, a project designed as a quality assurance of the instruction in clinical communication. In this paper comparable data are presented relating to the extent, form and content of the instruction. RESULTS AND INTERPRETATION: There are great variations as to what part of the curriculum the instruction is placed in, the extent of faculty-based teaching, training periods in general practice and hospital settings with feed-back on communication skills, as well as in faculty development. To what degree these variations influence doctors' communication skills when fully qualified could be assessed in a further stage of this project, which could also provide an empirical basis for improvements in the instruction given.

Clinical Competence↗
PubMed2002

The prevalence of DSM-III-R "prodromal" symptoms of schizophrenia in non-psychotic psychiatric outpatients.

A cross-sectional point prevalence study of the DSM-III-R prodromal symptoms in non-psychotic (n = 501) consecutive outpatients from a catchment area with 260000 inhabitants is presented. The relationship between the three most psychosis-specific prodromal symptoms and the development of psychosis during the following 6 months was also explored. The prevalence of any prodromal symptom was 25%, the most prevalent being impairment of role functioning (14%), isolation and withdrawal (11%) and lack of initiative (8%). The most prevalent symptom in affective disorders was lack of initiative (14%); in personality disorders, it was impairment of role functioning (21%). The prevalences of the most psychosis-specific symptoms "peculiar behaviour", "magical thinking" and "unusual perceptual experiences" was 1-2%. At re-evaluation 6 months later, three of 20 patients (15%) with one or more such symptoms had become psychotic, two with schizoaffective disorder, one with affective psychosis. It was concluded that DSM-III prodromal symptoms are common among non-psychotic outpatients, but most such symptoms are non-specific for psychosis. Persistent peculiar behaviour, magical thinking and unusual perceptual experiences have a very low prevalence but may indicate an increased risk for psychosis. Such patients should be followed with that risk in mind.

Adolescent↗
PubMed2002

Inpatient psychotherapy compared with usual care for patients who have schizophrenic psychoses.

The study examined whether some patients with schizophrenia benefit from intensive inpatient psychodynamic psychotherapy while others are harmed by it. Multiple regression analyses were conducted with combined data from a follow-up study of 25 inpatients who were treated in a psychotherapeutic program and a follow-up study of 71 patients who received standard hospital treatment. The mean duration of the follow-up period was seven years. The analyses showed that improvement in global mental health status from the index admission to follow-up was associated with the type of treatment and with the patient's clinical condition at the index admission. A strong interaction effect was found between these two variables. Psychotherapeutic inpatient programs may be beneficial to patients who have higher levels of global functioning at the start of treatment but detrimental to other patients.

Follow-Up Studies↗
PubMedDate not supplied

The relationship between interpersonal problems and occupational stress in physicians.

OBJECTIVE: This article examined the associations between occupational stress and interpersonal problems in physicians. METHOD: A nationwide representative sample of Norwegian physicians received the 64-item version of the Inventory of Interpersonal Problems (IIP-64) (N=862, response rate=70%) and six instruments measuring occupational stress. Comparison of means, correlation and reliability statistics and multiple regression analyses were applied. RESULTS: The IIP-64 total score had a significant impact on job satisfaction, perceived unrealistic expectancies, communication with colleagues and nurses and on stress from interaction with patients. Being overly subassertive was related to low job satisfaction. Being overly expressive was linked to the experience of unrealistic expectancies from others and lack of positive feedback, whereas overly competitive physicians tended to have poorer relationships with both colleagues and nurses. CONCLUSIONS: Addressing interpersonal problems in medical school and postgraduate training may be a valuable measure to prevent job stress and promote quality of care.

Female↗
PubMedDate not supplied

Mental health problems among young doctors: an updated review of prospective studies.

Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years. We selected clinically relevant mental health problems as the outcome measure. We found nine cohort studies that met our selection criteria. Each of them had limitations, notably low response rate at follow-up, small sample size, and/or short observation period. Most studies showed that symptoms of mental health problems, particularly of depression, were highest during the first postgraduate year. They found that individual factors, such as family background, personality traits (neuroticism and self-criticism), and coping by wishful thinking, as well as contextual factors including perceived medical-school stress, perceived overwork, emotional pressure, working in an intensive-care setting, and stress outside of work, were often predictive of mental health problems. The studies revealed somewhat discrepant findings with respect to gender. The implications of these findings are discussed.

Adaptation, Psychological↗