PubMed Health⌕ Search

Biomedical subjects

S Opjordsmoen

Publications and source records attributed to S Opjordsmoen.

At least 37 records · Page 2Linked to original sources

What are the basic dimensions of movements? A psychometric evaluation of the Comprehensive Body Examination III.

The movements were examined in accordance with the Comprehensive Body Examination. The study objects were 99 persons: 17 pain syndrome patients (PSP group), 27 psychotic patients (PP group), 4 non-psychotic patients (NPP group), and a comparison group consisting of 51 students and staff members (SS group). On the basis of factor analysis three subscales were made: 1) Resistance to Passive Movements (RPM), with nine items, 2) Assistance to Passive Movements (APM), with six items, and 3) Motor Disturbances (MD), with three items. The internal consistency of the subscales was high (Chronbach's alpha, 0.81-0.96), and the intercorrelation low to moderate. The RPM subscale distinguished significantly between the SS group and both patient groups; the APM and MD subscales distinguished between the SS group and the PP group. The MD subscale also distinguished between patients taking drugs and those who did not, but there was no difference between patients without medication and the SS group.

Adult↗

Shortened duration of untreated first episode of psychosis: changes in patient characteristics at treatment.

OBJECTIVE: This study examined whether duration of untreated psychosis can be shortened in patients with first episodes of DSM-IV schizophrenia spectrum disorders and whether shorted duration alters patient appearance at treatment. METHOD: Two study groups were ascertained in the same Norwegian health care sector: one from 1993-1994 with usual detection methods and one from 1997-1998 with early detection strategies that included education about psychosis. RESULTS: Patients with early detection had a shorter median duration of untreated psychosis by 21.5 weeks than patients with usual detection. The number with psychosis was greater in the early detection group; the number with schizophrenia was less. Early detection patients had more substance abuse and were younger, better adjusted premorbidly, and less ill. CONCLUSIONS: Early detection can shorten duration of untreated psychosis and help more patients when they are less severely ill. Given the devastation of psychosis, this is a significant treatment advance.

Adult↗

Unawareness of illness in chronic schizophrenia and its relationship to structural brain measures and neuropsychological tests.

The present study seeks to elucidate the relationship between unawareness of illness in schizophrenia and frontal lobe dysfunction, in addition to investigating the relationship between lack of insight and sociodemographic and clinical variables. Twenty-one medicated schizophrenic patients, recruited from in- and out-patient wards at Ullevâl Hospital, underwent the Scale to Assess Unawareness of Mental Disorder (SUMD), neuropsychological testing, psychiatric symptom ratings and neuroimaging procedures (CT). Also, 21 matched normal controls were neuropsychologically tested. CT data were assessed blindly by two experienced neuroradiologists, according to the degree of ventricular enlargement and/or sulcal widening, and an assessment of localisation of atrophy was made. Unawareness of illness was correlated with neuropsychological measures related to executive functioning, but not with other neuropsychological measures. Five patients showed slight frontal atrophy, while two showed moderate frontal atrophy. The remaining 13 patients did not show signs of frontal lobe atrophy. Frontal lobe atrophy documented by structural brain measures was associated with poor insight in schizophrenia. Furthermore, Anergia (BPRS), GAF score and 'undifferentiated' sub-diagnosis correlated with SUMD scores. Unawareness of illness in schizophrenia may be related to frontal lobe deficit. Also, awareness of illness may not be related to general psychopathology, but rather to specific aspects.

Adult↗

[Postnatal care--sleep, rest and satisfaction].

BACKGROUND: During the last decade most hospitals in Norway have introduced breastfeeding according to the baby's needs during night-time as well. The aim of this study was to examine whether women had sufficient sleep and rest in the maternity unit, and the factors influencing insufficient sleep and rest. The degree of satisfaction with the stay in the maternity unit and factors associated with satisfaction were also studied. MATERIAL AND METHODS: From April to November 1998, 160 postnatal women in two Norwegian communities were included in a questionnaire-based study, representing 89% of all women eligible for the study. RESULTS: 47% (75/160) of the women reported lack of sleep and rest in the maternity unit. The factor most strongly associated with lack of sleep and rest was not having a single room (adjusted odds ratio 11.0; 95% confidence interval: 1.7-69.1). 56% (88/158) of the women reported to be very satisfied, 39% (68/158) were moderately satisfied, and 5% (8/158) dissatisfied with the stay at the maternity unit. Not being very satisfied was associated with the hospital of delivery (adjusted OR 18.0; 95% CI: 2.2-149.1), and with insufficient sleep and rest (OR 3.3: 1.3-8.1). INTERPRETATION: Our results suggest that women do not get sufficient sleep and rest under existing circumstances in maternity units.

Adult↗

[Neurosyphilis--still a relevant differential diagnosis].

Syphilis, in all stages, is almost eradicated in Norway. Since 1993, only six to 17 patients have been registered per year. However, syphilis rates are increasing in some of Norway's neighbouring countries, e.g. Russia and the Baltic countries. Physicians must be aware of the disease. We report three patients admitted to an emergency psychiatric ward in Oslo, diagnosed with neurosyphilis during 1994-97. Doctor's delay in diagnosing was respectively seven and fifteen months for two of these patients. The diagnosis is difficult, for many reasons: The disease is rare; it can mimic several other diseases; incidental partial treatment with antibiotics given for other disorders may complicate the clinical picture; it may be difficult to obtain a reliable history; and new clinical pictures ("formes frustes") may occur. The traditional syphilis screening is not recommendable, but physicians' awareness and a low threshold for requiring syphilis serology tests is important in order to get an early diagnosis of one of the few curable psychiatric disorders.

Adult↗

Linkage analysis narrows the critical region for oculodentodigital dysplasia to chromosome 6q22-q23.

Oculodentodigital dysplasia (ODDD) is an autosomal dominant condition with high penetrance and variable expressivity. The anomalies of the craniofacial region, eyes, teeth, and limbs indicate abnormal morphogenesis during early fetal development. Neurologic abnormalities occur later in life and appear to be secondary to white matter degeneration and basal ganglia changes. In familial cases, the dysmorphic and/or neurodegenerative components of the phenotype can be more severe and/or present at a younger age in subsequent generations, suggesting genetic anticipation. These clinical features suggest that the ODDD gene is pleiotropic with important functions throughout pre- and postnatal development. We have performed two-point linkage analysis with seven ODDD families and 19 microsatellite markers on chromosome 6q spanning a genetic distance of approximately 11 cM in males and 20 cM in females. We have refined the location of the ODDD gene between DNA markers D6S266/D6S261 (centromeric) and D6S1639 (telomeric), an interval of 1.01 (male) to 2.87 (female) cM. The strongest linkage was to DNA marker D6S433 (Zmax = 8.96, thetamax = 0.001). Families show significant linkage to chromosome 6q22-q23 and no evidence for genetic heterogeneity.

Abnormalities, Multiple↗

Androgen replacement and quality of life in patients treated for bilateral testicular cancer.

Gonadal hormones and quality of life (QL) were assessed in bilaterally orchiectomized patients with testicular cancer who received intramuscular androgen replacement (ARP). 43 patients were to have serum analyses of testosterone LH, FSH and SHBG, preferably performed at the end of the interval between two intramuscular injections. They also completed a QL questionnaire consisting of the EORTC QLQ-C30, GHQ-28, IES and PAIS (sexuality). 17 of 31 evaluable patients had subnormal testosterone levels, and 9 highly elevated LH. Blood levels indicating hypogonadism were more often observed in the 25 patients whose ARP was scheduled at > or = 3 week intervals than in the 18 patients with < or = 2 weeks between ARP injections. A total of 11 patients reported hot flushes. The patients' QL was similar to that of a control group. However, 8 (20%) patients were 'cases' according to GHQ-28/IES, independent of their hormone levels. Current standard intramuscular ARP is not optimal in approximately 1/3 of the patients who have undergone bilateral orchiectomy for testicular cancer, particularly if scheduled at > or = 3 week intervals. Schedules for ARP have to be improved. In spite of intermittent hypogonadism most patients are psychosocially and sexually well adjusted to their health situation.

Adult↗

[Venous thromboembolism in connection with physical restraint].

A 29-year old man was admitted to an emergency psychiatric ward because of exacerbation of a chronic paranoid schizophrenia. He was restrained after arrival, and seven days later a deep venous thrombosis and a pulmonary embolism were diagnosed. No haematological predisposing factors (coagulation inhibitor deficiency, activated protein C resistance, or antiphospholipid antibodies) were identified, except for a questionable borderline increase of the fibrinolysis inhibitor PAI-1, and combined type II hyperlipidaemia. During the last 15-20 years, there has been a considerable reduction in the use of restraint and seclusion in Norway. The use of seclusion and restraint may be effective in preventing injury and reducing agitation, but these procedures may also have harmful physical, and in particular psychological side-effects. To our knowledge, this is the first report to demonstrate an association between venous thromboembolism and physical restraint. Immobilisation is a well-known risk factor for thrombophlebitis, and special attention should be paid to this problem on psychiatric wards. However, until more is known about thrombosis in relation to restraint, it is not advisable to recommend prophylactic treatment of thrombosis.

Adult↗

First-episode schizophrenia with long duration of untreated psychosis. Pathways to care.

BACKGROUND: The early course of illness in first-episode schizophrenia was examined with special emphasis on the duration of untreated psychosis and pathways to care. METHOD: The consecutively admitted individuals (n = 34) were assessed on premorbid functioning, duration of untreated psychosis, global functioning, symptoms and social network. To clarify the obstacles for receiving earlier treatment, 17 case histories with long duration of untreated psychosis were intensively studied. RESULTS: The duration of untreated psychosis was on average very long (130 weeks), the median value was 54 weeks. The long duration of untreated psychosis group (> 54 weeks) had greater deterioration in the premorbid phase, a weaker social network and were more withdrawn than the short duration of untreated psychosis group (< 54 weeks). The main obstacles for receiving treatment were withdrawal and poor social network. CONCLUSIONS: In order to identify people earlier, a system of detection must be mobile, easily accessible and attentive to early symptoms of psychosis. It seems to be important to educate the social network related to the individual about the importance of early treatment.

Adolescent↗

Internal consistency of the Seasonal Pattern Assessment Questionnaire (SPAQ).

We examined the consistency reliability of the widely used Seasonal Pattern Assessment Questionnaire (SPAQ). In total, 587 questionnaires from a random sample of the general population were analysed. The 6 items of the Seasonality Scale Index (SSI) correlated fairly well, and consequently this scale proved to have a high internal consistency (alpha = 0.82). Items from the SSI that measure seasonal variations in sleep and weight were consistent with other SPAQ scales that also measure these dimensions. Since the questionnaires analysed were from an epidemiological study, the high consistency reliability shows that the symptoms probed for by the SSI, tend to cluster in susceptible individuals in the general population.

Adolescent↗

[Drug-induced dystonia misinterpreted as hysteria].

Psychic distress is often expressed in the form of physical pain or disease, but the converse also occurs. Illnesses with an organic aetiology are sometimes misdiagnosed as psychogenic. We describe three patients who developed rare forms of acute drug-induced dystonia when treated with antipsychotic drugs. All three cases were initially misdiagnosed as "hysteria" because the patients had psychiatric illnesses and because the symptoms were bizarre and became worse when the patients became very anxious. Furthermore, if the patients were helped to relax the symptoms disappeared for a moment. One of the patients developed dystonia 24 hours after ingestion of 750 mg tetrabenazine in an attempt at suicide. Another patient who had HIV/AIDS developed severe dystonia after receiving only 2 mg haloperidol by mouth. The clinical presentation, treatment, and possible mechanisms of the pathophysiology of acute drug-induced dystonia are briefly reviewed.

Adrenergic Uptake Inhibitors↗

Early identification and treatment of schizophrenia: conceptual and ethical considerations.

To identify and start treatment of schizophrenic patients at an early stage has been a matter of growing interest in recent years (Alanen 1994; Birchwood 1992; Docherty et al. 1978; Falloon 1992; Lieberman et al. 1993). However, we are not aware of any controlled study definitively concluding that early treatment of schizophrenia is favorable. Many researchers discuss the topic, for example, regarding outcome and prognosis (Falloon 1992) or treatment response (Alanen 1994; Lieberman et al. 1993). In this article we take a closer look at the idea of early treatment of schizophrenia by analyzing the concept of early schizophrenia/early psychosis at an epistemological level and discuss related ethical problems.

Ethics, Medical↗

Sexuality in patients treated for penile cancer: patients' experience and doctors' judgement.

OBJECTIVE: To evaluate sexuality after successful treatment of penile cancer. PATIENTS AND METHODS: Post-therapy sexuality was evaluated in 30 men (median age 57 years; range 28-75) treated for cancer of the penis 80 months previously (median; range: 11-225 months). Treatment regimes were: local excision/laser beam treatment, 5; definitive radio-therapy, 12; partial penectomy, 9; total penectomy, 4. Patients underwent a semi-structured interview and completed three self-administered questionnaires (psychosocial adjustment to severe illness [PAIS], mental symptoms [GHQ], quality of life [EORTC QLQ C-30]). A global score of overall sexual functioning was constructed consisting of sexual interest, sexual ability, sexual satisfaction, sexual identity, partner relationship and frequency of coitus. RESULTS: In 10 of 12 patients treated by irradiation the sexual global score was not or only slightly reduced compared with two of nine patients after partial penectomy and one of five patients with local surgery/laser beam treatment. All four patients who had undergone total penectomy recorded a severely reduced sexual global score. Of the six single domains, sexual identity and partner relationship did not change with increasing age, whereas the other scores of sexual life deteriorated as the patient became older. In the patients treated by irradiation doctors evaluated the patients' post-treatment sexuality to be more impaired than that experienced by the patients. CONCLUSION: Within the limitations due to the small number of patients studied, radiotherapy seems to be the treatment of choice in limited cancer of the penis if preservation of sexuality is a major therapeutic aim. Physicians counselling patients with this rare malignancy need more information about treatment-related problems of sexuality after different therapeutic modalities.

Adult↗

Quality of life in patients treated for penile cancer. A follow-up study.

OBJECTIVES: To study the long-term psychosocial well-being of patients following successful physical treatment for cancer of the penis. PATIENTS AND METHODS: Thirty patients (median age at follow-up 57 years, range 28-75) were followed up for a median of 80 months after treatment for penile cancer (local excision/laser beam treatment, 5; radiotherapy, 12; partial penectomy, 9; total penectomy, 4). They underwent a semi-structured interview and completed the Impact of Events Scale, General Health Questionnaire and the EORTC QLQ C-30 questionnaire. Global scales for measuring sexual function, subjective well-being and social activity were constructed and found reliable and valid. RESULTS: There was a strong correlation between the well-being scale and the EORTC scales for overall quality of life and psychological distress. Patients treated with partial or total penectomy had a worse outcome with regard to sexual function than patients treated conservatively, but there was no difference in the other domains of quality of life, indicating that even the more radically treated patients usually adapted adequately. Half of the individuals had mental symptoms at follow-up, and these patients were less satisfied and showed less social activity. Seven men reported that, if asked again, they would choose treatment with lower long-term survival to increase the chance of remaining sexually potent, but the majority gave priority to higher long-term survival. CONCLUSION: Before treatment of penile cancer, physicians should thoroughly discuss the expected outcome and consequences of the different treatment options with the patient. Psychosocial treatment might be helpful for patients with mental symptoms.

Adult↗

Differences in diagnosis and long-term course and outcome between monosymptomatic and other delusional disorders.

A presentation is given of a long-term personal follow-up investigation of patients with paranoid psychoses consecutively admitted at the University Psychiatric Department in Oslo. The patients were followed-up for the first time after a period of 5-18 years, and again after 22-39 years. On the basis of the findings, it is suggested that the diagnostic category will best indicate the course and outcome for cases with delusional misidentification syndromes.

Adult↗