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Biomedical subjects

Sonja Heyerdahl

Publications and source records attributed to Sonja Heyerdahl.

At least 19 recordsLinked to original sources

Mental health problems in children and adolescents referred to a national epilepsy center.

This study aimed to investigate the occurrence of psychiatric morbidity in children and adolescents referred to a tertiary national epilepsy center (inpatient unit) and the extent of the unmet need for psychiatric services in this group. Participants were 74 children and adolescents aged 9-15 referred from February 2001 to October 2002 (67% response rate). The multi-informant (parent, teacher, self-report) Strengths and Difficulties Questionnaires (SDQs) were answered before or at admission. Patients with severe mental retardation or pervasive developmental disorder were excluded. We found a large proportion (77%) with a possible or probable psychiatric disorder. The parents, teachers, and adolescents themselves had higher mean SDQ scores than a British community sample on total difficulties, emotional symptoms, conduct problems, hyperactivity-inattention, peer problems, and impairment, but not self-reported conduct problems. Nearly 80% of the children who probably had a psychiatric disorder had no contact with the psychiatric service.

Adolescent↗

Self-reported strengths and difficulties in a large Norwegian population 10-19 years : age and gender specific results of the extended SDQ-questionnaire.

This study reports young people's assessment of own problems and strengths from a Norwegian survey (n=29,631, age range 10-19), based on the self-report version of the Strengths and Difficulties Questionnaire (response rate 84.3%). Differences according to the age and gender are illuminated. Girls reported most emotional problems and boys most conduct and peer problems. Compared to other countries, Norwegian adolescents reported more hyperactive behaviour. Total problem scores were highest in early-adolescence for boys (Mean=10.8, SD=6.1), and for girls it is in late adolescence (Mean 11.3, SD=5.2). One third of the subjects reported at least minor perceived difficulties. All symptom scales were strongly associated with perceived difficulties, impact and burden to others (P<0.001) with significant gender and age effects. Impact scores were included in the estimate of possible caseness. Combining symptom scores and impact scores, 3.7% of the sample was defined as a high risk group, while 8.8% needed special attention from mental health services. The results also suggested that SDQ could be a valuable screening instrument for older adolescents.

Adolescent↗

The relationship between age of menarche and mental distress in Norwegian adolescent girls and girls from different immigrant groups in Norway: results from an urban city cross-sectional survey.

Lower age of menarche has been associated with increased mental distress among adolescent girls. The association might be mediated via body image, as girls with early menarche tend to have higher weight than those with late onset menarche. Many of the existing studies of menarche and mental distress are based on samples of white, western girls. The aim of the study was to analyze the association between age of menarche and mental distress among Norwegian girls and girls from different immigrant groups, and to study the effect of body mass index (BMI) and the difference between current and desired weight, on the relationship between age of menarche and mental distress. The study was a cross-sectional population-based self-report survey of all 10th grade pupils in Oslo for two consecutive years. A total of 3694 girls (91%) participated, one quarter of which were first or second generation immigrants. The Hopkins Symptom Checklist-10 was used to measure mental distress. An inverse, linear association between age of menarche and mental distress was found for both Norwegian girls and girls from all the immigrant groups. Regardless of immigrant status, girls with early onset menarche had higher BMI and higher difference in current and desired weight than those with late onset menarche. In linear regression, the difference in current and desired weight was more strongly associated with mental distress both among the Norwegian girls and girls from immigrant groups than age of menarche and BMI when controlling for social and behavioral factors. Early age of menarche might serve as a predictor for psychopathology in Norwegians girls as well as in girls from different immigrant groups. The association between age of menarche and mental distress might be mediated via differences in current and desired weight.

Adolescent↗

Girls with anorexia nervosa as young adults: personality, self-esteem, and life satisfaction.

OBJECTIVE: The current study evaluated personality, self-esteem, and life satisfaction in former patients with different outcomes of childhood and adolescent-onset anorexia nervosa (AN). METHODS: Forty-four female patients with AN were assessed 8.5 +/- SD 3.4 years after treatment start with a clinical interview and questionnaires including the Temperament and Character Inventory (TCI) and the Rosenberg Self-Esteem Scale. Self-esteem and general life satisfaction in former patients were compared with women in a large population study. RESULTS: Former AN patients with no eating disorder and normal eating attitudes at follow-up (n = 21 [48%]) had similar TCI profiles and self-esteem as samples from normal populations, whereas participants with poorer outcome had significantly lower TCI Self Directedness, self-esteem, and life satisfaction scores. Life satisfaction was reduced in all outcome groups and was strongly associated with self-esteem. CONCLUSION: Personality, self-esteem, and life satisfaction varied significantly between outcome groups. The results indicate that young patients with AN with a good outcome may have normal personality and self-esteem features in young adulthood.

Adolescent↗

Alcohol use before and during pregnancy: a population-based study.

BACKGROUND: Few population-based studies have estimated alcohol consumption and binge drinking before and during pregnancy. METHODS: The study is a longitudinal questionnaire study. In Norway, virtually 100% attend an ultrasound screening at 17-18 weeks of pregnancy. In Oslo, a representative sample attending this between June 2000 and May 2001 were invited to join the study, accepted by 92%. Non-Norwegian-speaking and/or immigrants from non-Western countries were not invited; 1,749 (93%) completed the first questionnaire. MEASURES: T-ACE (screening for pregnancy risk drinking), frequency of alcohol use, Standard Units (SU) per occasion, SU/week, and binge drinking (>or=5 SU per occasion). Binary logistic regression analyses, Student's t-test and Pearson's chi square were used. RESULTS: Alcohol use was reported by 89% pre-pregnancy and by 23% after pregnancy week 12. Binge drinking was reported by 59% pre-pregnancy and by 25% during weeks 0-6. Change of drinking pattern occurred at pregnancy recognition for 85%, although 78% had planned the pregnancy, fetal welfare being the main reason. Participants reporting alcohol use during pregnancy were older, smokers, with more SU/week pre-pregnancy, had some elevated anxiety score, higher income, and a partner with higher education. However, mental health, high income, or education were not predictive of usually drinking 1 SU per occasion or more, and not of binge drinking. The latter was predicted mainly by smoking during pregnancy and being T-ACE positive. CONCLUSIONS: The study shows a drinking pattern before pregnancy recognition that, according to other studies, in 25% or more may cause suboptimal fetal development.

Adolescent↗

Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway.

OBJECTIVES: We examined whether high levels of consumption of sugar-containing soft drinks were associated with mental distress, hyperactivity, and conduct problems among adolescents. METHODS: A cross-sectional population-based survey was conducted with 10th-grade students in Oslo, Norway (n = 5498). We used the Hopkins Symptom Checklist and the Strengths and Difficulties Questionnaire to assess mental health outcomes. RESULTS: There was a J-shaped dose-response relationship between soft drink consumption and mental distress, conduct problems, and total mental health difficulties score; that is, adolescents who did not consume soft drinks had higher scores (indicating worse symptoms) than those who consumed soft drinks at moderate levels but lower scores than those with high consumption levels. The relationship was linear for hyperactivity. In a logistic regression model, the association between soft drink consumption and mental health problems remained significant after adjustment for behavioral, social, and food-related variables. The highest adjusted odds ratios were observed for conduct problems among boys and girls who consumed 4 or more glasses of sugar-containing soft drinks per day. CONCLUSIONS: High consumption levels of sugar-containing soft drinks were associated with mental health problems among adolescents even after adjustment for possible confounders.

Adolescent↗

[Congenital hypothyroidism and the impact of thyroxine treatment].

BACKGROUND: We have studied the significance of the thyroxine treatment for neuropsychological functioning in young adults with congenital hypothyroidism. SUBJECTS AND METHODS: This is a neuropsychological follow-up study of a three-year cohort of early treated congenital hypothyroidism in Norway (N = 49) at age 20. Siblings comprise the control group (N = 41, 21 years). RESULTS: The patient group performed weaker than the control group on cognitive and motor measures. They reported somewhat more psychosocial problems; fewer completed high school. A more severe hypothyroidism at the time of diagnosis was associated with a larger motor deficit at age 20. Better cognitive function in young adulthood was associated with a higher thyroxine starting dose and serum thyroxine level in the first years of life. Blood samples in young adulthood showed elevated thyrotropin levels in 45% of the patients. INTERPRETATION: This study supports the new guidelines for treatment of congenital hypothyroidism with a higher starting dose of 10-15 microg thyroxine/kg/24 hours. The young adults are in need of better medical follow up.

Adolescent↗

Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway.

BACKGROUND: Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year. METHODS: This population-based cross-sectional study included all 10th-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity. RESULTS: The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p < 0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p < 0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p < 0.05). CONCLUSION: In adolescents from a multicultural city in Norway, relative age within a school year significantly influenced academic performance. In contrast to data from Great Britain, relative age within a school year was not an important risk factor for mental health problems in adolescents in Oslo.

Adolescent↗

Psychiatric symptoms in low birth weight adolescents, assessed by screening questionnaires.

OBJECTIVE: The aim of this study was to explore psychiatric symptoms in low birth weight adolescents, and the usefulness of questionnaires compared with psychiatric interview. DESIGN/STUDY GROUPS: A population-based follow-up study of 56 very low birth weight (VLBW), 60 term small for gestational age (SGA) and 83 control adolescents at 14 years of age was made. OUTCOME MEASURES: The Achenbach System of Empirically Based Assessment (ASEBA) and the Strengths and Difficulties Questionnaire (SDQ) were rated by adolescents, parents and teachers. The results were compared with diagnostic assessment based on the semi-structured interview, Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS). RESULTS: VLBW adolescents had more psychiatric symptoms than controls, especially attention deficit, emotional, behavioural, social and also academic problems. Although less consistent, the SGA group had more emotional, conduct and attention deficit symptoms than controls. Results remained essentially the same when adolescents with low estimated IQ were excluded, and persisted after controlling for possible confounders. The sensitivity and specificity of ASEBA and SDQ differed between informants and groups. CONCLUSION: VLBW adolescents are at risk of developing psychiatric symptoms, and reduced social and academic skills by the age of 14. Term SGA adolescents may have discrete emotional, behavioural and attention deficit symptoms. ASEBA and SDQ provide a useful supplement to psychiatric interview.

Adolescent↗

Girls with anorexia nervosa as young adults. Self-reported and parent-reported emotional and behavioural problems compared with siblings.

This follow-up study had three objectives: 1) to investigate emotional and behavioural problems, adaptive functioning and substance use in former anorexia nervosa (AN) patients compared with siblings, 2) to compare information obtained from different informants, and 3) to compare questionnaire results with interview results. Fifty (of 55) female AN patients, representative for AN patients under 18 years referred to county health services, were assessed at a mean of 8.8 years after treatment start with the Young Adult Self-Report and the Young Adult Behaviour Checklist (mean age 23.1 years). In all, 48 patients, 25 siblings, 33 mothers and 27 fathers participated in the questionnaire study. Although 41/50 (82 %) had recovered from their eating disorder, the former AN patients had substantially more self-reported and parent-reported problems than their siblings, particularly with regard to Internalising Problems and on the Anxious/Depressed syndrome scale. Cross-informant agreement between the parents and between parents and patients was high, but low between parents and siblings. The patients with psychiatric diagnoses at follow-up had substantially higher problem scores than those without diagnoses both on the self-report and the parent-report, supporting the validity of the questionnaires. In conclusion, the self- and parent-reports showed a high level of Internalising Problems and were useful instruments in the assessment of former AN patients.

Adaptation, Psychological↗

Low-birth-weight adolescents: psychiatric symptoms and cerebral MRI abnormalities.

To explore associations between psychiatric symptoms and cerebral magnetic resonance imaging abnormalities in low-birth-weight adolescents, 55 very low-birth-weight ( or=10th centile) were assessed at 14-15 years of age. Outcome measures were Schedule for Affective Disorders and Schizophrenia for School-Age Children, Attention-Deficit/Hyperactivity Disorder Rating Scale IV, Autism Spectrum Screening Questionnaire, and qualitatively assessed cerebral magnetic resonance images. The very low-birth-weight group manifested increased prevalence of psychiatric symptoms and disorders compared with controls (P < 0.001), especially symptoms of attention-deficit/hyperactivity disorder, and high frequency of ventricular dilatation, white matter reduction, thinning of corpus callosum, and gliosis (P < 0.01 vs controls). The Attention-Deficit/Hyperactivity Disorder Rating Scale score was significantly associated with white matter reduction and thinning of corpus callosum in this group. The term small for gestational age group had increased prevalence of psychiatric symptoms compared with control subjects, but not more frequent abnormalities on cerebral magnetic resonance imaging. In conclusion, attention-deficit/hyperactivity disorder symptoms were significantly associated with white matter reduction and thinning of corpus callosum in very low-birth-weight adolescents. No associations were found for other psychiatric symptoms and brain abnormalities in any of the groups.

Adolescent↗

Ethnic group, acculturation, and psychiatric problems in young immigrants.

BACKGROUND: The goal of this study was to investigate the effects of ethnic origin and acculturation factors on psychiatric problems among immigrant adolescents. One aim was to examine variations in psychiatric problems according to gender and immigrant generation level. Another aim was to explore ethnic group differences in psychiatric problems and acculturation risk and protective factors. Finally, we examined the potential mediating effect of acculturation in the relationship between ethnic origin and psychiatric symptoms. METHOD: Questionnaire data were collected from 1275 immigrant 10th graders with 11 different ethnic origins. Psychiatric problems were measured by the Strength and Difficulty Questionnaire. Acculturation risk factors involved perceived discrimination and ethnic identity crisis. Protective factors were family values, host and ethnic culture competence. RESULTS: First-generation girls and second-generation boys were identified as particularly vulnerable to psychiatric problems. There was significant variation in psychiatric problems and acculturation between ethnic groups. There was substantial ethnic group-level correlation between emotional and conduct problems, and between discrimination and peer problems. Otherwise, a differentiated pattern of high-scoring ethnic groups emerged across the various symptom and acculturation indices. ANOVAs yielded unique effects on each symptom category of both ethnic group and the acculturation risk and protective factors, undermining the notion of a mediating effect of acculturation. CONCLUSIONS: There is a complex pattern of adaptation in cultural context and idiosyncratic relationships between distinct psychiatric symptom groups and socio-cultural factors. Information about the differentiated vulnerability of gender, generation, and ethnic groups to psychiatric morbidity is important to identify groups at special risk, and to produce interventions that are tailored to their needs. Future studies should examine how cultural factors contribute both to resilience and to an increased vulnerability to psychiatric problems.

Acculturation↗

Low-birthweight adolescents: quality of life and parent-child relations.

AIM: To explore the effect of low birthweight on quality of life, the parent-child relationship and the parents' mental health. DESIGN/STUDY GROUPS: A population-based follow-up of 56 very-low-birthweight ( or=10th centile) at 14 y of age. OUTCOME MEASURES: Child Health Questionnaire (Child Form, Parent Form), Parental Bonding Instrument rated by adolescents and parents; Symptom Checklist-90-Revised rated by mothers and fathers. RESULTS: There were no group differences in self-reported health or self-esteem. Parents reported more behavioural problems and lower psychosocial health for very-low-birthweight adolescents (p<0.001) compared with controls. Results did not differ significantly between small-for-gestational-age and control adolescents. The youngsters, their mothers and fathers perceived the same amount of relational warmth in all three groups. Very-low-birthweight parents reported more emotional impact than control parents, especially in the presence of psychiatric problems and cerebral palsy. There were no group differences in mothers' or fathers' mental health. CONCLUSION: The low-birthweight adolescents perceived quality of life as others did, but the parents reported functional disadvantages for the very-low-birthweight group. Birthweight did not influence the warmth in the parent-child relationship. Parents of very-low-birthweight adolescents experienced increased emotional burden, but they did not have more mental health problems than others.

Adolescent↗

Parenting correlates of child behavior problems in a multiethnic community sample of preschool children in northern Norway.

A multiethnic community sample of 191 families with four-year-old children in northern Norway was used to explore whether parenting factors were associated with child behavior problems, and whether these associations differed for boys and girls or for the two main ethnic groups in this region: the indigenous Sami and the majority Norwegians. The Child Behavior Checklist (CBCL) and a semi-structured interview on child-rearing were used as instruments. As would be expected from a developmental perspective, elevated scores of child behavior problems were associated with lower levels of parental cuddling and with higher levels of physical punishment. Family demographics such as low maternal age and single parenthood were also associated with more behavioral problems. Girls seemed to be more strongly influenced by child-rearing factors than boys. Subgroup analyses suggested that for harsh treatment, patterns of correlations differed between Sami and Norwegian groups, especially for boys. A positive correlation between physical punishment and externalizing problems emerged for Norwegian boys, but not for Sami boys. Teasing/ridiculing was positively correlated with internalizing problems for Norwegian boys, but inversely correlated for Sami boys. These findings emphasize the importance of taking the child's cultural context and gender into account when assessing parenting influences on behavioral problems in children.

Arctic Regions↗

Self-reported behavioural/emotional problems in Norwegian adolescents from multiethnic areas.

Self-reported behavioural/emotional problems were studied in 2647 15-18-year-old high school students by Youth Self-Report (YSR), Symptom Checklist (SCL-12) and a Conduct Problem scale. The response rate was 85%. The respondents were from three ethnic groups in northern Norway: indigenous Sami, Kvens (descendants of Finnish-speaking immigrants from northern Finland and Sweden) and Norwegians. Females' mean scores were higher than males' scores for Total Problems [47.2 (SD 19.3) vs. 40.9 (SD 19.4)], Internalising Problems, the Internalising syndrome scales and the Attention Problems scale. Males' mean scores were higher than females' scores for Delinquent Behaviour. There were few differences between the ethnic groups, but Sami had higher scores than Norwegians for the Withdrawn and Social Problems syndromes. Parental status (whether parents were living together) was weakly associated with Total Problems, Internalising and Externalising Problems, while age, socioeconomic status and urban/rural location were not associated with the problem scales. Results for Anxiety-depression (SCL-12) and Conduct Problems were compared with a national representative adolescent sample (n = 4567), showing slight differences between the samples in Anxiety-depression (with north Norwegian adolescents having lower scores) and no significant differences in Conduct Problems.

Adolescent↗

Good outcome of adolescent onset anorexia nervosa after systematic treatment. Intermediate to long-term follow-up of a representative county-sample.

We studied the intermediate to long-term outcome of childhood and adolescent onset anorexia nervosa (AN), in a sample that had received systematic treatment based on close cooperation between parents, paediatric department and child and adolescent psychiatry. Of 55 female AN-patients, 51 were examined 3.5-14.5 years after treatment start. The material includes all AN-patients under 18 years in one county that received inpatient treatment and almost all that received outpatient treatment, during the time period 1986-1998. Forty-two (82%) subjects had no eating disorder (ED) at follow-up, one (2%) had AN, one (2%) bulimia nervosa (BN) and seven (14%) had less severe ED (EDNOS). Except the one with BN, none had bulimic symptoms. There was no mortality. Twenty (41%) had one or more other axis-1 psychiatric diagnoses at follow-up. Depression and anxiety disorders were most frequent. Psychosocial functioning assessed by Global Assessment of Functioning (GAF) was fairly good; mean 73+/-SD14 for symptoms and mean 77+/-SD13 for functioning. Only 48% were satisfied with life, compared to 83% in a normal population sample. Our conclusion is that the eating disorder outcome was good. However, in accordance with other studies, many subjects had other psychiatric problems at follow-up.

Adolescent↗

The Strengths and Difficulties Questionnaire in the Nordic countries.

BACKGROUND: The Strengths and Difficulties Questionnaire (SDQ) has been translated into the different Nordic languages between 1996 and 2003. During the past few years, SDQs have been completed for nearly 100,000 children and adolescents in population-based studies as well as in clinical samples. The largest studies have been performed in Norway and Denmark, and in these countries the diagnostic interview DAWBA has also been used in conjunction with the SDQ. AIMS: In addition to a brief overview of past and ongoing SDQ work in Sweden, Finland, Norway, Denmark, and Iceland, we present scale means and standard deviations from selected community studies with comparable age groups, including parental reports for 7, 9 and 11 year-old children and self-reports of 13 and 15 year-olds. CONCLUSIONS: The descriptive statistics suggest that the distributions of SDQ scores are very similar across the Nordic countries. Further collaborative efforts in establishing norms and evaluating the validity of the SDQ as a screening instrument are encouraged.

Adolescent↗

Child-rearing in an indigenous Sami population in Norway: a cross-cultural comparison of parental attitudes and expectations.

Semi-structured interviews of 76 Sami mothers and 58 Sami fathers, and 86 Norwegian mothers and 58 Norwegian fathers of four-year olds, revealed consistent cross-cultural differences in parenting. ANCOVA results showed that parental permissiveness was higher in the Sami group. Moreover, the effect of ethnicity was different for boys and girls (mothers' reports). Co-sleeping and self-regulation of food and sleep were commonly practiced in the Sami, but not in the Norwegian families. Sami children were more socially independent than their Norwegian peers. Indirect or internal types of control were used more by Sami parents, and they were less tolerant of child aggression, in the form of temper tantrums and displays of jealousy. These patterns are similar to those found in other indigenous cultures in the circumpolar region. The results are discussed with reference to the Individualism-Collectivism dimension. The study challenges the Individualism-Collectivism construct for apparently confounding the individualism common in European liberalism with the individual autonomy commonly encountered among hunting-gathering peoples.

Child↗