Biomedical subjects

Ståle Pallesen

Publications and source records attributed to Ståle Pallesen.

At least 19 recordsLinked to original sources

PubMed2007

Seven minute screen performance in a normal elderly sample.

BACKGROUND AND OBJECTIVE: The Seven Minute Screen (7MS) is a brief cognitive case-finding instrument for dementia. The test is composed of four subtests that assess performance with regard to orientation, memory, visuospatial ability and language. The objective of this study was to describe 7MS performance in a normal sample of people aged 65 years and older. METHOD: The subjects were 66 Norwegian community-dwellers who met selection criteria modified from the Mayo Older American Normative Studies standard. Mean age was 73.2 years, age range was 65-93 years, and mean Mini-Mental State Examination score was 29.06, range 26-30. RESULTS: Analysis of the 7MS subtests revealed relatively modest influence of age, education and gender on test performance. The composite 7MS performance scores were associated with education. Normal performance was expressed as means, standard deviations and percentile values for the age groups 65-74 years and 75 + years. CONCLUSION: 7MS performance is described for a normal sample. These data have the potential to increase the clinicians' ability to interpret 7MS test results.

Aged↗

PubMed2006

Night-time thoughts in high and low worriers: reaction to caffeine-induced sleeplessness.

There is ample evidence for the existence of an association between sleeplessness and worry. Not much is known, however, concerning the nature of this relationship. Therefore, a study was conducted investigating the causal relationship between sleeplessness and nocturnal worry. A 2 x 2 (Worry x Induced sleeplessness) analysis of covariance design was used. The first factor consisted of a subject variable defined by scoring either high or low on a trait measure of worry (the Penn State Worry Questionnaire) and the second factor consisted of 300 mg caffeine or placebo. A total of 96 female undergraduate students participated. The dependent variables comprised measures of nocturnal worry (the Night-Time Thoughts Questionnaire) and subjective and objective sleep parameters. Overall, caffeine caused an increase in nocturnal worry and sleeplessness. A significant interaction effect occurred between Worry and Induced sleeplessness on one of the objective sleep parameters, but no other interaction effects were significant. The results suggest that worry may occur as an epiphenomenon of sleeplessness.

Adolescent↗

PubMed2006

Cognitive behavioral therapy vs zopiclone for treatment of chronic primary insomnia in older adults: a randomized controlled trial.

CONTEXT: Insomnia is a common condition in older adults and is associated with a number of adverse medical, social, and psychological consequences. Previous research has suggested beneficial outcomes of both psychological and pharmacological treatments, but blinded placebo-controlled trials comparing the effects of these treatments are lacking. OBJECTIVE: To examine short- and long-term clinical efficacy of cognitive behavioral therapy (CBT) and pharmacological treatment in older adults experiencing chronic primary insomnia. DESIGN, SETTING, AND PARTICIPANTS: A randomized, double-blinded, placebo-controlled trial of 46 adults (mean age, 60.8 y; 22 women) with chronic primary insomnia conducted between January 2004 and December 2005 in a single Norwegian university-based outpatient clinic for adults and elderly patients. INTERVENTION: CBT (sleep hygiene, sleep restriction, stimulus control, cognitive therapy, and relaxation; n = 18), sleep medication (7.5-mg zopiclone each night; n = 16), or placebo medication (n = 12). All treatment duration was 6 weeks, and the 2 active treatments were followed up at 6 months. MAIN OUTCOME MEASURES: Ambulant clinical polysomnographic data and sleep diaries were used to determine total wake time, total sleep time, sleep efficiency, and slow-wave sleep (only assessed using polysomnography) on all 3 assessment points. RESULTS: CBT resulted in improved short- and long-term outcomes compared with zopiclone on 3 out of 4 outcome measures. For most outcomes, zopiclone did not differ from placebo. Participants receiving CBT improved their sleep efficiency from 81.4% at pretreatment to 90.1% at 6-month follow-up compared with a decrease from 82.3% to 81.9% in the zopiclone group. Participants in the CBT group spent much more time in slow-wave sleep (stages 3 and 4) compared with those in other groups, and spent less time awake during the night. Total sleep time was similar in all 3 groups; at 6 months, patients receiving CBT had better sleep efficiency using polysomnography than those taking zopiclone. CONCLUSION: These results suggest that interventions based on CBT are superior to zopiclone treatment both in short- and long-term management of insomnia in older adults. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00295386.

Aged↗

PubMed2006

[Pharmacological treatment of pathological gambling].

BACKGROUND: The need for effective treatment for pathological gambling is urgent. The majority of treatment studies and available treatments today are based upon cognitive-behavioural therapy. Recently, however, several studies investigating the effects of pharmacological interventions have been published. We conducted a review of these studies. MATERIAL AND METHODS: Studies for inclusion were identified through searches in PubMed covering the period 1950 to June 2005. A total of 12 studies were included. RESULTS: Selective serotonin reuptake inhibitors and similar compounds were associated with improvement in two out of five placebo-controlled studies and in two out of three studies with a pre-post design. Opioid antagonists were associated with improvement in one placebo-controlled study and in one study with a pre-post design. Mood stabilisers gave improvement in the one placebo-controlled study as well as in both studies with a pre-post design. INTERPRETATION: Pharmacotherapy may yield beneficial effects in the treatment of pathological gamblers. Still, more well-controlled studies with control of comorbid psychiatric conditions are needed.

Antidepressive Agents, Second-Generation↗

PubMed2006

The long-term effect of insomnia on work disability: the HUNT-2 historical cohort study.

Chronic insomnia is common in the general population. Its effect on functioning and disability is usually attributed to an underlying condition, so the diagnosis of insomnia does not qualify for award of a disability pension in the United States or Europe. The aim of this study was to investigate whether insomnia, defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, contributed to long-term work disability. Using a historical cohort design, the authors gathered baseline data from a population-based Norwegian health study of 37,308 working-age people not claiming a disability pension through 1995-1997. The outcome was subsequent award of a disability pension (18-48 months after the health screening) as registered by the National Insurance Administration. Insomnia was a strong predictor of subsequent permanent work disability (adjusted odds ratio=3.90, 95% confidence interval: 3.20, 4.76). Sociodemographic and shift-work characteristics had little confounding effect (adjusted odds ratio=3.69, 95% confidence interval: 3.00, 4.53), and this association remained significant after adjustment for psychiatric and physical morbidity and for health-related behaviors (adjusted odds ratio=1.75, 95% confidence interval: 1.40, 2.20). This study suggests that insomnia should receive increased attention as a robust predictor of subsequent work disability.

Adult↗

PubMed2006

Anabolic steroid use in high school students.

A total of 1351 high school students (52.3% males, 47.7% females) with mean age 17.5 years (SD = 2.2) from randomized school classes in Hordaland County, Norway, participated in an Internet survey conducted in 2004 about the lifetime use of anabolic steroids and personal acquaintance with at least one user of anabolic steroids. In addition to questions about anabolic steroids the participants completed the Hospital Anxiety and Depression Scale and the Alcohol Use Disorders Identification Test. They also answered questions about demography, smoking, and narcotic use. The lifetime prevalence for use of anabolic steroids was 3.6% for males and 0.6% for females. In all, 27.9% of the respondents reported having at least one acquaintance that used or had used anabolic steroids. Use of anabolic steroids and having acquaintances using such drugs were strongly related to use of other drugs such as alcohol, nicotine, and narcotics. Implications for prevention are discussed and the study's limitations are noted.

Adolescent↗

PubMed2006

A comparison of actigraphy and polysomnography in older adults treated for chronic primary insomnia.

STUDY OBJECTIVES: The present study explores the accuracy and clinical utility of actigraphy compared with polysomnography in older adults treated for chronic primary insomnia. DESIGN: Polysomnographic and actigraphic data were collected before and after treatment. SETTING: A university-based outpatient clinic for adults and elderly. PARTICIPANTS: Thirty-four participants with chronic primary insomnia. Mean age was 60.5 years. INTERVENTIONS: Participants received either a manualized treatment package based on cognitive-behavior therapy and sleep management or hypnotic-drug treatment (7.5 mg zopiclone) for 6 weeks (these findings are reported elsewhere). MEASUREMENTS AND RESULTS: Although the sensitivity of actigraphy to detect sleep was very high (95.2%), actigraphy performed poorly in detecting wakefulness (specificity: 36.3%), yielding on an overall level of accuracy of 83.1%. However, the level of actigraphy accuracy was dependent upon polysomnography-registered sleep efficiency. Actigraphy underestimated total wake time and sleep-onset latency and consequently overestimated total sleep time and sleep efficiency. Compared with polysomnography, actigraphy captured only part of the treatment effects on total wake time and sleep-onset latency and failed to detect significant changes in sleep efficiency. CONCLUSIONS: The present findings suggest that the clinical utility of actigraphy is still suboptimal in older adults treated for chronic primary insomnia and should, hence, be used in this clinical setting with the concurrent use of supplementary assessment methods.

Aged↗

PubMed2006

A Norwegian adaptation of the Penn State Worry Questionnaire: factor structure, reliability, validity and norms.

A Norwegian version of the Penn State Worry Questionnaire (PSWQ) was administered to 304 undergraduate students together with the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI) and the Maudsley Obsessive Compulsive Inventory (MOCI). The PSWQ was also administered to a community sample comprising 879 subjects, together with the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI II) and the White Bear Suppression Inventory (WBSI). Structural equation modeling showed that a three-factor solution of the PSWQ gave the best goodness of fit. The Norwegian version of the PSWQ demonstrated adequate psychometric properties in terms of reliability and validity in both samples. Females scored higher than males on PSWQ.

Adult↗

PubMed2005

Psychological characteristics of patients with chronic obstructive pulmonary disease: a review.

OBJECTIVE: The aim of this study was to review research on psychological characteristics in chronic obstructive pulmonary disease (COPD) patients and to summarize the findings of associations between psychological variables and various aspects of life, illness, and health in COPD patients. METHODS: The following databases were searched: Medline, PsycINFO, and the Cochrane Library. RESULTS: A total of 81 studies, published between 1968 and 2004, was identified. The reviewed studies indicated that patients suffering from COPD have a high prevalence of psychological disorders and may function at a reduced level of efficiency due to neuropsychological impairments. Psychological characteristics also seemed to be associated with functional disability and reduced quality of life. CONCLUSION: Psychological characteristics are important variables that interact with physical symptoms, and they should be taken into account when treating COPD patients. More studies with rigorous methodological designs are needed to describe the role of psychological variables in COPD accurately and reliably.

Cognition Disorders↗

PubMed2005

Prevalence, severity and risk factors of restless legs syndrome in the general adult population in two Scandinavian countries.

BACKGROUND AND PURPOSE: To estimate prevalence and severity (using the International Restless Legs Syndrome Study Group Rating Scale (IRLS)) and to identify risk factors of restless legs syndrome (RLS). PATIENTS AND METHODS: Population-based cross-sectional study; 2005 randomly selected adults 18 years and above participated in a telephone interview in Norway and Denmark, employing the next-birthday technique. RESULTS: Of the cross-section, 11.5% fulfilled the diagnostic criteria for RLS. Half of these reported the symptoms as moderate to very severe. Mean duration of the complaint was 10 years. Prevalence was higher in females than in males (13.4 vs 9.4%) and lowest in the youngest age group (18-29 years, 6.3%). From 30 years and above, no clear age-related difference was seen. Main predictors of RLS were insomnia (odds ratios: 1.71-3.16) and symptoms of periodic limb movements in sleep (3.20-7.85). The response rate was 47%, making the results less reliable. CONCLUSIONS: This study indicates that there is a high occurrence of RLS among adults. Main predictors are insomnia and periodic limb movements in sleep.

Adult↗

PubMed2005

Outcome of psychological treatments of pathological gambling: a review and meta-analysis.

AIMS: To investigate the short- and long-term effect of psychological treatments of pathological gambling and factors relating to treatment outcome. DESIGN AND SETTING: This study provides a quantitative meta-analytical review of psychotherapeutic treatments of pathological gambling. Studies were identified by computer search in the PsycINFO and Medline databases covering the period from 1966 to 2004, as well as from relevant reference lists. INCLUSION CRITERIA: The target problem was pathological gambling, the treatment was psychological, the study was published in English and outcomes directly pertaining to gambling were employed. Single case studies, studies where elimination of gambling not was the priority and studies with insufficient statistical information were excluded from the present meta-analysis. PARTICIPANTS: A total of 37 outcome studies, published or reported between 1968 and 2004, were identified. Of these 15 were excluded, thus 22 studies were included, involving 1434 subjects. The grand mean age was 40.1 years. The overall proportion of men was 71.5%. MEASUREMENTS: The included studies were coded for outcome measures of pathological gambling. For each condition, means and standard deviations for gambling-related outcome measures, all based upon self-reports or therapist ratings, were compiled at three points in time: baseline, post-treatment and the last follow-up reported. FINDINGS: Effect sizes represent the difference between the mean score in a treatment condition and a control condition or the difference between mean scores at separated points in time for one group, expressed in terms of standard deviation units. At post-treatment the analysis indicated that psychological treatments were more effective than no treatment, yielding an overall effect size of 2.01 (P < 0.01). At follow-up (averaging 17.0 months) the corresponding effect size was 1.59 (P < 0.01). A multiple regression analysis showed that the magnitude of effect sizes at post-treatment were lower in studies including patients with a formal diagnosis of pathological gambling only, compared to studies not employing such inclusion criteria. Effect sizes were also higher in randomized controlled trials compared to not randomized controlled trials, higher in within subjects designs compared to between subjects designs and also positively related to number of therapy sessions. No mediator variables were significantly related to the magnitude of the effect sizes at follow-up. CONCLUSION: Psychological interventions for pathological gamble seem to be yield very favourable short- and long-term outcomes.

Adult↗

PubMed2005

Bright light treatment has limited effect in subjects over 55 years with mild early morning awakening.

31 subjects, age 55 yr. or older, suffering from mild early morning awakening were randomized to either a bright light (10,000 lux) or to a red dim light placebo condition (200 lux). Light exposure took place in the evening in the patients' homes, 60 to 30 min. before bedtime and lasted for 3 wk. The subjects kept a sleep diary for 2 wk. and wore an actigraph for 1 wk. both before treatment and at post-treatment. Of the eight sleep diary outcome variables, significant effects that could be attributed to the light treatment were only detected for time spent in bed after final morning awakening. None of the six actigraph outcome variables yielded any significant effect of the light therapy. Explanations for the limited therapeutic effects of bright light treatment obtained in the present study are discussed, such as the criteria defining early morning awakening, the selection procedure, problems with compliance, age of the sample, and the dose of light. The lack of an objective circadian marker in this study could represent a problem concerning the timing of the light exposure. Despite the limited success of bright light therapy in this study, bright light therapy should still be considered as a treatment option for early morning awakening.

Adult↗

PubMed2004

[Are sleep difficulties in night work a problem for the offshore industry?].

BACKGROUND: Shift work is increasingly used in industry and services; in the Norwegian offshore industry approximately 6750 employees work night shifts. We wanted to look into the implications of night shifts on sleep and circadian rhythm, with particularly focus on the offshore sector. MATERIAL AND METHODS: We conducted literature searches on Medline, covering the period from 1966 to 2003; only eight studies pertaining to the offshore activity in the North Sea with emphasis on sleep and night work were identified. RESULTS: Night shifts on oil platforms were associated with sleeping difficulties. The isolated setting on the installations in the North Sea probably facilitates biological adaptation to night work compared to work onshore. Light therapy has a documented effect for re-adaptation to normal daytime functioning upon returning home. INTERPRETATION: Night work disturbs sleep. The level of functioning during the first night shifts is probably lower than the optimal level of functioning. Only a few studies of adaptation to night work in the offshore industry have been conducted and little research has been done concerning swing shifts in the North Sea. The field is obviously in need of more empirically based knowledge.

Adaptation, Physiological↗

PubMed2004

[Shift work and accidents--relevance for the offshore industry].

BACKGROUND: Increased use of shift work depends on keeping productivity and safety at acceptable levels. Approximately 7000 workers in the Norwegian offshore industry are working night shifts. MATERIAL AND METHODS: We have reviewed relevant literature on injuries in relation to shift work. RESULTS: The literature is inconclusive. The reason for this is most likely that all the studies are either observational or retrospective; no controlled interventions were found. However, shift work generally and night shifts in particular seem to increase the risk of injury. When newer data are taken into account, these clearly indicate that shift work is associated with reduced safety and productivity. INTERPRETATION: We conclude that if and when shift work is needed, it should be organised with certain patterns and rest breaks in order to reduce the risk of accidents and injuries. Focused and well-planned research is strongly needed in this field. Very few studies have been conducted on shift work and health effects offshore.

Accidents, Occupational↗

PubMed2004

[Sleep disorders in elderly patients who take hypnotics on a regular basis].

BACKGROUND: Several studies have shown that the prevalence of sleep disorders such as sleep apnoea and periodic limb movements in sleep increases significantly with age. The assessment capacity is limited and there is a paucity of knowledge in this field among health professional, hence we hypothesise that these disorders are to a considerable extent under-diagnosed in the elderly, as the symptoms are often conceived of as insomnia. MATERIAL AND METHODS: Using ambulant clinical polysomnography, we investigated 19 patients aged 55 years or above who had been taking hypnotics on a daily basis (5 to 7 days a week) for at least one year. RESULTS: Among these 19 patients, the prevalence of sleep apnoea (AHI > 10) as well as periodic limb movements in sleep (PLM index > 10) was 42%; 74% had either sleep apnoea, periodic limb movements in sleep, or both. INTERPRETATION: Seen in relation to the fact that these elderly patients were given hypnotics for insomnia, the prevalence rates of sleep apnoea and periodic limb movements in sleep were high. We suggest that non-pharmacological alternatives should be considered and careful sleep assessment carried out before long-term prescription of hypnotics is instituted.

Aged↗

PubMed2004

Effect of antipsychotic withdrawal on behavior and sleep/wake activity in nursing home residents with dementia: a randomized, placebo-controlled, double-blinded study. The Bergen District Nursing Home Study.

OBJECTIVES: To explore the effect on sleep/wake activity and on behavioral and psychological symptoms of the withdrawal of antipsychotic medications from nursing home (NH) patients with dementia. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: NHs in Bergen, Norway. PARTICIPANTS: Thirty patients (mean age 83.5) taking haloperidol, risperidone, or olanzapine for nonpsychotic symptoms. INTERVENTION: Study participants were randomly assigned to withdrawal (intervention group) or continued treatment with antipsychotic medications (reference group) for 4 consecutive weeks. MEASUREMENTS: Behavioral rating using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and actigraphy. RESULTS: After antipsychotic withdrawal, behavioral scores remained stable or improved in 11 of 15 patients, whereas four had worsening scores. Actigraphy revealed decreased sleep efficiency after drug discontinuation and increased 24-hour and night activity in both groups. Actigraphy records of nighttime and daytime activity indicated sleep problems and restlessness, in terms of the NPI-Q. One patient was restarted on antipsychotics. CONCLUSION: Antipsychotic drug withdrawal affected activity and sleep efficiency over the short term. Increases in total activity and impaired sleep quality after drug discontinuation should be monitored, because the long-term effect of these changes is not known. The NPI-Q and actigraphy are feasible tools that disclose relevant changes occurring during antipsychotic withdrawal in NH patients with dementia. Their use in clinical practice should be substantiated by larger studies.

Aged↗

PubMed2003

Psychological treatment of late-life anxiety: an empirical review.

This study provides a meta-analytic review of nonpharmacological interventions for late-life anxiety, focusing on treatment efficacy. Included in the analysis are studies in which a comparison was made either to a control condition or to another treatment. A total of 15 outcome studies, published or reported between January 1975 and January 2002, were identified involving 495 participants (mean age exceeding 55.0 years and a grand mean of 69.5 years) and providing 20 separate treatment interventions. The analysis indicated that psychological interventions were reliably more effective than no treatment on self-rated and clinician-rated measures of anxiety, yielding an effect size of .55. Maintenance of treatment gains (a minimum of 6 months follow-up) was insufficiently reported across studies to allow for a reliable demonstration of an overall estimate of long-term efficacy. It is concluded that psychological interventions produce significant improvements, but the analyses must be qualified by data limitations in the research synthesis.

Aged↗

PubMed2002

[Valerian as a sleeping aid?].

BACKGROUND: Valeriana is a herbal over-the-counter drug, in Norway mainly used for insomnia. It is estimated that in Norway only, annual sales of valeriana amount to NOK 20 m. With this considerable consumption in mind, we wanted to review the scientific basis for valeriana as a sleep aid. MATERIAL AND METHODS: Through a literature search we identified 18 experimental studies examining the effects of valeriana on human sleep. RESULTS: The majority of studies reported positive effects of valeriana on subjective sleep parameters. Objective sleep measures yielded inconsistent results. All studies covered a short period of time. Few side effects of valeriana were reported. Only two studies compared valeriana to established hypnotics. INTERPRETATION: We conclude that valeriana may have some hypnotic effect. Long-term studies are clearly lacking, as well as studies comparing valeriana to well-established drug treatments for insomnia.

Humans↗