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Biomedical subjects

Ulrik Fredrik Malt

Publications and source records attributed to Ulrik Fredrik Malt.

8 recordsLinked to original sources
PubMed2004

A 7-year prospective quasi-experimental study of the effects of removing dental amalgam in 76 self-referred patients compared with 146 controls.

BACKGROUND: Dental amalgam has been suggested to cause long-term physical and mental problems. Claims that removal of the amalgam may lead to dramatic improvements in health have not been tested empirically in controlled studies with a long follow-up period. PURPOSE: To investigate the long-term effects of removal of dental amalgam on physical and mental symptoms in self-referred patients who complained of multiple somatic and mental symptoms attributed to dental amalgam fillings. METHODS: In a quasi experimental study, changes in the mental and physical symptoms in 76 patients who had their dental amalgam removed 7 years ago were compared with changes in symptoms among patients with known chronic medical disorders seen in alternative (n=51) and ordinary (n=51) medical family practices and noncomplaining patients with similar amounts of dental amalgam fillings (n=44) seen in an ordinary dental practice. The assessments included written self-reports, a 131-item somatic symptom checklist, Eysenck Personality Questionnaire (EPQ), the General Health Questionnaire (GHQ) and Toronto Alexithymia Scale (TAS). RESULTS: Subjects who removed their dental amalgam reported reduced physical and mental symptom load compared to status prior to removal, but only to a level comparable with that reported by the other groups with chronic medical disorders. The dental control group consistently reported lower symptom load during the whole period. In a hierarchical three-step regression model, pretreatment physical symptom load (P<.01), age (P<.10) and removal of dental amalgam (ns) predicted 26% of the variance in posttreatment physical symptom load. CONCLUSION: In a self-referred group of subjects with health complaints attributed to dental amalgam who remove their dental amalgam, the symptom load at follow-up corresponds to the level seen in chronic medical disorders despite the strong implicit placebo effect of the present quasi-experimental design. The finding does not support the hypothesis that removal of dental amalgam will reduce health complaints to normal levels and seriously questions the hypothesis that dental amalgam is an important cause of distress and health complaints.

Adolescent↗
PubMed2002

[Functional somatic diseases--a review].

Functional somatic illness is a clinical concept used to define medically unexplained somatic symptoms considered to express psychological distress. Functional somatic illness may express underlying psychiatric disorders (e.g. fibromyalgia due to non-fearful panic disorder, irritable bowel syndrome due to bipolar disorder). Sustained physiological activation caused by stressful life events combined with catastrophic thinking may be another cause. Functional somatic illness may also be caused by classic conditioning of physiological responses that may have been triggered by biological or emotional stimuli. Operant conditioning may also be a cause. The therapeutic alliance relies on acceptance of the reality of the subjective complaints, without a priori acceptance of the patient's attribution of the cause of the symptoms. We recommend initial exploration of the patient's own ideas about aetiology, including appropriate medical tests. The physician should then change the agenda to a biopsychosocial perspective and identify current stressors and psychosocial variables that reinforce symptoms. Only a few randomised trials have been performed. They suggest that psychological treatment should be systematic and structured, with a focus on information, alternative ways of perception, and problem solving. Active forms of physiotherapy and psychopharmacological drugs may be of some benefit in selected patients.

Humans↗
PubMed2002

[Chronic pelvic pain in women].

BACKGROUND: This paper reviews empirical and clinical evidence of the aetiology and treatment of medically unexplained chronic pelvic pain in women. MATERIAL AND METHODS: Clinical experience from an ongoing randomised treatment trial supplemented by computer-assisted reviews of studies obtained by a Premedline and Medline search (1996 to February 2002) and data from the Cochrane Database of Systematic Reviews and the EBM database of Abstracts of Reviews of Effectiveness. RESULTS: The aetiology of medically unexplained chronic pelvic pain is disputed but likely to be multifactorial. A history of interpersonal difficulties and a stressful life is common, and comorbid psychiatric disorders occur frequently. No treatment of choice emerges from the few controlled treatment trials, though a flexible biopsychosocial approach seems the most promising. INTERPRETATION: Empathic medical evaluation and follow-up within a biopsychosocial framework is recommended. Analgesic, hormonal and, if appropriate, surgical treatment can relieve pain. Additional benefits may be obtained by adding sensory awareness-directed physiotherapy aimed at changing painful muscle tensions, body attitude, movement pattern and dysfunctional respiration pattern. Co-morbid psychiatric disorders should be diagnosed and treated. Cognitive-behavioural stress management intervention aimed at improving coping with pain and current life-situation may be indicated in a subsample of patients.

Chronic Disease↗
PubMed2002

Stress response symptoms in relatives of acutely admitted psychotic patients: a pilot study.

OBJECTIVE: The aim of this study is to identify specific stress response symptoms in relatives of acutely admitted psychotic patients, and to compare these responses with those of relatives of chronic inpatients. METHOD: Twenty-five relatives of acutely hospitalized, psychotic patients and 21 relatives of chronic inpatients were assessed within days of the acute patient's admission and 6 weeks later. The Impact Event Scale assessed intrusion and avoidance; items from the General Health Questionnaire (GHQ) and the Spielberger State Anxiety Inventory (STAI) assessed arousal. RESULTS: At the first assessment, relatives of the acutely admitted psychotic patients reported higher intensity of intrusive symptoms, and more often a high arousal level compared to the relatives of chronic inpatients. Six weeks later, relatives of acutely admitted psychotic patients revealed both higher intensity and higher number of intrusive and avoidance symptoms, and higher level of arousal symptoms. Seven relatives of acutely admitted psychotic patients and no relatives of the chronic inpatients reported moderate to high level of intrusion, avoidance and arousal at both assessments. CONCLUSION: Relatives of acutely admitted psychotic patients revealed strong acute and persistent stress responses, similar to those described in subjects exposed to severe or life threatening illness. Even relatives of the chronic inpatients revealed stress-specific symptoms, but at a lower level. Specific stress response symptoms may impair the relatives' well-being, care-giving abilities, and their co-operation with the mental health system. Our results suggest that stress response symptoms in relatives should be given more attention.

Acute Disease↗
PubMed2002

Comparative levels of psychological distress, stress symptoms, depression and anxiety after childbirth--a prospective population-based study of mothers and fathers.

OBJECTIVE: To compare maternal and paternal psychological responses following birth of a healthy baby; and to explore predictors of parental psychological distress. DESIGN: A prospective, longitudinal, population-based cohort study. SETTING: A Norwegian district general hospital. POPULATION: One hundred and twenty-seven mothers and 122 fathers were included. METHODS: Eligible consenting parents were enrolled. The assessments, which were performed zero to four days after birth, at six weeks and at six months, included General Health Questionnaire-28 (GHQ-28), State Anxiety Inventory and Impact of Event Scale. The response rates at the three occasions were 97%, 85% and 71%. MAIN OUTCOME MEASURES: Symptoms of intrusion, avoidance, arousal and psychological distress including anxiety, depression, social dysfunction and somatisation. RESULTS: Clinically important psychological distress was reported by 37% of the mothers and 13% of the fathers a few days after childbirth (P < 0.001). Severe intrusive stress symptoms were reported by 9% and 2% of mothers and fathers, respectively (P = 0.002). Level of intrusive stress was the outcome that differed most clearly between mothers and fathers at all three points of time. Being a single parent, multiparity and a previous traumatic birth were significant independent predictors of acute maternal psychological distress. After six weeks and six months, the level of psychological distress including symptoms of depression fell to levels found in the general population. CONCLUSIONS: Childbirth does not seem to trigger long term psychological distress in most parents. Clinically important psychological distress occurred more frequently in mothers than in fathers. Acute maternal psychological distress was predicted by being a single parent, being multiparous, and having a previous traumatic birth.

Adolescent↗