[Unscientific article about biological rhythms and depression].
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Biomedical subjects
Publications and source records attributed to Vidje Hansen.
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BACKGROUND: Studies of diagnostic practice confirm that there is a diagnostic delay in diagnosing women with schizophrenia compared to diagnosing men. The aim of the present study was to investigate the diagnostic practice of Norwegian and Russian psychiatrists when it comes to early psychosis, emphasising gender differences. We wanted to study the association between patient gender as such and diagnostic decision-making among psychiatrists. MATERIALS AND METHODS: Psychiatrists in Norway and the Archangels region in Russia were invited to participate in a study of diagnostic practice, and received a written case description of a patient with early psychosis symptoms that could be interpreted as schizophrenia. They were, however, not informed that 50% of them received a female case description and 50% a male case description. Apart from the patient being described as "he" or "she" the stories were identical. Effects of patient gender, clinician gender, age and main area of interest were estimated using logistic regression analysis. RESULTS: A total of 467 psychiatrists answered the questionnaire. We found that schizophrenia diagnosis was given significantly more often to the male case than to the female case. Our finding remained significant after adjustment for country, clinician gender, age and main area of interest, and is unlikely to be explained by known biases. CONCLUSION: Patient gender in itself affects clinicians' diagnostic practice regarding schizophrenia, as schizophrenia diagnosis is given significantly more often to a male case description than to a female one, the descriptions being otherwise identical.
BACKGROUND: Over the last decades there has been an increasing pressure on the acute psychiatric wards in Norway. The major contributor to psychiatric acute admissions at the University Hospital of North Norway in the city of Tromsø in 2001 was the GP-based Tromsø Casualty Clinic, only open out-of-hours. We explored all acute psychiatric referrals from Tromsø Casualty Clinic in 2001. The purpose of the study was to characterize the admissions and assess the agreement between the referring doctors and the hospital specialists according to the need for hospitalization, agreement on application of the law and the diagnostic evaluation to assess whether the admissions were appropriate. METHODS: Retrospective, record based, descriptive study comprising 101 psychiatric acute referrals from the Tromsø Casualty Clinic to the psychiatric acute wards at the University Hospital of North Norway. RESULTS: The specialists accepted all referrals except one, they mostly agreed upon the diagnoses suggested by the referring doctors and they mostly confirmed the application of the law.Seventy-five percent of the admissions took place during weekends, public holidays or nighttimes. Diagnoses of psychoses or suicidal attempts accounted for 76 % of the total referrals. Substance abuse was noted for 43 %, and in 22 % of all admissions the patients had stopped taking their psychopharmacological medication. The police assisted the referring doctors in one third of all admissions, and was the legal representative in 52 out of 59 involuntary admissions. Thirty percent of the admissions were first- time admissions. Thirty-two percent of the hospital stays lasted for three days or less. Median length of stay was 6.5 days. CONCLUSION: The casualty clinic physicians and the hospital specialists mostly agreed in their evaluation of patients indicating that most of the admissions were appropriate. The police was more often involved in the involuntary admissions than intended in the law. The proportion of patients with substance abuse was significant. Alternative treatment strategies should be developed for non-psychotic patients in need of short-term stays.
OBJECTIVE: The aim of this study was to evaluate whether there were different seasonal variations of births in an Italian population of patients with schizophrenia, with other psychotic disorders, and with personality disorders than in the general population. METHODS: Birth dates of 1270 patients admitted to one university psychiatric unit in Rome between 1990 and 2003, with a diagnosis of schizophrenia, other psychotic disorder (OPD) and personality disorder/cluster A (PD) were analyzed according to seasonal variation. RESULTS: A significant excess of births in spring (with a peak in May) and a deficit in autumn (with a trough in October) was found in the sample of male schizophrenics (n = 506). No statistically significant variations were found in either the sample of female schizophrenics (n = 88) or in the combined sample with OPD and PD (n = 676). CONCLUSIONS: The findings serve to strengthen the existing hypotheses that schizophrenia is related to environmental factors acting on the development of the central nervous system intrauterinely.
BACKGROUND: There are very few prospective studies of mental distress in the general population. Two studies of general health in Finnmark county in northern Norway, performed 9 years apart, contained questions about depression and sleeping problems, which made it possible to study change in mental distress over time in the general population. METHODS: In a self-administered questionnaire, the subjects were asked about depression and sleeping problems, both generally and related to the dark period in winter, at two points in time: in 1987/88 and 1996/97. The persons participating in the two surveys were partly the same and partly new individuals. More than 12000 persons responded in 1987/88 and more than 7000 people in 1996/97. The cohort that answered questions about sleeping problems and depression at both time-points consisted of 3318 and 3682 persons, respectively. RESULTS: The prevalence of depression and sleeping problems, both generally and related to winter,decreased significantly in the course of the 9-year time-span. The decrease was also true for the cohort that answered at both time-points, except for sleeping problems related to winter, which were unchanged. The pattern of changes was identical for both genders and all age groups. CONCLUSIONS: Mental health in the general population seems to have improved during the period studied. The findings are also relevant for the discussion of the validity of the concept Seasonal Affective Disorder, and the presumed connection to light-deprivation.
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