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Lier H.O.,Section of Mental Health Research | Biringer E.,Section of Mental Health Research | Stubhaug B.,Section of Mental Health Research | Tangen T.,University of Bergen
Nordic Journal of Psychiatry | Year: 2013

Objective: The present study examined prevalence of psychiatric disorders before and 1 year after weight loss surgery. Furthermore, we studied if level of pre-operative shame could be a maintaining factor for psychiatric disorders at 1-year follow-up. Method: One-hundred and twenty-seven patients (F/M: 94/33) with mean body mass index (BMI) ± standard deviation (s) =45.3±5.2 kg/m2 and mean age 41.3±10.3 years participated in the study. Eighty-seven patients met for follow-up 1 year after surgery. Psychiatric disorders were assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.) and the Structured Clinical Interview (SCID-II). Levels of depression, anxiety and shame were assessed by the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Internalized Shame Scale (ISS). Results: Sixty-one patients (48%) at pre-operative assessment and 16 patients (18%) at 1-year follow-up had a comorbid psychiatric disorder. The strongest predictor of post-operative psychiatric disorder was pre-operative psychiatric disorder, odds ratio of 27.7 (95% CI for EXP (B) 3.2-239.8, P =0.003). Pre-operative level of shame (higher than 50-point ISS score) was also a significant predictor for post-operative psychiatric disorders, odds ratio of 9.1 (95% CI for EXP (B) 1.8-44.4, P =0.007). Conclusion: There was a significant reduction in prevalence of psychiatric disorders from pre-operative assessment to follow-up 1 year after surgery. Level of shame at pre-operative assessment was associated with maintenance of psychiatric problems. This finding is of clinical importance, since psychiatric disorders persisting after bariatric surgery have strong impact on the course of weight loss and quality of life. © 2013 Informa Healthcare.

Skogen J.C.,University of Bergen | Skogen J.C.,Section of Mental Health Research | Skogen J.C.,University of Stavanger | Overland S.,University of Bergen | And 3 more authors.
Addictive Behaviors | Year: 2011

The aim of this study was to examine the psychometric properties of the CAGE questionnaire, and the questionnaire's concurrent validity with current and previous alcohol consumption. This study employed data from the Nord-Trøndelag Health Survey wave 1 (HUNT-1 in 1984-86: N = 24,900) and wave 2 (HUNT-2 in 1995-97: N = 36,350). The concurrent validity of the CAGE questionnaire was examined both as a dichotomous variable with the recommended cut-off (<2 affirmative answers) for alcohol problems, and as a categorical scale. The categorical scale was constructed by counting responses from 0 to 4, and a separate category for current abstainers in HUNT-2. Current self-reported consumption above the gender specific 80th percentile was defined as "current excessive consumption". "Previous excessive consumers" were defined by meeting at least one of the two following criteria at the time of HUNT-1: reporting drinking too much alcohol in any period of their life, or reporting a high level of alcohol consumption. The internal reliability of CAGE was adequate, and in relation to alcohol consumption, there was a linear relationship between the CAGE score and both the current and previous excessive consumption. In conclusion, this study indicates good concurrent validity and adequate psychometric properties of the CAGE questionnaire. The dose-response pattern seen between the CAGE score and alcohol consumption, suggests that it can be used as an ordinal measure, rather than with a cut-off of two or more. The concurrent validity of the CAGE is better in women than in men. © 2010 Elsevier Ltd.

Skogen J.C.,University of Bergen | Skogen J.C.,Section of Mental Health Research | Skogen J.C.,University of Stavanger | Knudsen A.K.,University of Bergen | And 4 more authors.
Addiction | Year: 2012

Aims To examine associations of abstention, alcohol consumption and problem drinking with subsequent disability pensioning (DP), and whether previous excessive consumption ('sick-quitting') could explain some of the increased risk for DP among abstainers. Design Prospective population-based study. Setting and participants Data were from two waves of the Nord-Trøndelag Health Study (HUNT) linked with the national insurance database. The two main analyses included 37729 (alcohol consumption) and 34666 (problem drinking) participants. Measurements Alcohol consumption was measured by self-reported consumption, while problem drinking was assessed by the Cut down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire. Information on subsequent DP, including diagnosis for which the DP was awarded, was gathered from the national insurance database. Covariates included somatic illness and symptoms, mental health, health-related behaviour, socio-economic status and social activity. Findings Those reporting the highest level of alcohol consumption were not at increased risk for DP [hazard ratio (HR) 1.12, 95% confidence interval (CI): 0.92-1.38], whereas problem drinking was a strong predictor (HR 2.79, 95% CI: 2.08-3.75) compared to their corresponding reference groups. Alcohol abstainers were also at increased risk for DP, but among them, the previous consumers (HR 1.95, 95% CI: 1.48-2.57) and previous excessive consumers (HR 1.67, 95% CI: 1.01-2.74) were at higher risk for DP than constant abstainers. Conclusions Problem drinking is linked to subsequent requirement for a disability pension but mere alcohol consumption is not. This is partly explained by 'sick-quitting'. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Hansen A.L.,University of Bergen | Kvale G.,University of Bergen | Stubhaug B.,Section of Mental Health Research | Stubhaug B.,University of Bergen | Thayer J.F.,Ohio State University
Journal of Psychophysiology | Year: 2013

In psychotherapy research, there is a general lack of studies that include objective measurements that provide information about the basic underlying mechanisms involved in behavioral and psychiatric conditions. In this pilot study, we investigated cardiovascular activity and self-reported fatigue in patients with Chronic Fatigue Syndrome (CFS) compared to normal healthy controls who served as a reference group. Furthermore, based on a one-group pre-post design, we investigated whether exposure to a Comprehensive Cognitive Behavior Therapy (CCBT) program resulted in any changes in cardiovascular activity and self-reported fatigue in CFS patients. Overall, 19 female CFS patients and 21 normal healthy controls were included in the study. Cardiovascular activity measurements were heart rate (HR), low frequency/high frequency (LF/HF ratio), and heart rate variability (the root mean of the squared successive differences; rMSSD). Fatigue was measured using the Chalder Fatigue Questionnaire. Analyses of the results indicated that, compared to normal healthy controls, CFS patients were characterized by higher HR and self-reported fatigue prior to exposure to the CCBT. Interestingly, CFS patients showed a significant decrease in LF/HF ratio indicating a shift in sympathovagal balance toward greater vagal activation, and levels of experienced fatigue subsequent to CCBT. © 2012 Federation of European Psychophysiology Societies.

Hynninen M.J.,University of Bergen | Breitve M.H.,Section of Mental Health Research | Rongve A.,Section of Mental Health Research | Aarsland D.,University of Stavanger | And 3 more authors.
International Psychogeriatrics | Year: 2012

Background: Anxiety in persons with dementia has received little attention despite its severe consequences. In this observational cross-sectional study, we investigated the frequency of anxiety and associations between anxiety and socio-demographic and clinical variables in an outpatient sample with first-time diagnosed mild dementia. Methods: The study sample (n=169) comprised participants recruited from clinics in geriatric medicine and old age psychiatry for a longitudinal dementia study. Symptoms of anxiety were rated by a caregiver on the Neuropsychiatric Inventory (NPI) and by the patient on the anxiety tension item on the Montgomery and sberg Depression Rating Scale. Measures of caregiver stress, dementia-related impairment (Clinical Dementia Rating (CDR) scale), and cognitive functioning were also included. Results: According to caregiver reports, 19.5% had clinically significant anxiety and an additional 22.5% had subclinical anxiety. Half of the patients reported experiencing anxiety from time to time. Patients with Lewy-body dementia reported anxiety more often compared to patients with Alzheimers disease. Anxiety was associated with depression, higher caregiver stress, and more dementia-related impairment, but not with cognitive test performance. Caregiver stress and higher CDR score increased the odds for anxiety significantly, even when controlling for depression. Conclusion: Anxiety is common in patients with mild dementia, and seems to be associated not so much with cognitive test performance than with caregiver distress and the patients ability to function in daily life. Anxiety should be taken into account when assessing dementia, as well as screened for when examining patients with known dementia. © International Psychogeriatric Association 2012.

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