The burden of somatic diseases among people with alcohol- and drug use disorders are influenced by mental illness and low socioeconomic status. A registry-based cohort study in Norway

Objectives: Persons with alcohol use disorder (AUD) and drug use disorder (DUD) have a lower life expectancy than the general population. We examined the burden of somatic diseases among persons with AUD or DUD and investigated impact of socioeconomic status (SES) and mental health disorders on the co-occurrence of somatic diseases in these groups. Methods: We performed a retrospective, register-based cohort study with a 6-year follow-up of persons (aged ≥18 y) with AUD (13,478) or DUD (16,659). Cox regression analyses were used to estimate hazard ratios (HRs) of somatic diseases. Results: Patients with DUD were, on average, 10 years younger at the point of diagnosis than patients with AUD. Mental illnesses were prominent in both groups (AUD: 40.5%, and DUD: 46.9% vs 3.5% in controls). Adjusting for mental disorders, the risk of all somatic diseases among the AUD and DUD groups was reduced by 30%. Some of the elevated risk of somatic diseases among persons with AUD and DUD is explained by low SES, though less than that explained by the presence of mental disorders. The diseases with highest risk among AUD patients were metabolic disorders (16.9-fold) and hypertension (14.8-fold), and among AUD patients, viral hepatitis (23.3-fold), after adjusting for low SES and mental disorders. Conclusions: Persons with AUD had a higher risk of most somatic diseases, while those with DUD had specific risks for infections and viral hepatitis. Mental health disorders and SES adjusted the associations regarding most somatic diseases. In general, improvement of socio-economic conditions, preferably in combination with professional support to self-manage mental health problems, will reduce the risk of somatic illness in both groups. For DUD patients, available sterile user equipment will reduce the risk of viral hepatis. Keywords: Alcohol use; Diseases; Drug use; Mental illness; Socioeconomic status; Somatic © 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).The burden of somatic diseases among people with alcohol- and drug use disorders are influenced by mental illness and low socioeconomic status. A registry-based cohort study in NorwaypublishedVersio

What We Know and Don't Know About Mental Health Problems Among Immigrants in Norway

Mental health problems have been regarded as one of the main public health challenges of immigrants in several countries. Understanding and generating research-based knowledge on immigrant health problems is highly relevant for planning preventive interventions, as well as guiding social and policy actions. This review aims to map the available knowledge on immigrants’ mental health status and its associated risk factors in Norway. The reviewed literature about mental health problems among immigrant populations in Norway was found through databases, such as PUBMED, EMBASE, PsychINFO and MEDLINE. About 41 peer-reviewed original articles published since 1990s were included. In the majority of the studies, the immigrant populations, specifically adult immigrants from low and middle income countries, have been found with a higher degree of mental health problems compared to Norwegians and the general population. Increased risk for mental illness is primarily linked to a higher risk for acculturative stress, poor social support, deprived socioeconomic conditions, multiple negative life events, experiences of discrimination and traumatic pre-migration experiences. However, research in this field has been confronted by a number of gaps and methodological challenges. The available knowledge indicates a need for preventive interventions. Correspondingly, it strongly recommends a comprehensive research program that addresses gaps and methodological challenges

Effects of age and gender on the relationship between alcohol use disorder and somatic diseases: a national register study in Norway

Objective - This study aimed to examine how age and gender moderate the associations between alcohol use disorders (AUD) and several somatic diseases. Design and setting - We performed a retrospective, register-based cohort study with 6-year follow-up of patients with AUD and the general population. Data were acquired from the Norwegian Patient Registry. Cox regressions were used to estimate HRs of somatic diseases. Participants - Patients with AUD (17 023; 0.4%) were compared with the population without AUD (4 271 559; 99.6%), with adults aged 18 years or older who were registered residents of Norway on 1 January 2008. Main outcomes - Dichotomous variables of 12 specific somatic diseases (cardiovascular diseases, endocrine, nutritional, and metabolic diseases, cancer, and infectious diseases) were assessed. Diagnoses were set in specialist healthcare services. Results Patients with AUD, compared with a population without AUD, experienced a significantly greater burden of all studied somatic diseases. Middle-aged adults with AUD had increased risks (p0.05). Males with AUD had significantly higher risks for pulmonary heart diseases (HR=3.9, 95% CI 3.3 to 4.6) and metabolic disorders (HR 4.7, 95% CI 4.5 to 5.0), while females with AUD had a significantly higher risk for viral hepatitis (HR=4.4, 95% CI 3.8 to 5.1). Conclusions - Age moderated the associations between AUD and most somatic diseases, with middle-aged adults with AUD having a greater increased risk of somatic diseases compared with younger and older adults with AUD. Gender only moderated associations between AUD and pulmonary heart diseases, metabolic disorders and viral hepatitis. This has implications for the prioritisation of somatic resources among patients with AUD

Immigrants’ utilization of specialist mental healthcare according to age, country of origin, and migration history: a nation-wide register study in Norway

Purpose As the immigrant population rises in Norway, it becomes ever more important to consider the responsiveness of health services to the specific needs of these immigrants. It has been questioned whether access to mental healthcare is adequate among all groups of immigrants. This study aims to examine the use of specialist mental healthcare services among ethnic Norwegians and specific immigrants groups. Methods Register data were used from the Norwegian Patient Registry and Statistics Norway. The sample (age 0–59) consisted of 3.3 million ethnic Norwegians and 200,000 immigrants from 11 countries. Poisson regression models were applied to examine variations in the use of specialist mental healthcare during 2008–2011 according to country of origin, age group, reason for immigration, and length of stay. Results Immigrant children and adolescents had overall significantly lower use of specialist mental healthcare than ethnic Norwegians of the same age. A distinct exception was the high utilization rate among children and youth from Iran. Among adult immigrants, utilization rates were generally lower than among ethnic Norwegians, particularly those from Poland, Somalia, Sri Lanka, and Vietnam. Adult immigrants from Iraq and Iran, however, had high utilization rates. Refugees had high utilization rates of specialist mental healthcare, while labour immigrants had low use. Conclusion Utilization rates of specialist mental healthcare are lower among immigrants than Norwegians. Immigrants from Poland, Somalia, Sri Lanka, and Vietnam, had generally quite low rates, while immigrants from Iran had high utilization rates. The findings suggest that specialist mental healthcare in Norway is underutilized among considerable parts of the immigrant populationpublishedVersio

Predictors of Disordered Eating in Adolescence and Young Adulthood: A Population-Based, Longitudinal Study of Females and Males in Norway

We investigated longitudinal predictors for disordered eating from early adolescence to young adulthood (12–34 years) across gender and different developmental phases among Norwegian young people. Survey data from a population-based sample were collected at four time points (T) over a 13-year time span. A population-based sample of 5,679 females and males at T1 and T2, 2,745 at T3 and 2,718 at T4 were included in analyses, and linear regression and random intercept models were applied. In adolescence, initial disordered eating and parental overprotectiveness were more strongly related to disordered eating among females, whereas loneliness was a stronger predictor for adolescent males. Initial disordered eating during early adolescence predicted later disordered eating more strongly in late- than mid-adolescence. In young adulthood, no significant gender-specific risk factors were found. The findings provide support for both shared and specific risk factors for the developmental psychopathology of disordered eating.Norges forskningsråd 19622

Explaining consequences of employment insecurity: The dynamics of scarring in the United Kingdom, Poland and Norway

This deliverable presents three country studies on scarring effects of early employment insecurity in the United Kingdom, Poland and Norway. Traditional analysis of scarring effects has favoured the analysis of the impact of the experience of unemployment on the experience of subsequent unemployment (state dependence) and the monetary costs of previous unemployment in terms of lower subsequent wages (see e.g. Arulampalam, Booth and Taylor 2000; Arulampalam, Gregg and Gregory 2001). The three present country studies go beyond the traditional analysis of scarring effects in order to better understand the trade-offs experienced by young female and male workers when faced with an insecure labour market integration. With national longitudinal data, original methodological designs and research focus, each study contributes in an original way to the research literature. All three studies pay special attention to gender and education as potential moderating variables of scarring effects

The association between early marriage and mental disorder among young migrant and non-migrant women:a Norwegian register-based study

Background Marriage is considered beneficial for mental health when stable and of high quality. Yet, it is unclear whether marriage is equally advantageous for everyone regardless of marital timing or migrant background. This study aimed to investigate the association between early marriage and mental disorder, defined by outpatient mental healthcare (OPMH) service use, and whether the association varies between migrant and non-migrant women. Methods Using data from four Norwegian national registers, we applied discrete-time logistic regression analyses to study the aims of interest, among 602 473 young women aged 17-35 years. All women were followed from 2006 or the year they turned 17, and until first OPMH consultation, 2015 (study end), the year they turned 35, when emigrated, died, or changed marital status from married to separated, divorced, or widowed. Results Results show that unmarried and early married women had increased odds of mental disorder when compared to on-time married women. However, the differences between the early and on-time married women were explained by differences in educational level. There was no significant interaction between marital status and migrant background. Conclusions Differences in mental health between early- and on time married women are attributed to poorer educational attainment of women who marry early. Furthermore, migrant background seems to have a limited role in the association between marital timing and mental disorder. The promotion of formal education among young women could contribute to the accumulation of socioeconomic and psychosocial resources, thus, reducing the risk of mental disorder, also among early married women

Inpatients experiences about the impact of traumatic stress on eating behaviors: an exploratory focus group study

This study aimed to explore trauma-exposed inpatients experiences about the impact of traumatic stress on eating behavior. Thirteen female and two male inpatients with a history of trauma, recruited from a psychiatric clinic in Norway, participated in this qualitative explorative focus group study. The results in the present study describe the participants’ experiences about the impact of after effects of traumatic experiences on eating behaviors. The findings are summarized into four main themes: “experiencing eating behaviors as coping strategies”; “experiencing being addicted to food and sweets”; “experiencing eating behaviors controlled by stress and emotions”; and “experiencing lack of appetite and reduced capacity to plan and prepare meals”. The results contribute to the existing literature and provide an important understanding of changes in eating behavior that might appear in people struggling with traumatic stress after traumatic experiences. This knowledge is important and useful for health professionals offering help to those struggling with their eating behavior after traumatic experiences.publishedVersio

Developmental Trajectories of Postpartum Weight 3 Years After Birth: Norwegian Mother and Child Cohort Study

This study explored the developmental trajectories of postpartum weight from 0.5 to 3 years after childbirth, and aimed to determine the associations between postpartum weight trajectories and prepregnancy body mass index and adequacy of gestational weight gain (GWG). Data from the Norwegian Mother and Child Cohort study were used, following 49,528 mothers 0.5, 1.5, and 3 years after childbirth. Analyses were performed using latent growth mixture modeling. Three groups of developmental trajectories of postpartum weight were found, with most women (85.9 %) having a low level of weight retention initially and slight gain over 3 years, whereas 5.6 % of women started at a high postpartum weight retention (on average 7.56 kg) at 0.5 years but followed by a marked weight loss over time (2.63 kg per year on average), and the third trajectory represented women (8.5 %) who had high weight retention high initially (on average 4.67 kg at 0.5 years) and increasing weight over time (1.43 kg per year on average). Prepregnancy overweight and obesity and excessive GWG significantly predicted a high postpartum weight trend. Women had substantial variability in postpartum weight development—both initially after birth and in their weight trajectories over time. Early preventive interventions may be designed to assist women with prepregnancy overweight and obesity and excessive GWG, which helps to reduce the increasing trend for postpartum weight