PERSONLIGHED OG SYGDOM

The article discusses the relation between personality and physical disease. First, the most important methodological problems are described and it is argued that unambiguous conclusions about the relation between personality and disease are only possible on the basis of prospective longitudinal studies of healthy individuals. Next follows a discussion of various factors that may explain the relations between personality and health: possible relations between personality and symptom/illness behavior or health related behaviors. Personality may also moderate the effects of stress ormay provoke stress, and finally there may be a relation between personality and constitutional dispositions. The Five-Factor model of personality describes five broad personality dimensions: neuroticism, extroversion-introversion, conscientiousness, hostility-agreeableness, and intelligence. The relation between each of these personality traits and health is discussed on the basis of a selective literature review. It is concluded that there is a probable association between trait depression and disease, and between hostility and disease.I artiklen diskuteres sammenhængen mellem personlighed og fysisk sygdom. Først omtales de vigtigste metodeproblemer inden for området, og det påpeges, at sikre konklusioner om sammenhængen mellem personlighed og sygdom kun kan drages på basis af prospektive longitudinelle undersøgelser af raske personer. Dernæst diskuteres forskellige modeller, der kan forklare mulige sammenhænge mellem personlighed og helbred: symptom- og sygdomsadfærd, sundhedsrelateret adfærd, individets forarbejdning af stress, individets fremprovokering af stress, og endelig en mulig relation mellem personlighed og konstitutionelle dispositioner. Fem-faktor modellen beskriver personligheden ved fem overordnede personlighedsdimensioner: neuroticisme, introversion-extroversion, samvittighedsfuldhed, fjendtlighed-venlighed, og intelligens. Sammenhængen mellem hvert af disse personlighedstræk og helbred diskuteres på basis af udvalgt litteratur, og det konkluderes, at der er en sandsynlig sammenhæng mellem depressiv indstilling og sygdom og mellem fjendtlighed og sygdom

Satisfaction of trauma-affected refugees treated with antidepressants and Cognitive Behavioural Therapy

Purpose: This study seeks to evaluate the satisfaction of trauma-affected refugees after treatment with antidepressants, psycho-education and flexible Cognitive Behavioral Therapy (CBT) including trauma exposure. Material and methods: A treatment satisfaction questionnaire was completed by patients at the end of a randomised controlled trial (RCT) comparing treatment with CBT and antidepressants. A patient satisfaction score was developed based on the questionnaire, and predictors of satisfaction were analysed in regression models. Telephone interviews were conducted with patients dropping out of treatment before the end of the trial. Results: In total, 193 trauma-affected refugees with PTSD were included in the study. Patients were overall satisfied with flexible CBT including exposure treatment in cases where this was part of the treatment. There was no statistically significant association between treatment outcome and satisfaction and satisfaction and treatment efficacy were independent of each other. The results showed that bi-cultural patients who had lived in Denmark for more than a decade were satisfied with the treatment based on a western psychotherapy model. Discussion: Treatment with selective serotonin reuptake inhibitor and flexible CBT, including trauma exposure, is acceptable for trauma-affected refugees. More studies are needed to evaluate patient satisfaction with western psychotherapy models in refugee patients who have recently arrived and to compare satisfaction with alternative treatment models

Early life predictors of intelligence in young adulthood and middle age

BACKGROUND:Studies on early predictors of intelligence often focus on single or few predictors and often on childhood intelligence. This study compared the contributions of a broad selection of potential early predictors of intelligence at different adult ages. METHODS:Information on predictors was recorded prospectively in the Copenhagen Perinatal Cohort during pregnancy, at delivery, and at 1- and 3-year examinations for children born between 1959-61. Adult intelligence was assessed at three independent follow-ups using three different tests of intelligence: Børge Priens Prøve, Wechsler Adult Intelligence Scale, and Intelligenz-Struktur-Test 2000R. From a total of 4697 cohort members, three non-overlapping samples were derived. RESULTS:The included predictors explained between 22.2-24.3% of the variance in adult IQ, with parental socioeconomic status and sex explaining 16.2-17.0%. Other consistent predictors were head circumference at birth, increase in head circumference head during the first three years, and 3-year milestones. Head circumference was the most important anthropometric measure compared to measures of weight and length. CONCLUSION:Besides social status and sex, the strongest and most consistent early predictors of adult intelligence were physical or behavioural characteristics that to some extent reflect brain-and cognitive development

Psychosocial predictors of treatment outcome for trauma-affected refugees

Background: The effects of treatment in trials with trauma-affected refugees vary considerably not only between studies but also between patients within a single study. However, we know little about why some patients benefit more from treatment, as few studies have analysed predictors of treatment outcome. Objective: The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method: The participants were 195 adult refugees with posttraumatic stress disorder (PTSD) who were enrolled in a 6- to 7-month treatment programme at the Competence Centre for Transcultural Psychiatry (CTP), Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients’ past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results: Overall, the total score of the CTP Predictor Index was significantly correlated to pre- to post treatment score changes on the majority of the ratings mentioned above. While employment status was the only single item significantly correlated to HTQ-score changes, a number of single items from the CTP Predictor Index correlated significantly with changes in depression and anxiety symptoms, but the size of the correlation coefficients were modest. Conclusions: The total score of the CTP Predictor Index correlated significantly with outcomes on most of the rating scales, but correlations were modest in size, possibly due to the number of different factors influencing treatment outcome

An association of adult personality with prenatal and early postnatal growth: the EPQ lie-scale

BACKGROUND: Recent studies have noted differences in social acquiescence and interpersonal relations among adults born preterm or with very low birth weight compared to full term adults. In addition, birth weight has been observed to be negatively correlated with lie-scale scores in two studies. We attempted to replicate and extend these studies by examining young adult lie-scale scores in a Danish birth cohort. METHOD: Weight, length and head circumference of 9125 children from the Copenhagen Perinatal Cohort were measured at birth and at 1, 3 and 6 years. A subsample comprising 1182 individuals participated in a follow-up at 20–34 years and was administered the Eysenck Personality Questionnaire (EPQ) which includes a lie-scale (indicating social acquiescence or self-insight). Associations between lie-scale scores and weight, length and head circumference respectively were analysed by multiple linear regression adjusting for single-mother status, parity, mother’s age, father’s age, parental social status, age at EPQ measurement, intelligence, and adult size. RESULTS: Male infants with lower weight, length, and head-circumference at birth and the following three years grew up to have higher scores on the lie-scale as young adults. Most of these associations remained significant after adjustment for the included covariates. No associations were found for females. Analyses were also conducted with neuroticism, extraversion and psychoticism as outcome variables, but no significant associations were found for these traits after adjustment. CONCLUSIONS: The findings replicate and extend findings from previous studies suggesting that size at birth and during the first three years of life is significantly associated with social acquiescence in adult men. They highlight the potential influence of prenatal and early postnatal development on personality growth and development

Follow-up study of the treatment outcomes at a psychiatric trauma clinic for refugees

Purpose: To describe change in mental health after treatment with antidepressants and trauma-focused cognitive behavioral therapy. Methods: Patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen completed self-ratings of level of functioning, quality of life, and symptoms of PTSD, depression, and anxiety before and after treatment. Changes in mental state and predictors of change were evaluated in a sample that all received well-described and comparable treatment. Results: 85 patients with PTSD or depression were included in the analysis. Significant improvement and effect size were observed on all rating scales (p-value <0.01 and Cohen’s d 45-0.68). Correlation analysis showed no association between severity of symptoms at baseline and the observed change. Conclusion: Despite methodological limitations, the finding of a significant improvement on all rating scales is important considering that previous follow-up studies of comparable patient populations have not found significant change in the patients’ condition after treatment

Delayed age at transfer of adoptees to adoptive parents is associated with increased mortality irrespective of social class of the adoptive parents:a cohort study

Abstract Background Adverse early life experience and development may have long-term health consequences, but later environmental conditions may perhaps protect against the effects of such early life adversities. The aim was to investigate whether cause-specific and overall mortality rates among adoptees are associated with the age at which they were transferred to the adoptive family and whether the social class of the adoptive family modifies this association. Methods A cohort of 10,592 non-familial adoptions (biologically unrelated adoptee and adoptive parents) of Danish-born children formally granted in 1924–47 and with follow-up of total and cause-specific mortality through ages up to 85 years. The rates of death after the age of 16 from all causes combined, all natural causes, all external causes, and suicide were compared according to the age at which adoptees were transferred to their adoptive family by estimating hazard ratios in Cox regression models. Results Death rates from all causes were significantly higher in adoptees transferred between age 1 month and 4 years compared to those transferred immediately after birth with the hazard ratio peaking at 1.19 (95% confidence limit: 1.08 to 1.32) for adoptees transferred between 6 and 11 months. This result was primarily driven by a similar pattern for natural causes of death. For death from external causes and for suicide the hazard ratios were increasing with increasing age at transfer, and tests for trend were statistically significant. The social class of the adoptive family did not significantly modify these associations. Conclusions Transfer to an adoptive family later than at the time of birth may have adverse long-term consequences affecting overall and cause-specific mortality. These effects were not modified by the environment provided by the adoptive family as indicated by the social class of these families