Medically unexplained symptoms and somatoform disorders: prevalence, course and comorbidity. : An eleven year general population study in Norway.

Somatoform disorders (SDs) according to present classifications (ICD-10/DSM-IV) are characterized by “medically unexplained symptoms” (MUSs), i.e. physical symptoms that cannot be fully explained by any detectable medical condition, substance or alcohol abuse. A main aim of this thesis is to contribute to the ongoing classification debate of SDs. An adult general population sample of 605 respondents from Oslo and Lofoten were interviewed with the Composite International Diagnostic Interview somatoform section in 1990. In 2001, 421 (70% response rate) were interviewed again. An additional random sample of 1,247 individuals was also interviewed in 2001. MUSs are extensively forgotten over time. Diagnostic stability for current SDs is 42%, and for lifetime SDs 33%. Except for a small group (mainly young women) at risk for chronicity, prognosis of MUS-pain is good. Six-month prevalence rate for current SDs with severe functional impairment is 10%. Comorbidity with anxiety/depression is 45% and with musculoskeletal disorders 43%. New classification of SDs should be based on current symptomatology and symptoms of anxiety/depression present if SDs are to be classified as mental disorders

Psykoedukativ behandling for voksne med oppmerksomhets- og hyperaktivitetsforstyrrelse (ADHD): hurtigoversikt

Kunnskapssenteret i Folkehelseinstituttet fikk i oppdrag fra Bestillerforum RHF å lage en hurtigoversikt over mulig relevante forskningspublikasjoner om psykoedukativ behandling for voksne med oppmerksomhets- og hyperaktivitetsforstyrrelse (Attention Deficit Hyperactivity Disorder (ADHD)). METODE: Vi gjennomførte systematiske litteratursøk i ni medisinske, helsefaglige og samfunnsvitenskapelige databaser for å identifisere relevant forskningslitteratur om voksne med ADHD og psykoedukativ behandling. Søkene ble utført i september 2016. To personer vurderte uavhengig av hverandre titler og sammendrag fra identifiserte referanser mot inklusjonskriteriene. Fra primærstudiene har vi hentet informasjon om populasjon, tiltak, utfall, og forfatternes egne konklusjoner. Vi har sett gjennom, men ikke kritisk vurdert studiene. RESULTATER: Litteratursøket identifiserte totalt 362 unike referanser. Av disse vurderte vi tre enkelststudier som relevante, alle hadde få deltakere. Vi fant ingen mulig relevante systematiske oversikter. Ut fra de foreliggende søkeresultatene kan vi ikke trekke noen konklusjon om hvorvidt psykoedukativ behandling med eller uten samtidig farmakologisk behandling er effektiv for voksne personer med ADHD. Studiematerialet utgjør et for tynt grunnlag for å kunne foreta en fullstendig metodevurdering

Contemporary use and practice of electroconvulsive therapy worldwide

To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data-based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief-pulse wave, sine-wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory-ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences

Motivational interviewing for substance abuse.

Motivational interviewing is a short psychological treatment that can help people cut down on drugs and alcohol More than 76 million people worldwide have alcohol problems, and another 15 million have drug problems. Motivational interviewing (MI) is a psychological treatment that aims to help people cut down or stop using drugs and alcohol. The drug abuser and counsellor typically meet between one and four times for about one hour each time. The counsellor expresses that he or she understands how the clients feel about their problem and supports the clients in making their own decisions. He or she does not try to convince the client to change anything, but discusses with the client possible consequences of changing or staying the same. Finally, they discuss the clients' goals and where they are today relative to these goals. We searched for studies that had included people with alcohol or drug problems and that had divided them by chance into MI or a control group that either received nothing or some other treatment. We included only studies that had checked video or sound recordings of the therapies in order to be certain that what was given really was MI. The results in this review are based on 59 studies. The results show that people who have received MI have reduced their use of substances more than people who have not received any treatment. However, it seems that other active treatments, treatment as usual and being assessed and receiving feedback can be as effective as motivational interviewing. There was not enough data to conclude about the effects of MI on retention in treatment, readiness to change, or repeat convictions.The quality of the research forces us to be careful about our conclusions, and new research may change them