Reduction in mental distress among substance users receiving inpatient treatment

<p>Abstract</p> <p>Background</p> <p>Substance users being admitted to inpatient treatment experience a high level of mental distress. In this study we explored changes in mental distress during treatment.</p> <p>Methods</p> <p>Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis.</p> <p>Results</p> <p>We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress.</p> <p>Conclusions</p> <p>The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.</p

Seasonality in pain, sleep and mental distress in patients with chronic musculoskeletal pain at latitude 69° N

This is an Accepted Manuscript of an article published by Taylor & Francis in Chronobiology International on 28 May 2020, available online: https://doi.org/10.1080/07420528.2020.1764011.Seasonality is evident in several aspects of human health and behavior, whereas seasonality in chronic pain is less well studied. We examined seasonal variation in pain severity and pain dissemination, as well as in pain-associated conditions, such as sleep impairment, sleep timing, mental distress, fatigue and physical activity. We also examined if any of these associated conditions moderated the seasonality in pain. This prospective study was conducted in the subarctic municipality of Tromsø, Norway (69º North), on a sample of patients with chronic musculoskeletal pain (N = 56). Data were collected with self-report questionnaires and objective actigraphy measures (7 days) twice: winter and summer. Mixed linear regression models were fitted. A modest seasonality effect was observed in pain severity (highest in summer), but not in pain dissemination. Seasonality with increased physical activity and delayed sleep timing in the summer was also present. The remaining pain-associated self-report or objective measures indicated no seasonality. The season–pain association was not significantly moderated by any of the pain-associated conditions. Previous studies on healthy individuals residing in polar areas have suggested an opposite seasonal effect with delay of the sleep–wake rhythm in winter. Our results based on a clinical sample thus represent a novel finding that needs to be examined further with regard to seasonal circadian entrainment and alignment in pain populations. These results may have clinical value for the treatment of patients with musculoskeletal pain as seasonality may require seasonal adjustments of pain treatment strategies

Psychological correlates to dysfunctional eating patterns among morbidly obese patients accepted for bariatric surgery

Objective: To examine the relationships between dysfunctional eating patterns, personality, anxiety and depression in morbidly obese patients accepted for bariatric surgery. Design: The study used cross-sectional data collected in running a randomized controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). Subjects: A total of 102 patients (69 women, 33 men) with a mean (SD) age of 42.6 (9.8) years and a mean BMI 43.5 (4.4) kg/m2 participated. Measurements: Measurements included the NEO PI-R (personality: neuroticism, extroversion, openness, conscientiousness and agreeableness), the TFEQ R-21 (dysfunctional eating: emotional eating (EE), uncontrolled eating (UE) and cognitive restraint of eating (CR) and the HADS (anxiety and depression). Results: The personality traits neuroticism and conscientiousness were more strongly correlated with dysfunctional eating compared with anxiety and depression. These differences were most pronounced for emotional and cognitive restraint of eating. Emotional eating occurred more often in female than male patients, a finding that was partially mediated by neuroticism but not by anxiety and depression. Conclusion: Personality traits may be important to address in the clinical management of morbidly obese patients seeking bariatric surgery as neuroticism is particularly salient in female patients displaying an emotional eating behaviour

Note to first-year university students: Just do it! In the end, the fact that you study may be more important than how you study.

Education is important to society, yet many students do not complete the educations they start. In the present study of 426 students at a Norwegian university, we examined the predictive value of study-related variables with regard to student status one and five years after initial enrollment (stayers versus dropouts). The logistic regression analyses indicated that older students and students who spent less time studying were more likely to drop out after the first year. Students who completed less ECTS during the first year were more likely to drop out after five years. Contrary to our hypothesis, learning approaches and procrastination were not significant predictors for dropout. Overall, just studying and staying (on) the course mattered more for student success in the first year than self-reported measures on how the academic work was actually done. A caveat relates to the low response rate of the study (∼9%), which is addressed in the discussion

Sleep Characteristics in Adults With and Without Chronic Musculoskeletal Pain. The Role of Mental Distress and Pain Catastrophizing

Objectives: Sleep disturbance is associated with persistence and exacerbation of chronic pain. As this relationship seems to be bidirectional, factors underpinning sleep disturbance may prove important in multimodal rehabilitation approaches. The aim of this cross-sectional study was to examine the impact of psychological symptoms on subjective and objective sleep measures in patients with chronic musculoskeletal pain (CMP), as compared with pain-free controls. Materials and Methods: Sleep was assessed by self-report questionnaires, actigraphy, and polysomnography recordings in 56 patients (75.0% female; Mage=41.7 y, SD=10.8 y) with CMP and compared with 53 matched pain-free controls (71.7% female; Mage=41.8 y, SD=10.7). Mental distress (Hopkins Symptoms Checklist [HSCL]) and Pain Catastrophizing Scale (PCS) were tested as predictors of objective and subjective sleep measures in multiple regression models, and their indirect effects were tested in bootstrapped mediation models. Results: The sleep data revealed substantially more subjective sleep disturbance (Hedge g: 1.32 to 1.47, P<0.001), moderately worse sleep efficiency in the actigraphy measures (Hedges g: 0.5 to 0.6, P<0.01), and less polysomnography measured slow wave sleep (Hedges g: 0.43, P<0.05) in patients, as compared with controls. HSCL was strongly associated with the self-reported measures Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). HSCL also partially explained the association between pain and sleep, but HSCL was not associated with any of the objective sleep measures. More pain catastrophizing was related to less slow wave sleep. Discussion: The differences in subjective and objective sleep measures indicate that they probe different aspects of sleep functioning in patients with musculoskeletal pain, and their combined application may be valuable in clinical practice. Self-reported sleep disturbance seems to overlap with affective dimensions reflected by the HSCL questionnaire

Psychometric validation of the Carers of Older People in Europe Index among family caregivers of older persons with dementia

Source at https://doi.org/10.1177/2050312118792812 .Objectives: The Carers of Older People in Europe Index is a first-stage assessment tool to detect family caregivers in need of support. This instrument assesses caregivers’ subjective perceptions of their caregiving circumstances. The present study examines the psychometric properties of the Norwegian version of the Carers of Older People in Europe Index among family caregivers for older persons with dementia living at home. Methods: Cross-sectional survey data were collected from 430 dementia caregivers. The sample was randomly split as follows: the first half of the sample was used to identify the measurement model using an exploratory factor analysis, and the second half of the sample was used to cross-validate the model using a confirmatory factor analysis. The criterion validity and reliability (internal consistency and test–retest reliability) of the Carers of Older People in Europe Index were also examined. Results: Using an exploratory factor analysis, we extracted three factors that were consistent with previous findings: negative impact of caregiving, positive values of caregiving and quality of support. This model fit the data well using a confirmatory factor analysis. Moreover, a second-order model could replace the three-factor correlated model without sacrificing the model fit, supporting the use of a global impact of caregiving score. The three factors and the global factor correlated with the criteria measures in the expected directions. The internal consistency was assessed using Cronbach’s alpha and was good for the negative impact (α = 0.86) and the quality of support (α = 0.76) factors. The positive values factor was less consistent (α = 0.64). The test–retest reliability was examined using Spearman’s rank order correlation and was good for all three factors. Conclusion: The psychometric properties of the Norwegian version of the Carers of Older People in Europe Index are good. The instrument assesses dementia caregivers’ situations across three primary factors or alternatively validly summarizes the factors in a global impact of caregiving score

Who keeps on working? The importance of resilience for labour market participation

Background It is widely recognized that individuals’ health and educational attainments, commonly referred to as their human capital, are important determinants for their labour market participation (LMP). What is less recognised is the influence of individuals’ latent resilience traits on their ability to sustain LMP after experiencing an adversity such as a health shock. Aim We investigate the extent to which resilience is independently associated with LMP and moderates the effect of health shocks on LMP. Method We analysed data from two consecutive waves of a Norwegian prospective cohort study. We followed 3,840 adults who, at baseline, were healthy and worked full time. Binary logistic regression models were applied to explain their employment status eight years later, controlling for age, sex, educational attainment, health status at baseline, as well as the occurrences of three types of health shocks (cardiovascular diseases, cancer, psychological problems). Individuals’ resilience, measured by the Resilience Scale for Adults (RSA), entered as an independent variable and as an interaction with the indicators of health shocks. In separate models, we explore the role of two further indicators of resilience; locus of control, and health optimism. Results As expected, health shocks reduce the probability to keep on working full-time. While both the RSA and the two related indicators all suggest that resilience increases the probability to keep on working, we did not find evidence that resilience moderates the association between health shocks and LMP

Factors associated with met and unmet rehabilitation needs after stroke: A multicentre cohort study in Denmark and Norway

Objectives: To examine patient-reported needs for care and rehabilitation in a cohort following different subacute pathways of rehabilitation, and to explore factors underpinning met and unmet needs. Design: Observational multicentre cohort study. Patients and methods: A total of 318 Norwegian and 155 Danish patients with first-ever stroke were included. Participants answered questions from the Norwegian Stroke Registry about perceived met, unmet or lack of need for help and training during the first 3 months post stroke. The term “training” in this context was used for all rehabilitative therapy offered by physiotherapists, occupational or speech therapists. The term “help” was used for care and support in daily activities provided by nurses or health assistants. Results: Need for training: 15% reported unmet need, 52% reported met need, and 33% reported no need. Need for help: 10% reported unmet need, 58% reported met, and 31% reported no need. Participants from both Norway and Denmark had similar patterns of unmet/met need for help or training. Unmet need for training was associated with lower functioning, (odds ratio (OR) = 0.32, p  Conclusion: Similar levels of met and unmet needs for training and help at 3 months after stroke were reported despite differences in the organization of the rehabilitation services. Functioning and psychological factors were associated with unmet rehabilitation needs

Visual problems are associated with long-term fatigue after stroke

Objective: Post-stroke fatigue may be associated with functioning even in patients with mild stroke. In order to guide rehabilitation, the aim of this study was to investigate the independent contribution of 12 function-related domains to severe long-term fatigue. Design: Observational follow-up study. Subjects: A total of 144 stroke survivors (mean age 67.3, standard deviation (SD) 10.9 years) were included. Methods: Fatigue 3–4 years post-stroke was measured with the Fatigue Severity Scale (cut-off ≥5). Independent variables were the multidimensional Stroke-Specific Quality of Life scale with 12 domains, demographics, and baseline stroke characteristics. Results: Most of the participants had mild and moderate stroke. Thirty-five percent (n = 51) reported severe fatigue 3–4 years after stroke. Those living with a significant other, and working participants reported significantly less fatigue. All domains of the Stroke-specific Quality of Life scale were significantly associated with the Fatigue Severity Scale. Adjusted for age, sex, marital status, and work status, the domains “energy”, “mood”, and, unexpectedly, the domain “vision”, were all variables independently associated with severe long-term fatigue. Conclusion: Stroke survivors with prominent self-reported visual problems were more likely to experience fatigue. This finding should be verified in further studies. Visual examination and visual rehabilitation may reduce fatigue in selected stroke survivors