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Andersen LL, Bay H, Rugulies R. Study design of National Surveillance of the Work Environment of Employees in Denmark (NASWEED): Prospective cohort with register follow-up. Scand J Public Health 2024; 52:733-740. [PMID: 37387222 DOI: 10.1177/14034948231182022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
AIM The aim is to report the design and baseline data of the 'National Surveillance of the Work Environment of Employees in Denmark' study (NASWEED). METHODS NASWEED consist of (a) bi-annual cross-sectional samples, based on probability samples of wage earners of the general working population in Denmark from 2021 onwards (surveillance), (b) a prospective cohort of all previous respondents every two years (epidemiology, questionnaire follow-up) and (c) longitudinal follow-up in Danish registers about work and health (epidemiology, register follow-up). Between February and May 2021, a stratified (38 occupational industries) probability sample of 63,391 Danish residents aged 15-69 years who were employed for at least 34 hours per month received an invitation to participate, of whom 30,099 (47.5%) completed the questionnaire, 897 (1.4%) partially completed the questionnaire and 32,395 (51.1%) did not respond. Baseline was completed in June 2021. NASWEED covers various topics about the work environment (psychosocial, ergonomic, chemical, biological, safety, accidents, working from home, etc), health behaviours and somatic and mental health-related conditions. Statistical analyses will mainly build on survey procedures with model-assisted weights to ensure that the sample will yield representative estimates of the general working population. DISCUSSION NASWEED will monitor the development of the work environment and health in Denmark until 2030. The survey data will be included in epidemiological studies with repeated measurement of the work environment, health variables and covariates, and follow-ups in national registers to investigate the prospective association in the years and decades to come between the work environment and workers' health and labour market participation.
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Affiliation(s)
- Lars Louis Andersen
- National Research Centre for the Working Environment, Denmark
- Department of Health Science and Technology, Aalborg University, Denmark
| | - Hans Bay
- The Danish Working Environment Authority, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
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Jafree SR, Naveed A, Ahsan H, Burhan SK, Khan MA, Khawar A, Fischer F. Mental health and quality of life in patients with chronic liver disease: a single-center structural equation model. BMC Gastroenterol 2024; 24:193. [PMID: 38840079 PMCID: PMC11155103 DOI: 10.1186/s12876-024-03268-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 05/15/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Chronic liver disease (CLD) is one of the leading disease burdens in Pakistan. Until now, there has only been limited focus in the country on providing health services through tertiary services in urban cities, whereas there is almost no research in Pakistan on the mental health and quality of life of CLD patients. This study aimed to understand which predictors influence the mental health and quality of life of CLD patients in order to advise better policy protection. METHODS Data was collected from CLD patients at the Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan. A total of 850 respondents were part of the final sample. The age of respondents ranged from 18 to 79 years and included the following diagnosis: (i) Chronic Viral Hepatitis (n = 271), (ii) Cirrhosis (n = 259), (iii) Hepatocellular Carcinoma (n = 193), and (iv) Non-viral Liver Disease (n = 127). RESULTS Mean results reveal that females as well as illiterate patients need more support for mental health and communication with their physician; whereas men need more support to develop coping strategies. Structural equation modelling results reveal that the severity of symptoms (β = 0.24, p < 0.001), coping strategies (β=-0.51, p < 0.001), and doctor communication (β=-0.35, p < 0.001) predict mental health. Quality of life is associated with the severity of symptoms (β=-0.36, p < 0.001), coping strategies (β = 0.26, p < 0.05), and doctor communication (β = 0.09, p < 0.05). CONCLUSIONS A 'bio-psycho-social-spiritual' model is recommended for Pakistan's CLD patients which includes the integration of social officers to provide support in four key areas to secure mental health and quality of life of patients.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Lahore, Pakistan
| | - Ammara Naveed
- Pakistan Kidney Liver Institute and Research Centre, Lahore, Pakistan
| | - Humna Ahsan
- Department of Economics, Forman Christian College University, Lahore, Pakistan
| | | | - Masha Asad Khan
- Academic Dean of Humanities and Social Sciences, Kinnaird College for Women, Lahore, Pakistan
| | - Amna Khawar
- Department of Psychology, Lahore College of Women University, Lahore, Pakistan
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Lyhne JD, Smith A'B, Jensen LH, Hansen TF, Frostholm L, Timm S. Missingness mechanisms and generalizability of patient reported outcome measures in colorectal cancer survivors - assessing the reasonableness of the "missing completely at random" assumption. BMC Med Res Methodol 2024; 24:104. [PMID: 38702599 PMCID: PMC11067079 DOI: 10.1186/s12874-024-02236-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/26/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Patient-Reported Outcome Measures (PROM) provide important information, however, missing PROM data threaten the interpretability and generalizability of findings by introducing potential bias. This study aims to provide insight into missingness mechanisms and inform future researchers on generalizability and possible methodological solutions to overcome missing PROM data problems during data collection and statistical analyses. METHODS We identified 10,236 colorectal cancer survivors (CRCs) above 18y, diagnosed between 2014 and 2018 through the Danish Clinical Registries. We invited a random 20% (2,097) to participate in a national survey in May 2023. We distributed reminder e-mails at day 10 and day 20, and compared Initial Responders (response day 0-9), Subsequent Responders (response day 10-28) and Non-responders (no response after 28 days) in demographic and cancer-related characteristics and PROM-scores using linear regression. RESULTS Of the 2,097 CRCs, 1,188 responded (57%). Of these, 142 (7%) were excluded leaving 1,955 eligible CRCs. 628 (32%) were categorized as initial responders, 418 (21%) as subsequent responders, and 909 (47%) as non-responders. Differences in demographic and cancer-related characteristics between the three groups were minor and PROM-scores only marginally differed between initial and subsequent responders. CONCLUSION In this study of long-term colorectal cancer survivors, we showed that initial responders, subsequent responders, and non-responders exhibit comparable demographic and cancer-related characteristics. Among respondents, Patient-Reported Outcome Measures were also similar, indicating generalizability. Assuming Patient-Reported Outcome Measures of subsequent responders represent answers by the non-responders (would they be available), it may be reasonable to judge the missingness mechanism as Missing Completely At Random.
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Affiliation(s)
- Johanne Dam Lyhne
- Department of Oncology, University Hospital of Southern Denmark, Beriderbakken 4, Vejle, 7100, Denmark.
| | - Allan 'Ben' Smith
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Lars Henrik Jensen
- Department of Oncology, University Hospital of Southern Denmark, Beriderbakken 4, Vejle, 7100, Denmark
| | - Torben Frøstrup Hansen
- Department of Oncology, University Hospital of Southern Denmark, Beriderbakken 4, Vejle, 7100, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Signe Timm
- Department of Oncology, University Hospital of Southern Denmark, Beriderbakken 4, Vejle, 7100, Denmark
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du Prel JB, Koscec Bjelajac A, Franić Z, Henftling L, Brborović H, Schernhammer E, McElvenny DM, Merisalu E, Pranjic N, Guseva Canu I, Godderis L. The Relationship Between Work-Related Stress and Depression: A Scoping Review. Public Health Rev 2024; 45:1606968. [PMID: 38751606 PMCID: PMC11094281 DOI: 10.3389/phrs.2024.1606968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge. Methods We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria. Results Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified. Conclusion The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.
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Affiliation(s)
- Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | | | - Zrinka Franić
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Lorena Henftling
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Hana Brborović
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Damien M. McElvenny
- Research Group, Institute of Occupational Medicine, Edinburgh, United Kingdom
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, United Kingdom
| | - Eda Merisalu
- Estonian University of Life Sciences, Tartu, Estonia
| | - Nurka Pranjic
- Department of Occupational Medicine, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Unisanté, University of Lausanne, Lausanne, Switzerland
| | - Lode Godderis
- Department of Primary Care and Public Health, University of Leuven, Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
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Sørensen K, Dalsager L, Conway PM, Li J, Rugulies R. Leadership at work and risk of treatment for depressive and anxiety disorders in Denmark. A nationwide prospective study with register-based follow up. Psychiatry Res 2024; 337:115870. [PMID: 38696969 DOI: 10.1016/j.psychres.2024.115870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/10/2024] [Accepted: 03/21/2024] [Indexed: 05/04/2024]
Abstract
Positive leadership behaviours at work are associated with worker well-being and performance. However there is less knowledge about whether exposure to low levels of positive leadership behaviours increase workers' risk of clinical mental disorders. We investigated whether low levels of positive leadership behaviours are prospectively associated with risk of treatment for depressive and anxiety disorders. In a cohort study, we linked survey data from 59,743 respondents from the Work Environment and Health in Denmark survey with national health register data. Leadership behaviours were measured with an eight-item scale. Treatment was defined as redeemed prescription for antidepressants or anxiolytics or hospital treatment for depression or anxiety. Using Cox proportional hazard regression, adjusting for demographic variables, job type and sector, adverse life events and childhood adversities, we estimated the association between leadership behaviours at baseline and risk of treatment during follow-up. We identified 999 cases of depression and anxiety treatment during follow-up. Compared to high levels of leadership behaviours, exposure to medium low and low levels were associated with an increased risk of treatment after adjustment for covariates. The results suggest that low levels of positive leadership behaviours are associated with an increased risk of treatment for depressive or anxiety disorders.
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Affiliation(s)
- Kathrine Sørensen
- The National Research Centre for the Work Environment, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Louise Dalsager
- The National Research Centre for the Work Environment, Copenhagen, Denmark
| | | | - Jian Li
- Departments of Environmental Health Sciences and Epidemiology, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, USA
| | - Reiner Rugulies
- The National Research Centre for the Work Environment, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
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Vilsbøl S, Christiansen DH, Budtz CR, Andersen JH, Mose S. Change in number of pain sites - which factors are important? A 12-year prospective cohort study. BMC Musculoskelet Disord 2024; 25:219. [PMID: 38500099 PMCID: PMC10949606 DOI: 10.1186/s12891-024-07344-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/07/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Pain in multiple body sites is common and often persistent. The purpose of this prospective study was to examine the change in the number of pain sites (NPS) over time and to evaluate to which extent clinical, demographic, lifestyle and health-related factors predict a change in NPS. METHODS This was a population-based longitudinal cohort study of adults (n = 2,357). Data on pain, demographic, lifestyle, and health-related variables were collected by questionnaires in 2008 and 2020 and register data from 2006 to 2017. Data was analysed with linear regression. RESULTS We found a mean decrease in NPS over the 12-year follow-up period (-0.36 (95% CI; -0.44; -0.27) and 56% of this sample reported no change or only one pain site increase/decrease over 12 years. While participants reporting pain for less than 3 months at baseline had almost no change in NPS (-0.04 (95% CI; -0.18; 0.10)), participants with pain for longer than 3 months decreased by -0.51 (95% CI; -0.62; -0.41). Age at baseline (20-49 years), pain intensity, and obesity (BMI ≥ 30) were associated with an increase in NPS over the follow-up period. CONCLUSIONS NPS is relatively stable over time. We found a small mean decrease in NPS over 12 years varying between participants with pain for longer than 3 months and pain for less than 3 months respectively. The results also indicate that pain intensity, age, and obesity could be relevant factors to consider when predicting change in NPS.
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Affiliation(s)
- Susanne Vilsbøl
- School of Physiotherapy, VIA University College, Holstebro, Denmark
| | - David Høyrup Christiansen
- Centre for Research in Health and Nursing, Research, Regional Hospital Central Jutland, Viborg, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark & Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Cecilie Rud Budtz
- Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark & Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Center, Goedstrup Hospital, Aarhus University, Herning, Denmark
| | - Søren Mose
- School of Physiotherapy, VIA University College, Holstebro, Denmark.
- Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark.
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Ingeman K, Frostholm L, Wellnitz KB, Wright K, Frydendal DH, Onghena P, Rask CU. Internet-Delivered Therapy for Parents With Health Anxiety by Proxy: Protocol for a Single-Case Experimental Design Study. JMIR Res Protoc 2023; 12:e46927. [PMID: 37999936 DOI: 10.2196/46927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Health anxiety (HA) by proxy is described as parents' obsessive worries that their child is severely ill although this is not medically confirmed. Research on HA by proxy suggests that it is highly distressing for the parent and that the child may be at risk of developing maladaptive symptom coping strategies. No targeted treatment for this group exists. We developed PROXY, an 8-week psychological internet-delivered treatment for parents with HA by proxy. The treatment components of PROXY are informed by cognitive behavioral therapy as well as acceptance and commitment therapy, and it was developed in collaboration with parents experiencing HA by proxy and clinical experts. OBJECTIVE This paper describes the protocol for a study investigating the potential effects of PROXY on parents' worries about their children's health using a single-case experimental design (SCED). METHODS Five parents clinically evaluated as experiencing HA by proxy will be included. A replicated randomized SCED study will be conducted in which each participant will be randomized to receive treatment after a baseline period of between 7 and 26 days (phase A). The treatment phase duration is 8 weeks for all participants (phase B), followed by a follow-up phase lasting between 14 and 33 days (phase C), ensuring that all participants remain in the study for 96 days. Participants will report daily anxiety level by SMS text message throughout the study. They will also answer self-report questionnaires, including questions on HA by proxy and own HA, 4 times during the study. Data will be submitted to structured visual analysis to inspect anxiety level, the variability of anxiety, trends, the overlap of data points among phases, when effects occur, and the consistency of data patterns across participants. Furthermore, randomization tests will be conducted for each participant to test the null hypothesis that PROXY will have no effect on participants' anxiety. RESULTS The recruitment of parents began in June 2022. As of March 2, 2023, a total of 4 parents have been included in the study. Data collection was expected to cease in April 2023. CONCLUSIONS To the best of our knowledge, this protocol describes the only study of treatment for HA by proxy. As the prevalence of this condition is still unknown, a SCED was chosen because this method allows the inclusion of very few participants while still providing information on effects and treatment courses. Conducting the study with a replicated randomized phase design enables methodologically sound testing despite the inclusion of very few participants. The results will inform researchers on individual treatment courses and effects, which may direct future research in terms of the possible mechanisms of change, ideas for how to refine the treatment content, and how the treatment may be offered to patients in the future. TRIAL REGISTRATION ClinicalTrials.gov NCT04830605; https://clinicaltrials.gov/study/NCT04830605. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46927.
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Affiliation(s)
- Katrine Ingeman
- Research Unit, Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Lisbeth Frostholm
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Kaare Bro Wellnitz
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Kristi Wright
- Department of Psychology, Faculty of Arts, University of Regina, Regina, SK, Canada
| | - Ditte Hoffmann Frydendal
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Patrick Onghena
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Charlotte Ulrikka Rask
- Research Unit, Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Lyhne JD, Smith AB, Timm S, Simard S, Jensen LH, Frostholm L, Fink P. Validity and screening capacity of the FCR-1r for fear of cancer recurrence in long-term colorectal cancer survivors. Support Care Cancer 2023; 31:690. [PMID: 37950072 PMCID: PMC10638160 DOI: 10.1007/s00520-023-08159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Existing fear of cancer recurrence (FCR) screening measures is being shortened to facilitate clinical use. This study aimed to evaluate the validity and screening capacity of a single-item FCR screening measure (FCR-1r) in long-term colorectal cancer (CRC) survivors with no recurrence and assess whether it performs as well in older as in younger survivors. METHODS All Danish CRC survivors above 18, diagnosed and treated with curative intent between 2014 and 2018, were located through a national patient registry. A questionnaire including the FCR-1r, which measures FCR on a 0-10 visual analog scale, alongside the validated Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) as a reference standard was distributed between November 2021 and May 2023. Screening capacity and cut-offs were evaluated with a receiver-operating characteristic analysis (ROC) in older (≥ 65 years) compared to younger (< 65 years) CRC survivors. Hypotheses regarding associations with other psychological variables were tested as indicators of convergent and divergent validity. RESULTS Of the CRC survivors, 2,128/4,483 (47.5%) responded; 1,654 (36.9%) questionnaires were eligible for analyses (median age 76 (range 38-98), 47% female). Of the responders, 85.2% were aged ≥ 65. Ninety-two participants (5.6%) reported FCRI-SF scores ≥ 22 indicating clinically significant FCR. A FCR-1r cut-off ≥ 5/10 had 93.5% sensitivity and 80.4% specificity for detecting clinically significant FCR (AUC = 0.93, 95% CI 0.91-0.94) in the overall sample. The discrimination ability was significantly better in older (AUC = 0.93, 95% CI 0.91-0.95) compared to younger (0.87, 95% (0.82-0.92), p = 0.04) CRC survivors. The FCR-1r demonstrated concurrent validity against the FCRI-SF (r = 0.71, p < 0.0001) and convergent validity against the short-versions of the Symptom Checklist-90-R subscales for anxiety (r = 0.38, p < 0.0001), depression (r = 0.27, p < 0.0001), and emotional distress (r = 0.37, p < 0.0001). The FCR-1r correlated weakly with employment status (r = - 0.09, p < 0.0001) and not with marital status (r = 0.01, p = 0.66) indicating divergent validity. CONCLUSIONS The FCR-1r is a valid tool for FCR screening in CRC survivors with excellent ability to discriminate between clinical and non-clinical FCR, particularly in older CRC survivors.
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Affiliation(s)
- Johanne Dam Lyhne
- Department of Clinical Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
| | - Allan Ben Smith
- South West Sydney Clinical Campuses, Faculty of Medicine and Health, University of New South Wales (UNSW Sydney), Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia
| | - Signe Timm
- Department of Clinical Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Sébastien Simard
- Université du Québec À Chicoutimi (UQAC), Health Sciences Department, 555, Boul. de L'Université, Chicoutimi (Qc), Canada
| | - Lars Henrik Jensen
- Department of Clinical Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, 8000, Aarhus C, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, 8000, Aarhus C, Denmark
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Jacobsen SA, Frostholm L, Buhmann CB, Petersen MW, Ørnbøl E, Dantoft TM, Bjerregaard AA, Eplov LF, Carstensen TBW. Are Sexual Assaults Related to Functional Somatic Disorders? A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6947. [PMID: 37887685 PMCID: PMC10606494 DOI: 10.3390/ijerph20206947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
An increasing number of sexual assaults (SAs) are being reported. This study investigated associations between SA and FSD, conceptualized as bodily distress syndrome (BDS), and five functional somatic syndromes (FSSs): chronic widespread pain (CWP), irritable bowel (IB), chronic fatigue (CF), multiple chemical sensitivity (MCS), and whiplash-associated disorder (WAD). Participants (n = 7493) from the population-based cohort Danish Study of Functional Disorders (DanFunD) completed questionnaires on FSD, emotional distress, SA, and sociodemographics. Risk ratios (RRs) for each FSD and emotional distress were calculated in nine models with SA as the primary exposure using generalized linear models with binomial family and log link and were adjusted for other potential risk factors. The results showed that SA was associated with single-organ FSD (RR = 1.51; 95% CI = 1.22-1.87), multi-organ FSD (RR = 3.51; 95% CI = 1.89-6.49), CWP (RR = 1.28; 95% CI = 0.83-1.98), IB (RR = 2.00; 95% CI = 1.30-3.07), CF (RR = 1.81; 95% CI = 1.42-2.32), WAD (RR = 2.62; 95% CI = 1.37-5.03), MCS (RR = 3.04; 95% CI = 1.79-5.17), emotional distress (RR = 1.75; 95% CI = 1.21-2.54), and health anxiety (RR = 1.65; 95% CI = 1.10-2.46). Overall, SA victims experienced significantly more somatic symptoms than individuals not exposed to SA. Adjusting for physical and emotional abuse did not change the observed associations. Our results suggest a large impact of SA on the overall somatic and mental health of SA victims. Due to the cross-sectional study design, further studies are required.
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Affiliation(s)
- Sofie Abildgaard Jacobsen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8200 Aarhus N, Denmark; (L.F.); (M.W.P.); (E.Ø.); (T.B.W.C.)
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8200 Aarhus N, Denmark; (L.F.); (M.W.P.); (E.Ø.); (T.B.W.C.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | | | - Marie Weinreich Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8200 Aarhus N, Denmark; (L.F.); (M.W.P.); (E.Ø.); (T.B.W.C.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Eva Ørnbøl
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8200 Aarhus N, Denmark; (L.F.); (M.W.P.); (E.Ø.); (T.B.W.C.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Thomas Meinertz Dantoft
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, 2000 Frederiksberg, Denmark; (T.M.D.); (A.A.B.)
| | - Anne Ahrendt Bjerregaard
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, 2000 Frederiksberg, Denmark; (T.M.D.); (A.A.B.)
- Department of Epidemiology Research, Statens Serum Institute, 2300 Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Centre for Mental Health—CORE (Eplov), Mental Health Centre Copenhagen, Copenhagen University Hospital, 2100 Copenhagen, Denmark;
| | - Tina Birgitte Wisbech Carstensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8200 Aarhus N, Denmark; (L.F.); (M.W.P.); (E.Ø.); (T.B.W.C.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
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10
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Gehrt TB, Macoveanu J, Bailey CJ, Fisher PM, Pallesen KJ, Frostholm L. Resting-state connectivity and neural response to emotional images in patients with severe health anxiety: An fMRI study. J Affect Disord 2023; 324:370-378. [PMID: 36587909 DOI: 10.1016/j.jad.2022.12.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/21/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Severe health anxiety is a disorder characterized by a persistent preoccupation with one's health. In behavioral studies, biases in the processing of health-related stimuli (e.g., pictures, words) are consistently associated with health anxiety symptoms. The neural correlates of the observed behavioral abnormalities remain however poorly understood. METHODS In this functional magnetic resonance imaging study, 22 treatment-seeking patients with severe health anxiety and 22 control participants performed a resting-state and a picture matching task. Immediately after the resting-state, participants completed a questionnaire quantifying their thoughts and feelings during rest along several dimensions. The picture task included images of health-related and neutral scenes and of disgusted and neutral faces. RESULTS Compared to controls, patients with health anxiety showed increased functional connectivity in the dorsolateral prefrontal cortex within the left fronto-parietal resting-state network, which correlated positively with the self-reported thought dimensions of Self, Health Concern, and Thought Suppression. In the picture matching task, no significant group differences were found in the hypothesised regions (amygdala and insula) or at a whole-brain level in response to either health-related versus neural scenes or disgust versus neutral faces contrasts. LIMITATIONS A relatively small sample size and that no information about patients declining to participate was obtained. CONCLUSIONS Our findings suggest that behavioral biases in health anxiety may be related to aberrant left dorsolateral prefrontal cortex functional connectivity at rest. In contrast, the health anxiety patients did not show significant hyperactivations of amygdala and insula during processing of emotional stimuli, contrasting findings in other anxiety disorders.
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Affiliation(s)
- Tine B Gehrt
- Center on Autobiographical Memory Research, Aarhus University, Denmark.
| | - Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Denmark
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11
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Jafree SR, Nadir SMH, Mahmood QK, Burhan SK. The migrant Hazara Shias of Pakistan and their social determinants for PTSD, mental disorders and life satisfaction. J Migr Health 2023; 7:100166. [PMID: 36794096 PMCID: PMC9922968 DOI: 10.1016/j.jmh.2023.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 12/13/2022] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Background Ensuring safety and wellbeing of all the minority populations of Pakistan is essential for collective national growth. The Pakistani Hazara Shias are a marginalized non-combative migrant population who face targeted violence in Pakistan, and suffer from great challenges which compromise their life satisfaction and mental health. In this study, we aim to identify the determinants of life satisfaction and mental health disorders in Hazara Shias and ascertain which socio-demographic characteristics are associated with post-traumatic stress disorder (PTSD). Methods We used a cross-sectional quantitative survey, utilizing internationally standardized instruments; with an additional qualitative item. Seven constructs were measured, including household stability; job satisfaction; financial security; community support; life satisfaction; PTSD; and mental health. Factor analysis was performed showing satisfactory Cronbach alpha results. A total of 251 Hazara Shias from Quetta were sampled at community centers through convenience method based on their willingness to participate. Results Comparison of mean scores shows significantly higher PTSD in women and unemployed participants. Regression results reveal that people who have low community support, especially from national and ethnic community, religious community, and other community groups, had higher risk of mental health disorders. Structural equation modeling identified that four study variables contribute to greater life satisfaction, including: household satisfaction (β = 0.25, p < 0.001); community satisfaction (β = 0.26, p < 0.001); financial security (β = 0.11, p < 0.05); and job satisfaction (β = 0.13, p < 0.05). Qualitative findings revealed three broad areas which create barriers to life satisfaction, including: fears of assault and discrimination; employment and education problems; and financial and food security issues. Conclusions The Hazara Shias need immediate assistance from state and society to improve safety, life opportunities, and mental health. Interventions for poverty alleviation, mental health, and fair education and employment opportunities need to be planned in partnership with the primary security issue.
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Affiliation(s)
- Sara Rizvi Jafree
- Associate Professor & Chair, Department of Sociology, Forman Christian College University, Pakistan,Corresponding author.
| | - Syed Mujtaba Hasnain Nadir
- Gastroenterology and Clinical Informatics Speciality Trainee Registrar, Health Education England, North West Deanery, UK
| | - Qaisar Khalid Mahmood
- Assistant Professor, Department of Sociology, International Islamic University, Pakistan
| | - Syeda Khadija Burhan
- Assistant Professor, Department of Education, Forman Christian College University, Pakistan
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12
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Pedersen J, Framke E, Thorsen SV, Sørensen K, Andersen MF, Rugulies R, Solovieva S. The linkage of depressive and anxiety disorders with the expected labor market affiliation (ELMA): a longitudinal multi-state study of Danish employees. Int Arch Occup Environ Health 2023; 96:93-104. [PMID: 35857111 PMCID: PMC9823083 DOI: 10.1007/s00420-022-01906-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/29/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Depressive and anxiety disorders are prevalent among employees in general. Still, knowledge regarding the contribution of these disorders to the dynamics of the labor market in terms of working time, sickness absence, and unemployment is scarce. We aim to quantify the linkage of depressive and anxiety disorders with labor market participation using the expected labor market affiliation method (ELMA), in a large sample of Danish employees. METHODS We combined three survey waves on occupational health with six high-quality national registers in N = 43,148 Danish employees, of which the 2012 survey contributed 29,665 person years, the 2014 survey 33,043 person years, and the 2016 survey 35,375 person years. We used the new ELMA method to estimate the multi-state transition probabilities and 2-year expected time in work, sickness absence, and unemployment. Depressive and anxiety disorders were assessed by the Major Depression Inventory and the SCL-ANX4 scales, respectively. We adjusted for multiple variables by applying inverse probability weighting in groups of gender and age. RESULTS Depressive and anxiety disorders among employees link to reduced labor market affiliation by significantly changed transitions probabilities between the labor markets states, viewed as reduced working time by 4-51 days (in two years), increased time in sickness absence by 6-44 days (in two years), and unemployment by 6-12 days (in two years) when compared to employees without depression or anxiety disorders. The results were most pronounced for women employees and for employees with both depression and anxiety disorders. CONCLUSIONS The study reveals detailed insight into what extent depression and anxiety disorders influence the labor market affiliation, in terms of the complex interrelation between working time, sickness absence, and unemployment. The study emphasizes the importance of preventing and handling depressive and anxiety disorders among employees for strengthening work participation.
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Affiliation(s)
- Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
- The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Kathrine Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
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13
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Characteristics of a Danish Post-COVID Cohort Referred for Examination due to Persistent Symptoms Six Months after Mild Acute COVID-19. J Clin Med 2022; 11:jcm11247338. [PMID: 36555954 PMCID: PMC9783804 DOI: 10.3390/jcm11247338] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Post-COVID Clinics were recommended for patients with persistent symptoms following COVID-19, but no specific tests were suggested for evaluation. This study aimed to present a post-COVID clinic patient cohort and evaluate the use of a post-COVID symptom questionnaire (PCQ) score. METHODS Patients were referred from a population of approximately 1 million citizens. PCQ and standardized health scales were registered. Descriptive analyses were performed to assess the prevalence of symptoms, and correlation analyses was undertaken to asses convergent and discriminant trends between PCQ scores and health scales. RESULTS Of 547 patients, 447 accepted inclusion. The median age was 47 years and 12% of the patients were hospitalized. At a median of 6.3 (IQR 4.4-9.9) months after the onset of symptoms, 82% of the patients reported both physical exhaustion and concentration difficulties. Functional disability and extreme fatigue were reported as moderate to severe by 33% and 62% of the patients, respectively. The PCQ score correlated significantly with each of the standardized health scales. CONCLUSION Patients referred to a Post-COVID Clinic were previously generally healthy. At the time of diagnosis, they reported multiple symptoms with severely affected health. The PCQ score could be used as valid measure of Post-COVID severity.
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14
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Gehrt TB, Obermann M, Toth FE, Frostholm L. Adverse childhood experiences in patients with severe health anxiety: No evidence for an increased frequency compared to patients with obsessive-compulsive disorder. Scand J Psychol 2022; 63:565-572. [PMID: 35778854 PMCID: PMC9796245 DOI: 10.1111/sjop.12856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/01/2022] [Accepted: 06/13/2022] [Indexed: 01/01/2023]
Abstract
Theoretical models of health anxiety emphasize adverse childhood experiences in the development of the disorder, but few studies examine such events in patients with severe health anxiety and the results are difficult to compare across studies. The present study examined adult retrospective reports of illness-related and traumatic childhood experiences in 31 patients with severe health anxiety, 32 non-clinical control participants, and a clinical control group of 33 patients with obsessive-compulsive disorder. No evidence of an increased frequency of adverse childhood experiences in patients with severe health anxiety was found. However, patients with severe health anxiety who had experienced the death of a friend or family member or a major upheaval during childhood, perceived these events as having been more traumatic than the control participants. These findings suggest that biases in how adverse childhood experiences are interpreted or remembered might play a role in severe health anxiety. The findings are discussed in relation to the cognitive behavioral model of health anxiety, and some of the processes in interpretation and memory that could explain how adverse childhood experiences might play a role in the development and maintenance of severe health anxiety are outlined.
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Affiliation(s)
- Tine B. Gehrt
- Center on Autobiographical Memory ResearchAarhus UniversityAarhusDenmark
| | - Marie‐Louise Obermann
- Research Clinic for Functional DisordersAarhus University HospitalAarhusDenmark,Clinic for OCD and Anxiety DisordersAarhus University HospitalAarhusDenmark
| | - Fruzsina Eva Toth
- Clinic for OCD and Anxiety DisordersAarhus University HospitalAarhusDenmark,Regional Psychiatry Unit, Silkeborg HospitalCentral Denmark RegionSilkeborgDenmark
| | - Lisbeth Frostholm
- Research Clinic for Functional DisordersAarhus University HospitalAarhusDenmark,Department of Clinical MedicineAarhus UniversityAarhusDenmark
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15
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Christensen TN, Poulsen CH, Ebersbach BK, Eplov LF. Integrated mental health care and vocational rehabilitation intervention to improve return to work rates for people on sick leave due to common mental and functional disorders (IBBIS-II)-a study protocol for a randomized clinical trial. Trials 2022; 23:820. [PMID: 36175977 PMCID: PMC9522440 DOI: 10.1186/s13063-022-06718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental illness has an estimated financial burden on the Danish economy of 3.4% of the gross national product every year due to lost productivity, social benefits, and healthcare costs, and approximately 50% of people receiving long-term sickness benefits have a common mental illness. Furthermore, a significant treatment gap exists where less than 30% are treated for their mental illness. The primary objective of the randomized trial is to examine whether people on sick leave with a diagnosis of anxiety, depression, stress, personality disorders, or functional disorders return to work faster and have higher job retention if they receive an integrated and optimized vocational rehabilitation and mental health care intervention, compared to people who receive the standard mental health care and vocational rehabilitation service. METHODS The trial is designed as an investigator-initiated, randomized, two-group parallel, assessor-blinded, superior trial. A total of 900 participants with a common mental illness will randomly be assigned into two groups: (1) IBBIS-II, consisting of integrated mental health care and vocational rehabilitation, or (2) service as usual (SAU), at two sites in Denmark. The primary outcome is the difference between the two groups in time to return to work (RTW) at 12 months using data from the Danish Register for Evaluation of Marginalization (DREAM) database. DISCUSSION This study will contribute with new knowledge on vocational recovery and integrated vocational and health care interventions in a Scandinavian context. TRIAL REGISTRATION ClinicalTrials.gov NCT04432129 . Registered on June 16, 2020.
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Affiliation(s)
- Thomas Nordahl Christensen
- Copenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen, Denmark.
| | - Chalotte Heinsvig Poulsen
- Copenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Bea Kolbe Ebersbach
- Copenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen, Denmark
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16
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Ugbe UMJ, Esu EB, Efut JA, Bisongedam MM, Awa TM, Ekpo OI. Sociodemographic correlates and associated factors of depression and anxiety among internally displaced adults in Ogoja, Nigeria. Gen Psychiatr 2022; 35:e100749. [PMID: 35572773 PMCID: PMC9058780 DOI: 10.1136/gpsych-2022-100749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background Displaced persons in Nigeria experience various difficulties at different stages of their displacement, including mental and physical problems. These experiences have been associated with different types of mental disorders. Aims This study sought to identify sociodemographic correlates and other factors associated with depression and anxiety among internally displaced adults in Ogoja, Cross River State, Nigeria. Methods A cross-sectional study was conducted using non-probability and probability sampling techniques. Internally displaced adults (n=335) were identified in Ogoja locations with a high prevalence of internally displaced persons (IDPs). Their mental health symptoms were assessed using the Common Mental Disorder Questionnaire, and a semistructured questionnaire was employed to collect data on sociodemographic and displacement-related characteristics. Data were analysed using descriptive statistics, χ2 analysis and multivariable logistic regression. Results The prevalence of subtypes was 66.0% for anxiety disorder and 73.4% for depression. Factors found to be significant in each bivariate χ2 analysis were modelled for each outcome. The multivariate analysis revealed that prolonged displacement (adjusted odds ratio (AOR)=3.64; p=0.048), reduced family size (AOR=0.28; p<0.001) and fears of reprisal attacks (AOR=4.19; p=0.004) were significantly associated with anxiety disorder. Male gender (AOR=2.09; p=0.015), prolonged displacement (AOR=3.55; p=0.020), reduced family size (AOR=0.55; p=0.049), financial strain (AOR=5.43; p=0.023) and loss of loved ones (AOR=1.92; p=0.040) were significantly associated with depression. Conclusions The implications of the findings underline the complex aetiology of these two mental problems and the need to cater to the well-being of those at risk who have been exposed to trauma-related events. Accessible and affordable mental health services should be provided for these persons while also considering a social welfare scheme that covers their health expenses. Moreover, socioeconomic conditions targeting IDPs in the Ogoja Local Government Area should be improved by conducting large-scale mapping to identify this population.
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Affiliation(s)
| | | | - Joseph Ajah Efut
- Public Health, University of Calabar, Calabar, Cross River, Nigeria
| | | | - Theresa Mark Awa
- Public Health, University of Calabar, Calabar, Cross River, Nigeria
| | - Ofem Irom Ekpo
- Public Health, University of Calabar, Calabar, Cross River, Nigeria
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17
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Housing environment and mental health of Europeans during the COVID-19 pandemic: a cross-country comparison. Sci Rep 2022; 12:5612. [PMID: 35379838 PMCID: PMC8978496 DOI: 10.1038/s41598-022-09316-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/21/2022] [Indexed: 01/01/2023] Open
Abstract
AbstractMany studies have investigated the impact of the COVID-19 pandemic on mental health. Throughout the pandemic, time spent at home increased to a great extent due to restrictive measures. Here we set out to investigate the relationship between housing conditions and the mental health of populations across European countries. We analyzed survey data collected during spring 2020 from 69,136 individuals from four cohorts from Denmark, France, and the UK. The investigated housing conditions included household density, composition, and crowding, access to outdoor facilities, dwelling type, and urbanicity. The outcomes were loneliness, anxiety, and life satisfaction. Logistic regression models were used, and results were pooled using random-effects meta-analysis. In the meta-analysis, living alone was associated with higher levels of loneliness (OR = 3.08, 95% CI 1.87–5.07), and lower life satisfaction (OR = 1.27, 95% CI 1.05–0.55), compared to living with others. Not having access to an outdoor space and household crowding were suggestively associated with worse outcomes. Living in crowded households, living alone, or lacking access to outdoor facilities may be particularly important in contributing to poor mental health during a lockdown. Addressing the observed fundamental issues related to housing conditions within society will likely have positive effects in reducing social inequalities, as well as improving preparedness for future pandemics.
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18
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Holm T, Mors O. Psychological adjustment following mechanical restraint in individuals with schizophrenia. Nord J Psychiatry 2022; 76:104-113. [PMID: 34182878 DOI: 10.1080/08039488.2021.1939417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM While it is known that being mechanically restrained during hospitalization can, in severe cases, lead to PTSD in individuals with mental illness, less is known about why some develop posttraumatic stress reactions following restraint while others do not. This study examined whether the amount of exposure to mechanical restraint and patients' interpretations of the episodes' centrality to their identity were related to symptoms of PTSD in individuals with schizophrenia. METHODS We asked 20 individuals to recall mechanical restraint episodes and rate them on centrality to identity. They also completed scales measuring symptoms of posttraumatic stress, depression, trauma history, and were rated on positive and negative symptoms. Objective information about the number of times they had been restrained was obtained through Danish health registries. RESULTS Amount of exposure to mechanical restraint was not significantly related to PTSD symptoms, potentially due to limitations of our small sample. However, interpreting episodes as more central to identity was. This relationship remained significant when controlling for trauma history, positive symptoms, and depression. CONCLUSION The results suggest that clinically significant levels of PTSD are common in this population, and that considering patients' subjective interpretations of restraint episodes, and not merely the objective facts surrounding them is important for patients' psychological adjustment.
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Affiliation(s)
- Tine Holm
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
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19
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Pedersen MT, Andersen TO, Clotworthy A, Jensen AK, Strandberg-Larsen K, Rod NH, Varga TV. Time trends in mental health indicators during the initial 16 months of the COVID-19 pandemic in Denmark. BMC Psychiatry 2022; 22:25. [PMID: 35012486 PMCID: PMC8743441 DOI: 10.1186/s12888-021-03655-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/13/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and its associated national lockdowns have been linked to deteriorations in mental health worldwide. A number of studies analysed changes in mental health indicators during the pandemic; however, these studies generally had a small number of timepoints, and focused on the initial months of the pandemic. Furthermore, most studies followed-up the same individuals, resulting in significant loss to follow-up and biased estimates of mental health and its change. Here we report on time trends in key mental health indicators amongst Danish adults over the course of the pandemic (March 2020 - July 2021) focusing on subgroups defined by gender, age, and self-reported previously diagnosed chronic and/or mental illness. METHODS We used time-series data collected by Epinion (N=8,261) with 43 timepoints between 20 March 2020 and 22 July 2021. Using a repeated cross-sectional study design, independent sets of individuals were asked to respond to the Copenhagen Corona-Related Mental Health questionnaire at each timepoint, and data was weighted to population proportions. The six mental health indicators examined were loneliness, anxiety, social isolation, quality of life, COVID-19-related worries, and the mental health scale. Gender, age, and the presence of previously diagnosed mental and/or chronic illness were used to stratify the population into subgroups for comparisons. RESULTS Poorer mental health were observed during the strictest phases of the lockdowns, whereas better outcomes occurred during reopening phases. Women, young individuals (<34 yrs), and those with a mental- and/or chronic illness demonstrated poorer mean time-series than others. Those with a pre-existing mental illness further had a less reactive mental health time-series. The greatest differences between women/men and younger/older age groups were observed during the second lockdown. CONCLUSIONS People with mental illness have reported disadvantageous but stable levels of mental health indicators during the pandemic thus far, and they seem to be less affected by the factors that result in fluctuating time-series in other subgroups.
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Affiliation(s)
- Michelle T Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Thea O Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amy Clotworthy
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas K Jensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
- , Bartholinsgade 6Q, DK-1356, Copenhagen, Denmark.
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20
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Rolving N, Agerbo K, Aalkjær Clausen S, Denby KAR, Jacobsen AP, Langagergaard V. Does group-based cognitive therapy improve functional ability, pain, catastrophic thoughts and quality of life in patients with persistent low back pain and psychological risk factors? A randomised controlled trial in a secondary care setting. Clin Rehabil 2021; 36:317-330. [PMID: 34967224 DOI: 10.1177/02692155211056202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effects of a group-based cognitive behavioural intervention for patients with persistent low back pain (LBP) and psychological risk factors referred to secondary care. DESIGN A randomised controlled trial. SETTING Silkeborg Regional Hospital, Denmark. SUBJECTS A total of 136 participants with chronic LBP and psychological risk factors. INTERVENTIONS Participants were randomised to the standard care group, including examination by a rheumatologist and/or a physiotherapist, or the intervention group, including standard care plus a multidisciplinary group-based pain management programme. MAIN MEASURES Patient-reported outcomes were collected at baseline and after 6 and 12 months. The primary outcome was disability (Roland Morris Disability Questionnaire). Secondary outcomes included low back pain intensity, pain catastrophising, health-related quality of life, and sick leave. RESULTS Among 136 participants, 68 (mean age: 41.7 years (SD 11.8)) were randomised to standard care and 68 (mean age: 46.0 years (SD 10.8)) were randomised to the intervention group. Except for age, baseline characteristics were comparable between groups. 12-month follow-up was completed by 92.6% in the intervention group and 80.9% in the standard care group. Both groups achieved significant improvements on disability, with a reduction of -4.8 points (SD 6.1) in the intervention group compared to -3.7 points (SD 5.2), resulting in an insignificant difference between groups. No significant differences were found in the secondary outcomes. CONCLUSION A group-based pain management programme was no more effective than standard care for patients with persistent LBP and psychological risk factors.
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Affiliation(s)
- Nanna Rolving
- 224712DEFACTUM, Corporate Quality, Central Denmark Region, Aarhus, Denmark.,Spine Center, Diagnostic Center, 53179Silkeborg Regional Hospital, Silkeborg, Denmark.,Department of Public Health, 1006Aarhus University, Aarhus, Denmark
| | - Karina Agerbo
- Spine Center, Diagnostic Center, 53179Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Stine Aalkjær Clausen
- Spine Center, Diagnostic Center, 53179Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Kate Ane Rauff Denby
- Spine Center, Diagnostic Center, 53179Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Anna Puk Jacobsen
- Department of Social Affairs and Employment, Aarhus Municipality, Aarhus, Denmark.,Department of Clinical Social Medicine & Rehabilitation, Gødstrup Hospital, Aarhus, Denmark
| | - Vivian Langagergaard
- Spine Center, Diagnostic Center, 53179Silkeborg Regional Hospital, Silkeborg, Denmark.,Department of Clinical Social Medicine & Rehabilitation, Gødstrup Hospital, Aarhus, Denmark
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21
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Thastum MM, Schroeder A, Evald L, Naess-Schmidt E, Tuborgh A, Jensen JS, Svendsen SW, Nielsen JF, Rask CU. Self-Rated Executive Function and Health-Related Quality of Life in Young Adults With Persistent Post-Concussion Symptoms: A Cross-Sectional Study. Arch Clin Neuropsychol 2021; 37:762-774. [PMID: 34849526 DOI: 10.1093/arclin/acab091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To assess self-reported executive dysfunction in young adult patients with persistent post-concussion symptoms (PCS) 2-6 months post-injury, and the association with self-reported Health-Related Quality of Life (HRQoL). METHOD This cross-sectional study carried out in a hospital setting was a secondary analysis of data from a separate randomized trial testing the effect of a novel intervention, "Get going After concussIoN " (GAIN), for persistent PCS. Patients (18-30 years) were recruited from a clinical cohort of patients with a hospital diagnosis of concussion or referred by primary care physicians. Main measures were The Behaviour Rating Inventory of Executive Function-Adult Version providing two index scores, that is, the Metacognitive Index (MI) and the Behavioural Regulation Index (BRI), and the Quality of Life after Brain Injury-Overall Scale. RESULTS Compared with normative data, patients had elevated scores (i.e., worse functioning) on both the MI and the BRI. In linear regression analysis, the MI score, but not the BRI score, was negatively associated with self-reported HRQoL (MI: slope = -.27, 95% confidence interval, CI [-.53, -.02], p = .03; BRI: slope = -.19, 95% CI [-.49, .13], p = .24), suggesting a positive association of subjective executive dysfunction and lower HRQoL. However, the association was attenuated after adjustment for self-reported psychological distress (MI: slope = -.09, 95% CI [-.34, .17], p = .51). CONCLUSION Self-reported executive dysfunction is common in young adult patients with persistent PCS, but not strongly associated with decreased HRQoL after adjusting for concurrent psychological distress.
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Affiliation(s)
- Mille Moeller Thastum
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.,Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Andreas Schroeder
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Evald
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Erhard Naess-Schmidt
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Astrid Tuborgh
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Jens Sondergaard Jensen
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne Wulff Svendsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Jørgen Feldbaek Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
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22
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Work-unit measures of psychosocial job stressors and onset of bullying: a 2-year follow-up study. Int Arch Occup Environ Health 2021; 95:117-130. [PMID: 34636977 DOI: 10.1007/s00420-021-01777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Numerous studies have examined the health consequences of workplace bullying, but little is known about workplace antecedents of workplace bullying. This study examines whether high psychological demands, low levels of justice at work, and low decision latitude increase the occurrence of being bullied or witnessing bullying. METHODS In 2007, 4489 Danish public employees answered a questionnaire with follow-ups in 2009 (72%) and 2011 (73% of 2009 respondents). We examined the longitudinal association between exposure to job stressors in 2007 and 2009 and bullying in 2009 and 2011, respectively, on an individual and work-unit level. For each working condition (psychological demands, decision latitude, procedural and relational justice), we calculated a mean value. Odds ratios were calculated by logistic regression. RESULTS Low levels of individual-level relational justice, compared to high levels, were associated with a higher risk of both witnessing episodes of bullying (OR 1.66, 95% CI 1.11-2.48) and perceiving oneself as a target of bullying (OR 2.21, 95% CI 1.17-4.16). Low levels of work-unit level relational justice were associated with a higher risk of witnessing bullying (OR 1.55, 95% CI 1.04-2.30) but not perceiving oneself as a target of bullying. The other workplace characteristics exhibited no or less consistent associations across the different analytical approaches. CONCLUSION Low levels of relational justice prospectively predicted the occurrence of workplace bullying within a 2-year period for three out of four methodological approaches, suggesting that relational justice plays a role in the prevention of workplace bullying.
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23
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Stokholm L, Schrøder K, Nøhr EA, Rubin KH, Jørgensen JS, Petersen LK, Bliddal M. The COVIDPregDK Study: A national survey on pregnancy during the early COVID-19 pandemic in Denmark. Scand J Public Health 2021; 50:703-710. [PMID: 34641709 DOI: 10.1177/14034948211048746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM We aimed to describe the aim, data collection and content from a survey completed among pregnant women during the first peak of the COVID-19 pandemic in Denmark. METHODS The declaration of the COVID-19 pandemic in early 2020 challenged pregnant women's mental well-being due to a concern for their unborn child and their need for healthcare services through pregnancy and birth. To explore how the COVID-19 pandemic and the intensified measures such as the lockdown of Denmark impacted pregnant women's well-being and mental health, we conducted a questionnaire survey in the spring of 2020 when the COVID-19 pandemic was at its first peak, and the consequences for pregnant women and the unborn child were very uncertain. All women residing in Denmark and registered with an ongoing pregnancy on 24 April 2020 were invited to participate. The questionnaire included background information, variables on COVID-19 symptoms and validated batteries of questions on loneliness, anxiety, stress, quality of life, meditation and prayers. Additional questions were included to examine concerns related to pregnancy and childbirth during the pandemic. COHORT CHARACTERISTICS Almost 18,000 women answered the questionnaire, which represents 60% of all invited women who experienced a national lockdown for the first time. Their median age was 30 years, and they were more likely to be multiparous. CONCLUSIONS Data from the COVIDPregDK Study will enable us to gain valuable knowledge on how the pandemic, the intensified measures from the health authorities and the national lockdown affected pregnant women's mental health and their concerns during the COVID-19 pandemic.
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Affiliation(s)
- Lonny Stokholm
- Open Patient data Explorative Network, Odense University Hospital, Denmark.,Research unit OPEN, Department of Clinical Research, University of Sourthern Denmark, Denmark
| | - Katja Schrøder
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Denmark.,Department of Clinical Research, University of Southern Denmark, Denmark.,Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Denmark
| | - Ellen A Nøhr
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Denmark.,Department of Clinical Research, University of Southern Denmark, Denmark
| | - Katrine H Rubin
- Open Patient data Explorative Network, Odense University Hospital, Denmark.,Research unit OPEN, Department of Clinical Research, University of Sourthern Denmark, Denmark
| | - Jan S Jørgensen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Denmark.,Department of Clinical Research, University of Southern Denmark, Denmark
| | - Lone K Petersen
- Open Patient data Explorative Network, Odense University Hospital, Denmark.,Research unit OPEN, Department of Clinical Research, University of Sourthern Denmark, Denmark
| | - Mette Bliddal
- Open Patient data Explorative Network, Odense University Hospital, Denmark.,Research unit OPEN, Department of Clinical Research, University of Sourthern Denmark, Denmark
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24
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Holm T, Dolmer S, Staugaard SR, Simonsen A, Mors O. Psychological adjustment in care providers following restraint of psychiatric patients. Stress Health 2021; 37:729-741. [PMID: 33527630 DOI: 10.1002/smi.3032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/17/2022]
Abstract
Mental healthcare providers face many difficult interactions with patients that can be emotionally demanding and have adverse effects on their well-being. Recent theoretical models suggest that the interpretation of stressful episodes may be more important for psychological adjustment than the nature of the episodes. This study examined whether care providers' interpretations of mechanical restraint episodes were related to their adjustment. We asked 80 mental healthcare providers to recall mechanical restraint episodes and to rate them on centrality to identity and positive and negative influence on self-understanding. They also completed scales measuring current symptoms of post-traumatic stress, depression, life satisfaction, and well-being. The results showed that care providers who interpreted mechanical restraint episodes as having a central negative influence on their identity experienced more symptoms of post-traumatic stress. Care providers who gave higher ratings of positive self-change following episodes reported more well-being. Our findings suggest, that considering care providers' subjective interpretations of episodes and not merely the objective facts surrounding them is critical if we wish to mitigate the negative emotional impact of episodes.
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Affiliation(s)
- Tine Holm
- Department of Clinical Medicine, Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Psychosis, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Signe Dolmer
- Department of Clinical Medicine, Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Psychosis, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Søren Risløv Staugaard
- Department of Psychology and Behavioral Sciences, Center on Autobiographical Memory Research, Aarhus University, Aarhus, Denmark
| | - Arndis Simonsen
- Department of Clinical Medicine, Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Ole Mors
- Department of Clinical Medicine, Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
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25
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Mose S, Kent P, Smith A, Andersen JH, Christiansen DH. Trajectories of Musculoskeletal Healthcare Utilization of People with Chronic Musculoskeletal Pain - A Population-Based Cohort Study. Clin Epidemiol 2021; 13:825-843. [PMID: 34557040 PMCID: PMC8455515 DOI: 10.2147/clep.s323903] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background and Aim Chronic musculoskeletal pain is common and associated with more general healthcare-seeking. However, musculoskeletal-related healthcare utilization is under-explored. This study aimed to explore, describe and profile trajectories of long-term musculoskeletal healthcare for people reporting chronic musculoskeletal pain. Methods This exploratory prognostic cohort study combined survey and national health register data from a representative group of adult Danes reporting chronic musculoskeletal pain (N = 2929). Trajectories of long-term musculoskeletal healthcare use were generated using latent class growth analysis. Types of healthcare-seeking, individual, sociodemographic, health, belief and work-related factors were used to describe and profile identified trajectories. Results We identified five distinct trajectories of long-term musculoskeletal healthcare utilization (low stable, low ascending, low descending, medium stable and high stable). The low stable trajectory group (no or almost no annual contacts) represented 39% of the sample, whereas the high stable trajectory group (consistent high number of annual contacts) represented 8%. Most healthcare-seeking was in primary healthcare settings (GP/physiotherapy/chiropractor). Opioid consumption was primarily in the high stable trajectory group, and surgery was rare. There were statistically significant differences across the five trajectory groups in individual, sociodemographic, health, belief and work-related profiles. Conclusion Long-term use of musculoskeletal healthcare services varied in this chronic musculoskeletal pain population. Almost 40% coped without seeking care, whereas 8% had consistent high use of healthcare services. Chronic musculoskeletal pain was mostly managed in primary care settings, which aligns with musculoskeletal guidelines, as did the use of pain medication and surgery. People with different musculoskeletal healthcare trajectories had different individual, sociodemographic, health, belief and work-related profiles. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/o24sO5gidU4
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Affiliation(s)
- Søren Mose
- Department of Occupational Medicine, Danish Ramazzini Centre - University Research Clinic, Herning, Denmark.,School of Physiotherapy, VIA University College, Holstebro, Denmark
| | - Peter Kent
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Anne Smith
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre - University Research Clinic, Herning, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, Danish Ramazzini Centre - University Research Clinic, Herning, Denmark
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26
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Severinsen ER, Kähler LKA, Thomassen SE, Varga TV, Fich Olsen L, Hviid KVR, la Cour Freiesleben N, Rod NH, Nielsen HS. Mental health indicators in pregnant women compared with women in the general population during the coronavirus disease 2019 pandemic in Denmark. Acta Obstet Gynecol Scand 2021; 100:2009-2018. [PMID: 34546563 PMCID: PMC8653239 DOI: 10.1111/aogs.14258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/01/2021] [Accepted: 08/19/2021] [Indexed: 12/27/2022]
Abstract
Introduction The coronavirus disease 2019 (COVID‐19) pandemic and the associated regulations issued to minimize risk of disease transmission seem to have had an impact on general mental health in most populations, but it may have affected pregnant women even more because of pregnancy‐related uncertainties, limited access to healthcare resources, and lack of social support. We aimed to compare the mental health response among pregnant women with that in similarly aged women from the general population during the first wave of the COVID‐19 pandemic. Material and methods From April 14 to July 3, 2020, 647 pregnant women in their second trimester were enrolled in this study. For comparison, 858 women from the general Danish population (20–46 years) were sampled from an ongoing observational study. Participants responded to a questionnaire including six mental health indicators (concern level, perceived social isolation, quality of life, anxiety, mental health, and loneliness). Loneliness was measured using the UCLA Three‐item Loneliness Scale and anxiety by the Common Mental Health Disorder Questionnaire 4‐item Anxiety Subscale. Results The pregnant women had better scores during the entire study period for all mental health indicators, and except for concerns, social isolation, and mental health, the differences were also statistically significant. Pregnant women were more concerned about becoming seriously ill (40.2% vs. 29.5%, p < 0.001), whereas the general population was more concerned about economic consequences and prospects. Many pregnant women reported negative feelings associated with being pregnant during the COVID‐19 pandemic and concerns regarding social isolation and regulation‐imposed partner absence during hospital appointments and childbirth. All mental health indicators improved as Denmark began to reopen after the first wave of the pandemic. Conclusions Pregnant women exhibited lower rates of poor mental health compared with the general population. However, they were more concerned about becoming seriously ill, expressed negative feelings about being pregnant during the pandemic, and were worried about the absence of their partner due to imposed regulations. These finding may be taken into account by policy‐makers during pandemics to balance specific preventive measures over the potential mental health deterioration of pregnant women.
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Affiliation(s)
- Elin R Severinsen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lise K A Kähler
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Obstetrics and Gynecology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Sofie E Thomassen
- Department of Obstetrics and Gynecology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Line Fich Olsen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Kathrine V R Hviid
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Obstetrics and Gynecology, The Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Naja H Rod
- Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henriette S Nielsen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Obstetrics and Gynecology, The Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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27
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Mose S, Kent P, Smith A, Andersen JH, Christiansen DH. Number of musculoskeletal pain sites leads to increased long-term healthcare contacts and healthcare related costs - a Danish population-based cohort study. BMC Health Serv Res 2021; 21:980. [PMID: 34535148 PMCID: PMC8447684 DOI: 10.1186/s12913-021-06994-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with musculoskeletal pain seek more healthcare than the general population, however little is known about the long-term effect on healthcare use. The aim of this study was to examine the consequences of number of musculoskeletal pain sites on long-term care-seeking and healthcare-related costs and explore how health anxiety influences this relationship. METHODS We conducted a Danish population-based longitudinal cohort study of 4883 participants combining self-reported survey data from 2008 with ten-year follow-up data from national health registers. Using a causal inference framework, we examined associations between number of pain sites (range 0-7)/level of health anxiety (high/low level) and face-to-face healthcare contacts/healthcare-related costs. Data were analyzed using negative binomial regression with generalized estimating equations. Regression models were adjusted for sex, age, duration of pain, level of education, comorbidity, personality traits, risk of depression, marital status, physical job exposure, and previous healthcare utilization. RESULTS For each additional pain site general healthcare contacts (Incidence Rate Ratio (IRR): 1.04 (95% CI: 1.03-1.05)), healthcare-related costs (IRR: 1.06 (95% CI: 1.03-1.08) and musculoskeletal healthcare contacts (IRR: 1.11 (95% CI:1.09-1.14) increased. Those with high levels of health anxiety at baseline had a slightly higher number of general healthcare contacts (IRR 1.06 (1.01-1.11), independent of number of pain sites. However, level of anxiety did not influence the effect of number of pain sites on any healthcare use or cost outcomes. CONCLUSIONS We found evidence for a causal association between increasing number of pain sites and greater healthcare use and cost, and high levels of health anxiety did not increase the strength of this association. This suggests that number of pain sites could be a potential target for biopsychosocial interventions in order to reduce the need for future care-seeking.
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Affiliation(s)
- S Mose
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Herning, Denmark. .,VIA University College, School of Physiotherapy, Holstebro, Denmark.
| | - P Kent
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - A Smith
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - J H Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Herning, Denmark
| | - D H Christiansen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Herning, Denmark
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28
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Jensen RAA, Thomsen DK, Lind M, Ladegaard N, Bliksted VF. Storying the Past and the Future: Agency and Communion Themes Among Individuals With Schizophrenia and Depression. J Nerv Ment Dis 2021; 209:343-352. [PMID: 33835953 DOI: 10.1097/nmd.0000000000001302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT Research has linked disturbances in narrative identity with schizophrenia and other psychiatric disorders. One such disturbance is diminished agency and communion themes in past life stories. However, projecting oneself into the future is also central to identity and potentially impacts recovery. Hence, we examined themes of agency and communion in both past and future life stories and related themes to psychosocial functioning in 20 individuals with schizophrenia, 20 individuals with depressive disorder, and 19 nonpsychiatric controls. Participants were asked to describe up to 10 past and future chapters in their life stories and were assessed on psychosocial functioning and neurocognition. Chapters were coded for agency and communion themes. Both clinical groups displayed diminished agency and communion themes in past but not future life story chapters compared with the nonpsychiatric controls. Furthermore, agency themes in future chapters explained variance in psychosocial functioning after controlling for neurocognition. The results suggest that constructing a narrative identity to foster agency and communion in both past and future chapters may be an important part of recovering from schizophrenia and depression.
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29
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Evald L, Brønnick K, Duez CHV, Grejs AM, Jeppesen AN, Søreide E, Kirkegaard H, Nielsen JF. Younger age is associated with higher levels of self-reported affective and cognitive sequelae six months post-cardiac arrest. Resuscitation 2021; 165:148-153. [PMID: 33887400 DOI: 10.1016/j.resuscitation.2021.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/01/2021] [Accepted: 04/10/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Affective and cognitive sequelae are frequently reported in cardiac arrest survivors; however, little is known about the risk factors. We assessed the hypothesis that self-reported affective and cognitive sequelae six months after OHCA may be associated with demography, acute care and cerebral outcome. METHODS This is a sub-study of the multicentre "Target Temperature Management for 48 vs. 24 h and Neurologic Outcome after Out-of-Hospital Cardiac Arrest: A Randomised Clinical Trial" (the TTH48 trial) investigating the effect of prolonged TTM at 33 ± 1 °C. We invited patients with good outcome on the Cerebral Performances Categories (CPC score ≤ 2) to answer questionnaires on anxiety, depression, emotional distress, perceived stress and cognitive failures six months post OHCA. RESULTS In total 79 of 111 eligible patients were included in the analysis. There were no significant differences in baseline characteristics between the included group and the group lost to follow-up. Younger age was a negative predictor across all self-reported outcomes, even when controlling for gender, ROSC time, treatment allocation, cognitive impairment and global outcome (CPC 1 or 2). Female gender was a predictor of anxiety, though this should be interpreted cautiously as only eight women participated. A CPC score of 2 score was a negative predictor of self-reported affective outcomes, albeit not for self-reported cognitive failures. CONCLUSION Younger age was associated with higher levels of self-reported affective and cognitive sequelae six months post OHCA. Female gender may be associated with self-reported anxiety. A higher CPC score may be a proxy for self-reported affective sequelae.
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Affiliation(s)
- Lars Evald
- Hammel Neurorehabilitation Clinic and University Research Centre, Hammel, Denmark.
| | - Kolbjørn Brønnick
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Christophe Henri Valdemar Duez
- Research Centre for Emergency Medicine and Department of Intensive Care Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Anders Morten Grejs
- Research Centre for Emergency Medicine and Department of Intensive Care Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Anni Nørgaard Jeppesen
- Research Centre for Emergency Medicine and Department of Intensive Care Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Eldar Søreide
- Critical Care and Anaesthesiology Research Group, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine and Department of Intensive Care Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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Langagergaard V, Jensen OK, Nielsen CV, Jensen C, Labriola M, Sørensen VN, Pedersen P. The comparative effects of brief or multidisciplinary intervention on return to work at 1 year in employees on sick leave due to low back pain: A randomized controlled trial. Clin Rehabil 2021; 35:1290-1304. [PMID: 33843296 DOI: 10.1177/02692155211005387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare return to work (RTW) rates among patients with low back pain (LBP) and different job relations randomized to brief or multidisciplinary intervention. DESIGN A randomized controlled trial with 1-year follow-up. SETTING Silkeborg Regional Hospital, Denmark. SUBJECTS Four hundred seventy-six participants were divided into two groups concerning job relations: strong (influence on job and no fear of losing it) or weak (no influence on job and/or fear of losing it), and afterwards randomized to brief or multidisciplinary intervention. INTERVENTIONS Brief intervention included examination and advice by a rheumatologist and a physiotherapist. Multidisciplinary intervention included brief intervention plus coaching by a case manager making a plan for RTW with the patient. MAIN MEASURES Primary outcome was 1-year RTW rate. Secondary outcomes included pain intensity (LBP rating scale), disability (Roland Morris disability scale), and psychological measures (Common Mental Disorder Questionnaire, Major Depression Inventory, and EQ-5D-3L). RESULTS Mean (SD) age was 43.1 (9.8) years. Among 272 participants with strong job relations, RTW was achieved for 104/137 (76%) receiving brief intervention compared to 89/135 (66%) receiving multidisciplinary intervention, hazard ratio 0.73 (CI: 0.55-0.96). Corresponding results for 204 participants with weak job relations were 69/102 (68%) in both interventions, hazard ratio 1.07 (CI: 0.77-1.49). For patients with strong job relations, depressive symptoms and quality of life were more improved after brief intervention. CONCLUSION Brief intervention resulted in higher RTW rates than multidisciplinary intervention for employees with strong job relations. There were no differences in RTW rates between interventions for employees with weak job relations.
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Affiliation(s)
- Vivian Langagergaard
- Diagnostic Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark.,Department of Clinical Social Medicine and Rehabilitation, Gødstrup Hospital, Herning, Denmark
| | - Ole Kudsk Jensen
- Diagnostic Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Claus Vinther Nielsen
- Department of Clinical Social Medicine and Rehabilitation, Gødstrup Hospital, Herning, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Chris Jensen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Occupational Rehabilitation, Rauland, Norway
| | | | - Vibeke Neergaard Sørensen
- Diagnostic Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Pernille Pedersen
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
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Madsen KP, Willaing I, Rod NH, Varga TV, Joensen LE. Psychosocial health in people with diabetes during the first three months of the COVID-19 pandemic in Denmark. J Diabetes Complications 2021; 35:107858. [PMID: 33573890 PMCID: PMC7816585 DOI: 10.1016/j.jdiacomp.2021.107858] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023]
Abstract
AIMS To analyze trajectories of psychosocial health among people with diabetes during the first three months of lockdowns and reopenings of the COVID-19 pandemic in Denmark. METHODS An online longitudinal survey of 2430 people with diabetes consisting of six questionnaire waves (Q1-Q6) was conducted between March 19 and June 25, 2020. Psychosocial outcomes assessed were COVID-19 worries, quality of life, feelings of social isolation, psychological distress, diabetes distress, anxiety, and general and diabetes-specific loneliness. Trajectories in psychosocial health were analyzed with linear multilevel mixed-effects models. Subgroup analyses were conducted. RESULTS In total, 1366 (56%) people with diabetes responded to the first questionnaire. COVID-19 worries, feelings of social isolation, psychological distress, anxiety and general loneliness had all improved at Q6 compared to Q1 (p < 0.001). In general, improvements in psychosocial health started after the first reopening phase (April 15); however, general loneliness increased up to the first reopening phase (p ≤ 0.001) before decreasing, and quality of life decreased up to the first reopening phase (p = 0.002), with no improvements to follow. Subgroup analyses revealed that women had larger decreases in feelings of social isolation (p < 0.001) and in psychological distress (p = 0.035) and increases in quality of life (p < 0.001), between Q1 and Q6, compared to men. CONCLUSIONS Psychosocial health in people with diabetes improved following reopening of society. However, increases in loneliness and decreases in quality of life during lockdown indicates a potential need to mitigate the acute effects of such policies.
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Affiliation(s)
| | - Ingrid Willaing
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark; Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 København K, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 København K, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 København K, Denmark
| | - Lene Eide Joensen
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark
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Kirkegaard Thomsen D, Panattoni K, Allé MC, Bro Wellnitz K, Pillemer DB. Vicarious life stories: Examining relations to personal life stories and well-being. JOURNAL OF RESEARCH IN PERSONALITY 2020. [DOI: 10.1016/j.jrp.2020.103991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Clotworthy A, Dissing AS, Nguyen TL, Jensen AK, Andersen TO, Bilsteen JF, Elsenburg LK, Keller A, Kusumastuti S, Mathisen J, Mehta A, Pinot de Moira A, Rod MH, Skovdal M, Strandberg-Larsen K, Tapager IW, Varga TV, Vinther JL, Xu T, Hoeyer K, Hulvej Rod N. 'Standing together - at a distance': Documenting changes in mental-health indicators in Denmark during the COVID-19 pandemic. Scand J Public Health 2020; 49:79-87. [PMID: 32907495 PMCID: PMC7859573 DOI: 10.1177/1403494820956445] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Aims: There is a need to document the mental-health effects of
the COVID-19 pandemic and its associated societal lockdowns. We initiated a
large mixed-methods data collection, focusing on crisis-specific worries and
mental-health indicators during the lockdown in Denmark.
Methods: The study incorporated five data sources,
including quantitative surveys and qualitative interviews. The surveys included
a time series of cross-sectional online questionnaires starting on 20 March
2020, in which 300 (3×100) Danish residents were drawn every three days from
three population groups: the general population (N=1046),
families with children (N=1032) and older people
(N=1059). These data were analysed by trend analysis.
Semi-structured interviews were conducted with 32 people aged 24–83 throughout
Denmark to provide context to the survey results and to gain insight into
people’s experiences of the lockdown. Results: Absolute level
of worries, quality of life and social isolation were relatively stable across
all population groups during the lockdown, although there was a slight
deterioration in older people’s overall mental health. Many respondents were
worried about their loved ones’ health (74–76%) and the potential long-term
economic consequences of the pandemic (61–66%). The qualitative interviews
documented significant variation in people’s experiences, suggesting that the
lockdown’s effect on everyday life had not been altogether negative.
Conclusions: People in Denmark seem to have
managed the lockdown without alarming changes in their mental health.
However, it is important to continue investigating the effects of the
pandemic and various public-health measures on mental health over time and
across national contexts.
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Affiliation(s)
- Amy Clotworthy
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Agnete Skovlund Dissing
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Tri-Long Nguyen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Andreas Kryger Jensen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Thea Otte Andersen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Josephine Funck Bilsteen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Leonie K Elsenburg
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Amélie Keller
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Sasmita Kusumastuti
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Jimmi Mathisen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Amar Mehta
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark.,Statistics Denmark, Copenhagen, Denmark
| | - Angela Pinot de Moira
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | | | - Morten Skovdal
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Katrine Strandberg-Larsen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | | | - Tibor V Varga
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Johan Lerbech Vinther
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Tianwei Xu
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Klaus Hoeyer
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
| | - Naja Hulvej Rod
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Denmark
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Jensen RAA, Thomsen DK, Bliksted VF, Ladegaard N. Narrative Identity in Psychopathology: A Negative Past and a Bright but Foreshortened Future. Psychiatry Res 2020; 290:113103. [PMID: 32485486 DOI: 10.1016/j.psychres.2020.113103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/09/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
We examined narrative identity as a possible transdiagnostic marker of psychopathology by interviewing individuals with schizophrenia, individuals with depression and a nonclinical control group about past and future chapters in their life stories. Participants were 20 patients with schizophrenia, 20 patients with depression, and 20 nonclinical control participants matched on age, gender, and education. Participants described up to 10 chapters in their past and future life stories and self-rated chapters on emotional tone and self-event connections. In addition, cognitive function and current levels of symptoms was assessed. Both patient groups self-rated their past chapters as more negative and less positive compared to the control group, but did not differ from each other. There were no group differences in positivity of future chapters, but both patient groups identified fewer future chapters with shorter temporal projections. The results are consistent with the notion that negative past aspects of narrative identity are a transdiagnostic marker of psychopathology, while also suggesting that individuals with mental illness construct a positive future, which may support hope.
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Affiliation(s)
- Rikke Amalie Agergaard Jensen
- Department of Psychology and Behavioural Science, Aarhus University, Denmark; Center on Autobiographical Memory Research (CON AMORE), Aarhus University, Denmark.
| | - Dorthe Kirkegaard Thomsen
- Department of Psychology and Behavioural Science, Aarhus University, Denmark; Center on Autobiographical Memory Research (CON AMORE), Aarhus University, Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Nicolai Ladegaard
- Depression and Anxiety Research Unit, Aarhus University Hospital, Denmark
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Appel AM, Török E, Jensen MA, Garde AH, Hansen ÅM, Kaerlev L, Grynderup MB, Nabe-Nielsen K. The longitudinal association between shift work and headache: results from the Danish PRISME cohort. Int Arch Occup Environ Health 2020; 93:601-610. [PMID: 31927661 DOI: 10.1007/s00420-019-01512-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/27/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE We investigated the effect of shift work on headache. Furthermore, we investigated whether the association between shift work and headache was explained by potential mediators in terms of perceived stress, poor sleep and health behaviors. METHODS In this longitudinal study, we used questionnaire data (collected in 2007 and 2009) from civil servants and hospital employees from the PRISME study. 2952 individuals were available for the analyses of shift work and headache and 2272 individuals were available for the analyses of shift work and migraine. Headache was operationalized as the participants' experience of "being bothered by headache during the past 4 weeks". Migraine was operationalized as "ever being diagnosed with migraine by a medical doctor". We used binary logistic regression to compare shift workers with permanent day workers and adjusted for socio-demographic factors. In a subsequent step, we adjusted for potential mediators. RESULTS We found higher odds of unspecific headache (OR = 1.25; 95% CI 1.02-1.54) and migraine (OR = 1.72; 95% CI 1.04-2.86) among shift workers compared with day workers. Our results suggest that the effect of shift work on headache and migraine differ between men and women. Inclusion of potential mediators in the analyses did not attenuate the associations. CONCLUSION Shift workers have higher risk of reporting being bothered by headache as well as reporting being diagnosed with migraine. Future research is needed to disentangle the underlying mechanisms with the aim of reducing headache related to occupational exposures.
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Affiliation(s)
- Andreas Moses Appel
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
| | - Eszter Török
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Marie Aarrebo Jensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Anne Helene Garde
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Linda Kaerlev
- Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Kløvervænget 30, Entrance 216 Ground Floor East, 5000, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, 5000, Odense C, Denmark
| | | | - Kirsten Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
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Thastum MM, Rask CU, Næss-Schmidt ET, Tuborgh A, Jensen JS, Svendsen SW, Nielsen JF, Schröder A. Novel interdisciplinary intervention, GAIN, vs. enhanced usual care to reduce high levels of post-concussion symptoms in adolescents and young adults 2-6 months post-injury: A randomised trial. EClinicalMedicine 2019; 17:100214. [PMID: 31891145 PMCID: PMC6933237 DOI: 10.1016/j.eclinm.2019.11.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Evidence for effective interventions to prevent long-term sequelae after concussion is sparse. This study aimed to test the efficacy of Get going After concussIoN (GAIN), an interdisciplinary, individually-tailored intervention of 8 weeks duration based on gradual return to activities and principles from cognitive behavioural therapy. METHODS We conducted an open-label, parallel-group randomised trial in a hospital setting in Central Denmark Region. Participants were 15-30-year-old patients with high levels of post-concussion symptoms (PCS) 2-6 months post-concussion (i.e., a score ≥20 on the Rivermead Post-concussion Symptoms Questionnaire (RPQ)). They were randomly assigned (1:1) to either enhanced usual care (EUC) or GAIN+EUC. Masking of participants and therapists was not possible. The primary outcome was change in RPQ-score from baseline to 3-month FU. All analyses were done on an intention-to-treat basis using linear mixed-effects models. This trial is registered with ClinicalTrials.gov, number NCT02337101. FINDINGS Between March 1, 2015, and September 1, 2017, we included 112 patients. Patients allocated to GAIN+EUC (n=57) reported a significantly larger reduction of PCS than patients allocated to EUC (n=55) with a mean adjusted difference in improvement of 7·6 points (95% confidence interval (CI) 2·0-13·1, p=0·008), Cohen's d=0·5 (95% CI 0·1-0·9). Number needed to treat for prevention of one additional patient with RPQ ≥20 at 3-month FU was 3·6 (95% CI 2·2-11·3). No adverse events were observed. INTERPRETATION Compared with EUC, GAIN+EUC was associated with a larger reduction of post-concussion symptoms at 3-month FU. FUNDING Central Denmark Region and the foundation "Public Health in Central Denmark Region - a collaboration between municipalities and the region".
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Affiliation(s)
- Mille Moeller Thastum
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus, Denmark
- Corresponding author.
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Psychiatry, Denmark
| | | | - Astrid Tuborgh
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Psychiatry, Denmark
| | - Jens Sondergaard Jensen
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus, Denmark
| | - Susanne Wulff Svendsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Jørgen Feldbæk Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Andreas Schröder
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus, Denmark
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37
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Gehrt TB, Frostholm L, Obermann ML, Berntsen D. Autobiographical Memory and Episodic Future Thinking in Severe Health Anxiety: A Comparison with Obsessive–Compulsive Disorder. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10058-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Mehlsen M, Lyby MS, Mikkelsen MB, O'Toole MS. Performance-based assessment of distraction in response to emotional stimuli: Toward a standardized procedure for assessing emotion regulation performance. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.06.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hornemann C, Schröder A, Ørnbøl E, Christensen NB, Høeg MD, Mehlsen M, Frostholm L. Application of ICD-11 among individuals with chronic pain: A post hoc analysis of the Stanford Self-Management Program. Eur J Pain 2019; 24:297-311. [PMID: 31556212 DOI: 10.1002/ejp.1486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Chronic primary pain (CPP) is one of seven diagnostic groups within the proposed classification of chronic pain in ICD-11. Our aims were to apply the proposed ICD-11 criteria in a large cohort of chronic pain patients participating in the Chronic Pain Self-Management Program (CPSMP) and further investigate whether participants with CPP differed from participants with chronic secondary pain (CSP) regarding health, health expenditure and the effect of participating in the CPSMP. METHODS A secondary analysis of a randomized, controlled trial on the effect of the CPSMP. Four examiners categorized participants' pain according to ICD-11 using register-based medical diagnoses and patients' self-reported symptoms. Afterwards, differences between CPP and CSP were examined. RESULTS Out of 394 participants, 312 were successfully classified into CPP (n = 164) or CSP (n = 148) whereas 76 had a mixed pain condition. Participants with CPP were younger, more likely to be women, and had longer pain duration compared to participants with CSP. Participants with CPP reported worse health-related quality of life on the SF-36 Mental Component Summary and subscales of vitality, social functioning and bodily pain. Participants with CSP had more physical comorbidities and higher total health expenditure. None of the groups benefitted from the CPSMP. CONCLUSIONS We successfully applied the new classification of chronic pain in ICD-11 on the basis of ICD-10 medical diagnoses and symptom self-report. Participants with CPP differed significantly from participants with CSP on baseline characteristics, self-reported health measures and total health expenditure. The CPSMP was not effective in any of the groups. SIGNIFICANCE The current study applies the proposed new classification of chronic pain in ICD-11 and shares the experiences of the diagnostic rating procedure of individuals with chronic pain. Furthermore, it evaluates the effect of the Stanford Self-Management Program.
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Affiliation(s)
- Christina Hornemann
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark
| | - Andreas Schröder
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark
| | - Eva Ørnbøl
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark
| | - Nils Balle Christensen
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark
| | - Marian Dalgaard Høeg
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark
| | - Mimi Mehlsen
- The Department of Psychology and Behavioural Science, Aarhus University, Aarhus C, Denmark
| | - Lisbeth Frostholm
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark
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40
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Marcussen J, Hounsgaard L, O'Connor M, Möller S, Wilson R, Thuen F. Parental death in young adults with divorced compared to non-divorced parents: The effect on prolonged grief and mental health. DEATH STUDIES 2019; 45:437-450. [PMID: 31402764 DOI: 10.1080/07481187.2019.1648337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This cross-sectional survey compares the risk of mental health problems like poor well-being, complicated and prolonged grief, and mental disorders between young adults experiencing a divorced or non-divorced parent's death. 190 participants were recruited from Facebook via the Danish National Center for Grief. Well-being was measured using WHO-5, prolonged grief using PG-13 and complicated grief using BGQ, and common mental disorders using CMDQ. Findings confirmed deleterious effects on mental health in young adults experiencing parental death, but higher risk, when losing a divorced parent compared to a non-divorced parent, was associated to prolonged grief, complicated grief, bodily distress syndrome, and alcohol misuse.
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Affiliation(s)
- Jette Marcussen
- OPEN-Open Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Health Science Research Center, University College Lillebaelt, Odense, Denmark
- School of Nursing, University College Lillebaelt, Odense, Denmark
| | - Lise Hounsgaard
- OPEN-Open Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Health Science Research Center, University College Lillebaelt, Odense, Denmark
- Center for Psychiatric Nursing and Health, Research Institute of Regional Research, University of Southern Denmark, Odense, Denmark
- Institute for Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | - Maja O'Connor
- Department of Psychology and Behaviour Sciences, University of Aarhus, Aarhus, Denmark
| | - Sören Möller
- OPEN-Open Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rhonda Wilson
- Center for Psychiatric Nursing and Health, Research Institute of Regional Research, University of Southern Denmark, Odense, Denmark
- School of Nursing, Midwifery and Public Health, Faculty of Health, University of Canberra, Canberra, Australia
| | - Frode Thuen
- Center for Evidence-Based Practice, Bergen University College, Bergen, Norway
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Jensen RA, Kirkegaard Thomsen D, O'Connor M, Mehlsen MY. Age differences in life stories and neuroticism mediate age differences in subjective well‐being. APPLIED COGNITIVE PSYCHOLOGY 2019. [DOI: 10.1002/acp.3580] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Rikke A.A. Jensen
- Department of PsychologyAarhus University Aarhus Denmark
- Center on Autobiographical Memory Research (CON AMORE)Aarhus University Aarhus Denmark
| | - Dorthe Kirkegaard Thomsen
- Department of PsychologyAarhus University Aarhus Denmark
- Center on Autobiographical Memory Research (CON AMORE)Aarhus University Aarhus Denmark
| | - Maja O'Connor
- Department of PsychologyAarhus University Aarhus Denmark
- Unit for Bereavement ResearchAarhus University Aarhus Denmark
| | - Mimi Y. Mehlsen
- Department of PsychologyAarhus University Aarhus Denmark
- Unit for Psychooncology and Health PsychologyAarhus University Aarhus Denmark
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Winding TN, Andersen JH. Do negative childhood conditions increase the risk of somatic symptoms in adolescence? - a prospective cohort study. BMC Public Health 2019; 19:828. [PMID: 31242885 PMCID: PMC6595570 DOI: 10.1186/s12889-019-7198-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 06/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background In order to prevent health and social problems later in life, it is important to identify childhood conditions related to the development of somatic symptoms. This prospective study expands on previous research by investigating whether negative childhood conditions are related to somatization later in life, taking other risk factors into account. This study aims to investigate whether somatic symptoms of the participants’ parents, poor family functioning, or negative life events during childhood result in somatic symptoms in early or late adolescence. Methods The study population includes participants from the West Jutland Cohort Study who responded to the survey on their somatic symptoms at age 15 (n = 2963) and/or age 18 (n = 2341). The study also includes additional questionnaire information about the participants’ poor family functioning, number of negative life events, and parental reports of somatic symptoms as well as register information about parental socioeconomic background. Generalized linear models for the binomial family were used and the results were presented as relative risks (RR) and risk differences (RD) with 95% confidence intervals (95%-CI). Results Experiencing poor family functioning at age 15 showed associations with somatic symptoms at age 15 (RR 1.75, 95%-CI, 1.43–2.14 and RD 18, 95%-CI, 11–25%) and 18 (RR 1.32, 95%-CI, 1.00–1.75 and RD 7, 95%-CI, 0.2–14%). The relative risks between poor family functioning and somatic symptoms were 2.5 for the boys at age 15 and 1.71 for the girls at age 18. Having experienced two or more negative life events up to the age of 15 was associated with reporting somatic symptoms at age 15 (RR 1.73, 95%-CI, 1.31–2.28 and RD 24, 95%-CI, 11–37%). No relative risks above 1.35 were found between parents reporting somatic symptoms and participants reporting somatic symptoms at ages 15 or 18. Conclusions An increased awareness of the association between a poor social climate in the family and somatic symptoms may help professionals in health and educational systems prevent the development of such symptoms among adolescents.
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Affiliation(s)
- Trine N Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Johan H Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
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Udholm S, Nyboe C, Dantoft TM, Jørgensen T, Rask CU, Hjortdal VE. Small atrial septal defects are associated with psychiatric diagnoses, emotional distress, and lower educational levels. CONGENIT HEART DIS 2019; 14:803-810. [DOI: 10.1111/chd.12808] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sebastian Udholm
- Department of Cardiothoracic Surgery Aarhus University Hospital Aarhus Denmark
| | - Camilla Nyboe
- Department of Cardiothoracic Surgery Aarhus University Hospital Aarhus Denmark
| | - Thomas Meinertz Dantoft
- Center for Clinical Research and Prevention Bispebjerg & Frederiksberg Hospital Capital Region Copenhagen Denmark
| | - Torben Jørgensen
- Center for Clinical Research and Prevention Bispebjerg & Frederiksberg Hospital Capital Region Copenhagen Denmark
- Department of Public Health, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Faculty of Medicine Aalborg University Aalborg Denmark
| | - Charlotte U. Rask
- Department of Child and Adolescent Psychiatry, Psychiatry Aarhus University Hospital Aarhus Denmark
| | - Vibeke E. Hjortdal
- Department of Cardiothoracic Surgery Aarhus University Hospital Aarhus Denmark
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Emotional demands and exhaustion: cross-sectional and longitudinal associations in a cohort of Danish public sector employees. Int Arch Occup Environ Health 2019; 92:639-650. [PMID: 30864025 DOI: 10.1007/s00420-018-01398-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine cross-sectional and longitudinal associations between content-related emotional demands at work and exhaustion, and to investigate if these associations were modified by other psychosocial work characteristics. METHODS In 2007, 4489 Danish public service employees participated in the PRISME study by completing postal questionnaires, and 3224 participated in the follow-up in 2009. Content-related emotional demands were measured by a scale (scored 1 to 5) based on five work-content-related items, and exhaustion was measured with the general exhaustion scale from the Copenhagen Burnout Inventory (CBI) (scored 1 to 5). The cross-sectional and longitudinal associations with exhaustion were analysed in the same model and adjusted for effects of potential confounders. Effect modifications were examined separately for self-reported emotional enrichment, meaningful work, job control, social support at work and quantitative demands. RESULTS Exhaustion increased with increasing emotional demands, both cross-sectionally and longitudinally. However, although statistically significant, the effect was small. In the longitudinal analysis, a one unit increase in emotional demands was associated with a 0.03 unit (95% CI: 0.01-0.06) increase in exhaustion. We found statistically significant effect modification for three of six potentially modifying work characteristics. The effect of emotional demands on exhaustion was lower for participants with high levels of emotional enrichment (cross-sectionally and longitudinally), high levels of meaningful work (longitudinally), and higher for high levels of quantitative demands (cross-sectionally). CONCLUSIONS Increasing content-related emotional demands were associated with increasing levels of exhaustion, cross-sectionally and longitudinally. This effect was reduced if the work was experienced as emotionally enriching and meaningful.
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Bay-Richter C, Buttenschøn HN, Mors O, Eskelund A, Budac D, Kærlev L, Wegener G. Latent toxoplasmosis and psychiatric symptoms - A role of tryptophan metabolism? J Psychiatr Res 2019; 110:45-50. [PMID: 30583085 DOI: 10.1016/j.jpsychires.2018.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 02/02/2023]
Abstract
Toxoplasma gondii (TOX) is a common parasite which infects approximately one third of the human population. In recent years, it has been suggested that latent toxoplasmosis may be a risk factor for the development of mental disorders, particularly schizophrenia and anxiety. With regards to depression the results have been varied. The main objective of this study was to examine subpopulations from the Danish PRISME and GENDEP populations for TOX IgG antibodies. These consisted of: a group with symptoms of anxiety, a group suffering from burnout syndrome, as well as two different subpopulations with depression of differing severity. The secondary objective of this study was to examine whether tryptophan metabolism was altered in TOX-positive subjects within each subpopulation. Our results show that the anxiety and burnout populations were more likely to be TOX IgG seropositive. Furthermore, we find that the moderate-severe but not mild-moderate depressive subpopulation were associated with TOX seropositivety, suggesting a possible role of symptom severity. Additionally, we found that TOX positive subjects in the anxiety and burnout subpopulations had altered tryptophan metabolism. This relationship did not exist in the mild-moderate depressive subpopulation. These results suggest that TOX seropositivity may be related to anxiety, burnout and potentially to severity of depression. We furthermore show that the psychiatric symptoms could be associated with an altered tryptophan metabolism.
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Affiliation(s)
- Cecilie Bay-Richter
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Risskov, Denmark.
| | | | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
| | - Amanda Eskelund
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Risskov, Denmark
| | | | - Linda Kærlev
- Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Risskov, Denmark
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Maurici M, Arigliani M, Dugo V, Leo C, Pettinicchio V, Arigliani R, Franco E. Empathy in vaccination counselling: a survey on the impact of a three-day residential course. Hum Vaccin Immunother 2018; 15:631-636. [PMID: 30325260 PMCID: PMC6605730 DOI: 10.1080/21645515.2018.1536587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND In an era of hesitance to use vaccines, the importance of effective communication for increasing vaccine acceptance is well known. This study aimed to assess the impact of a three-day residential course concerning empathy and counselling abilities on patients' ratings of the level of empathy of physicians and nurses working in vaccination centers. METHODS The empathy of healthcare providers was evaluated using the Adapted Consultation and Relational Empathy (CARE) Measure. The survey involved 20 healthcare workers, doctors, and nurses in three immunization services of a Local Health Unit in South Italy. Before and after attending the course, all of them administered the questionnaire to 50 consecutive parents of vaccinated children. Statistical tests were used to assess the homogeneity of pre- and post -course samples, to measure the level of empathy perceived by parents in doctors and nurses in pre- and post-course evaluations, and to compare the average CARE Measure scores among groups. RESULTS Analysis of the questionnaires showed an increase of "excellent" scores and statistically significant differences between the pre- and post -course median values. Statistically significant differences between doctors and nurses were shown in almost all questions pre-course and in only four questions post-course. CONCLUSIONS This study demonstrated that a residential course is effective at improving patient-rated empathy of doctors and nurses working in vaccination centers and could result in an increase of parents' adherence to vaccination programs.
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Affiliation(s)
- Massimo Maurici
- a Department of Biomedicine and Prevention , University of Rome Tor Vergata , Italy
| | - Michele Arigliani
- b Department of Clinical and Experimental Medical Sciences , University Hospital of Udine , Italy
| | - Valentina Dugo
- c Department of Biomedicine and Prevention, Specialization School for Hygiene and Preventive Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Carlo Leo
- d Department of Clinical and Experimental Medical Sciences , University Hospital of Udine, Italy TO Department of Medicine , Udine , Italy
| | - Valentina Pettinicchio
- c Department of Biomedicine and Prevention, Specialization School for Hygiene and Preventive Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Raffaele Arigliani
- e Department of Biomedicine and Prevention , Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Elisabetta Franco
- a Department of Biomedicine and Prevention , University of Rome Tor Vergata , Italy
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Thastum MM, Rask CU, Naess-Schmidt ET, Jensen JS, Frederiksen OV, Tuborgh A, Svendsen SW, Nielsen JF, Schröder A. Design of an early intervention for persistent post-concussion symptoms in adolescents and young adults: A feasibility study. NeuroRehabilitation 2018; 43:155-167. [PMID: 30040756 DOI: 10.3233/nre-172391] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND About 5-15 % of patients with concussion experience persistent post-concussion symptoms (PCS) longer than 3 months post-injury. OBJECTIVE To explore the feasibility of a new intervention for young patients with persistent PCS and long-term changes after intervention. METHODS Thirty-two consecutive patients (15-30 years) with persistent PCS 2-4 months post-injury were recruited from a cohort study or referred to a non-randomized feasibility study of an individually tailored, 8-week, multidisciplinary intervention. Assessment was performed at baseline, end of intervention (EOI), and at 3- and 12-month follow-up (FU). Main measures were The Experience of Service Questionnaire (ESQ), Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and The Quality of Life after Brain Injury - Overall Scale (QOLIBRI-OS). RESULTS Twenty-three (72%) patients completed the intervention. The ESQ demonstrated high patient satisfaction. There was a decrease of PCS and an increase in quality of life from baseline to EOI: RPQ score -8.9 points, 95% CI 4.5 to 13.3, p < 0.001; QOLIBRI-OS score +10.5 points, 95% CI 2.5 to 18.5, p = 0.010. Improvement was maintained at 3- and 12-month FU. CONCLUSION The new early intervention is feasible and may prevent chronification of PCS. An RCT is currently performed to evaluate the effect of the intervention.
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Affiliation(s)
- Mille Moeller Thastum
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Charlotte Ulrikka Rask
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark.,Child and Adolescent Psychiatric Center, Risskov, Aarhus University Hospital, Denmark
| | | | | | - Oana-Veronica Frederiksen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Astrid Tuborgh
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark.,Child and Adolescent Psychiatric Center, Risskov, Aarhus University Hospital, Denmark
| | - Susanne Wulff Svendsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Joergen Feldbaek Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Andreas Schröder
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark
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Holm T, Thomsen DK, Bliksted V. Themes of unfulfilled agency and communion in life stories of patients with schizophrenia. Psychiatry Res 2018; 269:772-778. [PMID: 30380593 DOI: 10.1016/j.psychres.2018.08.116] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 08/28/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
Abstract
We examined themes of agency and communion in life stories of individuals with schizophrenia. Twenty-four individuals diagnosed with schizophrenia and 24 control participants matched on age, gender, and education described their life stories in a free format. The life stories were coded for the presence of agency and communion themes and whether or not the themes captured fulfillment of agency and communion needs. In addition, the temporal macrostructure was coded. Individuals with schizophrenia described their life stories with similar levels of temporal macrostructure as controls, but they expressed more themes focusing on unfulfilled agency and communion needs. We suggest possible avenues for using these insights to improve recovery in schizophrenia.
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Affiliation(s)
- Tine Holm
- Psychosis Research Unit, Aarhus University Hospital Risskov, Denmark.
| | | | - Vibeke Bliksted
- Psychosis Research Unit, Aarhus University Hospital Risskov, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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Emotional Demands at Work and the Risk of Clinical Depression: A Longitudinal Study in the Danish Public Sector. J Occup Environ Med 2018; 58:994-1001. [PMID: 27525526 DOI: 10.1097/jom.0000000000000849] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study is a 2-year follow-up study of different dimensions of work-related emotional demands as a predictor for clinical depression. METHODS In a two-wave study, 3224 (72%) public employees from 474 work-units participated twice by filling in questionnaires. Sixty-two cases of clinical depression were diagnosed. Emotional demands were examined as perceived and content-related emotional demands, individually reported and work-unit based. Support, meaningful work, and enrichment were considered as potential effect modifiers. RESULTS Individually reported perceived emotional demands predicted depression (odds ratio: 1.40; 95% confidence intervals: 1.02 to 1.92). The work-unit based odds ratio was in the same direction, though not significant. Content-related emotional demands did not predict depression. Support, meaningful work, and enrichment did not modify the results. CONCLUSIONS The personal perception of emotional demands was a risk factor for clinical depression but specific emotionally demanding work tasks were not.
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