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The 2-year course following detoxification treatment of substance abuse: the possible influence of psychiatric comorbidity.

https://arctichealth.org/en/permalink/ahliterature11106
Source
Eur Arch Psychiatry Clin Neurosci. 1997;247(6):320-7
Publication Type
Article
Date
1997
Author
K. Tómasson
P. Vaglum
Author Affiliation
Department of Psychiatry, National University Hospital, Landspítalinn, Reykjavík, Iceland.
Source
Eur Arch Psychiatry Clin Neurosci. 1997;247(6):320-7
Date
1997
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - psychology - rehabilitation
Diagnosis, Dual (Psychiatry) - psychology
Female
Follow-Up Studies
Humans
Male
Prospective Studies
Psychiatric Status Rating Scales
Research Support, Non-U.S. Gov't
Substance-Related Disorders - psychology - rehabilitation
Abstract
The influence of psychiatric comorbidity on the course and outcome in a nationwide representative sample (n = 351) of treatment-seeking substance users over a 28-month period was studied prospectively. The patients were administered the Diagnostic Interview Schedule and a questionnaire on drinking history. At 16 and 28 months after admission the patients returned a questionnaire on drinking history and mental health. In cases of those lacking information on either follow-up (45%), details on drinking status was obtained from informants. Completely abstinent were 16%. Generalized anxiety disorder and/or social phobia at the index admission predicted abstinence during the follow-up [odds ratio (OR) = 0.25], whereas onset of alcoholism among these patients after age 25 years predicted a worse prognosis (OR = 13.5). Also increasing number of social consequences related to abuse (OR = 1.3) and drinking more than the median (OR = 2.1) predicted a poor outcome. The abstinent group had significantly better mental health at follow-up. The patients with comorbid psychiatric disorders at admission were worse at follow-up. Although substance use disorders and comorbid psychiatric disorders have to a certain degree separate courses, there is nevertheless significant interaction between them. Early treatment and recognition of comorbid psychiatric disorders among substance abusers is necessary.
PubMed ID
9477012 View in PubMed
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A 2-year follow-up of involuntary admission's influence upon adherence and outcome in first-episode psychosis.

https://arctichealth.org/en/permalink/ahliterature145997
Source
Acta Psychiatr Scand. 2010 May;121(5):371-6
Publication Type
Article
Date
May-2010
Author
S. Opjordsmoen
S. Friis
I. Melle
U. Haahr
J O Johannessen
T K Larsen
J I Røssberg
B R Rund
E. Simonsen
P. Vaglum
T H McGlashan
Author Affiliation
Department of Psychiatry, Oslo University Hospital, Ullevål and Institute of Psychiatry, University of Oslo, Norway. o.s.e.ilner@medisin.uio.no
Source
Acta Psychiatr Scand. 2010 May;121(5):371-6
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Combined Modality Therapy
Commitment of Mentally Ill
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Male
Norway
Patient Admission - statistics & numerical data
Patient Compliance - psychology - statistics & numerical data
Psychiatric Status Rating Scales
Psychotherapy - statistics & numerical data
Psychotic Disorders - epidemiology - rehabilitation
Sex Factors
Young Adult
Abstract
To see, if voluntary admission for treatment in first-episode psychosis results in better adherence to treatment and more favourable outcome than involuntary admission.
We compared consecutively first-admitted, hospitalised patients from a voluntary (n = 91) with an involuntary (n = 126) group as to psychopathology and functioning using Positive and Negative Syndrome Scale and Global Assessment of Functioning Scales at baseline, after 3 months and at 2 year follow-up. Moreover, duration of supportive psychotherapy, medication and number of hospitalisations during the 2 years were measured.
More women than men were admitted involuntarily. Voluntary patients had less psychopathology and better functioning than involuntary patients at baseline. No significant difference as to duration of psychotherapy and medication between groups was found. No significant difference was found as to psychopathology and functioning between voluntarily and involuntarily admitted patients at follow-up.
Legal admission status per se did not seem to influence treatment adherence and outcome.
PubMed ID
20085554 View in PubMed
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Are "traditional" sex differences less conspicuous in young cannabis users than in other young people?

https://arctichealth.org/en/permalink/ahliterature11545
Source
J Psychoactive Drugs. 1994 Jul-Sep;26(3):257-63
Publication Type
Article
Author
H. Pape
T. Hammer
P. Vaglum
Author Affiliation
Norwegian Youth Research Centre, Oslo.
Source
J Psychoactive Drugs. 1994 Jul-Sep;26(3):257-63
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcohol Drinking - psychology
Female
Gender Identity
Humans
Male
Marijuana Smoking - psychology
Mental health
Norway
Research Support, Non-U.S. Gov't
Abstract
Recent research has revealed conspicuously few distinctions between young males and females who use cannabis. Such findings may reflect the general slackening of the sex-role pattern in the younger generations. Alternatively, they may reflect distinctive characteristics of the cannabis culture. Using data from a nationwide representative sample (n = 1,478) of young Norwegians (21-24 years old), this study explores whether "traditional" sex differences in respect to mental health and alcohol use are less conspicuous among users than among nonusers of cannabis. The respondents' sex-role-related values and preferences were also studied. Results indicate that the sex differences in mental health did not vary between users and nonusers of cannabis; however, female cannabis users were disproportionately young when they experienced their first intoxication by alcohol. Their level of drinking was also disproportionately high. This implied that the sex difference in alcohol use was smaller among users than among nonusers: male users of cannabis consumed 2.8 times more alcohol than their female counterparts, whereas the corresponding male to female ratio was 3:2 in the nonusers. The extensive use of alcohol in female cannabis users did not reflect mental health problems or a rejection of traditional sex-role characteristics. Cannabis-using males were less typically masculine in their values and preferences than other males, but not more feminine. The measures for sex-role-related preferences did not discriminate between female users and female nonusers of cannabis.
PubMed ID
7844655 View in PubMed
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Can we rely on simulated patients' satisfaction with their consultation for assessing medical students' communication skills? A cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature274246
Source
BMC Med Educ. 2015;15:225
Publication Type
Article
Date
2015
Author
T. Gude
H. Grimstad
A. Holen
T. Anvik
A. Baerheim
O B Fasmer
P. Hjortdahl
P. Vaglum
Source
BMC Med Educ. 2015;15:225
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Communication
Cost Savings - methods
Cross-Sectional Studies
Educational Measurement - methods - standards
Faculty, Medical
Female
Humans
Internship and Residency - methods - standards
Male
Middle Aged
Norway
Patient satisfaction
Patient Simulation
Physician-Patient Relations
Videotape Recording
Young Adult
Abstract
In medical education, teaching methods offering intensive practice without high utilization of faculty resources are needed. We investigated whether simulated patients' (SPs') satisfaction with a consultation could predict professional observers' assessment of young doctors' communication skills.
This was a comparative cross-sectional study of 62 videotaped consultations in a general practice setting with young doctors who were finishing their internship. The SPs played a female patient who had observed blood when using the toilet, which had prompted a fear of cancer. Immediately afterwards, the SP rated her level of satisfaction with the consultation, and the scores were dichotomized into satisfaction or dissatisfaction. Professional observers viewed the videotapes and assessed the doctors' communication skills using the Arizona Communication Interview Rating Scale (ACIR). Their ratings of communication skills were dichotomized into acceptable versus unacceptable levels of competence.
The SPs' satisfaction showed a predictive power of 0.74 for the observers' assessment of the young doctors and whether they reached an acceptable level of communication skills. The SPs' dissatisfaction had a predictive power of 0.71 for the observers' assessment of an unacceptable communication level. The two assessment methods differed in 26% of the consultations. When SPs felt relief about their cancer concern after the consultation, they assessed the doctors' skills as satisfactory independent of the observers' assessment.
Accordance between the dichotomized SPs' satisfaction score and communication skills assessed by observers (using the ACIR) was in the acceptable range. These findings suggest that SPs' satisfaction scores may provide a reliable source for assessing communication skills in educational programs for medical trainees (students and young doctors). Awareness of the patient's concerns seems to be of vital importance to patient satisfaction.
Notes
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Cites: Acad Psychiatry. 2014 Jun;38(3):354-6024777713
PubMed ID
26687201 View in PubMed
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[Career plans of future physicians. Level of ambition and plans for specialization among medical students]

https://arctichealth.org/en/permalink/ahliterature34170
Source
Tidsskr Nor Laegeforen. 1997 Aug 20;117(19):2807-11
Publication Type
Article
Date
Aug-20-1997
Author
J. Wiers-Jenssen
P. Vaglum
O. Ekeberg
Author Affiliation
Institutt for medisinske atferdsfag, Universitet i Oslo.
Source
Tidsskr Nor Laegeforen. 1997 Aug 20;117(19):2807-11
Date
Aug-20-1997
Language
Norwegian
Publication Type
Article
Keywords
Adult
Career Mobility
Education, Medical, Continuing
English Abstract
Female
Humans
Male
Norway
Self Concept
Socioeconomic Factors
Specialties, Medical
Students, Medical
Abstract
This nation-wide study inquiry concerned the intended future careers of medical students at the end of their studies and those of a cohort of first-year students. More first-year than final-year students hoped to obtain a position as a hospital physical or surgeon with management responsibility and twice as many men as women wanted such a position in both cohorts. High self esteem, having a doctor as father and successful examinations at medical school were associated with a high level of ambition. Compared with first-year students, more final-year students preferred family medicine and internal medicine, and less preferred surgery, psychiatry and social medicine. Plans for specialisation were influenced by the father's education level, successful examinations at medical school, whether they had children or not, and the university of graduation. More women preferred gynaecology, more men preferred surgery. The interest for surgery among female students is high compared with the low share of female surgeons. Assuming that these trends persist, psychiatry, laboratory medicine and social medicine risk insufficient recruitment. The share of women holding clinical professorships will probably remain low, even in a generation with more female than male medical students.
PubMed ID
9312874 View in PubMed
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Clinical epidemiologic first-episode psychosis: 1-year outcome and predictors.

https://arctichealth.org/en/permalink/ahliterature163098
Source
Acta Psychiatr Scand. 2007 Jul;116(1):54-61
Publication Type
Article
Date
Jul-2007
Author
E. Simonsen
S. Friis
U. Haahr
J O Johannessen
T K Larsen
I. Melle
S. Opjordsmoen
B R Rund
P. Vaglum
T. McGlashan
Author Affiliation
Roskilde Psychiatric University Hospital Fjorden, Roskilde, Denmark. rfes@ra.dk
Source
Acta Psychiatr Scand. 2007 Jul;116(1):54-61
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Adult
Affect
Denmark - epidemiology
Female
Humans
Male
Norway - epidemiology
Prospective Studies
Psychotic Disorders - drug therapy - epidemiology
Remission Induction
Schizophrenia - drug therapy - epidemiology
Social Behavior
Abstract
To describe 1-year outcome in a large clinical epidemiologic sample of first-episode psychosis and its predictors.
A total of 301 patients with first-episode psychosis from four healthcare sectors in Norway and Denmark receiving common assessments and standardized treatment were evaluated at baseline, at 3 months, and at 1 year.
Substantial clinical and social improvements occurred within the first 3 months. At 1-year 66% were in remission, 11% in relapse, and 23% continuously psychotic. Female gender and better premorbid functioning were predictive of less severe negative symptoms. Shorter DUP was predictive for shorter time to remission, stable remission, less severe positive symptoms, and better social functioning. Female gender, better premorbid social functioning and more education also contributed to a better social functioning.
This first-episode sample, being well treated, may be typical of the early course of schizophrenia in contemporary centers.
PubMed ID
17559601 View in PubMed
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Different intake procedures. The influence on treatment start and treatment response--a quasi-experimental study.

https://arctichealth.org/en/permalink/ahliterature8197
Source
J Subst Abuse Treat. 1992;9(1):53-8
Publication Type
Article
Date
1992
Author
E. Ravndal
P. Vaglum
Author Affiliation
Department of Behavioural Sciences in Medicine, University of Oslo, Norway.
Source
J Subst Abuse Treat. 1992;9(1):53-8
Date
1992
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholism - psychology - rehabilitation
Amphetamine
Comparative Study
Female
HIV Seroprevalence
Humans
Male
Middle Aged
Norway
Opioid-Related Disorders - psychology - rehabilitation
Patient Admission
Patient Compliance - psychology
Personality Assessment
Psychiatric Status Rating Scales
Psychotropic Drugs
Substance-Related Disorders - psychology - rehabilitation
Therapeutic Community
Abstract
Two hundred Norwegian substance abusers who consecutively applied for treatment in a hierarchical therapeutic community were divided into two different groups according to intake procedures: the intake group (IG) and the nonintake group (No-IG). Using a prospective design, we found that beginners in the program were more often infected with human immunodeficiency virus and that they used amphetamine more frequently and alcohol less frequently than nonbeginners. The type of intake procedure did not influence the percentage of those who started in the program, but it increased the number of clients who completed Phase 1, the 1-year inpatient phase of the program. Twice as many clients in the IG completed Phase 1 compared to those in the No-IG. From a clinical point of view, we conclude that the IG procedure should be offered to all applicants but that the model should be developed more as a role induction strategy, in which learning practical coping skills to adjust to the treatment program is essential.
PubMed ID
1593664 View in PubMed
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Early detection of psychosis: positive effects on 5-year outcome.

https://arctichealth.org/en/permalink/ahliterature140097
Source
Psychol Med. 2011 Jul;41(7):1461-9
Publication Type
Article
Date
Jul-2011
Author
T K Larsen
I. Melle
B. Auestad
U. Haahr
I. Joa
J O Johannessen
S. Opjordsmoen
B R Rund
J I Rossberg
E. Simonsen
P. Vaglum
S. Friis
T. McGlashan
Author Affiliation
Stavanger University Hospital, Psychiatric Clinic, Stavanger, Norway. tkmaclarsen@mac.com
Source
Psychol Med. 2011 Jul;41(7):1461-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Early Diagnosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway
Outcome Assessment (Health Care) - methods
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - psychology - therapy
Young Adult
Abstract
During the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long-term outcome. This study reports the effects of reducing DUP on 5-year course and outcome.
During 1997-2000 a total of 281 consecutive patients aged >17 years with first episode non-affective psychosis were recruited, of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) programme with public information campaigns and low-threshold psychosis detection teams was established in one healthcare area (ED-area), but not in a comparable area (no-ED area). Both areas ran equivalent treatment programmes during the first 2 years and need-adapted treatment thereafter.
At the start of treatment, ED-patients had shorter DUP and less symptoms than no-ED-patients. There were no significant differences in treatment (psychotherapy and medication) for the 5 years. Mixed-effects modelling showed better scores for the ED group on the Positive and Negative Syndrome Scale negative, depressive and cognitive factors and for global assessment of functioning for social functioning at 5-year follow-up. The ED group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders.
Early treatment had positive effects on clinical and functional status at 5-year follow-up in first episode psychosis.
Notes
Comment In: Psychol Med. 2012 Mar;42(3):669-7022099925
PubMed ID
20942996 View in PubMed
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Early detection strategies for untreated first-episode psychosis.

https://arctichealth.org/en/permalink/ahliterature71893
Source
Schizophr Res. 2001 Aug 1;51(1):39-46
Publication Type
Article
Date
Aug-1-2001
Author
J O Johannessen
T H McGlashan
T K Larsen
M. Horneland
I. Joa
S. Mardal
R. Kvebaek
S. Friis
I. Melle
S. Opjordsmoen
E. Simonsen
H. Ulrik
P. Vaglum
Author Affiliation
Rogaland Psychiatric Hospital, P.O. Box 1163, Hillevåg, 4095, Stavanger, Norway. joj@rps.no
Source
Schizophr Res. 2001 Aug 1;51(1):39-46
Date
Aug-1-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Comparative Study
Denmark
Ethics, Medical
Female
Health education
Health Services Accessibility
Humans
Male
Middle Aged
Norway
Outcome and Process Assessment (Health Care)
Psychotic Disorders - diagnosis - drug therapy
Referral and Consultation
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Schizophrenia - diagnosis - drug therapy
Schizotypal Personality Disorder - diagnosis - drug therapy
Abstract
Some studies in first-episode schizophrenia correlate shorter duration of untreated psychosis (DUP) with better prognosis, suggesting that timing of treatment may be important. A three-site prospective clinical trial in Norway and Denmark is underway to investigate the effect of the timing of treatment in first-episode psychosis. One health care sector (Rogaland, Norway) is experimental and has developed an early detection (ED) system to reduce DUP. Two other sectors (Ullevål, Norway, and Roskilde, Denmark) are comparison sectors and rely on existing detection and referral systems for first-episode cases. The study ultimately will compare early detected with usual detected patients. This paper describes the study's major independent intervention variable, i.e. a comprehensive education and detection system to change DUP in first onset psychosis.System variables and first results from the four-year inclusion period (1997-2000) are described. It includes targeted information towards the general public, health professionals and schools, and ED teams to recruit appropriate patients into treatment as soon as possible. This plus easy access to psychiatric services via ED teams systematically changed referral patterns of first-episode schizophrenia. DUP was reduced by 1.5 years (mean) from before the time the ED system was instituted (to 0.5 years). The ED strategies appear to be effective and to influence directly the community's help-seeking behaviour.
PubMed ID
11479064 View in PubMed
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Early identification of non-remission in first-episode psychosis in a two-year outcome study.

https://arctichealth.org/en/permalink/ahliterature141450
Source
Acta Psychiatr Scand. 2010 Nov;122(5):375-83
Publication Type
Article
Date
Nov-2010
Author
Erik Simonsen
S. Friis
S. Opjordsmoen
E L Mortensen
U. Haahr
I. Melle
I. Joa
J O Johannessen
T K Larsen
J I Røssberg
B R Rund
P. Vaglum
T H McGlashan
Author Affiliation
Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde University and University of Copenhagen, Copenhagen, Denmark. es@regionsjaelland.dk
Source
Acta Psychiatr Scand. 2010 Nov;122(5):375-83
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Chi-Square Distribution
Denmark - epidemiology
Female
Humans
Logistic Models
Male
Marital status
Middle Aged
Norway - epidemiology
Psychotherapy
Psychotic Disorders - diagnosis - epidemiology - psychology - therapy
Remission Induction
Sex Factors
Social Adjustment
Statistics, nonparametric
Substance-Related Disorders - psychology
Treatment Outcome
Young Adult
Abstract
To identify predictors of non-remission in first-episode, non-affective psychosis.
During 4 years, we recruited 301 patients consecutively. Information about first remission at 3 months was available for 299 and at 2 years for 293 cases. Symptomatic and social outcomes were assessed at 3 months, 1 and 2 years.
One hundred and twenty-nine patients (43%) remained psychotic at 3 months and 48 patients (16.4%) remained psychotic over 2 years. When we compared premorbid and baseline data for the three groups, the non-remitted (n = 48), remitted for
Notes
Comment In: Acta Psychiatr Scand. 2011 Jun;123(6):49421219270
PubMed ID
20722632 View in PubMed
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51 records – page 1 of 6.