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Assessment of the psychological effects of genetic screening for hereditary hemochromatosis.

https://arctichealth.org/en/permalink/ahliterature159800
Source
Ann Hematol. 2008 May;87(5):397-404
Publication Type
Article
Date
May-2008
Author
Peter Elsass
Palle Pedersen
Kristian Husum
Nils Milman
Author Affiliation
Institute of Psychology, University of Copenhagen, Copenhagen, Denmark.
Source
Ann Hematol. 2008 May;87(5):397-404
Date
May-2008
Language
English
Publication Type
Article
Keywords
Adult
Denmark
Genetic Testing - psychology
Hemochromatosis - genetics
Histocompatibility Antigens Class I - genetics
Humans
Male
Mass Screening - psychology
Membrane Proteins - genetics
Middle Aged
Patient satisfaction
Prospective Studies
Psychiatric Status Rating Scales
Questionnaires
Abstract
Discovery of genetic variants of the HFE gene has made it possible to screen for hereditary hemochromatosis. However, genetic screening raises ethical, legal, social, and psychological questions, which need to be addressed. To assess the psychological impact on individuals undergoing genetic screening for hereditary hemochromatosis and to determine the effects of providing different levels of information to the participants. Male residents, aged 30-50 years (n = 10,993) were invited to a genetic screening for hereditary hemochromatosis. Carriers of the gene variants H63D, S65C, and C282Y were offered additional biochemical screening using serum ferritin and transferrin saturation. Psychological factors were evaluated through questionnaires before and after genetic and biochemical screening. According to genotype, participants were divided into three groups with different risks profiles for having/developing clinical hemochromatosis (at-risk, uncertain risk, no risk). Before completion of the questionnaires, 929 participants received only genetic information and 366 received both genetic and biochemical information. At-risk participants receiving only genetic information generally displayed negative reactions to the test result, whereas participants receiving both genetic and biochemical information were more satisfied and had fewer negative psychological reactions to the test result. Genetic screening is more readily accepted by subjects when genetic information is supported by biochemical measurements, especially in participants with a risk of clinical disease.
PubMed ID
18080122 View in PubMed
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Effect of mindfulness-based stress reduction on somatic symptoms, distress, mindfulness and spiritual wellbeing in women with breast cancer: Results of a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature266884
Source
Acta Oncol. 2015 May;54(5):712-9
Publication Type
Article
Date
May-2015
Author
Hanne Würtzen
Susanne Oksbjerg Dalton
Jane Christensen
Klaus Kaae Andersen
Peter Elsass
Henrik L Flyger
Anne E Pedersen
Antonia Sumbundu
Marianne Steding-Jensen
Christoffer Johansen
Source
Acta Oncol. 2015 May;54(5):712-9
Date
May-2015
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - complications - pathology - psychology - surgery
Chemotherapy, Adjuvant
Denmark
Female
Follow-Up Studies
Humans
Linear Models
Middle Aged
Mindfulness - methods
Questionnaires
Radiotherapy, Adjuvant
Spirituality
Stress, Psychological - therapy
Time Factors
Abstract
Women with breast cancer experience different symptoms related to surgical or adjuvant therapy. Previous findings and theoretical models of mind-body interactions suggest that psychological wellbeing, i.e. levels of distress, influence the subjective evaluation of symptoms, which influences or determines functioning. The eight-week mindfulness-based stress reduction (MBSR) program significantly reduced anxiety and depression in breast cancer patients in a randomized controlled trial (NCT00990977). In this study we tested the effect of MBSR on the burden of breast cancer related somatic symptoms, distress, mindfulness and spiritual wellbeing and evaluated possible effect modification by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing.
A population-based sample of 336 women Danish women operated for breast cancer stages I-III were randomized to MBSR or usual care and were followed up for somatic symptoms, distress, mindfulness skills and spiritual wellbeing post-intervention and after six and 12 months. Effect was tested by general linear regression models post-intervention, and after six and 12 months follow-up and by mixed effects models for repeated measures of continuous outcomes. Effect size (Cohen's d) was calculated to explore clinical significance of effects among intervention group. Finally, modification of effect of MBSR on burden of somatic symptoms after 12 months' follow-up by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing were estimated.
General linear regression showed a significant effect of MBSR on the burden of somatic symptoms post-intervention and after 6 months' follow-up. After 12 months' follow-up, no significant effect of MBSR on the burden of somatic symptoms was found in mixed effect models. A statistically significant effect of MBSR on distress was found at all time-points and in the mixed effect models. Significant effects on mindfulness were seen after six and 12 months and no significant effect was observed for spiritual wellbeing. No significant modification of MBSR effect on somatic symptom burden was identified.
This first report from a randomized clinical trial on the long-term effect of MBSR finds an effect on somatic symptom burden related to breast cancer after six but not 12 months follow-up providing support for MBSR in this patient group.
PubMed ID
25752972 View in PubMed
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Equity in the use of publicly subsidized psychotherapy among elderly Danish cancer patients--a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature118016
Source
Acta Oncol. 2013 Feb;52(2):355-63
Publication Type
Article
Date
Feb-2013
Author
Annika B von Heymann-Horan
Pernille E Bidstrup
Luise C Kristiansen
Anja Olsen
Klaus K Andersen
Peter Elsass
Christoffer Johansen
Susanne O Dalton
Author Affiliation
Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark. heymann@cancer.dk
Source
Acta Oncol. 2013 Feb;52(2):355-63
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Female
Financing, Government - statistics & numerical data - utilization
Healthcare Disparities - statistics & numerical data
Humans
Male
Middle Aged
Neoplasms - epidemiology - psychology - rehabilitation
Psychotherapy - economics - statistics & numerical data
Questionnaires
Registries
Abstract
Approximately 30% of cancer patients suffer from psychological distress, and psychotherapy has been shown to be effective in alleviating it. Based on the 'Behavioral Model of Health Service Use', we investigated equity in the use of publicly subsidized psychotherapy in a cohort of Danish cancer patients. We present descriptive data on patients' use of psychotherapy and examine characteristics of those who used this service.
The study population comprised 3646 participants in the prospective Diet, Cancer and Health cohort, diagnosed with a first cancer between 2003 and 2009, aged 56-80 years. Data on cancer diagnosis, psychotherapy use and comorbid conditions were obtained from registers, whereas data on demographics, social support and health status were obtained from questionnaires. Cox proportional hazards regression was used to identify factors related to use, which were subsequently evaluated with regard to equity.
Subsidized psychotherapy was used by 2.3% of the cancer patients. Longer education (> 10 years compared to 74 years: 0.07, 0.01-0.57, compared to
PubMed ID
23244710 View in PubMed
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The importance of early anti-social behaviour among men with a schizophrenia spectrum disorder in a specialist forensic psychiatry hospital unit in Denmark.

https://arctichealth.org/en/permalink/ahliterature96341
Source
Crim Behav Ment Health. 2010 Jul 14;
Publication Type
Article
Date
Jul-14-2010
Author
Liselotte Pedersen
Kirsten Rasmussen
Peter Elsass
Helle Hougaard
Author Affiliation
Department of Forensic Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Denmark.
Source
Crim Behav Ment Health. 2010 Jul 14;
Date
Jul-14-2010
Language
English
Publication Type
Article
Abstract
Background People with a major mental disorder are at increased risk of committing crimes, especially violent crimes, compared with the general population. Sub-groups have been identified based on age of onset of anti-social or violent behaviour. Mentally disordered offenders with early onset anti-social behaviour tend to have a lifelong pattern of it, but in a clinical setting, are they easily identifiable as a distinct sub-group?Aims Our main aim was to establish whether distinct groups of early and later onset offenders can be identified from the standard clinical record of men with schizophrenia spectrum disorders selected for hospital treatment after conviction for a serious crime, and to test the hypothesis that even in such a clinically selected group, early onset offending would be associated with subsequent persistent and versatile offending.Methods A retrospective case file review of all 83 men with a schizophrenia spectrum disorder in a complete 2-year discharge cohort from one specialist secure forensic hospital unit (2001-2002).Results A sub-group of patients with early onset anti-social behaviour was confirmed. Prior to this specialist hospitalisation, this group had sustained significantly more criminal convictions and were more criminally versatile than their late onset peers.Conclusions The recognition of clinically meaningful sub-groups among hospitalised offender patients seems straightforward, and may be useful in the development of more specifically focused intervention and in making sense of more longer-term outcomes. Copyright (c) 2010 John Wiley & Sons, Ltd.
PubMed ID
20632435 View in PubMed
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Who participates in a randomized trial of mindfulness-based stress reduction (MBSR) after breast cancer? A study of factors associated with enrollment among Danish breast cancer patients.

https://arctichealth.org/en/permalink/ahliterature260715
Source
Psychooncology. 2013 May;22(5):1180-5
Publication Type
Article
Date
May-2013
Author
Hanne Würtzen
Susanne Oksbjerg Dalton
Klaus Kaae Andersen
Peter Elsass
Henrik Lavlund Flyger
Antonia Sumbundu
Christoffer Johansen
Source
Psychooncology. 2013 May;22(5):1180-5
Date
May-2013
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - complications - psychology
Denmark
Female
Humans
Middle Aged
Mindfulness - methods
Patient Selection
Psychiatric Status Rating Scales
Randomized Controlled Trials as Topic - methods
Stress, Psychological - prevention & control
Treatment Refusal - psychology - statistics & numerical data
Abstract
Discussion regarding the necessity to identify patients with both the need and motivation for psychosocial intervention is ongoing. Evidence for an effect of mindfulness-based interventions among cancer patients is based on few studies with no systematic enrollment.
We used Danish population-based registries and clinical databases to determine differences in demographics, breast cancer and co-morbidity among 1208 women eligible for a randomized controlled trial (www.clinicaltrials.gov identifier: NCT00990977) of mindfulness-based stress reduction MBSR.
Participants (N = 336) were found to be younger (p
PubMed ID
22592966 View in PubMed
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