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Acute and continuation therapy in unipolar depression: observations from the run-in phase of a maintenance trial.

https://arctichealth.org/en/permalink/ahliterature93367
Source
Acta Psychiatr Scand. 2008 Aug;118(2):123-9
Publication Type
Article
Date
Aug-2008
Author
Gram L F
Author Affiliation
Clinical Pharmacology, IST, University of Southern Denmark, Winsløwparken 19, DK-5000 Odense C, Denmark. lf_gram@yahoo.com
Source
Acta Psychiatr Scand. 2008 Aug;118(2):123-9
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antidepressive Agents - therapeutic use
Denmark
Depressive Disorder - drug therapy - psychology - therapy
Electroconvulsive Therapy
Female
Follow-Up Studies
Humans
Male
Mental Disorders - drug therapy - psychology
Middle Aged
Psychiatric Status Rating Scales - statistics & numerical data
Psychotropic Drugs - therapeutic use
Recurrence
Severity of Illness Index
Time
Treatment Outcome
Abstract
OBJECTIVE: The aim of the study was to analyze treatments and outcome in depressed patients. METHOD: Patients with recurrent depressive disorder (n = 289), recruited for a prophylaxis study, were followed up in hospital settings for 6 months with diagnostic and depression ratings at baseline and monthly depression ratings. Data on psychotropic drugs were retrieved from hospital case records. Independent associations between baseline, treatment and outcome variables were examined by logistic regression models. RESULTS: Depressive symptoms subsided gradually. After 6 months, 21% had dropped out, 43% were rated as remitted (HAM-D-17 15). Patients once remitted rarely relapsed (
PubMed ID
18384466 View in PubMed
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Adherence to psychotropic medication in completed suicide in Sweden 2006-2013: a forensic-toxicological matched case-control study.

https://arctichealth.org/en/permalink/ahliterature310406
Source
Eur J Clin Pharmacol. 2019 Oct; 75(10):1421-1430
Publication Type
Journal Article
Date
Oct-2019
Author
Jonas Forsman
Heidi Taipale
Thomas Masterman
Jari Tiihonen
Antti Tanskanen
Author Affiliation
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. jonas.forsman@ki.se.
Source
Eur J Clin Pharmacol. 2019 Oct; 75(10):1421-1430
Date
Oct-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Case-Control Studies
Female
Humans
Male
Medication Adherence
Middle Aged
Psychotropic Drugs - therapeutic use
Registries
Suicide, Completed - statistics & numerical data
Sweden - epidemiology
Abstract
To investigate the influence of adherence to psychotropic medications upon the risk of completed suicide by comparing person-level prescriptions and postmortem toxicological findings among complete-suicide cases and non-suicide controls in Sweden 2006-2013.
Using national registries with full coverage on dispensed prescriptions, results of medico-legal autopsies, causes of death, and diagnoses from inpatient care, estimated continuous drug use for 30 commonly prescribed psychotropic medications was compared with forensic-toxicological findings. Subjects who had died by suicide (cases) were matched (1:2) with subjects who had died of other causes (controls) for age, sex, and year of death. Odds ratios were calculated using logistic regression to estimate the risk of completed suicide conferred by partial adherence and non-adherence to pharmacotherapy. Adjustments were made for previous inpatient care and the ratio of initiated and discontinued dispensed prescriptions, a measure of the continued need of treatment preceding death.
In 5294 suicide cases and 9879 non-suicide controls, after adjusting for the dispensation ratio and other covariates, partial adherence and non-adherence to antipsychotics were associated with 6.7-fold and 12.4-fold risks of completed suicide, respectively, whereas corresponding risk estimates for antidepressant treatment were not statistically significant and corresponding risk increases for incomplete adherence to antidepressant treatment were lower (1.6-fold and 1.5-fold, respectively) and lacked statistical significance.
After adjustment for the need of treatment, biochemically verified incomplete adherence to antipsychotic pharmacotherapy was associated with markedly increased risks of completed suicide.
PubMed ID
31218371 View in PubMed
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Advertising for psychotropic drugs in the Nordic countries: metaphors, gender and life situations.

https://arctichealth.org/en/permalink/ahliterature52881
Source
Soc Sci Med. 1991;32(4):465-71
Publication Type
Article
Date
1991
Author
E. Riska
U. Hägglund
Author Affiliation
Department of Sociology, Abo Akademi University, Finland.
Source
Soc Sci Med. 1991;32(4):465-71
Date
1991
Language
English
Publication Type
Article
Keywords
Advertising - methods - trends
Denmark
Female
Finland
Humans
Hypnotics and Sedatives - therapeutic use
Occupations
Periodicals
Psychotropic Drugs - therapeutic use
Sex
Sweden
Tranquilizing Agents - therapeutic use
Abstract
Advertisements for psychotropic drugs which appeared in the leading medical journals in Finland, Sweden and Denmark were analyzed to identify the picture content and trends in advertising between 1975 and 1985. The most common picture was a metaphor, the frequency of which increased in the 1980s. The second largest picture category was a patient, the rate of which remained constant during the study period. Both the use of a metaphor and a patient was related to the low sales of the drug in respective country whereas picture of a drug package was related to a stable market position of a drug in the country. The patients were increasingly depicted as men in the Danish and Swedish journal whereas the pictures of females were most common in the Finnish one. The portrayal of working persons, especially office workers and teachers, was a new feature in the advertisements in the 1980s. It is argued that the drug industry still uses gender as a device to expand their market of psychotropic drugs in a new way.
PubMed ID
2024162 View in PubMed
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Age-related patterns in mental health-related complementary and alternative medicine utilization in Canada.

https://arctichealth.org/en/permalink/ahliterature141498
Source
Int Psychogeriatr. 2011 Apr;23(3):459-71
Publication Type
Article
Date
Apr-2011
Author
Rebecca Crabb
John Hunsley
Author Affiliation
Special Fellowship Program in Advanced Geriatrics, Geriatric Research Education and Clinical Center, VA Palo Alto, CA 94304–1290, USA. rebecca.crabb@va.gov
Source
Int Psychogeriatr. 2011 Apr;23(3):459-71
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Canada - epidemiology
Chi-Square Distribution
Complementary Therapies - utilization
Cross-Sectional Studies
Female
Health Care Surveys
Health status
Humans
Logistic Models
Male
Mental Disorders - drug therapy - therapy
Mental Health Services - utilization
Middle Aged
Psychotropic Drugs - therapeutic use
Socioeconomic Factors
Abstract
The aim of this study was to examine whether age-related differences in rates of use of complementary and alternative medicine (CAM) specifically for mental health problems parallel well-known age-related differences in use of conventional mental health services and medications.
A sample of middle-aged (45-64 years; n = 10,762), younger-old (65-74; n = 4,113) and older-old adults (75 years and older; n = 3,623) was drawn from the 2001-2002 Canadian Community Health Survey (CCHS), Cycle 1.2, Mental Health and Wellbeing. Age-related utilization rates of conventional and complementary mental health services and medications/products were calculated. Logistic regression analyses were used to examine the strength of association between age group and utilization of services and medications or products in the context of other important sociodemographic and clinical characteristics.
When considered in the context of other sociodemographic and clinical characteristics, older age was positively associated with mental health-related utilization of alternative health products. Older age was not significantly associated with mental health-related consultations with CAM providers.
Overall, age-related patterns in mental health-related use of CAM did not directly correspond to age-related patterns in conventional mental health care utilization, suggesting different sets of predictors involved in seeking each type of care.
Notes
Erratum In: Int Psychogeriatr. 2011 Apr;23(3):472
PubMed ID
20716388 View in PubMed
Less detail
Source
Child Care Health Dev. 1985 Nov-Dec;11(6):355-73
Publication Type
Article
Author
T. Elston
J B Thomas
Source
Child Care Health Dev. 1985 Nov-Dec;11(6):355-73
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Anorexia Nervosa - epidemiology - etiology - therapy
Behavior Therapy
Body Image
Child
Culture
Family
Family Therapy
Female
Humans
Length of Stay
Male
Prognosis
Psychological Theory
Psychotherapy
Psychotropic Drugs - therapeutic use
Puberty
Sex Factors
Sweden
Abstract
This paper, following a brief historical note, reviews the literature on anorexia nervosa. It begins by describing the characteristics of the syndrome and then considers incidence, aetiology and treatment. The results of treatment are described and the paper concludes by attempting a prognosis for those who are diagnosed anorexic. The authors are eclectic in their literature survey and also present some experience collected in a hospital school. The paper is intended as a teaching synthesis for clinicians new to this area or for those seeking a brief introduction to the present 'state of the art' in theory and practice.
PubMed ID
3907882 View in PubMed
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An Original Stepwise Multilevel Logistic Regression Analysis of Discriminatory Accuracy: The Case of Neighbourhoods and Health.

https://arctichealth.org/en/permalink/ahliterature280453
Source
PLoS One. 2016;11(4):e0153778
Publication Type
Article
Date
2016
Author
Juan Merlo
Philippe Wagner
Nermin Ghith
George Leckie
Source
PLoS One. 2016;11(4):e0153778
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Female
General practitioners
Humans
Logistic Models
Longitudinal Studies
Male
Middle Aged
Multilevel Analysis - methods
Psychotropic Drugs - therapeutic use
Public Health - statistics & numerical data
ROC Curve
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Sweden
Abstract
Many multilevel logistic regression analyses of "neighbourhood and health" focus on interpreting measures of associations (e.g., odds ratio, OR). In contrast, multilevel analysis of variance is rarely considered. We propose an original stepwise analytical approach that distinguishes between "specific" (measures of association) and "general" (measures of variance) contextual effects. Performing two empirical examples we illustrate the methodology, interpret the results and discuss the implications of this kind of analysis in public health.
We analyse 43,291 individuals residing in 218 neighbourhoods in the city of Malmö, Sweden in 2006. We study two individual outcomes (psychotropic drug use and choice of private vs. public general practitioner, GP) for which the relative importance of neighbourhood as a source of individual variation differs substantially. In Step 1 of the analysis, we evaluate the OR and the area under the receiver operating characteristic (AUC) curve for individual-level covariates (i.e., age, sex and individual low income). In Step 2, we assess general contextual effects using the AUC. Finally, in Step 3 the OR for a specific neighbourhood characteristic (i.e., neighbourhood income) is interpreted jointly with the proportional change in variance (i.e., PCV) and the proportion of ORs in the opposite direction (POOR) statistics.
For both outcomes, information on individual characteristics (Step 1) provide a low discriminatory accuracy (AUC = 0.616 for psychotropic drugs; = 0.600 for choosing a private GP). Accounting for neighbourhood of residence (Step 2) only improved the AUC for choosing a private GP (+0.295 units). High neighbourhood income (Step 3) was strongly associated to choosing a private GP (OR = 3.50) but the PCV was only 11% and the POOR 33%.
Applying an innovative stepwise multilevel analysis, we observed that, in Malmö, the neighbourhood context per se had a negligible influence on individual use of psychotropic drugs, but appears to strongly condition individual choice of a private GP. However, the latter was only modestly explained by the socioeconomic circumstances of the neighbourhoods. Our analyses are based on real data and provide useful information for understanding neighbourhood level influences in general and on individual use of psychotropic drugs and choice of GP in particular. However, our primary aim is to illustrate how to perform and interpret a multilevel analysis of individual heterogeneity in social epidemiology and public health. Our study shows that neighbourhood "effects" are not properly quantified by reporting differences between neighbourhood averages but rather by measuring the share of the individual heterogeneity that exists at the neighbourhood level.
Notes
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PubMed ID
27120054 View in PubMed
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Are Posttraumatic Stress Symptoms Related to Mental Health Service Use? A Prospective Study of Danish Soldiers Deployed to Afghanistan.

https://arctichealth.org/en/permalink/ahliterature282788
Source
J Clin Psychiatry. 2016 Oct;77(10):e1226-e1232
Publication Type
Article
Date
Oct-2016
Author
Trine Madsen
Søren Bo Andersen
Karen-Inge Karstoft
Source
J Clin Psychiatry. 2016 Oct;77(10):e1226-e1232
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Cross-Sectional Studies
Denmark
Drug Utilization - statistics & numerical data
Female
Follow-Up Studies
Health Services Needs and Demand - statistics & numerical data
Humans
Male
Mental Health Services - utilization
Patient Admission - statistics & numerical data
Prospective Studies
Psychotherapy - statistics & numerical data
Psychotropic Drugs - therapeutic use
Statistics as Topic
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology - therapy
Surveys and Questionnaires
Utilization Review - statistics & numerical data
Veterans - psychology - statistics & numerical data
Abstract
Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan.
Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers responded to a comprehensive questionnaire including a measure of PTSD symptoms (the PTSD Checklist-Civilian version). These self-reported data were combined with individual-level records of receiving psychotherapy from the Military Psychological Division at the Danish Defense and psychiatric treatment from the Danish registers.
The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription for psychiatric medicine. Approximately one-third received psychotherapy at the Military Psychological Division. In those reporting high PTSD symptomatology, 83% utilized 1 or more types of mental health service. At predeployment and homecoming, high PTSD symptomatology was significantly (P
PubMed ID
27529142 View in PubMed
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[Are psychiatric disorders identified and treated by in-prison health services?]

https://arctichealth.org/en/permalink/ahliterature9405
Source
Tidsskr Nor Laegeforen. 2004 Aug 26;124(16):2094-7
Publication Type
Article
Date
Aug-26-2004
Author
Hans Langeveld
Henning Melhus
Author Affiliation
Psykiatrisk klinikk, Sentralsjukehuset i Rogaland, Postboks 1163 Hillevåg, 4095 Stavanger. jhl@sir.no
Source
Tidsskr Nor Laegeforen. 2004 Aug 26;124(16):2094-7
Date
Aug-26-2004
Language
Norwegian
Publication Type
Article
Keywords
Behavioral Symptoms - diagnosis - epidemiology - therapy
English Abstract
Female
Forensic Psychiatry
Humans
Male
Mental Disorders - diagnosis - epidemiology - therapy
Mental health services
Mentally Disabled Persons - psychology
Norway - epidemiology
Personality Disorders - diagnosis - epidemiology - therapy
Prisoners - psychology
Prisons
Psychotic Disorders - diagnosis - epidemiology - therapy
Psychotropic Drugs - therapeutic use
Questionnaires
Substance-Related Disorders - diagnosis - epidemiology - therapy
Abstract
BACKGROUND: The prevalence in Norwegian prisons of psychiatric disorders in relation to the treatment potential in the prison health system has not been properly examined. MATERIAL AND METHOD: The prevalence of psychiatric disorders, drug problems and personality disorders was examined in a prison population in the western health region in Norway. Additionally, treatments of these disorders were surveyed. The methods used were structured clinical interviews, self reports and reviews of medical case notes. RESULTS: Psychiatric disorders in need of treatment were found in 18 out of 40 interviewed inmates. Of these 18, 13 actually received treatment with psychoactive medication. Criteria for alcohol and drug addiction or misuse were fulfilled by over 90%. Personality disorders were found in 80% and antisocial personality disorder in more than 60%. INTERPRETATION: The prevalence of psychiatric disorders including personality disorders and drug addiction is high among inmates. Compared to international studies, more of the inmates with psychiatric disorders that we interviewed receive psychoactive medication.
Notes
Comment In: Tidsskr Nor Laegeforen. 2004 Aug 26;124(16):207915334117
PubMed ID
15334122 View in PubMed
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The association between immigrant subgroup and poor mental health: a population-based register study.

https://arctichealth.org/en/permalink/ahliterature108380
Source
J Nerv Ment Dis. 2013 Aug;201(8):645-52
Publication Type
Article
Date
Aug-2013
Author
Anna-Clara Hollander
Daniel Bruce
Bo Burström
Solvig Ekblad
Author Affiliation
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden. anna-clara.hollander@ki.se
Source
J Nerv Ment Dis. 2013 Aug;201(8):645-52
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cross-Sectional Studies
Emigrants and Immigrants - classification - statistics & numerical data
Female
Humans
Male
Mental Disorders - drug therapy - ethnology
Mental Health - statistics & numerical data
Middle Aged
Psychotropic Drugs - therapeutic use
Refugees - classification - statistics & numerical data
Registries - statistics & numerical data
Sweden - ethnology
Young Adult
Abstract
Ethnicity and immigrant subgroup (classified as refugee or nonrefugee) are associated with poor mental health among immigrants. The aim of this study was to assess whether national origin-based differences in poor mental health can be explained by immigrant subgroup and if its importance varies depending on origin. A cross-sectional, population-based study of Swedish residents was conducted in 2006. The outcome was poor mental health, measured with the proxy variable psychotropic drugs purchased. Explanatory variables included immigrant subgroup and origin. Potential confounders were age, marital status, education, time in Sweden, and children. Logistic regression was carried out. The total population was 5,507,262. Immigrants from countries outside the Organisation for Economic Co-operation and Development (OECD) numbered 298,641. Immigrant subgroup partly explained the higher likelihood of poor mental health among non-OECD immigrants; when each country or area was analyzed separately, most refugees had a higher likelihood than nonrefugees did. Immigrant subgroup partly explained the origin-based differences in mental health, but this varied between different groups of origin.
PubMed ID
23896844 View in PubMed
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Association between perceived stress, multimorbidity and primary care health services: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature294801
Source
BMJ Open. 2018 02 24; 8(2):e018323
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-24-2018
Author
Anders Prior
Mogens Vestergaard
Karen Kjær Larsen
Morten Fenger-Grøn
Author Affiliation
Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
Source
BMJ Open. 2018 02 24; 8(2):e018323
Date
02-24-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Female
Health Surveys
Humans
Life Style
Male
Mental Health Services - utilization
Middle Aged
Multimorbidity
Patient Acceptance of Health Care - statistics & numerical data
Primary Health Care - utilization
Psychiatric Status Rating Scales
Psychotherapy
Psychotropic Drugs - therapeutic use
Regression Analysis
Sex Distribution
Socioeconomic Factors
Stress, Psychological - epidemiology - therapy
Abstract
Mental stress is common in the general population. Mounting evidence suggests that mental stress is associated with multimorbidity, suboptimal care and increased mortality. Delivering healthcare in a biopsychosocial context is key for general practitioners (GPs), but it remains unclear how persons with high levels of perceived stress are managed in primary care. We aimed to describe the association between perceived stress and primary care services by focusing on mental health-related activities and markers of elective/acute care while accounting for mental-physical multimorbidity.
Population-based cohort study.
Primary healthcare in Denmark.
118?410 participants from the Danish National Health Survey 2010 followed for 1?year. Information on perceived stress and lifestyle was obtained from a survey questionnaire. Information on multimorbidity was obtained from health registers.
General daytime consultations, out-of-hours services, mental health-related services and chronic care services in primary care obtained from health registers.
Perceived stress levels were associated with primary care activity in a dose-response relation when adjusted for underlying conditions, lifestyle and socioeconomic factors. In the highest stress quintile, 6.8% attended GP talk therapy (highest vs lowest quintile, adjusted incidence rate ratios (IRR): 4.96, 95%?CI 4.20 to 5.86), 3.3% consulted a psychologist (IRR: 6.49, 95%?CI 4.90 to 8.58), 21.5% redeemed an antidepressant prescription (IRR: 4.62, 95%?CI 4.03 to 5.31), 23.8% attended annual chronic care consultations (IRR: 1.22, 95%?CI 1.16 to 1.29) and 26.1% used out-of-hours services (IRR: 1.47, 95%?CI 1.51 to 1.68). For those with multimorbidity, stress was associated with more out-of-hours services, but not with more chronic care services.
Persons with high stress levels generally had higher use of primary healthcare, 4-6 times higher use of mental health-related services (most often in the form of psychotropic drug prescriptions), but less timely use of chronic care services.
Notes
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