Birgit Petersson

Salivary changes and dental erosion in bulimia nervosa.

OBJECTIVE Our aim was to study if bulimia nervosa (BN) has an impact on salivary gland function and if such changes are related to dental erosion. STUDY DESIGN Twenty women with BN and twenty age- and gender-matched controls participated. Flow rate and composition of whole and glandular saliva, as well as feeling of oral dryness were measured. Dental erosion was measured on casts. RESULTS Compared with control subjects, unstimulated whole saliva (UWS) flow rate was reduced in persons with BN, primarily owing to intake of medication (P = .007). No major compositional salivary changes were found. In the BN group, the dental erosion score was highest and complaints of oral dryness were more frequent. CONCLUSIONS The BN persons had impaired UWS, mainly owing to medication; increased feeling of oral dryness; and more dental erosion. Dental erosion was related to the duration of eating disorder, whereas no effect of vomiting frequency or intake of acidic drinks on reduced UWS was observed.

Ambivalence among women applying for abortion

Background. Our purpose was to characterize women expressing ambivalence when applying for abortion.

Suicide attempts among Greek and Danish women and the quality of their relationships with husbands or boyfriends

Greek and Danish women 15–45 years old who attempted suicide were interviewed with an extensive semistructured schedule, in Athens and Copenhagen, after admission to the intensive care unit of 2 general hospitals and one psychiatric reception ward. This article presents 2 groups from each country, a group of married women and a group with steady relationships (n= 56), focusing on the quality of their relationships and their significance for the womens suicide attempts. Most of the women in both countries had very poor relationships, as concerns communication, intimacy, concern, recreation, sharing of everyday activities and social and private life. A high degree of psychological and physical violence was found in all 4 groups. The burdensome and humiliating relationship created shame in the women. After unsuccessful attempts to change the relationship and inability to leave it because of financial and emotional dependence, the women attempted suicide to escape from the situation.

Stress and symptoms of depression among medical students at the University of Copenhagen

Objective: This article aims to assess the levels of stress and symptoms of depression among Danish medical students, as well as explore the effect of social support on psychological distress. The results are based on numbers from the follow-up study ‘From Student to Graduate’ (j.nr 2006-41-6876). Materials and methods: Two dimensions of stress, frequency and perception, were measured on a scale from 0–6. Odds ratios and significance of associations between the various exposure variables and the outcome measure, symptoms of depression, were calculated using multiple logistic regression and Wald tests. Results: 30.5% of the students reported depressive symptoms. Stress frequency measured a mean of 2.26 (SD = 1.35). The mean for stress perception was 2.85 (SD = 1.30). Women reported higher levels of stress and depression compared to male medical students, but the differences were not significant (p > 0.05). Only the dimensions of stress and coping alone were significantly associated with reporting symptoms of depression (p < 0.001). Students coping alone had a two times higher odds ratio for reporting depressive symptoms. Conclusions: Nearly one third of the participants reported feeling depressed. Stress levels were moderate, but significantly associated with symptoms of depression. The interaction between the stress dimensions and the outcome measure illustrates the importance of stress appraisal. Coping alone with psychological problems was significantly associated with symptoms of depression.

Psychiatric status among stepchildren and domestic and international adoptees in Denmark. A comparative nationwide register-based study.

Aims: To investigate adoptees’ psychiatric contact compared with non-adoptees and to clarify the related diagnoses. Method: Observational, nationwide, register-based study, where correlations between psychiatric, demographic and socioeconomic variables were analyzed for adoptees compared with non-adoptees. The study period is 1992—2008. The setting is Denmark, encompassing seven different types of adoptees registered from 1988 to 2005 (n = 13,524). The non-adoptees (n = 839,989) are matched on sex, age and residence. Various comparison models are designed: one with delayed entries (17 years) shows a 5.0% psychiatric contact prevalence for non-adoptees and 9.2% for adoptees (adjusted odds ratio: 2.91). Another design without delayed entries (2 years) shows a 2% prevalence for non-adoptees and 3.9% for adoptees (adjusted odds ratio 2.65). p-values <0.0005. Results: Only one type of adoptee: ‘‘registered partner’s adoption of the other partner’s child’’ has a lower risk than non-adoptees (odds ratio: 0.26). Comparison within the same birth region shows a significant increased risk for most adoption types. More adoptees than non-adoptees have more than one contact. Age at adoption is an additional risk factor for4one year only. The most frequent diagnosis is ‘‘Inherent or acquired brain suffering’’ (ICD-10: F50 — F99). Conclusions: The results stress that ‘‘adoptee’’ is an independent risk factor for psychiatric contact for international as well as for Danish adoptees. Danish stepchildren have a higher risk than non-adopted Danish children, while ‘‘registered partner’s child adopted by the other partner’’ have a lower risk than non-adopted Danish children.

Greenlandic adoptees’ psychiatric inpatient contact. A comparative register-based study

Aims: The aim is to highlight adoptees’ and stepchildren’s psychiatric contact and diagnoses compared with non-adoptees. Methods: The setting is Greenland and the methodology is a comparative in-ward patient register-based study. The background is the Greenlandic tradition for adoption and community child care and international research stressing that adoptees demonstrate adverse health outcomes. The cohort is in-ward patients (>24 hours), born between 1973 and 2005. Correlation between various dependent and independent variables are analyzed. The research makes different comparative statements of psychiatric admissions and diagnoses related to adoptees and stepchildren compared to non-adoptees with respect to demographic and socioeconomic indicators. The psychiatric data material is collected from 1992 to 2008 and the socioeconomic indicators are included from 1996. Results: The findings show, contrary to findings related to adoptees in Western societies, that being an adoptee in Greenland does not increase the risk for psychiatric admission, but being a ‘‘female stepchild’’ does. The adjusted risk for adoptees is ‘‘non-significant’’ at 1.1 (95% confidence interval (95% CI) 0.6— 1.9) but the adjusted risk for female stepchildren is ‘‘significant’’ at 3.4 (95% CI 1.8—6.6). The most frequent diagnosis is ‘‘Inherent or acquired brain suffering’’. The findings open up possibilities for new hypotheses as to reasons for adoptees’ adverse health outcomes in the Western world. Conclusions: Epidemiological and medical contact recording do not exist outside central hospital level in Greenland, therefore, in order to put psychiatric contact patterns into perspective, in-depth field studies are required in close collaboration with the local Greenlandic population.

Juvenile delinquency and psychiatric contact among adoptees compared to non-adoptees in Denmark: A nationwide register-based comparative study

Introduction: Research stresses that adoptees are at high risk of psychiatric contact, but are they also more likely to be at risk of juvenile delinquency? The aim is to clarify whether the variable “adoptee” is an independent risk factor for criminal conviction and to highlight relationships between convictions and their relapses and psychiatric contacts. Method: A nationwide comparative register-based study, 1994–2004. The cohort is composed of 282,986 individuals aged 15–27, Danish and foreign born (immigrants); 1.3% are adoptees, included adopted stepchildren. Results: The variable “adoptee” is not a risk factor for transnational adoptees and Danish ≤12 months at adoption, but Danish adoptees >12 months at adoption and adopted stepchildren have a 3–4 times higher risk than non-adoptees. However, “country of origin” has a negative impact on foreign-born adoptees and foreign-born non-adoptees. “Age at adoption”, “psychiatric contact” and “not living with parents” (at time of inclusion) are risks of conviction and conviction relapse. Boys are at higher risk than girls, but girls’ psychiatric contact is highest. Stepchildren are an overlooked risk group. Conclusion: “Adoptee”, as such, is not a risk factor for convictions, but it seems that it is the way adoption-related matters are handled. Gender-specific care for children and adolescents with new thinking in relation to child relinquishment, institutionalization and mental health care is important to ensure both boys and girls a youth free of crime.

Introduction: Gender and health

It is an impossible task to press all aspects of the Gender and Health theme into a journal’s special issue. I have therefore been obliged to make choices. A common way of illustrating or, rather, trying to define the good health of a population is to describe the incidences of illness, but in such a way that non-sick individuals are considered as healthy. Many comprehensive investigations which have compared the state of health in various countries, for instance by measuring mean life expectancy, are based on such considerations (Helweg-Larsen et al. 1977). When looking especially at the development in the Health Care System in recent years and its benefits, which have been largely preventive, such restricted views often seem meaningless, and particularly so if one wants to study gender differences in the Health Care System. It is, and has been, especially women’s contact with the Health Care System in connection with pregnancy and birth that has made the gender differences become very much conspicuous, that is, once they were recognized. Preventive examinations were first and foremost aimed at women and children, for example screening for mamma and cervical cancer. Not until in late years have some countries undertaken preventive examinations including men, for example screening for lung cancer. When the need for incorporating gender differences had been pointed out, it was shown that there have been, and still are, many significant differences in the biology, the prevalence of illness, the reaction to pathogenic conditions, the effect of treatment, etc., of males and females. And it is indeed essential that the system see to it that these differences are incorporated on all levels. In spite of this it has been most difficult to meet the demand for shedding light on the health conditions of both men and women. In some countries, for example the US, it has been necessary, according to American health legislation, to request that researchers include both sexes in their research projects. For many reasons we have thus only just lifted a corner of the veil which covers differences and similarities of males and females, their health and illness. And it is therefore essential to continue examining this state of affairs and not keep looking at the female as different from the male, who, according to tradition, represents normality. For the male—being x feet tall and weighing x stone—still constitutes the basis for much medical research, as we know that he has many special characteristics which have to be 5 In tr od uc ti on N O R A no . 1 20 04 , V ol um e 12

Can you dope yourself with food? On the abuse aspect of Bulimia Nervosa

Petersson B. Can you dope yourself with food? On the abuse aspect of Bulimia Nervosa.