Eiríkur Örn Arnarson

Dental anxiety in Iceland: an epidemiological postal survey

In this study, we examined the prevalence of specific (dental) phobia among a sample of the Icelandic population. In addition to dental anxiety we explored factors that could be related to dental anxiety. In the period 1972–73, a stratified sample of 1641 schoolchildren in Reykjavík was selected for a study on malocclusion, dental maturation and other factors. Twenty‐two years later (1995), a postal survey conducted in this group looked at many variables relating to oral health, including orofacial pain, functional oral disorders, self‐perception of dental and general appearance and need for orthodontic treatment. Out of 1529 individuals contacted, 1192 completed questionnaires were returned (response rate 78%). Questions based on DSM‐IV criteria of specific (dental) phobia (DP) were included. Ninety‐six participants reported that they had avoided dental treatment during the previous 6 months. Twenty‐one respondents fulfilled DSM‐IV criteria for specific (dental) phobia (DP) and 75 admitted to many symptoms of dental anxiety (DA). Specific (dental) phobia (DP) was more prevalent among women than among men. The divorced or widowed were most at risk, as were non‐salaried respondents. Most respondents attributed the onset of their phobias to a specific painful or fearful experience. There was a significant difference between the total dentally anxious (TDA = DA+DP) and the not dentally anxious (NDA) with regard to sex (women‐higher TDA) and marital status (divorced or widowed‐higher TDA). The TDA had statistically fewer teeth than the NDA and received dental treatment less frequently.

The scope of early traumatic brain injury as a long-term health concern in two nationwide samples: prevalence and prognostic factors.

Primary objectives: To examine the scope of paediatric traumatic brain injury (TBI) as a health concern and to identify prognostic factors for TBI-related sequelae. Methods and procedures: The study was prospective and nationwide. A questionnaire was sent to a study group (SG) of all 0–19 years old in Iceland, diagnosed ∼16 years earlier with TBI during a 1-year period, 1992–1993 (n = 550) and to a control group (CG) (n = 1232), selected from the National Register. Main outcomes and results: In the CG 49.5% reported having sustained TBI and 7.0% reported long-term disability. In the group with TBI, force of impact to the head, more than one incident of TBI and the injury severity by gender interaction predicted late symptoms. TBI severity had substantially less effect than force of impact and was close to non-existent for females. Conclusions: Based on two independent nationwide samples, the scope of TBI as a health concern in adolescence and young adulthood is greater than previously documented. The findings suggest that TBI event-related factors, especially force of impact, have greater predictive value than clinical symptoms of severity at the acute stage, females being more sensitive to the effects of mild TBI than males.

Urban-rural differences in pediatric traumatic head injuries: A prospective nationwide study

Aims To estimate differences in the incidence of recorded traumatic head injuries by gender, age, severity, and geographical area. Methods The study was prospective and nationwide. Data were collected from all hospitals, emergency units and healthcare centers in Iceland regarding all Icelandic children and adolescents 0–19 years old consecutively diagnosed with traumatic head injuries (N = 550) during a one-year period. Results Annual incidence of minimal, mild, moderate/severe, and fatal head injuries (ICD-9 850–854) was 6.41 per 1000, with 95% confidence interval (CI) 5.9, 7.0. Annual incidence of minimal head injuries (ICD-9 850) treated at emergency units was 4.65 (CI 4.2, 5.1) per 1000, mild head injuries admitted to hospital (ICD-9 850) was 1.50 (CI 1.3, 1.8) per 1000, and moderate/severe nonfatal injuries (ICD-9 851–854) was 0.21 (CI 0.1, 0.3) per 1000. Death rate was 0.05 (CI 0.0, 0.1) per 1000. Young children were at greater risk of sustaining minimal head injuries than older ones. Boys were at greater risk than girls were. In rural areas, incidence of recorded minimal head injuries was low. Conclusions Use of nationwide estimate of the incidence of pediatric head injury shows important differences between urban and rural areas as well as between different age groups.

The Prevalence of Depressive Symptoms in Pre-adolescent School Children in Iceland

Abstract The Icelandic translation of the Children Depression Inventory (CDI) was administered to 436 children attending fifth through ninth grade of primary school (228 girls and 208 boys). The cohort was composed of three equally big groups, from the fifth to sixth grade, seventh grade and eight to ninth grade. The CDI total scores were somewhat lower than in most Anglo-Saxon studies. A cut-off score of 15 identified the upper 10% of the children as depressed. An analysis of variance yielded a significant difference due to grade, but no sex difference, and no interaction between grade and sex. The reliability of the inventory was satisfactory. The factor structure found by Kovacs (1992) was not replicated. It is proposed that total scores should be used rather than scores on specific factors for the Icelandic translation.

Body esteem, perceived competence and depression in Icelandic adolescents

The aim of the present study was to investigate the psychometric properties of the Icelandic version of the BESAA (Body Esteem Scale for Adolescents and Adults) and also the relationships between bodily self-esteem and depression. Subjects were 316 pupils of 6th-8th grade of four elementary schools, two from the Reykjavík area and two from the countryside. Three self-report scales were administered: CDI (Childrens Depression Inventory), BESAA and PCSC (Perceived Competence Scale for Children). The psychometric properties of the BESAA were satisfactory. Body esteem predicted depression, even when different aspects of perceived competence had been taken into account. This may mean that attention should be directed more directly to body esteem in attempts to prevent depression in young people.

The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

Aims To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later. Methods Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent. Results Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms. Conclusions Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity.

Long-term outcome of medically confirmed and self-reported early traumatic brain injury in two nationwide samples

Abstract Primary objectives: To assess long-term effects of early traumatic brain injury (TBI) on mental health, cognition, behaviour and adjustment and to identify prognostic factors. Methods and procedures: A 1-year nationwide cohort of all 0–19 year old Icelandic children and adolescents diagnosed with TBI in 1992–1993 (n = 550) received a questionnaire with clinical outcome scales and questions on TBI and socio-economic status (SES) by mail ∼16 years post-injury. A control group (n = 1232), newly selected from the National Registry, received the same questionnaire. Non-respondents answered a shorter version by telephone. Overall participation was 67%. Main outcomes and results: Medically confirmed and self-reported TBI was reflected in worse outcome. Force of impact, number and severity of TBIs predicted poorer results. Parental SES and demographic factors had limited effects. Not reporting early, medically confirmed TBI did not exclude cognitive sequelae. In self-reported disability, absence of evaluation for compensation was not linked to outcome. Conclusions: Clinical outcome was consistent with late complaints attributed to early TBI. TBI-related variables had greater prognostic value than other factors. Self-reporting of TBI sustained very early in life needs supplementary information from parents and medical records. More consistency in compensation evaluations following paediatric TBI is indicated.