Helga Ask

Mental disorder and caregiver burden in spouses: the Nord-Trøndelag health study

BackgroundResearchers generally agree that mental disorder represents a burden to the family. The present study concerns the subjective burden of living with a person with mental disorder, more specifically the association between mental disorder in the index person and subjective well-being and symptoms of anxiety and depression in the spouse.MethodsData were obtained from questionnaires administered to the adult population of Nord-Trøndelag County, Norway during the period 1995-1997. The present study is based on a subsample where 9,740 couples were identified. Subjective burden in spouses of persons with mental disorder was compared with subjective burden in spouses of persons without mental disorder, using analysis of variance (ANOVA). All analyses were stratified by sex.ResultsAdjusting for several covariates, spouses of persons with mental disorder scored significantly lower on subjective well-being and significantly higher on symptoms of anxiety and depression compared to spouses of index persons without mental disorder. Although highly significant, the effect sizes were moderate, corresponding to a difference in standard deviations ranging from .34 - .51.ConclusionsOur study supports the notion that there is an association between mental disorder in one partner and subjective burden in the spouse, but not to the same extent that have been reported in earlier studies, as our results do not indicate that a large proportion of the spouses reach a symptom level of anxiety and depression that reflects clinical mental disorder.

Mental health and wellbeing in spouses of persons with dementia: the Nord-Trøndelag health study

BackgroundCaring for a spouse diagnosed with dementia can be a stressful situation and can put the caregiving partner at risk of loss of mental health and wellbeing. The main aim of this study was to investigate the relationship between dementia and spousal mental health in a population-based sample of married couples older than 55 years of age. The association was investigated for individuals living together with their demented partner, as well as for individuals whose demented partner was living in an institution.MethodsData on dementia were collected from hospitals and nursing homes in the county of Nord-Trøndelag, Norway. These data were combined with data on spousal mental health, which were collected in a population-based health screening: the Nord-Trøndelag Health Study (HUNT). Of 6,951 participating couples (>55 years), 131 included one partner that had been diagnosed with dementia.ResultsOur results indicate that after adjustment for covariates, having a partner with dementia is associated with lower levels of life satisfaction and more symptoms of anxiety and depression than reported by spouses of elderly individuals without dementia. Spouses living together with a partner diagnosed with dementia experienced moderately lower levels of life satisfaction (0.35 standard deviation [SD]) and more symptoms of depression (0.38 SD) and anxiety (0.23 SD) than did their non-caregiving counterparts. Having a partner with dementia that resided in a nursing home was associated with clearly lower life satisfaction. Compared with non-caregivers, these spouses reported lower levels of life satisfaction (1.16 SD), and also more symptoms of depression (0.38 SD), and more symptoms of anxiety (0.42 SD).ConclusionsHaving a partner with dementia is associated with loss of mental health and reduced life satisfaction. The risk of adverse mental health outcomes is greatest after the partner’s nursing home admission.

Paternal and maternal alcohol abuse and offspring mental distress in the general population: the Nord-Trøndelag health study

BackgroundThe degree to which parental alcohol abuse is a risk factor for offspring mental distress is unclear, due to conflicting results of previous research. The inconsistencies in previous findings may be related to sample characteristics and lack of control of confounding or moderating factors. One such factor may be the gender of the abusing parent. Also, other factors, such as parental mental health, divorce, adolescent social network, school functioning or self-esteem, may impact the outcome. This study examines the impact of maternal and paternal alcohol abuse on adolescent mental distress, including potentially confounding, mediating or moderating effects of various variables.MethodsData from the Nord-Trøndelag Health Study (HUNT), a Norwegian population based health survey, from 4012 offspring and their parents were analyzed. Parental alcohol abuse was measured by numerical consumption indicators and CAGE, whereas offspring mental distress was measured by SCL-5, an abbreviated instrument tapping symptoms of anxiety and depression. Statistical method was analysis of variance.ResultsMaternal alcohol abuse was related to offspring mental distress, whereas no effect could be shown of paternal alcohol abuse. Effects of maternal alcohol abuse was partly mediated by parental mental distress, offspring social network and school functioning. However, all effects were relatively small.ConclusionsThe results indicate graver consequences for offspring of alcohol abusing mothers compared to offspring of alcohol abusing fathers. However, small effect sizes suggest that adolescent offspring of alcohol abusing parents in general manage quite well.

Impact of hearing impairment on spousal mental health: the Nord-Trondelag Health Study.

BACKGROUND Previous studies indicate that hearing loss have negative emotional implications also on spouses of the hearing impaired persons. We sought to assess the relationship between hearing impairment and spousal mental health in the general population. METHODS Pure tone audiometry and questionnaires were administered to the adult population of Nord-Trøndelag County, Norway (1996-97). In the age group between 20 and 44 years, the number of cases with hearing impairment was very low; thus, this age group was excluded from analyses. In total, 8607 couples with women over 44 years and 9530 couples with men over 44 years were identified. Associations between measured and self-reported hearing impairment and spousal self-reported symptoms of anxiety and depression, and subjective well-being were estimated. Stratified by sex and adjusting for several covariates, mental health in spouses of persons with hearing impairment was compared with that of spouses of persons with normal hearing using the general linear model. RESULTS Audiometrically measured hearing was not significantly associated with spousal mental health. Moderate relations between self-reported hearing and spousal mental health were observed. CONCLUSION Contrary to previous results based on self-reported hearing loss, our results based on audiometry did not indicate severe loss of mental health among spouses of persons with impaired hearing.

Psychological distress and subjective well‐being in partners of somatically ill or physically disabled: The Nord‐Trøndelag Health Study

This study investigated the cross-sectional associations between various somatic conditions in one partner and the level of distress and well-being in the spouse. The study is based on survey data from the Norwegian Nord-Trøndelag Health Study, HUNT II (1995-1997). A sample of 9,797 married or cohabiting couples with valid data on subjective well-being (SWB), psychological distress (Hopkins Symptom Check List (SCL)-10) and somatic illness were identified. Regression analyses stratified by sex were conducted with SCL-10 and SWB scores as dependent variables and a joint somatic score as predictor, including; stroke, cancer, angina, myocardial infarction and physical disability (PD). The contribution of each somatic condition was also explored. Spouses of persons previously diagnosed with at least one somatic condition scored significantly lower on SWB and significantly higher on SCL-10 than spouses of healthy persons, though effect sizes were small. The effect seems to be at least partly mediated by the ill partners psychological distress. Of the specific conditions, PD had the most significant contribution for both genders, though an association between male angina and spousal distress/SWB was also demonstrated.

Effects of sample handling and analytical procedures on thyroid hormone concentrations in pregnant women's plasma

Background: Maternal thyroid function is a critical mediator of fetal brain development. Pregnancy-related physiologic changes and handling conditions of blood samples may influence thyroid hormone biomarkers. We investigated the reliability of thyroid hormone biomarkers in plasma of pregnant women under various handling conditions. Methods: We enrolled 17 pregnant women; collected serum and plasma were immediately frozen. Additional plasma aliquots were subjected to different handling conditions before the analysis of thyroid biomarkers: storage at room temperature for 24 or 48 hours before freezing and an extra freeze–thaw cycle. We estimated free thyroid hormone indices in plasma based on T3 uptake. Results: High correlations between plasma and serum (>0.94) and intraclass correlation coefficients for plasma handling conditions (0.96 to 1.00) indicated excellent reliability for all thyroid hormone biomarkers. Conclusion: Delayed freezing and freeze–thaw cycles did not affect reliability of biomarkers of thyroid function in plasma during pregnancy. See video abstract at, http://links.lww.com/EDE/B180.

Association of Gestational Age at Birth With Symptoms of Attention-Deficit/Hyperactivity Disorder in Children

Importance Preterm birth is associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD); however, it is unclear to what extent this association can be explained by shared genetic and environmental risk factors and whether gestational age at birth is similarly related to inattention and hyperactivity/impulsivity and to the same extent in boys and girls. Objectives To investigate the association between gestational age at birth and symptoms of ADHD in preschool and school-age children after adjusting for unmeasured genetic and environmental risk factors. Design, Setting, and Participants In this prospective, population-based cohort study, pregnant women were recruited from across Norway from January 1, 1999, through December 31, 2008. Results of a conventional cohort design were compared with results from a sibling-comparison design (adjusting for genetic and environmental factors shared within families) using data from the Norwegian Mother and Child Cohort Study. Data analysis was performed from October 1, 2017, through March 16, 2018. Exposures Analyses compared children and siblings discordant for gestational age group: early preterm (delivery at gestational weeks 22-33), late preterm (delivery at gestational weeks 34-36), early term (delivery at gestational weeks 37-38), delivery at gestational week 39, reference group (delivery at gestational week 40), delivery at gestational week 41, and late term (delivery after gestational week 41). Main Outcomes and Measures Maternally reported symptoms of ADHD in children at 5 years of age and symptoms of inattention and hyperactivity/impulsivity at 8 years of age. Covariates included child and pregnancy characteristics associated with the week of delivery and the outcomes. Results A total of 113 227 children (55 187 [48.7%] female; 31 708 [28.0%] born at gestational week 40), including 33 081 siblings (16 014 female [48.4%]; 9705 [29.3%] born at gestational week 40), were included in the study. Children born early preterm were rated with more symptoms of ADHD, inattention, and hyperactivity/impulsivity than term-born children. After adjusting for unmeasured genetic and environmental factors, children born early preterm had a mean score that was 0.24 SD (95% CI, 0.14-0.34) higher on ADHD symptom tests, 0.33 SD (95% CI, 0.24-0.42) higher on inattention tests, and 0.23 SD (95% CI, 0.14-0.32) higher on hyperactivity/impulsivity tests compared with children born at gestational week 40. Sex moderated the association of gestational age with preschool ADHD symptoms, and the association appeared to be strongest among girls. Early preterm girls scored a mean of 0.8 SD (95% CI, 0.12-1.46; P = .02) higher compared with their term-born sisters. Conclusions and Relevance After accounting for unmeasured genetic and environmental factors, early preterm birth was associated with a higher level of ADHD symptoms in preschool children. Early premature birth was associated with inattentive but not hyperactive symptoms in 8-year-old children. This study demonstrates the importance of differentiating between inattention and hyperactivity/impulsivity and stratifying on sex in the study of childhood ADHD.