Henrik Steen Andersen

A longitudinal study of prisoners on remand: psychiatric prevalence, incidence and psychopathology in solitary vs.non‐solitary confinement

Objective: To compare two levels of stress (solitary confinement (SC) and non‐SC) among remand prisoners as to incidence of psychiatric disorders in relation to prevalent disorders.

POST-TRAUMATIC STRESS REACTIONS AMONGST RESCUE WORKERS AFTER A MAJOR RAIL ACCIDENT

Rescue tasks under heavy strain may act as traumatic events creating stress reactions among the rescue workers. After a major rail accident the rescue workers were examined by questionnaire at 3 and 7 months postaccident using the General Health Questionnaire-28 (GHQ), Impact of Event Scale (IES) and a structured questionnaire made for the purpose. Eighteen percent of the 77 rescue workers who participated in the study had GHQ-case-score and 10% had IES-case-score at 7 months using the usual GHQ-cut-off (4/5) and a low IES-cut-off (19/20). For the case-scorers there was a tendency towards increased GHQ- and IES-scores from 3 to 7 months. Five (6%) had post-traumatic stress disorders (PTSD) of low to moderate severity at 7 months.

Tsunami-affected Scandinavian tourists : Disaster exposure and post-traumatic stress symptoms

Background: Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies. Aims: To examine the association between exposure to the 2004 Southeast Asian tsunami and symptoms of post-traumatic stress in three Scandinavian tourist populations. Methods: Postal survey of Norwegian, Danish and Swedish Southeast Asia tourists registered by the police when arriving at national airports. Follow-up time was 6 (Norway), 10 (Denmark) and 14 months (Sweden) post-disaster; 6772 individuals were included and categorized according to disaster exposure: danger exposed (caught or chased by the waves), non-danger exposed (other disaster-related stressors) and non-exposed. Outcome measures were the Impact of Event Scale—Revised (IES-R) and Post Traumatic Stress Disorder Check List (PCL). Results: Danger exposed reported more post-traumatic stress than non-danger exposed, and the latter reported more symptoms than non-exposed (each P<0.001). Comparison of the Norwegian and Swedish data suggested that symptoms were attenuated at 14 months follow-up (P<0.001). Female gender and low education, but not age, predicted higher levels of symptoms. Conclusions: Disaster-exposed tourists repatriated to unaffected home environments show long-term post-traumatic stress disorder symptoms related to the severity of exposure.

Derivation of actual evapotranspiration in the Senegalese Sahel, using NOAA-AVHRR data during the 1987 growing season

The actual evapotranspiration from one test site in the northern part of Senegal was calculated using a combination of NOAA-AVHRR data and meteorological data. AVHRR data were calibrated and corrected for the influence of the atmosphere. The relationship ET − RN = ab(Ts − Ta) was established on the basis of in situ measurements of fluxes during a field campaign September–October 1988. The flux measurements are presented, and the influence of surface roughness on the relationship is analyzed. A simple method for time integration of actual evapotranspiration between days with satellite data is presented.

Patients With Rett Syndrome Sustain Low-Energy Fractures

We present the first case-control study addressing both fracture occurrence and fracture mechanisms in Rett syndrome (RTT). Two previous studies have shown increased fracture risk in RTT. This was also our hypothesis regarding the Danish RTT population. Therefore, we investigated risk factors associated with low-energy trauma and the association to methyl-CpG-binding protein 2 (MECP2) mutations. A total of 61 female patients with RTT and 122 healthy controls matched according to age and pubertal/menopause status were examined by questionnaires, bone biochemical markers in blood, and clinical and x-ray evaluations. National register search on fracture diagnoses was done to obtain complete fracture histories. Our results showed that patients with RTT sustained significantly more low-energy fractures from early age compared with controls, even though overall fracture occurrence apparently was not increased. Low-energy fractures were significantly associated with less mobility and lack of ambulation. Associations with MECP2 mutations or epilepsy were not demonstrated, contrary to previous findings. Blood biochemistry indicated a possible need for D vitamin supplementation in RTT. Our study casts light on fracture occurrence in RTT and points to a need for future research in bone development and fracture risk to establish directions for improved prevention and treatment of low-energy fractures in RTT.

Land surface temperature estimation based on NOAA-AVHRR data during the HAPEX-Sahel experiment

Abstract Accurate estimation of land surface temperature can be regarded as an important prerequisite of the global or regional monitoring of water, energy, and radiation budgets. An accurate estimation of land surface temperature involves correction for both the atmospheric and the surface emissivity effect. Combined ground truth, radiosonde and remote sensing data from the HAPEX-Sahel experiment have been used to evaluate three existing AVHRR-based split-window models designed for land surface temperature estimation and an algorithm for emissivity difference estimation. Local or regional model coefficients have been determined on the basis of simulated AVHRR measurements. The applied model for the emissivity difference determination turned out to be very sensitive under situations with medium to high water vapour content. It was found that results from the three models compared well except at large view angles. In semi-arid regions with high atmospheric water vapour content the atmospheric effect accounts for almost 90% of the correction whereas the emissivity effect typically accounts for 10%. An absolute evaluation was not performed, but comparison with ground truth data showed that the model-predicted temperatures were well within the expected range.

The course of adjustment disorder in Danish male conscripts

Conscription has been employed for more than a century. To evaluate the course and fate of conscripts deemed mentally unfit for immediate continued service, a prospective questionnaire study of conscripts referred for mental evaluation was conducted. Questionnaires were completed at the time of enrolment, time of admittance for evaluation, time of discharge from their evaluation and at 1-year follow-up. Out of a class of 6949 conscripts, 93 were referred for psychiatric evaluation and 69 of those referred decided to enter the study (60 of these were in time deemed unfit for further military service). At the time of admittance, on average after 79 days of service, there was a significant 36%, 34%, 20% and 20% increase in depression, sleep, somatization and interpersonality scores, respectively. At the time of discharge 14 days after admittance, the symptom scores had dropped to a level comparable to scores at the time of enrolment. At 1-year follow-up, the descending trend in scores was maintained, though not reaching statistical significance compared with scores at time of discharge. The scores at 1-year follow-up were also, except for a higher depression score, comparable with the scores of a control group of conscripts evaluated 1 year after service. The psychological profile of conscripts referred for evaluation was different at the time of enrolment compared with conscripts in general, the scores being between 9% (interpersonality) and 29% (depression) higher. They also had a higher prevalence of adverse family events in their history. The course observed is indifferent from other situations of enforced stress.

Ganser syndrome after solitary confinement in prison: A short review and a case report

A short review of the Ganser syndrome is given. The condition is a rare, probably dissociative, disorder with transient Vorbeireden as the central symptom. The case of a middle-aged man developing a transient Ganser syndrome after long-term solitary confinement in a remand prison is presented. Systematic investigation of 268 remand prisoners confirms the rarity of the syndrome, as only the case subject had this disorder.A short review of the Ganser syndrome is given. The condition is a rare, probably dissociative, disorder with transient Vorbeireden as the central symptom. The case of a middle-aged man developing a transient Ganser syndrome after long-term solitary confinement in a remand prison is presented. Systematic investigation of 268 remand prisoners confirms the rarity of the syndrome, as only the case subject had this disorder.

Exposure characteristics and peri-trauma emotional reactions during the 2004 tsunami in Southeast Asia-what predicts posttraumatic stress and depressive symptoms?

This study examined the impact of disaster-related stressors and peri-trauma emotional reactions on mental health 10 months after the 2004 Southeast Asian tsunami disaster in a sample of 660 Danish tourists evacuated from the disaster area. The estimated rates of posttraumatic stress disorder and depression were 10.2% and 6.4%, respectively. The strongest predictors of posttraumatic stress and depressive symptoms were peri-trauma fear and dissociation. Among exposure variables, only witnessing others suffering was associated with both these disorders, whereas loss of family members and history of psychiatric treatment emerged as independent risk factors for depression. These variables explained a smaller proportion of variance in posttraumatic stress symptoms. These findings contribute to a body of evidence showing the critical role that appraisal of trauma plays in posttraumatic stress disorder and depression.

Use of Health Care Services Before and After a Natural Disaster Among Survivors With and Without PTSD

OBJECTIVE This study used a questionnaire to identify individuals who met criteria for posttraumatic stress disorder (PTSD) ten months after surviving a disaster and compared their use of health care services before and after the disaster with that of survivors who did not meet criteria for PTSD. METHODS Ten months after the December 26, 2004, Southeast Asian tsunami, Danish tourists who had been in areas exposed to the disaster were mailed a questionnaire asking about demographic characteristics and exposure to the tsunami. The questionnaire included the PTSD Checklist, which measures symptoms of posttraumatic stress. Individuals who met DSM-IV PTSD criterion A1--in this case, being caught, touched, or chased by the waves or having witnessed the death, serious injury, or suffering of others--were included in the analyses (N=635). The Danish National Health Service Register provided longitudinal data on annual number of contacts with health care services before (2002-2004) and after (2005-2007) the tsunami. RESULTS Survivors with PTSD or partial PTSD used health care services more than survivors without PTSD before and after the tsunami. The severity of posttraumatic stress symptoms was positively correlated with postdisaster use of health care services. However, when adjusted for predisaster health care use, this association was not significant. CONCLUSIONS Postdisaster health care service utilization was predicted by predisaster health care service utilization and was hardly affected by the onset of PTSD itself. Associations between PTSD and subsequent health problems must be interpreted with caution.