Lasse Eriksen

Social skills training in groups for alcoholics: One-year treatment outcome for groups and individuals☆

In an experimental comparison, 24 inpatients at an Alcoholism Treatment Center with the DSM-III diagnosis alcohol dependence (alcoholism) were randomly assigned to a Social Skills Training Group (SSTG) or a Control Group (CG). Both groups received, in addition, the traditional treatment program at the institution. Self-report questionnaires, as well as questionnaires for significant others, were used to get biweekly information after discharge on current drinking habits, working days, and nights slept home. A lottery procedure ensured an extremely high return rate of questionnaires during 1 year follow-up (23 of 24 clients returned all questionnaires). SSTG clients drank on the average 2/3 of the amount of pure alcohol or its equivalent (740 cl, that is 14.2 cl/week) that the CG clients did (1196 cl, that is 23.0 cl/week) during 1 year follow-up after discharge. SSTG clients had twice as many sober days (281 or 77% compared to 116 or 32%) and working days (223 or 97% compared to 104 or 45%). The average length of abstinence period after discharge were 51.6 days for SSTG and 8.3 for CG clients. All SSTG clients had drunk after 143 days, and all CG clients after 31 days. During drinking days, however, SSTG had drunk almost twice as much as CG clients. The average number of nights slept home were 345 (95%) for the SSTG versus 316 (87%) for the CG. In addition to group data, detailed individual data are also presented.

Conditioned Abstinence in Alcoholics: A Controlled Experiment

The existence of conditioned abstinence symptoms in 16 abstinent alcoholics was investigated by comparing their subjective, physiological, and behavioral responses while viewing slides of alcohol-related and non-alcohol-related stimuli. The alcoholics were randomly assigned to one of two groups. The first group viewed a set of six alcohol-related slides the first day and a set of six non-alcohol-related slides the following day. The second group looked at the same slides, but the order of presentation was reversed. Alcohol-related slides produced significantly greater increases in subjectively reported alcohol craving and anxiety scores. There were no differences between the two sets with regard to physiological measures or subjective reports of heart rate. The global observations showed significant differences between the alcohol-related and non-alcohol-related slides.

Prevalence of eating disorders in Norwegian general hospitals 1990–1994: Admissions per year and seasonality.

OBJECTIVE To study the occurrence of eating disorders in patients admitted to somatic hospitals. METHOD For all, approximately 3.3 million, admissions to Norwegian general hospitals in the period 1990-1994, admissions with the primary diagnoses for the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) were selected. Data on gender, age groups, emergency admission, different hospital types, length of stay, seasonal differences, and differences along the latitudes were related to the primary diagnosis. RESULTS A small number of men with eating disorders were admitted; 9-17 times more women were admitted (140-183 female and 11-15 male admissions per year). The male/female ratio was on the mean 8% for the period. About two thirds to three fourths were emergency admissions. The mean length of stay was 12-19 days, and the median stay was 6-8 days. A significant (p = .03) season of admission was found. A significant number of admissions occurred in the beginning of March and a minimum in June. The best model was two harmonics without trend. DISCUSSION There are few reports on eating disorders in somatic inpatients in the literature, but our results indicate that it is important to consider the general hospital in this connection. Bulimia nervosa was rather unusual in the present study, while anorexia nervosa was prevalent, specifically for women. Seasonality has rarely been reported in relation to hospitalization.

Prevalence of all relevant eating disorders in patients waiting for bariatric surgery: a comparison between patients with and without eating disorders.

OBJECTIVE: To study the prevalence of all relevant eating disorders in 157 obese patients waiting for bariatric surgery. Another aim was to explore for possible differences between gender, and those with and without ED. The dependent variables were: socio-demographic characteristics, BMI, obesity onset, and obesity-related somatic diseases. METHODS: ED was assessed using the self-report questionnaire, “Eating Disorders in Obesity” (EDO). The patients answered a questionnaire that targeted socio-demographic and health information. RESULTS: Subgroups were based on the patients responses to items on the EDO: 1 patient (0.6%) with Bulimia Nervosa (BN), 6 (3.8%) with Eating Disorder Not Otherwise Specified (EDNOS), 21 (13.4%) with Binge Eating Disorder (BED), and 23 (14.6%) with Binge Eating (BE). The patients in the EDNOS group were those who lacked one criterion of the BN diagnosis. The patients in the BE group lacked one criterion of the BED diagnosis. Twenty-eight (17.8%) fulfilled the DSM-IV-TR criteria for ED. When patients with BE were added, 51 patients (32.5%) were identified with ED or sub-threshold ED. In the explorative part of the study, no gender differences in socio-demographic variables, BMI, obesity onset, and obesity-related somatic diseases emerged. With the exception of age, no differences were found in these variables between those with and without ED. CONCLUSION: Employing all relevant eating disorders and binge eating symptoms (BE) for this population identified patients with pathological eating behaviors, which are not detected in previous studies measuring only BED and BE.

An epidemiological study of eating disorders in Norwegian psychiatric institutions

OBJECTIVE The aim was to establish the prevalence of eating disorders in psychiatric patients. METHOD The total inpatient (n = 8,942) and outpatient (n = 10,125) Norwegian psychiatric population was investigated with a staff-report questionnaire. RESULTS The prevalence of eating disorders in the inpatient population was 3.8% for women and 1.6% for men. In the outpatient population, the differentiated diagnoses anorexia nervosa (AN), bulimia nervosa (BN), and the comorbidity of AN+BN was 5.7%, 7.3%, and 1.6% for women, and 0.8%, 0.7%, and 0.3% for men (this could be reduced to AN and BN prevalences of 7.3% and 8.9% for women and 1.0% and 1.0% for men). DISCUSSION The level of the prevalence figures is in the expected area, thus the present study confirms earlier studies with smaller psychiatric populations.

Prevalence of eating disorders among norwegian women and men in a psychiatric outpatient unit

OBJECTIVE The primary purpose of the study was to establish lifetime and point prevalence of different eating disorders in a psychiatric outpatient population of both men and women. METHOD A questionnaire was sent out to 364 patients referred to a psychiatric outpatient department. Of these questionnaires, 234 (64.3%) were completed and returned. Patient questionnaires were analyzed to assess the prevalence for different groups of eating disorders according to DSM-III-R criteria. RESULTS In women there was a lifetime prevalence of 5.2% of anorexia nervosa (AN), 16.1% bulimia nervosa (BN), 6.5% binge eating disorder (BED), and 11.0% eating disorder not otherwise specified (EDNOS), in total 38.7%. The point prevalence was 1.9% AN, 5.2% BN, 3.2% BED, nd 8.4% EDNOS, in total 18.7%. The lifetime prevalence in men was 0% AN, 10.7% BN, 6.7% BED, and 4.0% EDNOS, in total 21.3%. Point prevalence was found to be 0% AN, 2.7% BN, 5.3% BED, and 6.7% EDNOS, in total 14.7%. Staff information yielded substantially lower rates of eating disorders among these patients. There was a significantly higher rate of eating disorders in the close family of eating-disordered patients compared to the patient group without such a disorder. DISCUSSION The results support earlier studies indicating that younger patients have more eating disorders. The men showed frequencies of BN and BED at the same level as women, but the frequency of EDNOS was lower, and there were no cases of AN.

Experiences and preferences of users with major mental disorders regarding helpful care in situations of mental crisis

Aims: To examine the experiences of and preferences for helpful care in situations of mental crisis from the perspective of people with major mental disorders. Methods: Qualitative individual interviews with 19 users with major mental disorder, 13 men and six women, aged 22–60 years. Analysis was conducted with systematic text condensation. Results: The main tendencies among a majority of the users are a clear understanding of their own problems and ways of handling these, and the desire for early help from providers whom they know well and who are open to dialogue and reflection. A clear majority perceived a high threshold for contacting the mental health system due to negative experiences and lack of user involvement in treatment planning and implementation. Conclusion: The findings challenge traditional views of professionalism and describe important implications for mental health services from the user’s perspective. Our study provides a clear indication of the importance of becoming an active participant in one’s own life, and the need for deeper understanding among the professionals in relation to user experiences and preferences for helpful care in periods of mental health crisis in order to optimize the care.

Stress and Happiness among Adolescents with Varying Frequency of Physical Activity

The aim of this cross-sectional study was to investigate associations between physical activity, stress, and happiness, as well as possible sex and age differences on these variables in a survey of 1, 508 adolescent pupils (13 to 18 yr.) in middle Norway. Adolescents who reported they participated in physical activity 2 to 3 times per week or more scored significantly lower on stress and higher on happiness than those who participated in physical activity 1 day per week or less. There was no significant difference on stress and happiness between those being physically active 2 or 3 times a week and those being active almost every day. There was no sex difference in physical activity frequency. Girls had higher mean scores on stress, and boys scored higher on happiness. Adolescents 15 to 16 years old showed higher stress scores than those 17 to 18 years old, but there were no significant differences between the different age groups when looking at happiness and physical activity. A statistically significant two-way interaction of sex by age was found on both stress and happiness.

Psychometric properties of the Patient Activation Measure-13 among out-patients waiting for mental health treatment: A validation study in Norway

OBJECTIVE The Patient Activation Measure-13 (PAM-13) has been found useful for assessing patient knowledge, skills and confidence in management of chronic conditions, but the empirical evidence from mental health is sparse. The psychometric properties of PAM in out-patients waiting for treatment in community mental health centers (CMHC) have therefore been examined. METHODS A total of 290 adults from two CMHC completed PAM. An exploratory factor analysis was conducted with 273 patients. Data at baseline and after 4 weeks were used to analyze test-retest reliability (n=60) and to analyze the sensitivity to change (n=51). RESULTS The exploratory factor analysis revealed a fit for a two-factor model (Cronbachs α was 0.86 and 0.67), and was assessed for a one-factor model (α=0.87). The test-retest intraclass correlation coefficient was 0.76. Sensitivity to change was good with a statistically significant activation improvement (p<0.001) on patients receiving a peer co-led-educational intervention (Cohens d was 0.85). CONCLUSION PAM has appropriate and acceptable psychometric properties in mental health settings. PRACTICE IMPLICATIONS Assessing activation before treatment might be useful for scheduling the delivery of mental health services as well as evaluating educational interventions aimed at improving patient engagement in mental health.

Health-Related Quality of Life in Obese Presurgery Patients with and without Binge Eating Disorder, and Subdiagnostic Binge Eating Disorders

Objective. To study health-related quality of life (HRQoL) in obese presurgery patients with binge eating disorder (BED) and with subdiagnostic binge eating disorder (SBED) compared to patients without eating disorders or SBED. Method. Participants were patients referred to St. Olavs University Hospital, Norway, for bariatric surgery. Eating Disorders in Obesity (EDO) questionnaire was used to diagnose BED and SBED. Short-Form Health Survey (SF-12) assessed health-related quality of life. Questionnaires were returned by 160 of 209 patients. The present study sample consisted of 143 patients (103 women and 40 men) as 17 patients did not complete the SF-12. Results. Patients with BED and patients with SBED both had significantly lower mental HRQoL, but not physical HRQoL, compared to patients without eating disorders. Discussion. The findings indicate that obese presurgery patients with BED, and also SBED, may have special treatment needs in regard to their mental health.