Patients’ beliefs and attitudes about medications play a role in whether they adhere to their medications or not. Knowledge on how beliefs and attitudes about medications can be influenced is therefore important.

The current study aimed to assess whether patients’ perceived support from their therapists regarding use of medications was associated with their beliefs and attitudes about medications. Because non-adherence in patients with psychosis frequently results in relapses and emergencies, this knowledge may be very useful for therapists and patients.

This cross-sectional study included 310 patients diagnosed with psychosis from 31 clinical units in Norwegian mental health specialist care. We assessed beliefs about medications using the Beliefs about Medicines Questionnaire (BMQ). BMQ-specific consists of two subscales, BMQ-necessity and BMQ-concerns. Higher score on the necessity subscale indicates stronger beliefs in the necessity of taking the medicine. Higher score on the concern subscale indicates stronger concerns about taking the medicine. We used a newly developed self-report questionnaire, MedSupport, to assess the patients’ perceived support from therapists in dealing with their medications. Higher score on the MedSupport means that the patient experienced more support with decisions related to medications. Linear mixed effect models were used to investigate possible associations of sociodemographic factors, clinical factors and patients’ perceptions of medication support with BMQ.

Patients’ perceptions of medication support from therapists were positively associated with positive beliefs towards medications, β = 0.20, 95% CI [0.04 to 0.35], p=0.012, and negatively associated with concerns about taking the medications, β = -0.31, 95% CI [-0.44 to -0.17], p < 0.001, when other relevant variables were taken into consideration.

The present study shows that therapists may affect patients’ beliefs and concerns about medications. Consequently, medication support may lead to improved adherence to medications prescribed.

None Declared

Mental distress has been suggested as an etiological factor of fertility problems. The aim of the study was to investigate the predictive value of common mental symptoms for fertility problems in a population sample.

The predictive value of anxiety and depression symptoms for incident fertility problems over an 11 year span was investigated in a N=5,873 female sub-sample from the Nord-Trøndelag Health Studies (HUNT 1 and HUNT 2). Only women who had not experienced fertility problems at the time of HUNT 1 were included. Fertility problems were reported retrospectively at HUNT 2. Sub-/infertility was defined as having tried to get pregnant for more than one year without success. Symptoms of anxiety and depression at HUNT 1 were measured by the one-dimensional 12-item Anxiety Depression Index (ADI).

Mean age at HUNT 2 was 42 years (S.D. 4.96, range 28-49). N=152 reported having tried to get pregnant for more than one year. No predictive value of anxiety and/or depression symptoms for sub-/infertility was found (crude OR=0.97 (95% CI=0.82; 1.15), p=0.736; analyses adjusted for age, level of education, civil status, somatic conditions, parity, and gynaecological surgery: OR=0.97 (95% CI=0.81; 1.15), p=0.687). Results were comparable in a sub-sample who had never been pregnant.

There is no prospective effect of common mental health symptoms on incident fertility problems in women. This zero-finding emerges from a large population-based data set with a long follow-up interval, and it provides evidence against the hypothesised causal relationship between mental distress and sub-/infertility.

The aim of the present study was to examine if patients’ expectancy after bariatric surgery was related to improvement of body appearance, health, physical fitness, or ability to work. Further, the relationship between psychiatric comorbid disorders and outcome expectancies after surgery was investigated.

The study population consisted of 94 patients (F/M:74/20) age 22 to 62 years (mean 41.1, SD=10.2), with BMI from 33.4 to 64.7 kg/m2 (mean 44.9 kg/m2, SD=5.5). Psychiatric assessment was done prior to bariatric surgery, and included structured psychiatric interviews (M.I.N.I. International Neuropsychiatric Interview and Structured Clinical Interview for DSM IV Axis II disorders). The patients were asked to identify their most important expectancies after surgery.

The overall prevalence of current psychiatric disorders was 47%, with Social Phobia (18%, n=17), Dysthymic Disorder (14%, n=13), and Avoidant Personality Disorder (17%, n=16) as the most common ones. Thirty-six percent (n=34) rated improvement of health, 34% (n=32) physical fitness, 22% (n=21) improvement of body appearance, and 7% (n=7) ability to work as their most important expectancy after surgery. Patients with psychiatric comorbidity rated significantly more frequent improvement in body appearance as their most preferred outcome than patients without psychiatric comorbidity (34%/ 12%, p= .01, chi-square test).

Patients with psychiatric disorders rated improvement in body appearance as their most preferred outcome after surgery more often than patients without psychiatric comorbidity. Future studies should examine whether patient expectations predict outcomes and satisfaction after surgery.

It is generally acknowledged that individuals with intellectual disabilities (ID) benefits from psychotropic treatment for mental disorders (MD) in the same way as people in the general population. It has also been shown that problem behavior (PB) does not respond to psychotropic treatment. Thus, we hypothesized that the presence of MD was assocated with psychotropic treatment, whereas PB (not MD) was not.

In a community sample of adults with ID (N=593), the presence of dementia, psychoses, depression, mania, obsessive-compulsive disorders, five anxiety disorders and eight problem behaviors were screened using the Psychopathology Checklists for Adults with Intellectual Disability (P-AID). Information regarding the use of psychotropic medicine (ACT-N) was collected. Staff members in group homes served as informants both for the screening and the use of drug.

Psychotropic medication was reported in 40% of the sample. Of the 23% that presented with MD only, 44% received psychotropic medication (p=.310). Of the 12% that presented with both MD and PB, 51% received such medication (p=.032). The strongest association was found between psychotropic treatment and having PB only. Among the 8% that showed PB only, 52% received psychotropic medication (p=.022).

Contrary to our expectations, the presence of PB rather than MD were associated with the use of psychotropic treatment. The present findings suggest that people with ID often receives no psychotropic treatment for MD, or they receives such treatment for the wrong reason, leaving the accuracy of psychotropic treatment to a minimum.

Clinical studies have found higher occurrences of anxiety and depression in women who experience fertility problems. However, the relationship between common mental symptoms and sub-/infertility should also be investigated in the normal population.

In a valid N=15,000 sample of women (mean age=36 years, s.d.=8.4, range 19-49) in the Nord-Trøndelag Health Study 1995-97 (HUNT 2), the relationship of anxiety- and/or depression with fertility problems was explored by means of logistic regression analysis. Psychological symptoms were measured by the 14-item Hospital Anxiety and Depression Scale (HADS) (cut-off=14+, i.e. 90th percentile). Sub-/infertility was defined as having ever tried to get pregnant for more than one year without success. Analyses were adjusted for age, education, civil status, somatic conditions, parity, and gynaecological surgery.

In all, 2,058 (14%) of women were sub- or infertile. Mean HADS total score was 7.8 (s.d. 5.73, range 0-35) in this group and 7.1 (s.d. 5.43, range 0-39) in the group without fertility problems. Odds ratios for fertility problems in the group that scored above HADS cut-off were 1.26 (95% CI=1.09; 1.45), p=0.002 in the crude analysis and 1.13 (95% CI=0.97;1.31), p=0.123 in the adjusted analysis.

The effect size for the relationship between common mental disorders and fertility problems in this epidemiological study was weak. However, it may represent a more true estimate of the relationship than findings from earlier clinical studies, as such clinical studies may be biased due to differences between help-seeking patients and healthy controls.

Depressed patients tend to under-estimate their everyday memory function. Whether this under-estimation is related to the depressive state, or whether it represents underlying personality traits present also between or after depressive episodes, is not clear.

Comparisons of subjective memory evaluation as measured by the Everyday Memory Questionnaire (EMQ) were made between sub-groups with Current Depression (N=14), Previous Depression (N=19), and Healthy Controls (N=10). Analyses were adjusted for effects of sociodemographic variables, use of medication, and premorbid intellectual abilities (Similarities sub-test (WASI)). To assess the relationship between affective state and subjective memory function irrespective of actual memory performance, adjustment for objective memory performance as represented by the Total recall sub-task from CVLT and Long-delayed free recall from RCFT was included in a final step in the ANCOVA model.

The overall crude relationship between group and EMQ total score was significant (F(2,40)=4.11, p=0.011, eta sq.= .17). In posthoc follow-up tests, the Currently Depressed reported significantly lower on EMQ than both Previously Depressed and Controls (Dunnett's C test, p= .018 and p= .034, respectively). However, after adjustment for relevant confounders and mediators, both the Previously and Currently Depressed performed significantly worse on EMQ compared to Controls (overall ANCOVA F(2,33)=9.22, p= .001, eta sq.= .36; pairwise follow-ups p= .001 and p= .011, respectively).

Depressed patients’ under-estimation of their memory function is independent of mood state and it may represent a vulnerability or personality structure involving negative cognitive patterns that may be successfully targeted by cognitive therapy.

Elevation of serum cortisol is found in many patients with major depressive disorder (MDD) and may be due to a chronic dysfunction in the feedback regulation in the Hypothalamic-Pituitary-Adrenal axis. Saliva cortisol is a valid indicator of serum cortisol. The predictive value of saliva cortisol for remission of depressive symptomatology was investigated.

Saliva cortisol was measured in a sub-sample (N=19) with unipolar MDD according to DSM-IV. Mean score on the Montgomery Aasberg Depression Rating Scale (MADRS) was 26.8 (standard deviation 3.7, range 22-32). At follow-up, two years later, mean MADRS was 13.6 (SD 10.7, range 0-37). In a linear regression model, saliva cortisol at baseline was entered as independent variable and MADRS-score at follow-up as dependent variable.

A significant correlation between the level of saliva cortisol at baseline and MADRS-score at follow-up was found (R=0.33, P=0.036). After adjustment for MADRS at baseline, the level of saliva cortisol explained 21% of the variance in MADRS at follow-up (P=0.018). After further adjustment for age, gender, and use of antidepressant medication, the model still produced significant results (R2=0.50, P=0.026).

Higher level of saliva cortisol is predictive of less improvement in depressive symptomatology over time in unipolar MDD. This finding is in line with a model in which higher secretion of cortisol is associated with a more chronic course in depression. It underlines the importance of biological correlates as predictors of outcome in psychiatric disorders.

Communication disorders are often described in children with Attention Deficit Hyperactivity Disorder (AD/HD), but language related problems are neither among the cardinal features nor required to fulfil diagnostic criteria of AD/HD.

To investigate communication impairments in a group of children with AD/HD compared to a group of Typically Developing (TD) children.

Fifty-six Norwegian children aged 6–15 years participated. The AD/HD group consisted of 28 children and was matched on age and gender with a TD group. The parents completed a Norwegian translation of the Children's Communication Checklist Second Edition (CCC-2).

In the AD/HD group communication impairment was identified in 23 out of 28 children (82.1%) compared to only one child in the TD group (3.6%). The two groups differed significantly on 9 out of 10 subscales of the CCC-2, as well as on the GCC (MANOVA, p ≤ .001).

Children with AD/HD are likely to exhibit communication problems relative to typically developing children. The two groups differed on 9 out of 10 subscales on the CCC-2. These results add to the growing body of research showing that communication disorders are frequent among children with AD/HD. They underline the importance of routine screening of communication to be performed as part of the assessment procedure in children with AD/HD.

Obesity is associated with psychological, social and physical problems. The aim of this study was to examine the prevalence of subjective health complaints and their impact on work ability in a sample with morbid obesity.

Fortysix patients, 31 women and 15 men, aged 23 to 65 years (mean 43.7, s.d. 10.7), with BMI from 37 to 60 kg/m2 (mean 45 kg/m2, s.d. 5.02), on a waiting list for bariatric surgery participated. Subjective health complaints were measured by the 29-items Subjective Health Complaint Inventory. Five subscales were computed; Allergy, Flu, Musculoskeletal pain, Gastrointestinal problems and Pseudoneurology.

All participants reported subjective health complaints the last month, in particular they suffered from musculoskeletal (mean 8.2, s.d. 5.46), pseudoneurological (mean 4.7, s.d. 4.31) and gastrointestinal (mean 3.2, s.d. 5.46) complaints. Mean sickness absence the last year was 185 days (s.d. 163.32). Days of sickness absence were significant correlated with the Musculoskeletal (r = .35, p= .023) and Pseudoneurological (r= .40, p= .009) subscales.

All patients reported subjective health complaints, with mean levels of symptoms considerably higher than in the general population. In particular, levels of musculoskeletal and pseudoneurological complaints were high, and these complaints were significantly related to work absence. It thus seems like subjective health complaints influence work ability to a significant degree in patients with morbid obesity.