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Fimland, M. S., Vie, G., Holtermann, A., Krokstad, S., & Nilsen, T. I. L. (2018). Occupational and leisure-time physical activity and risk of disability pension: prospective data from the HUNT Study, Norway. Occup Environ Med, 75(1), 23–28.
Abstract: OBJECTIVES: To prospectively investigate the association between occupational physical activity (OPA) and disability pension due to musculoskeletal cause, mental cause or any cause. We also examined the combined association of OPA and leisure-time physical activity (LTPA) with disability pension. METHODS: A population-based cohort study in Norway on 32 362 persons aged 20-65 years with questionnaire data on OPA and LTPA that were followed up for incident disability pension through the National Insurance Database. We used Cox regression to estimate adjusted HRs with 95% CIs. RESULTS: During a follow-up of 9.3 years, 3837 (12%) received disability pension. Compared with people with mostly sedentary work, those who performed much walking, much walking and lifting, and heavy physical work had HRs of 1.26 (95% CI 1.16 to 1.38), 1.44 (95% CI 1.32 to 1.58) and 1.48 (95% CI 1.33 to 1.70), respectively. These associations were stronger for disability pension due to musculoskeletal disorders, whereas there was no clear association between OPA and risk of disability pension due to mental disorders. People with high OPA and low LTPA had a HR of 1.77 (95% CI 1.58 to 1.98) for overall disability pension and HR of 2.56 (95% CI 2.10 to 3.11) for disability pension due to musculoskeletal disorders, versus low OPA and high LTPA. CONCLUSIONS: We observed a positive association between OPA and risk of disability pension due to all causes and musculoskeletal disorders, but not for mental disorders. Physical activity during leisure time reduced some, but not all of the unfavourable effect of physically demanding work on risk of disability pension.
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Harvey, S. B., Overland, S., Hatch, S. L., Wessely, S., Mykletun, A., & Hotopf, M. (2018). Exercise and the Prevention of Depression: Results of the HUNT Cohort Study. Am J Psychiatry, 175(1), 28–36.
Abstract: OBJECTIVE: The purpose of the present study was to address 1) whether exercise provides protection against new-onset depression and anxiety and 2) if so, the intensity and amount of exercise required to gain protection and, lastly, 3) the mechanisms that underlie any association. METHOD: A “healthy” cohort of 33,908 adults, selected on the basis of having no symptoms of common mental disorder or limiting physical health conditions, was prospectively followed for 11 years. Validated measures of exercise, depression, anxiety, and a range of potential confounding and mediating factors were collected. RESULTS: Undertaking regular leisure-time exercise was associated with reduced incidence of future depression but not anxiety. The majority of this protective effect occurred at low levels of exercise and was observed regardless of intensity. After adjustment for confounders, the population attributable fraction suggests that, assuming the relationship is causal, 12% of future cases of depression could have been prevented if all participants had engaged in at least 1 hour of physical activity each week. The social and physical health benefits of exercise explained a small proportion of the protective effect. Previously proposed biological mechanisms, such as alterations in parasympathetic vagal tone, did not appear to have a role in explaining the protection against depression. CONCLUSIONS: Regular leisure-time exercise of any intensity provides protection against future depression but not anxiety. Relatively modest changes in population levels of exercise may have important public mental health benefits and prevent a substantial number of new cases of depression.
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Idstad, M., Torvik, F. A., Borren, I., Rognmo, K., Roysamb, E., & Tambs, K. (2015). Mental distress predicts divorce over 16 years: the HUNT study. BMC public health, 15, 320.
Abstract: BACKGROUND: The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. METHODS: The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. RESULTS: Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. CONCLUSIONS: Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce.
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Jeppesen, E., Bjelland, I., Fossa, S. D., Loge, J. H., & Dahl, A. A. (2013). Psychosocial problems of teenagers who have a parent with cancer: a population-based case-control study (young-HUNT study). J Clin Oncol, 31(32), 4099–4104.
Abstract: PURPOSE: High prevalence of psychosocial problems has been observed in clinical studies of teenagers who have a parent with cancer. In contrast, we used a population-based design to study such problems in teenagers who have a parent with cancer (cases) compared with matched teenagers with cancer-free parents (controls). We hypothesized that higher prevalence of psychosocial problems would be observed in cases compared with controls and that sex differences would be observed between cases and controls. METHODS: We used data from a cross-sectional population-based survey of teenagers (Young-HUNT study). Among 8,986 teenage participants, 120 of their parents had invasive cancer before the Young-HUNT study according to the Norwegian Cancer Registry. These parents had 143 teenagers (cases) participating in the Young-HUNT study. Matched on sex, age, and municipality, 429 control teenagers with cancer-free parents were drawn from the Young-HUNT study. Six psychosocial problems were studied. RESULTS: No significant differences in psychosocial problems were observed between cases and controls in the total sample. Fewer case daughters reported eating problems compared with control daughters, and more case sons reported eating problems compared with control sons. More case daughters than case sons reported somatic stress symptoms and low self-esteem and displayed more caseness of anxiety/depression. These three sex differences were also observed among controls, indicating that they were general sex differences. CONCLUSION: In this population-based study, teenagers who had a parent with cancer did not have higher prevalence of psychosocial problems than controls. Sex differences observed in previous clinically based studies were confirmed but may simply reflect sex differences observed among teenagers in general.
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Mangerud, W. L., Bjerkeset, O., Holmen, T. L., Lydersen, S., & Indredavik, M. S. (2014). Smoking, alcohol consumption, and drug use among adolescents with psychiatric disorders compared with a population based sample. J Adolesc, 37(7), 1189–1199.
Abstract: This study investigated frequencies of smoking, alcohol use, and illicit drug use by diagnostic category in 566 adolescent psychiatric patients, comparing this sample with 8173 adolescents from the general population in Norway who completed the Young-HUNT 3 survey. Frequencies of current alcohol use were high in both samples but were lower among psychiatric patients. Compared with adolescents in the general population, adolescents in the clinical sample had a higher prevalence of current smoking and over four times higher odds of having tried illicit drugs. In the clinical sample, those with mood disorders reported the highest frequencies of smoking, alcohol use, and illicit drug use, whereas those with autism spectrum disorders reported the lowest frequencies. Our results show an increased prevalence of risky health behaviors among adolescents with psychiatric disorders compared with the general population. The awareness of disorder-specific patterns of smoking and substance use may guide preventive measures.
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