Ingvar Bjelland | University of Bergen (original) (raw)

Papers by Ingvar Bjelland

Background: An association between depression and folate status has been demonstrated in clinical... more Background: An association between depression and folate status has been demonstrated in clinical studies, whereas data are sparse on the relationship between de- pression and other components of 1-carbon metabo- lism such as vitamin B12, homocysteine, and the methy- lenetetrahydrofolate reductase677C→T polymorphism. The relationship between anxiety and these compo- nents is less well known. This study examined the asso- ciations

Background: Cohort Norway (CONOR) containing blood samples and standardised health and exposure v... more Background: Cohort Norway (CONOR) containing blood samples and standardised health and exposure variables of about 170,000 subjects, is based on data from health surveys in different parts of Norway. In all participants mental distress is measured by seven questions modified after various mental health measure- ment instruments. The purpose of the present study was to examine the agreement between these

Social Science & Medicine, 2008

The relationship of education to the experience of anxiety and depression throughout adult life i... more The relationship of education to the experience of anxiety and depression throughout adult life is unclear. Our knowledge of this relationship is limited and inconclusive. The aim of this study was to examine (1) whether higher educational level protects against anxiety and/or depression, (2) whether this protection accumulates or attenuates with age or time, and (3) whether such a relationship appears to be mediated by other variables. In a sample from the Nord-Trøndelag Health Study 1995e1997 (HUNT 2) (N ¼ 50,918) of adults, the cross-sectional associations between educational level and symptom levels of anxiety and depression were examined, stratified by age. The long-term effects of educational level on anxiety/depression were studied in a cohort followed up from HUNT 1 (1984e1986) to HUNT 2 (N ¼ 33,774). Low educational levels were significantly associated with both anxiety and depression. The coefficients decreased with increasing age, except for the age group 65e74 years. In the longitudinal analysis, however, the protective effect of education accumulated somewhat with time. The discrepancy between these two analyses may be due to a cohort effect in the cross-sectional analysis. Among the mediators, somatic health exerted the strongest influence, followed by health behaviors and socio-demographic factors. Higher educational level seems to have a protective effect against anxiety and depression, which accumulates throughout life.

The Journal of nutrition, 2006

The Hordaland Homocysteine Study (HHS) is a population-based study of more than 18,000 men and wo... more The Hordaland Homocysteine Study (HHS) is a population-based study of more than 18,000 men and women in the county of Hordaland in Western Norway. The first investigation (HHS-I) took place in 1992-93, when the subjects were aged 40-67 y. In 1997-99, a follow-up study (HHS-II) of 7,053 subjects was carried out. In this large population, plasma levels of total homocysteine (tHcy) are associated with several physiologic and lifestyle factors and common diseases. Increasing age, male sex, smoking, coffee consumption, high blood pressure, unfavorable lipid profile, high creatinine, and the MTHFR 677C > T polymorphism are among the factors associated with increased tHcy levels; physical activity, moderate alcohol consumption, and a good folate or vitamin B-12 status are associated with lower tHcy levels. Subjects with raised tHcy levels have increased risk of cardiovascular morbidity, cardiovascular and noncardiovascular mortality, and are more likely to suffer from depression and fro...

Objective: To review the literature of the validity of the Hospital Anxiety and Depression Scale ... more Objective: To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS). Method: A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression? Results: Most factor analyses demonstrated a twofactor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from .40 to .74 (mean .56). Cronbach's alpha for HADS-A varied from .68 to .93 (mean .83) and for HADS-D from .67 to .90 (mean .82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range .49 to .83. Conclusions: HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population. D

Journal of Psychosomatic Research, 2002

British Journal of Nutrition, 2013

Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neu... more Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a cross-sectional study, 2195 subjects (55 % women), aged 70-74 years, underwent extensive cognitive testing including the Kendrick Object Learning Test (KOLT), Trail Making Test (part A, TMT-A), modified versions of the Digit Symbol Test (m-DST), Block Design (m-BD), Mini-Mental State Examination (m-MMSE) and Controlled Oral Word Association Test (COWAT). Compared with low concentrations, high choline (.8·4 mmol/l) was associated with better test scores in the TMT-A (56·0 v. 61·5, P¼ 0·004), m-DST (10·5 v. 9·8, P¼ 0·005) and m-MMSE (11·5 v. 11·4, P¼ 0·01). A generalised additive regression model showed a positive dose -response relationship between the m-MMSE and choline (P¼0·012 from a corresponding linear regression model). Betaine was associated with the KOLT, TMT-A and COWAT, but after adjustments for potential confounders, the associations lost significance. Risk ratios (RR) for poor test performance roughly tripled when low choline was combined with either low plasma vitamin B 12 (# 257 pmol/l) concentrations (RR KOLT ¼ 2·6, 95 % CI 1·1, 6·1; RR m-MMSE ¼ 2·7, 95 % CI 1·1, 6·6; RR COWAT ¼ 3·1, 95 % CI 1·4, 7·2) or high methylmalonic acid (MMA) ($3·95 mmol/l) concentrations (RR m-BD ¼ 2·8, 95 % CI 1·3, 6·1). Low betaine (# 31·1 mmol/l) combined with high MMA was associated with elevated RR on KOLT (RR KOLT ¼ 2·5, 95 % CI 1·0, 6·2). Low plasma free choline concentrations are associated with poor cognitive performance. There were significant interactions between low choline or betaine and low vitamin B 12 or high MMA on cognitive performance.

Scandinavian Journal of Primary Health Care, 2003

Objective Á / To examine the relationship between anxiety disorders and depression and various so... more Objective Á / To examine the relationship between anxiety disorders and depression and various somatic health problems in the general population.

Korresponderende forfatter: Professor dr. med. Alv A. Dahl, Klinikk for psykiatri, Aker universit... more Korresponderende forfatter: Professor dr. med. Alv A. Dahl, Klinikk for psykiatri, Aker universitetssykehus HF, Sognsvannsveien 21, 0320 Oslo Telefon: 22923820 Telefax: 22923971 e-post: a.a.dahl@psykiatri.uio.no SAMMENDRAG For å øke bredden av det psykiatriske forskningsmiljøet i Bergen, ble det i 1999 startet en arbeidsgruppe for psykiatrisk epidemiologi. Arbeidsgruppen har 15 medlemmer som alle har pågående prosjekter, og som har møttes regelmessig. Materialet for gruppens arbeid har vaert Helseundersøkelsene i Nord-Trøndelag (HUNT-II) og i Hordaland (HUSK). Utfallsvariablene i våre prosjekter har vaert angst og depresjon målt ved selvutfyllingtesten Hospital angst og depresjonsskala (HADS). I Bergensgruppen er angst og depresjon undersøkt i forhold til kodimensjonalitetet, fysisk aktivitet, body mass index/hip-waist ratio, global helse, gastrointestinale symptomer, menopause, p-piller, svangerskap og fødsler, søvnplager, røyking, migrene, whiplash, epilepsi, folat-metabolisme, kreft, yrke og helsetjenester. Det ser ut til at vi har dannet grunnlaget for en stabil og produktiv gruppe som sammen med andre grupper kan bidra til et aktivt miljø for psykiatrisk epidemiologi ved Universitetet i Bergen. Dahl AA, Bjelland I, Moe TJ, Mykletun A, Roness A. Establishing a working group for psychiatric epidemiologic research in Bergen. Nor J Epidemiol 2002; 12 (3): 355-360.

Psychotherapy and Psychosomatics, 2003

Background: An association between depression and folate status has been demonstrated in clinical... more Background: An association between depression and folate status has been demonstrated in clinical studies, whereas data are sparse on the relationship between depression and other components of 1-carbon metabolism such as vitamin B 12 , homocysteine, and the methylenetetrahydrofolate reductase 677C→T polymorphism. The relationship between anxiety and these components is less well known. This study examined the associations between folate, total homocysteine, vitamin B 12 , and the methylenetetrahydrofolate reductase 677C→T polymorphism, and anxiety and depression in a large population-based study.

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

The Bergen Child Study is a longitudinal study of child mental health from the city of Bergen, No... more The Bergen Child Study is a longitudinal study of child mental health from the city of Bergen, Norway. We present methods and results from the first wave of the study, focusing on prevalence of disorders, associations with risk factors, and the use of services. The target population included all 9,430 children attending grades 2 to 4 in Bergen schools during the academic year 2002/2003. The main screening instrument was the Strengths and Difficulties Questionnaire, whereas diagnoses were based on the Development and Well-Being Assessment. Information about child and family risk factors and service use was also obtained in this second stage. In the first phase, the teacher Strengths and Difficulties Questionnaire was obtained for 9,155 (97%) of the target children and the matching parent Strengths and Difficulties Questionnaire for 6,297 (67%); 1,011 children (11%) were assessed with the Development and Well-Being Assessment in the second phase. The weighted prevalence for any DSM-IV psychiatric disorder was 7.0% (95% confidence interval 5.6%-8.5%). Disorders were associated with age, gender, learning difficulties, family type, and poverty. Although 75% of children with attention-deficit/hyperactivity disorder had been in contact with specialist mental health services, this was true for only 13% of those with pure emotional disorders. The overall prevalence of psychiatric disorders in children is relatively low in this Norwegian sample, when assessed with the Development and Well-Being Assessment. Children with emotional disorders have limited access to specialist services.

Journal of Psychosomatic Research, 2005

The aim of this study was to examine the association between haemoglobin levels, anxiety disorder... more The aim of this study was to examine the association between haemoglobin levels, anxiety disorder, and depression in cancer patients. Cancer patients attending The Norwegian Radium Hospital (NRH) rated themselves on the Hospital Anxiety and Depression Scale (HADS). Five hundred thirty-two patients also had valid measurements of haemoglobin at the same time. The associations between tertile haemoglobin levels (7.0-12.3 g/dl, 12.4-13.8 g/dl, 13.9-17.1 g/dl) and HADS-defined anxiety disorder and depression were analysed by logistic regression. HADS-defined depression was identified in 116 cases (22%) and anxiety disorder in 149 (28%). The haemoglobin levels of the lower and middle tertiles were associated with depression (OR=3.85, 95% CI: 2.06-7.21, and OR=2.45, 95% CI: 1.25-4.81, respectively). Adjustment for covariates did not change the association significantly. No association between haemoglobin and anxiety disorder was found. In cancer patients, the risk of depression increases with decreasing haemoglobin levels. This should be taken into account when treatment of anaemic or depressed cancer patients is decided upon.

Journal of Epidemiology & Community Health, 2007

Background: Low blood pressure has mainly been regarded as ideal, but recent studies have indicat... more Background: Low blood pressure has mainly been regarded as ideal, but recent studies have indicated an association with depression in elderly people. Objective: To investigate whether low blood pressure is associated with anxiety and depression in the general population. Design: Cross-sectional study. Setting: Participants in the population-based Nord-Trøndelag Health Study (HUNT-2, 1995-7), Norway. Participants: 60 799 men and women aged 20-89 years filled in the Hospital Anxiety and Depression Scale as part of a general health study. Systolic and diastolic blood pressure was classified in age-stratified and sex-stratified centile groups. Main results: Compared with participants with systolic blood pressure within the 41-60 centile (reference) group, the odds ratio for anxiety was 1.31 (95% confidence intervals (CI) 1.16 to 1.49), for depression 1.22 (95% CI 1.03 to 1.46), and for comorbid anxiety and depression 1.44 (95% CI 1.24 to 1.68) in the group with (5 centile systolic blood pressure. Slightly weaker associations were found of low diastolic blood pressure with anxiety and depression. These associations were similar across sex and age groups. Physical impairment, smoking and angina pectoris influenced the associations only marginally, whereas stroke, myocardial infarction, use of drugs for hypertension, body mass index and several other covariates had no influence.

The Journal of Clinical Psychiatry, 2006

This study aimed to examine whether subjects taking selective serotonin reuptake inhibitors (SSRI... more This study aimed to examine whether subjects taking selective serotonin reuptake inhibitors (SSRIs) are more likely to have elements of the metabolic syndrome compared with those taking no psychotropic drugs. For comparison, we also studied subjects taking antipsychotic drugs. We used data from The Hordaland Health Study &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;97-&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;99, a general community cross-sectional health survey including 25,315 subjects aged 40 to 49 and 70 to 74 years. For the groups studied, we estimated prevalence and odds ratios (ORs) for obesity, hypercholesterolemia, low high-density lipoprotein cholesterol, hyper-triglyceridemia, and diabetes. We observed an association between use of SSRIs as a group (N = 461) and abdominal obesity (OR = 1.40, 95% CI = 1.08 to 1.81) and hypercholesterolemia (OR = 1.36, 95% CI = 1.07 to 1.73) after adjusting for multiple possible confounders. There was also a trend toward an association between SSRI use and diabetes. In a subgroup analysis of subjects taking SSRIs, the use of paroxetine (N = 187) was markedly associated with both general and abdominal obesity but not with hypercholesterolemia. In contrast, the use of citalopram (N = 142) was not associated with any of the metabolic outcome variables, while the use of any other SSRI (sertraline, fluoxetine, or fluvoxamine) (N = 131) as a mixed subgroup was associated with both abdominal obesity and hypercholesterolemia. We also replicated the previously reported associations between use of antipsychotics and obesity and metabolic disturbances. We have shown that use of at least some SSRIs is associated with clinical and biochemical elements of the metabolic syndrome. Our data indicate differences in the metabolic side effect profile among various SSRI drugs, although treatment bias might have influenced these results. We suggest that patients taking SSRIs be carefully monitored for obesity and dyslipidemia.

Journal of Affective Disorders, 2008

Background: The purpose of this study was to assess how seasonal changes in mood and behaviour we... more Background: The purpose of this study was to assess how seasonal changes in mood and behaviour were associated with depression and anxiety symptoms in a sample from a general population, and to investigate how prevalence figures were affected by month of questionnaire completion. Methods: The target population included all individuals in the Hordaland county (Norway) born 1953-57 (N = 29,400). In total, 8598 men (57% response rate) and 9983 women (70% response rate) attended the screening station. Half of the men (randomly chosen) and all of the women were offered a questionnaire to fill in with items on seasonality. This was measured using the Global Seasonality Score (GSS), a central component of the Seasonal Pattern Assessment Questionnaire (SPAQ). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression. Both questionnaires were completed by 2980 men (68.9%) and 8074 women (80.9%). Results: Seasonality was positively associated with levels of both anxiety and depression regardless of the season the interview took place. In subjects with a low/moderate degree of seasonality there were modestly higher levels of depressive symptoms during November through March than the other months. Limitations: We had a substantial number of non-responders. Conclusions: Our results raise the possibility of seasonality being a separate dimensional trait associated with both anxiety and depression.

Journal of Affective Disorders, 2007

Background: Clinical trials suggest that omega-3 fatty acids improve the outcome of depression. T... more Background: Clinical trials suggest that omega-3 fatty acids improve the outcome of depression. This study aimed to evaluate the association between intake of cod liver oil, rich in omega-3 fatty acids, and high levels of symptoms of depression and anxiety in the general population. Methods: We used data from the "The Hordaland Health Study '97-'99" (HUSK), a population based cross-sectional health survey from Norway including 21,835 subjects aged 40-49 and 70-74 years. Symptoms of depression and anxiety were measured by The Hospital Anxiety and Depression Scale (HADS). We used logistic regression to study associations. Results: Among the participants, 8.9% used cod liver oil daily. A total of 3.6% had high levels of depressive symptoms. The prevalence of such depressive symptoms among the subjects who used cod liver oil daily was 2.5%, as compared to 3.8% in the rest of the population. The users of cod liver oil were significantly less likely to have depressive symptoms than non-users after adjusting for multiple possible confounding factors (odds ratio = 0.71, 95% confidence interval 0.52 to 0.97). These factors included age, gender, smoking habits, coffee consumption, alcohol consumption, physical activity, and education. In addition, we found that the prevalence of high levels of depressive symptoms decreased with increasing duration (0-12 months) of cod liver oil use (multivariate adjusted test for trend, P = 0.04). We were only able to study this latter association in a subset of the population aged 40-46 years. Limitations: Data are cross sectional.

Heart & Lung: The Journal of Acute and Critical Care, 2008

European Psychiatry, 2005

Objective: In nicotine dependent subjects cues related to smoking elicit brain activity in region... more Objective: In nicotine dependent subjects cues related to smoking elicit brain activity in regions linked to attention, memory, emotion and motivation. Besides craving further determinants of cue reactivity and their impact on underlying neural systems are still unknown. Neither for nicotine nor for other drugs of abuse the influence of severity of dependence has been studied. We therefore investigated whether nicotine dependence gradually influences brain activation by visual smoking cues and how this is related to craving intensity.

European Psychiatry, 2002

Behaviour Research and Therapy, 2014

Objective: Conducted a randomized controlled trial to investigate the effectiveness of cognitive ... more Objective: Conducted a randomized controlled trial to investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT) treatment approaches for anxiety disorders in children and adolescents. Methods: Referred youth (N ¼ 182, M age ¼ 11.5 years, range 8e15 years, 53% girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures. After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement, and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests. Results: Significantly more youth lost all anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment. Conclusion: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their transportability from university to community settings.

Social Science & Medicine, 2008

The Journal of nutrition, 2006

Journal of Psychosomatic Research, 2002

British Journal of Nutrition, 2013

Scandinavian Journal of Primary Health Care, 2003

Psychotherapy and Psychosomatics, 2003

Background: An association between depression and folate status has been demonstrated in clinical... more Background: An association between depression and folate status has been demonstrated in clinical studies, whereas data are sparse on the relationship between depression and other components of 1-carbon metabolism such as vitamin B 12 , homocysteine, and the methylenetetrahydrofolate reductase 677C→T polymorphism. The relationship between anxiety and these components is less well known. This study examined the associations between folate, total homocysteine, vitamin B 12 , and the methylenetetrahydrofolate reductase 677C→T polymorphism, and anxiety and depression in a large population-based study.

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

Journal of Psychosomatic Research, 2005

Journal of Epidemiology & Community Health, 2007

The Journal of Clinical Psychiatry, 2006

Journal of Affective Disorders, 2008

Journal of Affective Disorders, 2007

Heart & Lung: The Journal of Acute and Critical Care, 2008

European Psychiatry, 2005

European Psychiatry, 2002

Behaviour Research and Therapy, 2014