Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway.

BACKGROUND: Over-the-counter analgesics (OTCA) such as Paracetamol and Ibuprofen are frequently used by adolescents, and the route of administration and access at home allows unsupervised use. Psychological distress and pain occur simultaneously and are more common among females than among males. There is a dynamic interplay between on-label pain indications and psychological distress, and frequent OTCA use or misuse can exacerbate symptoms. No studies have to date provided an overview of frequent OTCA use in a larger population-based study. The current study used survey data to explore associations between and the relative predictive value of on-label pain indication and measures of psychological distress, together with sex differences for weekly OTCA use. METHODS: This study included 349,528 adolescents aged 13-19. The data was collected annually between January 2014 and December 2018 as part of the Norwegian Young Data survey. Performance analysis was conducted to explore the relative roles and associations between on-label pain indication and psychological distress in weekly OTCA use. A mixed-effects logistic regression model was used to explore the unique contributions from four domains of on-label pain indication and psychological distress as measured by a combined measure of anxiety and depression (HSCL-10) and peer-bullying involvement as victims or bullies. RESULTS: Thirty percent of females and 13 % of males use OTCA weekly. Headache is the strongest on-label pain predictor of weekly OTCA use, followed by abdominal pain. Depression and anxiety are the strongest psychological predictor of weekly OTCA use, and higher symptom levels and being female increase the strength of this association. Anxiety and depression also predict weekly OTCA use after controlling for physiological pain. CONCLUSIONS: Sex, pain and anxiety and depression are inter-correlated and strong predictors of frequent OTCA use. Frequent OTCA use in the context of psychological distress may be a form of self-medication that can exacerbate symptoms and decrease psychosocial function. Longitudinal studies that explore causal trajectories between frequent on-label OTCA use and psychological distress are required. OTCA use among adolescents, and particularly among females, with anxiety and depression should be administered with caution and closely monitored.

Caregivers' feeding practices in Ethiopia: association with caregiver and child characteristics.

Feeding is a source of interaction and communication. It affects children's physical and psychological/emotional development. The present study aims to examine the association between caregiver and child characteristics and caregivers' feeding practices among preschools in Addis Ababa. We conducted a cross-sectional study among 542 caregivers of children aged between 3 and 6 years old in selected preschools. We used the Child Feeding Questionnaire (CFQ) to measure caregivers' feeding practices. Multiple linear regression was used for analysis. Caregivers who had higher levels of perceived feeding responsibility (ß 0⋅20, P < 0⋅001), who were more concerned about their child being overweight (ß 0⋅11, P < 0⋅001) and who had more depressive symptoms (ß 0⋅23, P 0⋅05) were associated with food restriction practice. Caregivers who were less concerned about their child being overweight (ß -0⋅10, P < 0⋅001) and who had higher levels of perceived feeding responsibility (ß 0⋅25, P < 0⋅001) were associated with pressure to eat practice. Caregivers who had higher education (ß 0⋅29, P < 0⋅05), who had higher levels of perceived feeding responsibility (ß 0⋅47, P < 0⋅001), who were more concerned about their child being overweight (ß 0⋅15, P < 0⋅001) and who were less concerned about their child underweight (ß -0⋅06, P < 0⋅05) were associated with monitoring feeding practice. In addition, as the children have gotten older (ß 0⋅08, P < 0⋅05), there is increased use of monitoring feeding practice. This study is one of few studies that show the association between caregiver and child characteristics and feeding practices in developing countries such as Ethiopia. It is essential to include responsive feeding components in national nutritional programmes to improve preschool children's nutritional status in Ethiopia.

Unhealthy weight control behaviors among Ethiopian female adolescents.

BACKGROUND: Unhealthy weight control behaviors are a serious concern, impairing the quality of life in adolescents. Although recent epidemiological studies indicate a high level of disordered eating in developing countries, such data in Ethiopia are scarce. Thus, this study aimed to determine the extent of unhealthy weight control behaviors (i.e., purging and nonpurging) and corresponding associated factors among urban Ethiopian adolescents. METHOD: A cross-sectional study using self-administered questionnaires was applied to 690 randomly selected female high school adolescents in Addis Ababa, Ethiopia in 2017. Measures included unhealthy weight control behaviors, body mass index, subjective perception of body weight, appearance satisfaction, depressive symptoms, and socio-demographic factors. Logistic regression was applied for data analyses, that is, adjusted odds ratio (aOR) with 95% confidence interval (CI). RESULTS: The level of unhealthy weight control behaviors (i.e., a score of at least once a week in the last 1 month) was 30.7% (N = 208). Specifically, the extent of purging and nonpurging weight control behaviors was 1.5% (N = 10) and 29.8% (N = 202), respectively. Factors that were significantly associated with unhealthy weight control behaviors were perception of being overweight [aOR = 3.01; 95%CI: 1.11-8.11], being overweight [aOR = 3.28; 95%CI: 1.54-7.01], severe depression [aOR = 4.09; 95%CI: 1.73-9.96], and high socio-economic status [aOR = 2.07; 95%CI: 1.30-2.80]. CONCLUSION: This study reveals a considerable level of unhealthy weight control behaviors among female adolescents in an urban setting in Ethiopia. Researchers and policy makers should focus their attention upon this emerging public health challenge and develop associated strategies.

Cytokine concentrations are related to level of mental distress in inpatients not using anti-inflammatory drugs.

OBJECTIVE: Cross-sectional data show elevated levels of circulating cytokines in psychiatric patients. The literature is divided concerning anti-inflammatory drugs' ability to relieve symptoms, questioning a causal link between inflammatory pathways and psychiatric conditions. We hypothesised that the development of circulating cytokine levels is related to mental distress, and that this relationship is affected by the use of anti-inflammatory drugs. METHODS: The study was a longitudinal assessment of 12-week inpatient treatment at Modum Bad Psychiatric Center, Norway. Sera and self-reported Global Severity Index (GSI) scores, which measure psychological distress, were collected at admission (T0), halfway (T1) and before discharge (T2). Other variables known to distort the neuroimmune interplay were included. These were age, gender, diagnosis of PTSD, antidepressants and anti-inflammatory drugs. A total of 128 patients (92 women and 36 men) were included, and 28 were using anti-inflammatory medication. Multilevel modelling was used for data analysis. RESULTS: Patients with higher levels of IL-1RA and MCP-1 had higher GSI scores (p = 0.005 and p = 0.020). PTSD patients scored higher on GSI than non-PTSD patients (p = 0.002). These relationships were mostly present among those not using anti-inflammatory drugs (n = 99), with higher levels of IL-1RA and MCP-1 being related to higher GSI score (p = 0.023 and 0.018, respectively). Again, PTSD patients showed higher GSI levels than non-PTSD patients (p = 0.014). CONCLUSIONS: Cytokine levels were associated with level of mental distress as measured by the GSI scores, but this relationship was not present among those using anti-inflammatory drugs. We found no association between cytokine levels and development of GSI score over time.

PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress.

BACKGROUND: A reciprocal relationship between activated innate immune system and changes in mood and behavior has been established. There is still a paucity of knowledge on how the immune system responds during psychiatric treatment. We aimed to explore circulating cytokines and assess psychiatric symptom severity scores during 12 weeks of inpatient psychiatric treatment. METHODS: The study was a longitudinal assessment of 124 patients (88 women and 36 men) in treatment at Modum Psychiatric Center, Norway. The patient sample comprised a mixed psychiatric population of whom 39 were diagnosed with posttraumatic stress disorder (PTSD). Serum blood samples for cytokine analysis and measures of mental distress using Global Severity Index were collected at admission (T0), halfway (T1), and before discharge (T2). Other factors assessed were age, gender, and the use of antidepressants and anti-inflammatory drugs. Multilevel modeling was used for longitudinal analyses to assess the repeated cytokine samples within each patient. RESULTS: Overall level of IL-1RA was higher in PTSD patients when compared to those without PTSD (P=0.021). The level of IL-1ß, MCP-1, and TNF-α increased over time in PTSD compared to non-PTSD patients (P=0.025, P=0.011 and P=0.008, respectively). All patients experienced reduced mental distress as measured by self-reported Global Severity Index scores. Stratified analysis showed that PTSD patients who used anti-inflammatory drugs had higher levels of IL-1ß (P=0.007) and TNF-α (P=0.049) than PTSD patients who did not use such drugs. CONCLUSION: The study indicates that traumatized patients may have a distinct neuroimmune development during recovery. Their activated immune system shows even further activation during their rehabilitation despite symptom reduction.

Developmental trajectories of postpartum weight 3 years after birth: Norwegian Mother And Child Cohort study.

This study explored the developmental trajectories of postpartum weight from 0.5 to 3 years after childbirth, and aimed to determine the associations between postpartum weight trajectories and prepregnancy body mass index and adequacy of gestational weight gain (GWG). Data from the Norwegian Mother and Child Cohort study were used, following 49,528 mothers 0.5, 1.5, and 3 years after childbirth. Analyses were performed using latent growth mixture modeling. Three groups of developmental trajectories of postpartum weight were found, with most women (85.9 %) having a low level of weight retention initially and slight gain over 3 years, whereas 5.6 % of women started at a high postpartum weight retention (on average 7.56 kg) at 0.5 years but followed by a marked weight loss over time (2.63 kg per year on average), and the third trajectory represented women (8.5 %) who had high weight retention high initially (on average 4.67 kg at 0.5 years) and increasing weight over time (1.43 kg per year on average). Prepregnancy overweight and obesity and excessive GWG significantly predicted a high postpartum weight trend. Women had substantial variability in postpartum weight development-both initially after birth and in their weight trajectories over time. Early preventive interventions may be designed to assist women with prepregnancy overweight and obesity and excessive GWG, which helps to reduce the increasing trend for postpartum weight.

Binge Drinking, Cannabis and Tobacco Use Among Ethnic Norwegian and Ethnic Minority Adolescents in Oslo, Norway.

The aim of the study was to assess prevalence and factors associated with binge drinking, cannabis use and tobacco use among ethnic Norwegians and ethnic minority adolescents in Oslo. We used data from a school-based cross-sectional survey of adolescents in junior- and senior high schools in Oslo, Norway. The participants were 10,934 adolescents aged 14-17 years, and just over half were females. The sample was comprised of 73.2 % ethnic Norwegian adolescents, 9.8 % 1st generation immigrants, and 17 % 2nd generation adolescents from Europe, the US, the Middle East, Asia and Africa. Logistic regression models were applied for the data analyses. Age, gender, religion, parental education, parent-adolescent relationships, depressive symptoms and loneliness were covariates in the regression models. Ethnic Norwegian adolescents reported the highest prevalence of binge drinking (16.1 %), whereas the lowest prevalence was found among 2nd generation adolescents from Asia (2.9 %). Likewise, the past-year prevalence for cannabis use ranged from 10.6 % among 2nd generation Europeans and those from the US to 3.7 % among 2nd generation Asians. For daily tobacco use, the prevalence ranged from 12.9 % among 2nd generation Europeans and the US to 5.1 % among 2nd generation Asians. Ethnicity, age, gender, religion, parental education, and parent-adolescent relationships and mental health status were significantly associated with binge drinking, cannabis and tobacco use. These factors partly explained the observed differences between ethnic Norwegians and ethnic minority adolescents in the current study. There are significant differences in substance use behaviors between ethnic Norwegian and immigrant youth. Factors like age, gender, religion, parental education and relationships and mental health status might influence the relationship between ethnicity and substance abuse. The findings have implications for planning selective- as well as universal prevention interventions.