Sleep duration and mental health in young adults.

BACKGROUND: The association between sleep duration and mental illness has been established in middle-aged and older populations, yet remains less explored in younger adults. Additionally, a common limitation to existing studies is the lack of statistical power to explore less common disorders. The purpose of this study was to examine sleep duration as a predictor for a range of mental disorders and well-being in a longitudinal sample of young adults. METHODS: Data were derived from two waves (w1, w2) of the SHoT survey, which invited all full-time university and college students in Norway. The response rates were 34.4 % (n = 62,498) in 2021 (w1) and 35.1 % (n = 59,554) 2022 (w2). This study utilized a nested longitudinal sample from both w1 and w2, encompassing 21,289 students. Demographics, sleep duration (w1), and mental health (w2) were measured by self-report questionnaires. Sex-stratified linear regression models and log-link binomial regression analyses were employed to determine the proportion and calculate the risk ratios, respectively, for mental illness across different sleep duration categories. RESULTS: The mean age of the sample was 24.8 years ± 4.5 years (w1). Students with shorter sleep durations, and to some degree longer sleep durations (illustrating a ᒐ-shaped association), exhibited a higher risk for all assessed mental disorders and well-being outcomes one year later, compared to students sleeping 8-9 h. The ᒐ-shaped trend was consistent for both female and male students. CONCLUSION: Sleep duration appears to be a transdiagnostic marker for mental health in young adults.

Prevalence of mental disorders among Norwegian college and university students: a population-based cross-sectional analysis.

Background: Self-report data indicate a sharp increase in mental health problems among college and university students in recent years, but accurate prevalence estimates of mental disorders are lacking. The current study used a validated psychiatric diagnostic survey, developed into a self-administered electronic version, to examine the prevalence of common mental disorders in a large national sample of college and university students in Norway. Methods: Participants (aged 18-35 years) from the national Students' Health and Wellbeing (SHOT) Study in 2022 were recruited to a follow-up online survey of mental disorders from January to February 2023 (n = 10,460). Current (30-days), 12-months and lifetime prevalence of common mental disorders were examined using a newly developed self-administered electronic version of the Composite International Diagnostic Interview (CIDI 5.0). Findings: The prevalence of a current mental disorder was high for both women (39.7% [2737/6886], 95% CI 38.6-40.9) and men (25.7% [751/2918], 95% CI 24.2-27.4). The most common disorders were major depressive episode (females 17.1% [1250/7329] and males 10.8% [331/3059]) and generalized anxiety disorder (females 16.0% [1157/7221] and males 8.2% [250/3032]), while 5.6% [387/6948] and 7.7% [228/2963] of the females and male students, respectively, fulfilled the criteria for an alcohol use disorder. The prevalence estimates for 12-month and lifetime were, as expected, even higher. Interpretation: The findings suggest an alarmingly high prevalence of several mental disorders among Norwegian college and university students. Implications and potential methodological and contextual explanations of these findings are discussed. Funding: Norwegian Ministry of Education and Research.

Fear of missing out and binge-drinking among adolescents.

INTRODUCTION: No previous studies have examined the cross-sectional association between fear of missing out (FOMO) and binge-drinking among adolescents. The aim of the present study was: (i) to estimate the magnitude of this association; (ii) to assess the impact of potential confounders (i.e. sensation-seeking, symptoms of depression and self-regulation); and (iii) determine if it is uniform across all levels of these characteristics. METHODS: Cross-sectional study of adolescents from 33 middle schools in Norway, stratified according to geographic location, urban and rural locations, and standard of living. Participants were a nation-wide sample of N = 2646 adolescents (mean age 16.2 years, 43% boys). Self-report data were collected on binge-drinking, FOMO, sensation-seeking, symptoms of depression and self-regulation. RESULTS: Overall, 21% reported binge-drinking ≤ once per month in the past 12 months, while 9% reported binge-drinking more than once per month. Multinomial logistic regression showed that the crude effect, where greater FOMO was associated with greater risk of binge-drinking, was substantial (relative-risk ratio = 1.50 [1.35, 1.66], P < 0.001), but somewhat attenuated after including all potential confounders (relative-risk ratio = 1.28 [1.14, 1.43], P < 0.001). Effect modification analyses showed that the effect of FOMO on binge-drinking ≤ once per month was stronger for adolescents with low symptom levels of depression and weaker for adolescents at high levels of depression. DISCUSSION AND CONCLUSION: Norwegian adolescents with higher FOMO have greater risk of binge-drinking.

The Association Between Self-Reported Screen Time, Social Media Addiction, and Sleep Among Norwegian University Students.

The aim of this study was to assess the relationship between daily screen time and sleep, evening screen time and sleep, and between social media addiction and sleep in a student population. This cross-sectional study is based on data from a national survey of all college and university students in Norway (the SHoT2018 study; n = 49,051). The sleep outcomes were sleep duration, sleep onset latency, sleep efficiency, and insomnia operationalized according to formal DSM-5 criteria. The results show a strong negative association between time spent on screen-based devices and sleep quality and quantity, and where screen use in bed had more consistent negative associations with sleep. Furthermore, there were higher rates of insomnia among those with higher levels of addiction, and curvilinear relationships with sleep duration, sleep onset latency, and sleep efficiency. Those with higher levels of addiction also had more evening screen time. The findings suggest that screen use plays an important role in students' sleep quantity and quality, where evening screen time has a stronger relationship with sleep compared to total daily screen time. The results also suggest a role of social media addiction, and addictive social media use may be a target for intervention in order to reduce evening screen time.

Population attributable fractions for Type 2 diabetes: an examination of multiple risk factors including symptoms of depression and anxiety.

BACKGROUND: Population attributable fractions (PAFs) are frequently used to quantify the proportion of Type 2 diabetes cases due to single risk factors, an approach which may result in an overestimation of their individual contributions. This study aimed to examine Type 2 diabetes incidence associated with multiple risk factor combinations, including the metabolic syndrome, behavioural factors, and specifically, depression and anxiety. METHODS: Using data from the population-based HUNT cohort, we examined incident diabetes in 36,161 Norwegian adults from 1995 to 2008. PAFs were calculated using Miettinen's case-based formula, using relative risks estimated from multivariate regression models. RESULTS: Overall, the studied risk factors accounted for 50.5% of new diabetes cases (78.2% in men and 47.0% in women). Individuals exposed to both behavioural and metabolic factors were at highest risk of diabetes onset (PAF = 22.9%). Baseline anxiety and depression contributed a further 13.6% of new cases to this combination. Men appeared to be particularly vulnerable to the interaction between metabolic, behavioural and psychological risk factors. CONCLUSION: This study highlights the importance of risk factor clustering in diabetes onset, and is the first that we know of to quantify the excess fraction of incident diabetes associated with psychological risk factor interactions.

Alcohol and Illicit Drug Use Are Important Factors for School-Related Problems among Adolescents.

The aim of this study was to investigate the association between alcohol and drug use, and school-related problems measured by low grade point average (GPA) and high school attendance. We also examined potential confounding effects from mental health problems. Although the issue is not new within current literature, the present study has its strengths in a large number of participants and the utilization of registry-based data on school-related functioning. A cross-sectional design is employed in this study using data from a large population-based sample of adolescents, youth@hordaland, in a linkage to official school registry data, and the current study presents data from N = 7,874. The main independent variables were alcohol use and drug use, as well as potential alcohol- and drug-related problems. The dependent variables were registry-based school attendance and grades. All the alcohol- and drug measures included were consistently associated with low GPA (Odds ratios (OR) ranging 1.82-2.21, all p < 0.001) and high levels of missed days from school (ORs ranging 1.79-3.04, all p < 0.001) and high levels of hours missed from school (ORs ranging 2.17-3.44, all p < 0.001). Even after adjusting for gender, age, socioeconomic status and mental health problems all the associations between alcohol and illicit drug use and the school-related outcomes remained statistically significant. Increasing number of indications on alcohol/drug-related problems and increasing levels of alcohol consumption were associated with more negative school-related outcomes. The results suggest that alcohol- and drug use, and particularly alcohol/drug-related problems, are important factors for school-related problems independently of mental health problems.

Symptoms of anxiety and depression in type 2 diabetes: Associations with clinical diabetes measures and self-management outcomes in the Norwegian HUNT study.

OBJECTIVE: To determine if symptoms of depression and anxiety are differentially associated with clinical diabetes measures and self-management behaviours in individuals with Type 2 diabetes, and whether these associations vary by patient sex. RESEARCH DESIGN AND METHODS: A cross-sectional analysis using data from 2035 adults with Type 2 diabetes in the Nord-Trøndelag Health Study. Multivariate logistic regression was used to explore associations between symptoms of depression and anxiety and waist girth, HDL cholesterol, systolic blood pressure, triglycerides, c-reactive protein, glycemic control, diet adherence, exercise, glucose monitoring, foot checks for ulcers, and the subjective patient experience. Analyses were stratified by sex. RESULTS: Depression was associated with a lower likelihood of avoiding saturated fats (OR=0.20 [95% CI: 0.06, 0.68]) and increased odds of physical inactivity (OR=1.69 [95% CI: 1.37, 2.72]). Anxiety was associated with increased odds of eating vegetables (OR=1.66 [95% CI: 1.02, 2.73]), and an over two-fold increase of feeling that having diabetes is difficult. In women, anxiety was associated with elevated c-reactive protein levels (OR=1.57 [95% CI: 1.05, 2.34]). In men, depressive symptoms were associated with elevated HbA1c (OR=5.00 [95% CI: 1.15, 8.23). CONCLUSIONS: Symptoms of depression and anxiety were differentially associated with some key diabetes-related measures. Our results suggest sex-specific differences with respect to two important clinical outcomes (i.e., anxiety and CRP in women and depression and glycemic control in men). These findings should alert practitioners to the importance of detection and management of psychological symptoms in individuals with Type 2 diabetes.

The factor structure of the Hopkins Symptoms Checklist (HSCL-25) in a student population: A cautionary tale.

AIMS: The Hopkins Symptoms Checklist (HSCL-25) is a widely used self-report measurement for mental health problems, but its factor structure is still uncertain, with divergent results in different social or cultural settings. We aimed to investigate the previously suggested factor structures of the HSCL-25, as well as a model including an explicit somatic factor among students in Norway. METHODS: The study population is based on data from the Norwegian study of students' health and wellbeing, SHoT ('Studentenes Helse- og Trivselsundersøkelse'), and the present study comprises N = 13,525 participants. Using confirmatory factor analyses we investigated previously suggested factor structures, as well as a 3-factor structure, with specific subscales for anxiety, depression and somatic symptoms, suggested by the authors. After identification of the best-fitting model(s), measurement invariance across sexes, as well as associations with self-reported socioeconomic and social factors, use of medication and help-seeking behaviour were examined. RESULTS: Based on the fit indices alone, bi-factor models fitted the data the best. However, upon further scrutiny when exploring the viability of the bi-factor models, we deemed the reliability of the specific subscales as extremely low and not viable as subscales. We therefore suggest that a uni-dimensional model was the most appropriate in our study. CONCLUSIONS: Based on considerations of fit indices, viability of subscales and associations with social and socioeconomic factors we suggest that a uni-dimensional model is most appropriate for HSCL-25 in a student population. Future investigations should examine how the revisions could improve the psychometric properties of the scale.

Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk.

OBJECTIVE: Depression is strongly linked to increased mortality in individuals with type 2 diabetes. Despite high rates of co-occurring anxiety and depression, the risk of death associated with comorbid anxiety in individuals with type 2 diabetes is poorly understood. This study documented the excess mortality risk associated with symptoms of depression and/or anxiety comorbid with type 2 diabetes. RESEARCH DESIGN AND METHODS: Using data for 64,177 Norwegian adults from the second wave of the Nord-Trøndelag Health Study (HUNT2), with linkage to the Norwegian Causes of Death Registry, we assessed all-cause mortality from survey participation in 1995 through to 2013. We used Cox proportional hazards models to examine mortality risk over 18 years associated with type 2 diabetes status and the presence of comorbid affective symptoms at baseline. RESULTS: Three clear patterns emerged from our findings. First, mortality risk in individuals with diabetes increased in the presence of depression or anxiety, or both. Second, mortality risk was lowest for symptoms of anxiety, higher for comorbid depression-anxiety, and highest for depression. Lastly, excess mortality risk associated with depression and anxiety was observed in men with diabetes but not in women. The highest risk of death was observed in men with diabetes and symptoms of depression only (hazard ratio 3.47, 95% CI 1.96, 6.14). CONCLUSIONS: This study provides evidence that symptoms of anxiety affect mortality risk in individuals with type 2 diabetes independently of symptoms of depression, in addition to attenuating the relationship between depressive symptoms and mortality in these individuals.

Health-related behaviour in relation to transition into age retirement: An observational study based on HUNT3.

OBJECTIVES: In western countries, more years are being spent in age retirement. The transition phase into age retirement may be important for physical and mental health in the years following retirement. The aim of the present study was to investigate whether age retirement is associated with changes in the level of physical activity, smoking habits and alcohol habits. DESIGN: Using data on self-reported health-related behaviour from a population-based study (The Nord-Trøndelag Health Study (HUNT3)) linked to registry data on age retirement, participants who retired within two years prior to and two years after participating in the Nord-Trøndelag Health Study (N = 2,197) were compared. PARTICIPANTS: A total of 2,197 participants were included. SETTING: Population-based study in Norway. MAIN OUTCOME MEASURES: Registry data on age retirement. RESULTS: No systematic differences in alcohol consumption, smoking or physical activity over the strata defined by time before or after age retirement were identified. CONCLUSION: The current and previous findings do not suggest that transition into age retirement changes health-related behaviours. However, there is probably merit in investigating complicating factors related to the retirement process, such as degree of voluntariness, as these factors may influence the impact of age retirement on health behaviours.

Trajectories and stability of self-reported short sleep duration from adolescence to adulthood.

The trajectories and stability of self-reported sleep duration recorded at ages 13, 15, and 23 years on reported sleep duration at age 30 years among 1105 students (55% male) who participated in the Norwegian Longitudinal Health and Behaviour Study were examined. Questionnaire data were used to obtain demographic and sleep variables. Dichotomised short sleep duration was based on normative values and set as ≤ 8.5 h (age 13 years), ≤ 8 h (age 15 years) and ≤ 7 h (ages 23 and 30 years). Results indicated a significant overall reduction in total sleep duration (h per night) across age groups. Sleep duration (continuous) at age 15 and 23 years (whole group) was moderately but positively correlated with sleep duration at age 30 years (P < 0.01). When split by sex, at age 15 years, this association was present among females only (P < 0.01); however, at age 23 years, this association was present in both male and females (both P < 0.001). Categorical short sleep at age 23 years (whole group) was associated with short sleep at age 30 years (unadjusted odds ratio = 3.67, 95% confidence interval 2.36-5.69). Following sex stratification, this effect was significant for both males (unadjusted odds ratio = 3.77, 95% confidence interval: 2.22-6.42) and females (unadjusted odds ratio = 2.71, 95% confidence interval: 1.46-5.04). No associations were noted for categorical short sleep at ages 13 or 15 years, and subsequent short sleep at 30 years. Habitual short sleep duration during middle adulthood is not sustained from the time of early adolescence. Rather, these trends appear to be formed during early adulthood.

Electromagnetic hypersensitivity (EHS) in the media - a qualitative content analysis of Norwegian newspapers.

OBJECTIVES: Electromagnetic hypersensitivity (EHS) is a condition characterized by experiencing symptoms after perceived exposure to weak electromagnetic fields (EMFs). There is substantial debate concerning the aetiology of EHS, but experimental data indicate no association between EHS and actual presence of EMFs. Newspapers play a key role in shaping peoples' understanding of health-related issues. The aim of this study was to describe the content of newspaper articles concerning aetiology and treatment of EHS. DESIGN: Qualitative content analysis of newspaper articles. SETTING: Norwegian newspaper articles were identified using a comprehensive electronic media archive. PARTICIPANTS: Norwegian newspaper articles published between 1 February 2006 and 11 August 2010. MAIN OUTCOME MEASURES: Statements coded according to source of information, whether it was pro or con scientific evidence on EHS aetiology, and type of intervention presented as treatment option for EHS. RESULTS: Of the statements concerning EHS aetiology (n = 196), 35% (n = 69) were categorized as pro evidence, 65% (n = 127) as con evidence. Of the statements about EHS interventions assessed, 78% (n = 99) were categorized as 'radiance reduction', 4% (n = 5) as 'complementary medicine', and 18% (n = 23) as 'other'. Cognitive behavioural therapy (CBT) and psychotropic drugs were never presented as possible treatment options for EHS. CONCLUSIONS: The newspaper media discourse of EHS aetiology and recommended treatment interventions is much in conflict with the current evidence in the field. The majority of statements concerning aetiology convey that EHS is related to the presence of weak EMFs, and radiance reduction as the most frequently conveyed measure to reduce EHS-related symptoms.