Predicting Literacy Skills at 8 Years From Preschool Language Trajectories: A Population-Based Cohort Study.

Purpose This article explored the predictive values of three main language delay (LD) trajectories (i.e., persistent, late onset, and transient) across 3-5 years on poor literacy at 8 years. Additionally, the effect of gender was assessed, using both gender-neutral and gender-specific thresholds. Method The data comprised mother-reported questionnaire data for 8,371 children in the Norwegian Mother, Father, and Child Cohort Study. Analyses were conducted using binary logistic regression in SPSS to make predictions about risk. Results LD reported at preschool age was associated with excess risk of poor literacy at 8 years with odds ratios ranging from 3.19 to 9.75 dependent on trajectory, persistent LD being the strongest predictor. The odds ratio of transient LD was similar to that of late-onset LD. Gender was not found to play an important role in the association between oral language and literacy, as the gender difference disappeared when gender-specific deficit criterion was used. Conclusion Our study supports the longitudinal association between preschool oral language and school-aged literacy skills and highlights the importance of different LD trajectories across preschool ages in predicting later literacy. Furthermore, practitioners are recommended to consider gender-specific cutoffs in relation to language and literacy measures.

Childhood sensorineural hearing loss and adult mental health up to 43 years later: results from the HUNT study.

BACKGROUND: Hearing loss is a global public health problem putting millions of people at risk of experiencing impediments in communication and potentially impaired mental health. Many studies in this field are based on small, cross sectional samples using self-report measures. The present study aims to investigate the association between childhood sensorineural hearing loss and mental health in adult men and women longitudinally in a large cohort with a matched control group, and hearing is measured by pure-tone audiometry. Studies of this kind are virtually non-existing. METHODS: The present study combines data from two large studies; the School Hearing Investigation in Nord-Trøndelag (SHINT) carried out yearly from 1954 to 1986, and the second wave of the Nord-Trøndelag Health Study (HUNT 2) conducted from 1995 to 1997. The participants were 7, 10 or 13 years during the SHINT, and between 20 and 56 years old during HUNT 2. The total sample consisted of 32,456 participants (of which 32,104 in the reference group). Participants with a sensorineural hearing loss in SHINT of 41 dB or more were classified with moderate-severe hearing loss (N = 66), 26-40 dB as mild (N = 66) and 16-25 dB as slight (N = 220). Mental health in adulthood was measured in HUNT 2 by symptoms of anxiety and depression, subjective well-being, and self-esteem. The association between childhood sensorineural hearing loss and adult mental health was tested by means of ANOVA. RESULTS: There was a significant relation between slight childhood sensorineural hearing loss and lowered subjective well-being in women (B = -.25, p = 0.038). Further investigation of the results revealed a significant association between slight hearing loss and symptoms of anxiety and depression (B = .30, p = 0.054) and between mild hearing loss and lowered self-esteem (B = .63, p = 0.024) among women aged 20-39 years. There were no significant relations between childhood sensorineural hearing loss and any of the three mental health outcomes among men. CONCLUSIONS: This study suggests that women with slight or mild sensorineural hearing loss from childhood experience elevated levels of symptoms of anxiety and depression, lowered subjective well-being and lowered self-esteem. However, the results should be interpreted with caution due to a lack of power in some analyses.

Early prenatal exposure to pandemic influenza A (H1N1) infection and child psychomotor development at 6 months - A population-based cohort study.

BACKGROUND: Studies investigating gestational influenza and child neurodevelopment are still scarce, particularly concerning timing of infection in pregnancy. This is the first study to investigate associations between gestational influenza and infant psychomotor development and temperament at 6 months. METHODS: Data from The Norwegian Influenza Pregnancy Cohort, established during the 2009 swine flu pandemic, were utilized. Information on influenza infection, vaccination, maternal health and child health and development is available from questionnaires, national registry data and maternal blood samples drawn at delivery. Maternal influenza A H1N1 pdm09 infection was serologically confirmed. 609 children with complete data were identified. Children of exposed and non-exposed mothers were compared using generalized linear models. RESULTS: Children exposed to influenza during gestational weeks (gw) 0-8 had adjusted general development scores indicating slightly delayed development compared to non-exposed children (0.28 standard deviations (SD) 95% confidence interval (CI): -0. 01; 0.58; p = 0.06). The temperamental scores of children exposed during gw 0-8 were slightly higher (0.31 SD; 95% CI: -0. 03; 0.64; p = 0.07) than non-exposed children indicating a more difficult temperament. In comparison, the developmental scores for children exposed in gw 9-40 were -0.31 SD (95% CI: -0. 65; 0.04; p = 0.09) better than non-exposed children, while the temperamental scores were 0.17 (95% CI: -0. 23; 0.56; p = 0.36) for the same period. CONCLUSION: Modest associations were found between maternal influenza A (H1N1) pdm infection during gestational weeks 0-8 and psychomotor development at 6 months.

A Twin Study of Normative Personality and DSM-IV Personality Disorder Criterion Counts: Evidence for Separate Genetic Influences.

OBJECTIVE: Both normative personality and DSM-IV personality disorders have been found to be heritable. However, there is limited knowledge about the extent to which the genetic and environmental influences underlying DSM personality disorders are shared with those of normative personality. The aims of this study were to assess the phenotypic similarity between normative and pathological personality and to investigate the extent to which genetic and environmental influences underlying individual differences in normative personality account for symptom variance across DSM-IV personality disorders. METHOD: A large population-based sample of adult twins was assessed for DSM-IV personality disorder criteria with structured interviews at two waves spanning a 10-year interval. At the second assessment, participants also completed the Big Five Inventory, a self-report instrument assessing the five-factor normative personality model. The proportion of genetic and environmental liabilities unique to the individual personality disorder measures, and hence not shared with the five Big Five Inventory domains, were estimated by means of multivariate Cholesky twin decompositions. RESULTS: The median percentage of genetic liability to the 10 DSM-IV personality disorders assessed at wave 1 that was not shared with the Big Five domains was 64%, whereas for the six personality disorders that were assessed concurrently at wave 2, the median was 39%. Conversely, the median proportions of unique environmental liability in the personality disorders for wave 1 and wave 2 were 97% and 96%, respectively. CONCLUSIONS: The results indicate that a moderate-to-sizable proportion of the genetic influence underlying DSM-IV personality disorders is not shared with the domain constructs of the Big Five model of normative personality. Caution should be exercised in assuming that normative personality measures can serve as proxies for DSM personality disorders when investigating the etiology of these disorders.

The association of high sensitivity C-reactive protein and incident Alzheimer disease in patients 60 years and older: The HUNT study, Norway.

BACKGROUND: With ageing, long-standing inflammation can be destructive, contributing to development of several disorders, among these Alzheimer's disease (AD). C-reactive protein (CRP) is a relatively stable peripheral inflammatory marker, but in previous studies the association between highly sensitive CRP (hsCRP) and AD have shown inconsistent results. This study examines the association between AD and hsCRP in blood samples taken up to 15 years prior to the diagnoses of 52 persons with AD amongst a total of 2150 persons ≥60 years of age. RESULTS: Data from Norway's Nord-Trøndelag Health Study (HUNT 2) and the Health and Memory Study (HMS) were linked. The participants had an average age of 73 years, and diagnosed with AD up to 15 years [mean 8.0 (±3.9)] following hsCRP measurement. Logistic regression models showed an adverse association between hsCRP and AD in participants aged 60-70.5 (odds ratio: 2.37, 95% CI: 1.01-5.58). Conversely, in participants aged 70.6-94, there was an inverse association between hsCRP and AD (odds ratio: 0.39, 95% CI: 0.19-0.84). When applying multivariate models the findings were significant in individuals diagnosed 0.4-7 years after the hsCRP was measured; and attenuated when AD was diagnosed more than seven years following hsCRP measurement. CONCLUSIONS: Our study is in line with previous studies indicating a shift in the association between hsCRP and AD by age: in adults (60-70.5 years) there is an adverse association, while in seniors (>70.6 years) there is an inverse association. If our findings can be replicated, a focus on why a more active peripheral immune response may have a protective role in individuals ≥70 years should be further examined.

Self-esteem and relationship satisfaction during the transition to motherhood.

In the current study, we used 5 waves of longitudinal data from a large representative sample of Norwegian mothers (N = 84,711) to examine the association between romantic relationship satisfaction and self-esteem before and after childbirth in subgroups of first-, second-, third-, and fourth-time mothers. Maternal self-esteem showed a highly similar change pattern across subgroups. Specifically, self-esteem decreased during pregnancy, increased until the child was 6 months old, and then gradually decreased over the following years. The replication of this trajectory across subgroups and pregnancies suggests that this is a normative change pattern. For relationship satisfaction, the birth of the first child seemed to have the strongest impact compared with the birth of subsequent children. In first-time mothers, relationship satisfaction was high during pregnancy, sharply decreased around childbirth, and then gradually decreased in the following years. In second-, third-, and fourth-time mothers, the decrease in relationship satisfaction after childbirth was more gradual and linear compared with the sharp decrease found in first-time mothers. Moderate positive correlated changes between self-esteem and relationship satisfaction indicated that these constructs were linked over time. Discussion focuses on the implications of the results for theory and future research on self-esteem, relationship satisfaction, and personality-relationship transactions. (PsycINFO Database Record

Interaction between Parental Education and Twin Correlations for Cognitive Ability in a Norwegian Conscript Sample.

We examine a sample of Norwegian twin conscripts for evidence of an interaction between parental education and the heritability of general cognitive ability (GA). Ability scores were obtained on 1706 pairs of twins who were conscripted into the Norwegian Armed Forces between 1931and 1960. Education scores were available for mothers and fathers; the majority of the parents had less than a high school education. GA scores were heteroscadistic with respect to mid-parent education, with reduced variability at higher levels of education. Both MZ and DZ twin correlations for GA were linearly and negatively related to mid-parent education, DZ twins substantially more so. When the model was extended to an ACE model consisting of standardized positive ACE variance components, the modification appeared to disappear. Further analysis revealed that this occurred because the steep decline of DZ twin correlations with increasing mid-parent education resulted in a violation of the classical twin model for much of the parameter space. Other phenomena that might result in large declines in DZ twin correlations are considered, along with implications for other studies of socioeconomic interactions with the heritability of GA in European samples.

Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study.

BACKGROUND: A lot of attention has been paid to the relationship of blood pressure and dementia because epidemiological research has reported conflicting evidence. Observational data has shown that midlife hypertension is a risk factor for cognitive decline and dementia later in life, whereas there is evidence that low blood pressure is predictive in later life. The aim of the present study was to examine the association between dementia and blood pressure measured up to 27 years (mean 17.6 years) prior to ascertainment. METHODS: In Nord-Trøndelag County, Norway, incident dementia data were collected during 1995-2011, and the diagnoses were validated by a panel of experts in the field. By using the subjects' personal identification numbers, the dementia data were linked to data from the Nord-Trøndelag Health Study (the HUNT Study), a large, population-based health study performed in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). A total of 24,638 participants of the HUNT Study were included in the present study, 579 of whom were diagnosed with Alzheimer disease, mixed Alzheimer/vascular dementia, or vascular dementia. Multiple logistic regression analyses were conducted to analyze the association between dementia and blood pressure data from HUNT 1 and HUNT 2. RESULTS: Over the age of 60 years, consistent inverse associations were observed between systolic blood pressure and all-cause dementia, mixed Alzheimer/vascular dementia, and Alzheimer disease, but not with vascular dementia, when adjusting for age, sex, education, and other relevant covariates. This was observed for systolic blood pressure in both HUNT 1 and HUNT 2, regardless of antihypertensive medication use. There was an adverse association between systolic blood pressure, pulse pressure, and Alzheimer disease in individuals treated with antihypertensive medication under the age of 60 years. CONCLUSIONS: Our data are in line with those in previous studies demonstrating an inverse association between dementia and systolic blood pressure in individuals over the age of 60 years. We cannot exclude a survival effect, however. Among middle-aged subjects (<60 years), elevated systolic blood pressure and pulse pressure were associated with eventual Alzheimer disease in individuals who reported using antihypertensive medication.

Stability and change in etiological factors for alcohol use disorder and major depression.

Alcohol use disorder (AUD) and major depressive disorder (MDD) are often comorbid. It is not understood how genetic risk factors for these disorders relate to each other over time and to what degree they are stable. Age-dependent characteristics of the disorders indicate that different genetic factors could be relevant at different stages of life, and MDD may become increasingly correlated with AUD over time. DSM-IV diagnoses of AUD and MDD were assessed by interviews of 2,801 young adult twins between 1999 and 2004 (T1) and 2,284 of the same twins between 2010 and 2011 (T2). Stability, change, and covariation were investigated in longitudinal biometric models. New genetic factors explained 56.4% of the genetic variance in AUD at T2. For MDD, there was full overlap between genetic influences at T1 and T2. Genetic risk factors for MDD were related to AUD, but their association with AUD did not increase over time. Thus, genetic risk factors for AUD, but not MDD, vary with age, suggesting that AUD has age-dependent heritable etiologies. Molecular genetic studies of AUD may therefore benefit from stratifying by age. The new genetic factors in AUD were not related to MDD. Environmental influences on the 2 disorders were correlated in middle, but not in young adulthood. The environmental components for AUD correlated over time (r = .27), but not for MDD. Environmental influences on AUD can have long-lasting effects, and the effects of preventive efforts may be enduring. Environment influences seem to be largely transient. (PsycINFO Database Record

Pre-pregnancy mental distress and musculoskeletal pain and sickness absence during pregnancy - a twin cohort study.

Background: Sickness absence (SA) among pregnant women is high. The aim of this study was to examine whether factors known to predict SA in general also predict SA during pregnancy by estimating the association between prior mental distress and musculoskeletal pain and SA during pregnancy, and to assess the influence of familial (genetic and shared environmental) factors. In this prospective cohort study, data from 2076 female twins born 1967-79 who participated in a questionnaire study in 1998 were linked to register data on SA and childbirth during the years 1998-2008. Baseline measures included mental distress (symptoms of anxiety and depression; SCL-5) and musculoskeletal pain (lumbar spine, neck/shoulder and/or persisting muscular pain). SA was measured as a ratio of days on SA divided by potential working days. Negative binomial regression was performed for individual and within-pair effects. Musculoskeletal pain, but not mental distress, was prospectively associated with overall SA during pregnancy in the adjusted individual-level analyses. With each standard deviation increase in musculoskeletal pain, SA granted for any disorder increased with 12% (IRR 1.12, 95% CI = 1.07-1.17) and SA granted for pregnancy related disorders increased with 9% (IRR 1.09, 95% CI = 1.02-1.17). Within-pair estimates were similar, suggesting little or no familial confounding. Women with previous musculoskeletal pain are at increased risk of SA during pregnancy, whereas no increased risk in women with previous symptoms of mental distress could be demonstrated. SA during pregnancy seems partly to be associated with different factors than SA in general.

Occupational noise exposure, hearing loss, and notched audiograms in the HUNT Nord-Trøndelag hearing loss study, 1996-1998.

OBJECTIVES/HYPOTHESIS: To study the prevalence and usefulness of audiometric notches in the diagnosis of noise-induced hearing loss (NIHL). STUDY DESIGN: Audiograms and data on noise exposure from 23,297 men and 26,477 women, aged 20 to 101 years, from the Nord-Trøndelag Hearing Loss Study, 1996-1998. METHODS: The prevalence of four types of audiometric notches (Coles, Hoffman, Wilson) and 4 kHz notch were computed in relation to occupational noise exposure, age, sex, and report of recurrent ear infections. RESULTS: The prevalence of notches in the 3 to 6 kHz range (Wilson, Hoffman, and Coles) ranged from 50% to 60% in subjects without occupational noise exposure, and 60% to 70% in the most occupationally noise-exposed men. The differences were statistically significant only for bilateral notches. For 4 kHz notches, the prevalence varied from 25% in occupationally nonexposed to 35% in the most occupationally exposed men, and the differences were statistically significant for both bilateral and unilateral notches. For women, the prevalence of notches was lower than in men, especially for 4 kHz notches, and the differences between occupationally noise exposed and nonexposed were smaller. Recreational exposure to high music was not associated with notched audiograms. CONCLUSIONS: The detection of bilateral notches and unilateral 4 kHz notches is of some value in diagnosing NIHL, especially in men. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1442-1450, 2017.

Simplified risk assessment of noise induced hearing loss by means of 2 spreadsheet models.

OBJECTIVES: The objective of this study has been to test 2 spreadsheet models to compare the observed with the expected hearing loss for a Norwegian reference population. MATERIAL AND METHODS: The prevalence rates of the Norwegian and the National Institute for Occupational Safety and Health (NIOSH) definitions of hearing outcomes were calculated in terms of sex and age, 20-64 years old, for a screened (with no occupational noise exposure) (N = 18 858) and unscreened (N = 38 333) Norwegian reference population from the Nord-Trøndelag Hearing Loss Study (NTHLS). Based on the prevalence rates, 2 different spreadsheet models were constructed in order to compare the prevalence rates of various groups of workers with the expected rates. The spreadsheets were then tested on 10 different occupational groups with varying degrees of hearing loss as compared to a reference population. RESULTS: Hearing of office workers, train drivers, conductors and teachers differed little from the screened reference values based on the Norwegian and the NIOSH criterion. The construction workers, miners, farmers and military had an impaired hearing and railway maintenance workers and bus drivers had a mildly impaired hearing. The spreadsheet models give a valid assessment of the hearing loss. CONCLUSIONS: The use of spreadsheet models to compare hearing in occupational groups with that of a reference population is a simple and quick method. The results are in line with comparable hearing thresholds, and allow for significance testing. The method is believed to be useful for occupational health services in the assessment of risk of noise induced hearing loss (NIHL) and the preventive potential in groups of noise-exposed workers. Int J Occup Med Environ Health 2016;29(6):991-999.

Noise-induced hearing loss in a longitudinal study of Norwegian railway workers.

OBJECTIVE: The aim of this study was to analyse longitudinal data to assess the risk of noise-induced hearing loss (NIHL) in Norwegian railway workers. DESIGN: Longitudinal. SETTING: A major Norwegian railway company. METHODS: We examined data from the first and last audiograms for the period 1991-2014, from 9640 railway workers with varying occupational noise exposure and with an average observation period of 10 years. The course of hearing acuity in seven groups of railway workers (train drivers, conductors, bus drivers, traffic controllers, train maintenance workers, track maintenance workers and others) were compared with each other and with ISO standards (ISO 1999). RESULTS: The change in hearing threshold during the observation period was 2-3 dB in the 0.5-4 kHz range and 6-7 dB in the 3-6 kHz range adjusted for age and sex, for all occupational groups, which is slightly less than expected (8 dB) according to ISO 1999. CONCLUSIONS: The risk of NIHL in Norwegian railway workers during the period 1991-2014 has been negligible.

Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees.

BACKGROUND: Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. METHODS: Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. RESULTS: All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. CONCLUSIONS: Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among individuals with somatic disorders. This disorder has good treatment response and may be overlooked as a target for interventions aimed at prevention of sick leave.

How sociodemographic and hearing related factors were associated with use of hearing aid in a population-based study: The HUNT Study.

BACKGROUND: The purpose was to study hearing aid (HA) use in persons 65 years and older, and to investigate how socioeconomic and hearing related factors were associated to use of HA. METHOD: This study included 11,602 persons (65 years and above) from the second Nord-Trøndelag Health Study (HUNT2) and the integrated North-Trøndelag hearing loss study (NTHLS) in 1995-1997. Audiometry was taken of all participants. Missing information about use of HA in possible users of HA existed in data from 1103 (9.5 %) of the participants. Effects of sociodemographic variables, low, medium and high frequency hearing thresholds and being bothered by their hearing were explored in men and women, adjusting the effects for each other. Cross tabulations and logistic regression analyses were used. RESULTS: In all, 14 % (1472 of 10,499) were users of HA, but 62 % had a mean hearing impairment (HI) based on 0.5, 1, 2, 4 kHz over both ears >25 dB. Use of HA was associated with higher education. Adjusting for all covariates and hearing variables, each 10 dB medium frequency threshold shift increased the chance of HA-use by a factor of two-three in both men and women. Having reported being bothered by hearing loss additionally increased the chance around sevenfold. Low frequency hearing thresholds were not associated with HA-use in women. In men, low frequency hearing thresholds up to 50 dB increased odds for use of HA, but low frequency hearing thresholds ≥ 70 dB decreased odds for use of HA. Men living with a spouse had higher odds for using HA compared to men without a spouse. For women there is no difference between those with and without spouse in use of HA. Men and women without spouse did not differ in their use of HA. CONCLUSIONS: About two third of 65 years and older participants had a HI higher than 25 dB, but only one seventh used HA. Use of HA was associated with higher than basic education. Men without a spouse were less likely to use HA compared to men with a spouse.

Effect of household size on mental problems in children: results from the Norwegian Mother and Child Cohort study.

BACKGROUND: Most people in industrialized societies grow up in core (parents only) families with few if any siblings. Based on an evolutionary perspective, it may be argued that this environment reflects a mismatch, in that the tribal setting offered a larger number of close affiliates. The present project examined whether this mismatch may have a negative impact on mental health. METHODS: We used data from the Norwegian Mother and Child Cohort Study (MoBa), which includes 114 500 children. The mothers were recruited during pregnancy and followed up with questionnaires as the infants grew older. Correlates between number and type of people living in the household and questions probing mental health were corrected for likely confounders. RESULTS: The number of household members correlated with scores on good mental health at all ages tested (3, 5 and 8 years). The effects were distinct, highly significant, and present regardless of how mental issues were scored. The outcome could be attributed to having older siblings, rather than adults beyond parents. The more siblings, and the closer in age, the more pronounced was the effect. Living with a single mother did not make any difference compared to two parents. Girls were slightly more responsive to the presence of siblings than boys. Household pets did not have any appreciable impact. CONCLUSION: A large household is associated with fewer mental problems in children.

Cohort Profile Update: The Norwegian Mother and Child Cohort Study (MoBa).

This is an update of the Norwegian Mother and Child Cohort Study (MoBa) cohort profile which was published in 2006. Pregnant women attending a routine ultrasound examination were initially invited. The first child was born in October 1999 and the last in July 2009. The participation rate was 41%. The cohort includes more than 114 000 children, 95 000 mothers and 75 000 fathers. About 1900 pairs of twins have been born. There are approximately 16 400 women who participate with more than one pregnancy. Blood samples were obtained from both parents during pregnancy and from mothers and children (umbilical cord) after birth. Samples of DNA, RNA, whole blood, plasma and urine are stored in a biobank. During pregnancy, the mother responded to three questionnaires and the father to one. After birth, questionnaires were sent out when the child was 6 months, 18 months and 3 years old. Several sub-projects have selected participants for in-depth clinical assessment and exposure measures. The purpose of this update is to explain and describe new additions to the data collection, including questionnaires at 5, 7, 8 and 13 years as well as linkages to health registries, and to point to some findings and new areas of research. Further information can be found at [www.fhi.no/moba-en]. Researchers interested in collaboration and access to the data can complete an electronic application available on the MoBa website above.

Coping With Strain (CWS) course - its effects on depressive symptoms: A four-year longitudinal randomized controlled trial.

The Coping With Strain (CWS) course is a modification of the Coping With Depression (CWD) course. CWD is by far the most studied psycho-educational intervention to reduce and prevent depression, but CWD has never been tested in a randomized controlled trial in the workplace. This study seeks to examine the extent to which CWS, on a short-term and a long-term basis, reduces depressive symptoms in employees. After advertising at workplaces, 119 employees were randomized into Intervention Group I (IG1), which immediately participated in CWS, or Intervention Group II (IG2), which functioned as a control group for six months until its participation in CWS. The follow up period lasted for four years in both IG1 and IG2. Linear mixed models were fitted to the data. Depressive symptoms were significantly reduced during the course. The reduction of depressive symptoms was maintained over a period of four years in both IG1 and IG2, although there is a slight increase towards the end of the follow-up period. CWS is effective in reducing depressive symptoms among employees. The effects are long lasting and may be maintained over a period of four years.

Is the twin-singleton difference in BMI related to the difference in birth weight? A register-based birth cohort study of Norwegian males.

OBJECTIVE: The aim was to test the hypothesis that the difference in body mass index (BMI) between twins and singletons may be attributed to a difference in birth weight. METHODS: Data from the Medical Birth Registry of Norway were linked with data from the Norwegian Conscript Service. This study used data on 411,186 males who were born in single or twin births in Norway during 1967 to 1984, and who were examined at the mandatory military conscription (98% were examined the year they turned 18 or 19 years of age). RESULTS: The difference in BMI between singletons and twins was 0.49 kg/m(2) (95% confidence interval [CI]: 0.41, 0.56) after adjustment for background factors and gestational age at birth. When birth weight was added to the model, the difference was reduced to 0.17 kg/m(2) (95% CI: 0.09, 0.25). The corresponding figures for sibships that included both singletons and twins were 0.63 kg/m(2) (95% CI: 0.39, 0.86) and 0.38 kg/m(2) (95% CI: 0.06, 0.70) when twins were compared with their singleton brothers. In both the analysis of the total study population and the analysis of the sibships, birth weight was significantly associated with the BMI after adjustment for twin status, gestational age at birth, and background factors. CONCLUSIONS: Male twins born in Norway during 1967 to 1984 had lower BMI at the military conscription than had singletons, and a part of this difference may probably be attributed to lower intrauterine growth rate among twins. Am. J. Hum. Biol. 28:566-573, 2016. © 2016 Wiley Periodicals, Inc.

Association of psychological distress late in life and dementia-related mortality.

OBJECTIVE: It is not fully understood how subjective feelings of psychological distress prognosticate dementia. Our aim was to investigate the association between self-reported psychological distress and risk of dementia-related mortality. METHOD: We included 31,043 eligible individuals between the ages of 60 and 80 years, at time of examination, from the CONOR (Cohort of Norway) database. They were followed for a period of 17.4 years (mean 11.5 years). The CONOR Mental Health Index, a seven-item self-report scale was used. A cut-off score equal to or above 2.15 on the scale denoted psychological distress. Cox regression was used to assess the association between psychological distress and risk of dementia-related mortality. RESULTS: Total number of registered deaths was 11,762 and 1118 (9.5%) were classified as cases of dementia-related mortality. We found that 2501 individuals (8.1%) had psychological distress, of these, 119 (10.6%) had concomitant dementia-related mortality. Individuals with psychological distress had an increased risk of dementia-related mortality HR = 1.52 (95% confidence interval (CI) 1.25-1.85) after adjusting for age, gender and education. The association remained significant although attenuated when implemented in a full adjusted model, including general health status, smoking, obesity, hypertension, diabetes and history of cardiovascular disease; hazard ratio, HR = 1.30 (95% CI 1.06-1.59). CONCLUSION: Our results indicate that psychological distress in elderly individuals is associated with increased risk of dementia-related mortality. Individuals at increased risk of dementia may benefit from treatments or interventions that lessen psychological distress, but this needs to be confirmed in future clinical studies.