The definition of case is a core issue in psychiatric epidemiology. Psychiatric symptom screening scales have been extensively used in population studies for many decades. Structured diagnostic interviews have become available during recent years to give exact diagnoses through carefully undertaken procedures. The aim of this article was to assess how well the Hopkins Symptom Checklist-25 (HSCL-25) predicted cases by the Composite International Diagnostic Interview (CIDI), and find the optimal cut-offs on the HSCL-25 for each diagnosis and gender. Characteristics of concordant and discordant cases were explored. In a Norwegian two-stage survey mental health problems were measured by the HSCL-25 and the CIDI. Only 46% of the present CIDI diagnoses were predicted by the HSCL-25. Comorbidity between CIDI diagnoses was found more than four times as often in the concordant cases (case agreed upon by both instruments) than in the discordant CIDI cases. Concordant cases had more depression and panic/generalized anxiety disorders. Neither the anxiety nor the depression subscales improved the prediction of anxiety or depression. The receiver operating characteristic (ROC) curves confirmed that the HSCL-25 gave best information about depression. Except for phobia it predicted best for men. Optimal HSCL-25 cut-off was 1.67 for men and 1.75 for women. Of the discordant HSCL-25 cases, one-third reported no symptoms in the CIDI, one-third reported symptoms in the CIDI anxiety module, and the rest had symptoms spread across the modules. With the exception of depression, the HSCL-25 was insufficient to select individuals for further investigation of diagnosis. The two instruments to a large extent identified different cases. Either the HSCL-25 is a very imperfect indicator of the chosen CIDI diagnoses, or the dimensions of mental illness measured by each of the instruments are different and clearly only partly overlapping.

The aim of this study was to investigate the prevalence of symptoms of depression and anxiety amongst multiple sclerosis (MS) patients, and the associations with demographic and clinical characteristics. The current treatment for depression and anxiety was also evaluated amongst the MS patients. A total of 140 MS patients from Eastern Norway underwent neuropsychiatric and clinical examinations, with registration of symptoms of depression and anxiety (Hopkins Symptom Checklist-25), as well as information about any help seeking for depression were obtained. A total of 31.4% patients reported symptoms of depression, whilst 19.3% reported anxiety; both symptoms were significantly higher than that amongst the general population (P < 0.001). Fatigue and younger age at onset were significantly associated with symptoms of depression, whilst fatigue and pain, lower Expanded Disability Status Scale score and younger age at onset were associated with symptoms of anxiety. The proportion of reported treatment of depression was 15.9% and for anxiety 11.1%. Of untreated patients with symptoms, 18.2% expressed the need for treatment. A greater focus on depression and anxiety amongst MS patients is needed to establish the appropriate treatment for patients suffering from MS.

Smoking has been found to be associated with depression. Biologic hypotheses support causation in both directions. This study examined the association between cigarette smoking and a subsequent first depression. In 1990, 2,014 adults in Norway were interviewed about their lifestyle and mental health. A 2001 reinterview by trained interviewers defined the study cohort of 1,190 participants. The cases were those who experienced a first depression whose onset was estimated to occur during the follow-up period, based on retrospective assessment by the Composite International Diagnostic Interview (International Classification of Diseases, Tenth Revision). Cox regression was used to estimate the hazard rate of depression during follow-up. Alternative explanations for a direct causal influence from smoking on subsequent depression were assessed, and a sensitivity analysis was performed. The risk of depression was four times as high for heavy smokers compared with never smokers. A dose-response relation with an increasing hazard for past smokers and for an increasing number of cigarettes smoked per day for current smokers was found. Similarly, increasing smoking time was associated with increasing risk. Failure of other plausible alternatives to explain the observed association between smoking and depression might reflect a direct causal influence of smoking on depression.

The findings provide evidence of psychiatric illness being a rising and major health problem, but the role of recall bias must be further investigated.

BackgroundConsistent with global trends, the prevalence of obesity is increasing among Norwegian adults. This study aimed to investigate individual trends in BMI (kg/m2) by age, gender, and socio-economic status over an 11-year period.MethodsA cohort of 1169 adults (n = 581 men; n = 588 women) self-reported BMI during a general health interview twice administered in two regions in Norway.ResultsAverage BMI increased significantly from 23.7 (SD = 3.4) to 25.4 (SD = 3.8), with equivalent increases for both genders. Proportion of obesity (BMI ≥ 30) increased from 4% to 11% for women and 5% to 13% for men. Of those already classified as overweight or obese in 1990, 68% had gained additional weight 10 years later, by an average increase of 2.6 BMI units. The greatest amount of weight gain occurred for the youngest adults (aged 20–29 years). Age-adjusted general linear models revealed that in 1990, women with a lower level of education had a significantly greater BMI than more educated women. In both 1990 and 2001, rural men with the highest level of household income had a greater BMI than rural men earning less income. Weight gain occurred across all education and income brackets, with no differential associations between SES strata and changes in BMI for either gender or region.ConclusionResults demonstrated significant yet gender-equivalent increases in BMI over an 11-year period within this cohort of Norwegian adults. Whereas socio-economic status exerted minimal influence on changes in BMI over time, young adulthood appeared to be a critical time period at which accelerated weight gain occurred.