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Summary: New drugs for treating hepatitis C have considerably increased the probability of being cured. Treatment uptake, however, is still low. The objectives of this study were to analyse the impact of initiatives that may increase the proportion of infected people on treatment and interventions aimed at reducing the incidence of new infection among people who inject drugs. A compartmental model for Norway was used to simulate hepatitis C and related complications. We analysed 2 different screening initiatives aimed to increase the proportion of infected people on treatment. Interventions aiming at reducing the hepatitis C incidence analysed were opioid substitution therapy (OST), a clean needle and syringe programme and a combination of both. The most cost‐effective strategy for increasing hepatitis C treatment uptake was screening by general practitioners while simultaneously allowing for all infected people to be treated. We estimated that this intervention reduces the incidence of hepatitis C by 2030 by 63% compared with the current incidence. The 2 harm reduction strategies both reduced the incidence of hepatitis C by about 70%. Combining an increase in the current clean needles and syringe programme with OST was clearly the most cost‐effective option. This strategy would reduce the incidence of hepatitis C by 80% compared with the current incidence by 2030. Thus, interventions to reduce the burden and spread of hepatitis C are cost‐effective. Reaching the WHO target of a 90% reduction in hepatitis C incidence by 2030 may be difficult without combining different initiatives. [ABSTRACT FROM AUTHOR]

Background: A two-year action project to establish the indicators for mental health monitoring in Europe started in 1999 under the sponsorship of the EC Health Monitoring Programme. Aims: This paper reports the results of a pilot survey conducted to test the feasibility of the set of survey indicators proposed. The test phase of the implementation of the set of mental health indicators involved five of the Active Partners (France, Germany, Greece, Finland, and Norway) of the Mental Health Indicators Project. Method: The sample consists of 2059 subjects, 923 men (44.8%) and 1136 (55.2%) women. The number of subjects interviewed in each country ranged between 378 (Norway) and 441 (France). Results: The coverage of collected data was good. However, telephone interviews did not appear to be the method-of-choice for conducting surveys regarding mental health indicators in the future. The prevalence figures of major depression and risk of having a problem with alcohol are in agreement with the major European studies. Conclusions: The set of indicators could be easily incorporated into general health surveys, as the interviews conducted were not time-consuming. The results supported the view that the citizens interviewed have found the survey easily acceptable. Declaration of interest: None. [ABSTRACT FROM AUTHOR]

The objective is to investigate the effect on mortality of psychosocial variables, with special focus on social support, social participation, and locus of control. The study is designed as a prospective study with a 17 year follow up period, using univariate and multivariate proportional hazards regression analysis to estimate the predictive power of psychosocial variables, when controlling for sociodemographic and biological factors. The study is based on a population sample randomly drawn from different neighbourhoods of Oslo in 1975/76, for the purpose of surveying health, in particular mental health, in relation to various social and psychosocial variables. The initial data were gathered by structured interviewing, whereas the data about mortality and cause of death, was gathered from the Central Bureau of Statistics. The initial sample included 1010 persons above the age of 18 years, with no upper age limit. The follow up with respect to mortality covered the whole sample, with the exception of a very few who had left the country. When controlling for socio-demographic and biological factors, low social participation, and to a lesser extent, few close relationships and external locus of control, were associated with increased mortality. The effect of social participation and locus of control may indicate that life style, and individual psychological resources, are at least as important for survival as support from others in stressful life situations. [ABSTRACT FROM AUTHOR]

Background: In a follow-up survey from Oslo, 503 persons were re-interviewed using the same questionnaire after 10 years.Method: The questionnaire includes questions about social support, social characteristics of the neighbourhood and mental health. Information about the neighbourhood was also gathered from key informants.Results: Of the five types of neighbourhoods surveyed, only one showed marked change over time with respect to social characteristics. This was an initially poorly functioning neighbourhood with poor mental health among the residents, where substantial improvements took place as part of the further development of the area. Parallel with the improvement in social environment there was a significant improvement in mental health among those who continued to live in the same area, as opposed to those who continued to live in the other areas. Selective migration could not explain this finding.Conclusions: The findings support the environment stress hypothesis, implying that the quality of a neighbourhood has an impact on mental health. The implications for psychiatric prevention are discussed. [ABSTRACT FROM AUTHOR]

Background: In a 10-year follow-up of a survey from Oslo, 503 persons were reinterviewed using the same questionnaire.Method: The questionnaire includes information about social support, 'locus of control' and mental health as well as negative life events and long-lasting mental strain during the year prior to the follow-up.Results: The study confirms the "buffer hypothesis", that social support protects against the development of mental disorder only when the individual is exposed to stressors, like negative life events. This buffering effect was especially strong for depression.Conclusions: The buffering effect only applies to the 'externals'--those who have personality-related feelings of powerlessness and lack of control over their own lives. The 'internals' do not have the same need for social support to cope with life stressors, and have low symptom scores even when negative life events are combined with relative weak social support. [ABSTRACT FROM AUTHOR]

Help-seeking for emotional problems addressed to priests was compared with help-seeking addressed to general practitioners (GPs), psychiatrists and psychologists in two demographically different areas of Norway. Only small differences were found between the rural and the urban area, and a substantial proportion of people contacted priests for personal/emotional problems. This contact was not related to dissatisfaction with the mental health system, and we found no evidence for a ‘religiosity gap’ between mental health professionals, on the one hand, and people contacting priests, on the other. People contacting priests also had a stronger general willingness to seek help from other professionals compared to the general population. In both the rural and urban areas, seeking help from priests because of mental problems was related to having experienced a personal loss (death of a spouse, separation, divorce), in addition to having a religious commitment. [ABSTRACT FROM AUTHOR]

Abstract Background Little is known of the importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home. The objectives of the present study were to investigate the associations of social support, somatic health problems and socio-economic factors with psychological distress. We also examined changes in the association of somatic health problems and socio-economic factors with psychological distress after adjusting for social support. Methods A random sample of 4,000 persons aged 65 years or more living at home in Oslo was drawn. Questionnaires were sent by post, and the total response was 2,387 (64%). Psychological distress was assessed using Hopkins Symptom Checklist (HSCL-10) and social support with the Oslo-3 Social Support Scale (OSS-3). A principal component analysis (PCA) included all items of social support and psychological distress. Partial correlations were used, while associations were studied by logistic regression. Results After adjusting for socio-demographics and somatic health problems, we reported a statistically significant association between psychological distress and social support: “Number of close friends”, OR 0.61; 95% CI 0.47-0.80; “Concern and interest”, OR 0.68; 95% CI 0.55-0.84. A strong association between lack of social support and psychological distress, irrespective of variables adjusted for, indicated a direct effect. The associations between psychological distress and physical impairments were somewhat reduced when adjusted for social support, particularly for hearing, whereas the associations between somatic diagnoses and psychological distress were more or less eliminated. Income was found to be an independent determinant for psychological distress. Conclusions Lack of social support and somatic health problems were associated with psychological distress in elders. Social support acted as a mediator, implying that the negative effect of somatic health problems, especially hearing, on psychological distress was mediated by low social support. We hypothesize that physical impairments reduced social support, thereby increasing psychological distress to a greater extent than the selected diagnoses. The combination of poor social support, poor somatic health and economic problems may represent a vulnerable situation with respect to the mental health of older persons. Free interventions that highlight social support should be considered in mental health promotion.

Abstract Background Late-life depression is a common condition and a challenging public health problem. A lack of social support is strongly associated with psychological distress. Senior centres seem to be suitable arenas for community-based health promotion interventions, although few studies have addressed this subject. The objectives were to examine the effect of a preventive senior centre group programme consisting of weekly meetings, on social support, depression and quality of life. Methods A questionnaire was sent to a random sample of 4,000 persons over 65 in Oslo, and a total of 2,387 completed questionnaires were obtained. These subjects served as a basis for recruitment of participants for a trial, with scores on HSCL-10 being used as a main inclusion criterion. A total of 138 persons were randomized into an intervention group (N = 77) and control group (N = 61). Final analyses included 92 persons. Social support (OSS-3), depression (BDI), life satisfaction and health were measured in interviews at baseline and after 12 months (at the end of the intervention programme). Perceptions of benefits from the intervention were also measured. Mean scores, SD, SE and CI were used to describe the changes in outcomes. Effect sizes were calculated based on the original scales and as Cohen’s d. Paired sample tests and ANOVA were used to test group differences. Results There was an increase in social support in both groups, but greatest in the intervention group. The level of depression increased for both groups, but more so in the control than the intervention group. There was a decrease in life satisfaction, although the decrease was largest among controls. There were almost no differences in reported health between groups. However, effect sizes were small and differences were not statistically significant. In contrast, most of the participants said the intervention meant much to them and led to increased use of the centre. Conclusions In all probability, the intervention failed to meet optimistic targets, but possibly met quite modest ones. Since intention-to-treat analysis was not possible, we do not know the effect on the intervention group as a whole. A further evaluation of these programmes is necessary to expand the group programme. For the depressed, more specialized programmes to cope with depression may be a more appropriate intervention. Trial Registration DRKS00003120 on DRKS