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Background: Self-report data indicate a deterioration of population mental health in many countries during the COVID-19 pandemic. A Norwegian epidemiological diagnostic psychiatric interview survey was conducted from January to September 2020, allowing for comparison of current prevalence of mental disorders from before through different pandemic phases. Prevalence of suicide deaths were compared between 2020 and 2014-2018. Methods: Participants from the Trondelag Health Study (HUNT) in Trondheim were recruited through repeated probability sampling. Using the Composite International Diagnostic Interview (CIDI 5.0) (n=2,154), current prevalence of mental disorders was examined in repeated cross-sectional analyses. Data on suicide was retrieved from the Norwegian Cause of Death Registry and compared for the first phase of the pandemic with the same months 2014-2018. Findings: Prevalence of mental disorders decreased significantly from the pre-pandemic phase (January 28th to March 11th 2020; 15·3% [95% CI 12·4-18·8]) to the first pandemic phase (March 12th – May 31st ; 8·7% [6·8-11·0]) and was fairly stable through the interim phase (June 1st July 31st ; 14·2% [11·4-17·5]) and the second phase (August 1st -September 18th ; 11·9% [9·0-15·6]). Suicidal ideation was non-significantly (n.s) increased during the pandemic. Suicide deaths were 15% lower (n.s) in March-May 2020 (n=140) compared with the same months pooled over 2014-2018 (n=165). Interpretation: We found no increase in mental disorders or suicides during the COVID-19 pandemic up through early autumn 2020. COVID-19 related mortality, transmission rates, intensity and implementation of measures and lockdowns have been less severe in Norway than many other countries and could account for these results. Funding: None Declaration of Interests: Dr. Hotopf reports grants from European Commission IMI/EFPIA, grants from National Institute of Health Research, grants from Medical Research Council, and grants from Economic and Social Research Council outside the submitted work. In the past 3 years, Dr. Kessler was a consultant for Datastat, Inc., Sage Pharmaceuticals, and Takeda. The authors Dr. Knudsen, Dr. Gustavson, Dr. Krokstad, Dr. Skogen, Dr. Stene-Larsen, Dr. Overland and Dr. Reneflot report no conflict of interest. Ethics Approval Statement: The survey was a collaboration between the Norwegian Institute of Public Health (NIPH) and the HUNT Research Centre and approved by the Regional Committee for Medical Research Ethics (2017/28/REK midt).

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-Trondelag 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.

A social gradient in sleep has been demonstrated across the life span, but previous studies have been cross-sectional and used self-reported socioeconomic status (SES) indicators. Using registry-based data on family income trajectories, the current study examined the association between relative poverty in childhood and subsequent sleep in adolescence.Data on family income during 2004-2010 was obtained from the National Income Registry. Poverty was defined as household income60% of the mean national income. Information on self-reported sleep was based the youth@hordaland-survey (n = 8873) conducted in 2012 when the adolescents were 16-19 years old. Latent class analysis (LCA) was used to identify trajectories of family household poverty, and analysis of variance and general linear models were used to examine associations between income trajectories and sleep, adjusting for confounders.LCA identified four classes: 'never poor', two classes characterized by moving in or out of poverty, and 'chronically poor'. Compared to the 'never poor' group, adolescents from families in the 'moving into poverty' group displayed worse sleep across most sleep measures, including shorter sleep, lower sleep efficiency, and more nocturnal wake time (but not sleep onset latency). Neither adolescents from families who had moved out of poverty by increasing family income, nor the 'chronically poor' group differed significantly from the reference group.The study found that downward socioeconomic mobility was associated with increased adolescent sleep problems. More studies are required on the mechanisms that may account for the association, to find targeted and effective strategies to prevent short sleep duration in adolescents from families with unstable financial circumstances.

Objective Most individuals experiencing whiplash accidents recover rapidly. A considerable proportion, however, develop chronic symptoms. Psychological factors may slow recovery, possibly by increasing the likelihood of other symptoms being misattributed to, and amplified by the whiplash injury. We aimed to investigate how pre-injury mental and somatic symptoms, self-rated health, use of health-services and medications, health-behavior and socio-demographics predict the development of chronic whiplash. Methods Data from two waves of a large, population based study (HUNT2 (baseline) and HUNT3) were used. Individuals reporting no whiplash at baseline were identified in HUNT3. Characteristics reported at baseline were compared between those who had developed chronic whiplash in HUNT3 (n = 199) and those who had not (n = 20,600), using Pearson's chi-squared tests, independent sample t-tests and logistic regression analyses. Results Individuals developing chronic whiplash reported worse baseline health than those reporting no chronic whiplash. Poor self-rated health was a strong risk factor for subsequent chronic whiplash (OR = 2.26, 95%CI: 1.68–3.04). Musculoskeletal pain also increased the risk (OR = 1.21, 95%CI: 1.15–1.26), as did diffuse somatic symptoms (OR = 2.09, 95%CI: 1.47–2.96), use of different health services (OR = 1.31, 95%CI: 1.19–1.45), high use of medications (OR = 1.28, 95%CI: 1.14–1.43) and symptoms of anxiety (OR = 1.93, 95%CI: 1.39–2.68). Physical activity was protective (OR = 0.67, 95%CI: 0.49–0.91). Most socio-demographic variables were not significantly associated with chronic whiplash. Conclusion Poor somatic and mental pre-injury health increased the risk of subsequent chronic whiplash. This suggests that chronic whiplash is not merely an organic disorder, and highlights the importance of individual expectations, symptom reattribution and amplification in development of chronic whiplash.