The Nordic Journal of Psychiatry, formerly “Nordisk Psykiatrisk Tidsskrift”, is an international journal that publishes excellent psychiatric research with a broad scope. It is the official journal for the eight psychiatric associations in the Nordic and Baltic countries. It is a main source of information about current Nordic psychiatry and related fields, The journal is distributed to members of the Nordic and Baltic Psychiatric Associations as well as to members of Associations for Child and Adolescent Psychiatry. This gives access to all articles published in the journal from 1946.
Job satisfaction of doctors in psychiatry
The purpose of this study is to explore how doctors in mental health services perceive their work, and factors affecting their job satisfaction. A Questback survey was sent to all employed members of NPA in June 2020 and in December 2021. In 2021, more than half of the respondents (56%) were satisfied, 16% were dissatisfied and 27% were neutral. The oldest and youngest doctors were most satisfied. Partial treatment responsibility was related to reduced job satisfaction as well as access to an experienced colleague, time for direct patient contact and ability to treat patients in a satisfactory manner. Job satisfaction decreased from 2020 to 2021. The authors conclude that psychiatrists seem to be torn between treating their own patients and being medically responsible for other therapists' patients. Time for patient contact and discussions with colleagues are crucial for psychiatrists' well-being at work.
Sandvik MK, Nesvåg R, Jorem J, Lien L. Which factors affect job satisfaction of doctors in psychiatry? Nord J Psychiatry. 2024 Apr;78(3):198-204. doi: 10.1080/08039488.2024. 2303314. Epub 2024 Jan 21. PMID: 38247281
Pain during a depressive episode and relationship to cytokine levels
Depressed patients have an increased incidence of pain. A pathophysiological connection between depression and pain is still not revealed. Since there are few studies of pain and immune activation in patients with depression, the authors did this naturalistic follow-up study of 50 patients with a major depressive disorder (MDD) depressive episode, without any inflammatory or autoimmune conditions. They obtained data of depression, pain and cytokine levels before and after 12 weeks of depression treatment. At inclusion three out of four patients experienced pain, and the pain scores correlated with the depression scores. After treatment, as depression was relieved, the pain scores dropped significantly and were no longer correlated to the depression scores. There were no correlations between pain scores and cytokine levels. Pain level at inclusion did not correlate with depression treatment outcome. The authors conclude that pain is a feature of depression, that pain levels and cytokine values didn't correlate and that pain at inclusion did not predict depression treatment outcome.
Dahl J, Ormstad H, Aass HCD, Malt UF, Andreassen OA. Changes in pain during a depressive episode and relationship to cytokine levels in major depressive disorder. Nord J Psychiatry 2024 Apr;78(3):181-188. doi: 10.1080/08039488.2023.2290654. Epub 2024 Jan 22. PMID: 38251060
Mood instability in patients with unipolar depression measured using smartphones
The author’s objective was to investigate the association between mood instability, calculated based on daily smartphone-based patient-reported data on mood, and functioning, quality of life, perceived stress, empowerment, rumination, recovery, worrying and wellbeing. Patients with depression completed daily smartphone-based self-assessments of mood for 6 months, making it possible to calculate mood instability using the Root Mean Squared Successive Difference (rMSSD) method. A total of 59 patients with UD were included. Data were analyzed using mixed effects regression models. There was a statistically significant association between increased mood instability and increased perceived stress and worrying and decreased quality of life, recovery and wellbeing. There were no statistically significant associations between mood instability and functioning, empowerment, and rumination. The authors conclude that the findings underscore the significant influence of mood instability on patients' daily lives and that identification of mood fluctuations offer potential insights into the trajectory of the illness.
Kessing LV, Tønning ML, Busk J, Rohani D, Frost M, Bardram JE, Faurholt-Jepsen M. Nord J Psychiatry. 2024 Aug;78(6):518-524. doi: 10.1080/08039488.2024.2369179. Epub 2024 Jun 21. PMID: 38905155
Substance use in homeless patients with mental disorders
Dual diagnosis homeless patients often cause differential diagnostic difficulties and fail to receive effective treatment. The purpose of this study was to explore substance use in homeless patients with mental disorders and their subjective perspectives on their substance use. 44 homeless dual diagnosis patients were examined in interviews focusing on their substance use and their subjective perspective on their substance use. The most frequently used substances were cannabinoids (70.5%) and alcohol (45.5%), followed by cocaine, sedative/hypnotics, and amphetamine. While substance use seems to contribute to keep the patients homeless, substance use was also reported to play an important role in coping with life on the streets by offering social contact and some relief from a desperate situation. The authors conclude that substance use, mental disorder, and homelessness seem to be closely entangled, reinforcing each other and making it difficult to help these vulnerable patients. Diagnostic overshadowing may cause delays in adequate diagnosis and treatment of this group of patients.