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1.
  • Kleppang, Annette Løvheim, et al. (author)
  • Leisure-time physical activity among adolescents and subsequent use of antidepressant and hypnotic drugs : a prospective register linkage study.
  • 2018
  • In: European Child and Adolescent Psychiatry. - : Springer. - 1018-8827 .- 1435-165X. ; 28:2, s. 177-188
  • Journal article (peer-reviewed)abstract
    • In this prospective study, the association between physical activity and subsequent use of antidepressant and hypnotic drug use in adolescents aged 15-16 years was examined. This study is based on information retrieved from the Norwegian Youth Health Surveys (2000-2003) and linked to prescription data from the Norwegian Prescription Database (2004-2013). In total, the study included 10711 participants with a participation rate of 87%. Adolescents were asked how many hours per week they spent on physical activity that made them sweat and/or be out of breath outside of school. Incident psychotropic drug use (outcome measure) was defined as ≥ 1 prescription of one of the following psychotropic drugs: hypnotics and antidepressants registered in the Norwegian Prescription Database. In the crude model for the time period 2004-2007, the odds of incident hypnotic use were lower for those who were physically active 1-2 h per week (OR 0.48-0.64), compared to those who were physically inactive (< 1 h per week). However, the association become non-significant 4-year post-baseline (2008-2010 and 2011-2013). In the crude model for the time periods 2004-2007, 2008-2010 and 2011-2013, the odds of incident antidepressant use were lower for physically active adolescents (2004-2007: OR 0.46-0.71, 2008-2010: OR 0.40-0.67 and 2011-2013: OR 0.37-0.58, compared to those who were physically inactive < 1 h. However, after adjustment for confounders, the association became non-significant in all time periods except in physical activity 5-7 and 8-10 h in the period 2008-2010. Physical activity does not indicate any association with later use of antidepressants, and the significant association with incident hypnotic drug use was for short-term follow-up only and disappeared on longer term follow-up periods. Given the scarcity of longitudinal studies examining the association between physical activity and mental health as well as psychotropic drug use among young people, the current study adds to previous research.
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2.
  • Kleppang, Annette Løvheim (author)
  • Mental health and physical activity in adolescence
  • 2018
  • Doctoral thesis (other academic/artistic)abstract
    • The aim of this thesis is to examine the association between physical activity and mental health among Norwegian adolescents.The thesis includes four studies among adolescents in grade 10, aged 15-16 years. Studies I, II and III are based on the Norwegian Youth Health Surveys and study IV is based on data retrieved from Ungdata. In 2000-2003 (Youth Health Survey), the adolescents completed a paper and pencil self-administered questionnaire at school during lesson time. In both 2009 (Youth Health Survey) and 2017 (Ungdata), the adolescents completed an anonymous web-based questionnaire.The Rasch analysis from study I showed that overall, the HSCL-10 showed good reliability and the items worked well. One item “Sleeping difficulties”, in the HSCL-10 instrument clearly misfit and some items worked differently for boys and girls. Study II showed that the association between physical activity, screen-based sedentary behaviour and psychological distress was weak. In study III, a significant association between physical activity and incident use of hypnotics was shown at short-term follow up. No significant associations were found for later use of antidepressants. Study IV showed that participating in a sports club was significantly associated with lower odds of depressive symptoms.Mental health and physical activity are both complex phenomena. When investigating the association between adolescent`s physical activity and mental health, it is important to look at physical activities in different contexts, not only volume and frequency.
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3.
  • Kleppang, Annette L, et al. (author)
  • Psychological distress among Norwegian adolescents : Changes between 2001 and 2009 and associations with leisure time physical activity and screen-based sedentary behaviour
  • 2019
  • In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 47:2, s. 166-173
  • Journal article (peer-reviewed)abstract
    • Aims: The aim of this work was to examine psychological distress among Norwegian adolescents in relation to changes over time and the associations with leisure time physical activity and screen-based sedentary behaviour. Methods: This cross-sectional study was based on data retrieved from the Norwegian Youth Health Surveys in 2001 and 2009 in Hedmark County. Adolescents aged 15–16 years old completed a questionnaire regarding physical activity, sedentary behaviour, psychological distress and other health and lifestyle variables. The self-report Hopkins Symptom Checklist-10 was used to assess psychological distress. Multinomial logistic regression was used to analyse the associations between psychological distress, physical activity and sedentary behaviour. Results: Self-reported psychological distress increased significantly from 2001 to 2009 (from 19.4 to 28.2%), with the proportion of girls reporting psychological distress being twice as large as the proportion of boys. The proportion of adolescents who were physically active for ⩾11 hours per week increased significantly over the same period (from 6.0 to 10.4%). Sedentary behaviour ⩾6 hours per school day increased significantly among both sexes between 2001 and 2009. Physical activity (⩾11 hours) and sedentary behaviour (⩾6 hours) were both significantly associated with psychological distress. Conclusions: The association between physical activity, sedentary behaviour and psychological distress was weak; only high amounts of physical activity and high amounts of screen-based sedentary behaviour were associated with psychological distress. Longitudinal studies are needed to provide further insights into these associations and to understand the extent to which these variables might be causally related.
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5.
  • Myhrene Steffenak, Anne Kjersti, et al. (author)
  • Experience of psychotropic drug use among young people with mental health problems
  • 2015
  • In: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 35:4, s. 241-248
  • Journal article (peer-reviewed)abstract
    • The aim of the study is to describe the experience of psychotropic drug use among young people with mental health problems. Young people experience mental health problems, and some will need to take psychotropic drugs for either a short or a long time. Psychotropic drugs may be effective in reducing mental distress, but raise questions about increasing use, side effects, long-term treatment and off-label use. Qualitative interviews were accomplished with eight young people who had taken psychotropic drugs. Three categories were identified: ‘Effects of psychotropic drugs’, ‘Access of professional care and follow-up’ and ‘Social life and psychotropic drug use’. The young people experienced both beneficial and undesired effects from the psychotropic drugs. They experienced lack of access to professional support and follow-up. Life with family and friends was influenced negatively by psychotropic drug use and the young people were afraid of being lonely and stigmatized. The results may have implications for those who work with young people. Young people striving with mental health problems and psychotropic drug use have to have access to professional support and follow-up. Knowledge about effects of psychotropic drug use among young people is needed. The work about openness about mental health problems among young people has to continue.
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7.
  • Myhrene Steffenak, Anne Kjersti, 1955- (author)
  • Mental Distress and Psychotropic Drug Use among Young People, and Public Health Nurses` Conceptions of Their Roles
  • 2014
  • Doctoral thesis (other academic/artistic)abstract
    • Aim: The overall aim of this thesis was to study mental distress, health and lifestyle habits, social factors and psychotropic drug use by young people, and how PHNs conceive their roles in relation to this.Methods: Quantitative and qualitative methods were used. Study I included data  from the Norwegian Youth Health Study (NYHS, 11 620 participants, aged 15-16 years) (2000–2003) linked to the Norwegian Prescription Database (NorPD) (2004–2009). Study II included prescription data on psychotropic drugs among 15-16 year olds from the NorPD (2006–2010). Eight young people were interviewed and qualitative content analysis was used to analyse the data (III). Study IV included interviews with 20 Public Health Nurses (PHN), and was analysed using a phenomenographic approach.Main results: Mental distress was reported among 15.5% of the adolescents non-users of psychotropic drugs, 75% of whom were girls. In both genders reporting mental distress, incident psychotropic use was higher one to nine years, up to 27.7% among girls, as compared with the rest of the participants. In addition, health, lifestyle habits and social factors were associated with incident use (I). Psychotropic drug use increased during 2006–2010, hypnotics and melatonin accounted for most of the increase. In total, 16.4% of all incident psychotropic drug users in 2007 were still having prescriptions dispensed in 2010 (II). Young people experience both beneficial and undesired effects from psychotropic drugs. Access to professional support and follow-up was experienced as insufficient. Life with family, friends, school and work was influenced by psychotropic drug use, and they were afraid of being lonely and stigmatized (III). The PHNs conceived their roles in relation to young people as; the discovering PHNs who became aware of psychotropic drug use in the health dialogues and chose either to act or not to act in relation to this. Those PHNs who took action continued to be the cooperating PHNs who cooperated with the young people, their families, schools, and others. If cooperation was established, the supporting PHNs teach and support the young people in relation to psychotropic drug use (IV).Conclusions: Attention must be paid to poor mental health and increasing psychotropic drug use by young people. Advances in knowledge, treatment and follow-up are needed. The prevalence of mental distress among young people, with differences between the genders, as well as between socioeconomic groups, should have consequences for health promotion strategies. PHNs in Norway, working in health centres and schools, have responsibility and opportunity to identify and follow-up young people with mental health problems.
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9.
  • Steffenak, Anne Kjersti Myhrene, et al. (author)
  • Public health nurses' perception of their roles in relation to psychotropic drug use by adolescents : a phenomenographic study
  • 2015
  • In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:7-8, s. 970-979
  • Journal article (peer-reviewed)abstract
    • Aims and objectivesThe purpose of the paper was to describe the perceptions of public health nurses' roles in relation to psychotropic drug use by adolescents. BackgroundMental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. DesignA phenomenographic approach was used to analyse the data. MethodA qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. ResultsThe public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. ConclusionThe public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. Relevance to clinical practiceThe results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health.
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