Olav Linaker

• Dr. Med.
• Professor at Norwegian University of Science and Technology

BACKGROUND: Successful mental health treatment requires active patient participation and pre-therapy educational (PTE) might be a key strategy for achieving this goal. PTE provides a framework for preparation for therapy that aims to educate patients about the nature of, and rationale for treatment and might enhance the ability of patient to remai...

Objective: To investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders. Methods: A randomized controlled trial with 53 adult patients; 26 participants received a SRIT contract, which they could use to refer themselves into a Community Mental Health Centre up to five days...

Objective: To investigate the 1-month effects of an educational programme co-led by peers delivered before treatment on treatment preferences, self-management knowledge and motivation in comparison to usual care. Methods: Adults referred to a community mental health centre were randomised to either a control group (n=48) or a peer co-led educati...

The Patient Activation Measure-13 (PAM-13) has been found useful for assessing patient knowledge, skills and confidence in management of chronic conditions, but the empirical evidence from mental health is sparse. The psychometric properties of PAM in out-patients waiting for treatment in community mental health centers (CMHC) have therefore been e...

Patients with epilepsy often have different mood symptoms and behavioral trait characteristics compared to the non-epileptic population. In the present prospective study, we aimed to assess differences in behavioral trait characteristics between acutely admitted, psychiatric in-patients with epilepsy-associated depressive symptoms and gender/age-ma...

Background Chronic widespread pain (CWP) is common and associated with prominent negative consequences. The aim of this study was to assess the prevalence of persistent CWP in an 11-year prospective cohort study in the general population, and to examine anxiety, depression, alcohol use, poor sleep, body mass index (BMI) and chronic disease, along w...

Few studies have used prospective designs in large population surveys to assess the risk of developing chronic widespread pain (CWP). We wanted to examine (1) how many persons without CWP developed it after 11 years and (2) how anxiety, depression, alcohol use, smoking, sleeping problems, and body mass index (BMI) were associated with this developm...

Biological factors have been associated with deliberate self-harm (DSH) but have not been integrated with clinical factors in routine risk assessments.This study aimed to examine the incremental validity of lipid levels and platelet serotonin when combined with psychosocial factors in risk assessments for repeated admissions due to DSH. In this pro...

Concerns about protecting patient's privacy are experienced as a limitation in the opportunity to obtain and utilize social support by many physicians. As resources of social support can modify the process of burnout, patient confidentiality may increase risk of this syndrome by interfering with proper stress adaptation. This study investigates if...

Concerns about protecting patient's privacy can interfere with proper stress adaptation which isassociated with physician's health. It is important to investigate relevant organizational confounders to this phenomenon to enable interventions that can ameliorate the subjective burden of patient confidentiality. This study investigatesfactors in the...

The aim of the study was to explore the predictive validity of the Suicidal Scale of the Mini-International Neuropsychiatric Interview as a screen for suicidal behavior and non-suicidal self-injury following discharge from an acute psychiatric ward. Using a prospective, naturalistic design, the patients were screened with the Suicidal Scale when di...

Background and aims: The mother-infant relationship may represent a risk or a protective factor for child development. Hence, an early focus on the relationship may be a worthwhile preventive measure. A simple 10-item instrument, the Mother and Baby Interaction Scale, could be a convenient screening instrument for early bonding failure. In this pi...

The aims of the study are to examine the differences in symptoms, functioning and self-reported motives for drinking alcohol among seriously mentally ill patients with and without alcohol problems. The subjects (n = 69) were included from a patient register. They completed the Short Michigan Alcoholism Test (SMAST 13) and the drinking motives measu...

Violence risk assessment instruments are mainly based on historical and clinical risk factors. Biological factors have been related to violent behaviour but hardly used in risk assessment. A recent study indicated that both low total cholesterol (TC) and the patients' own estimates about their risk of future violent behaviour, the Self-report Risk...

The aim of the study was to describe the contemporary practice of electroconvulsive therapy (ECT) in Norway. A 42- item questionnaire on the practice of ECT was sent to all the 125 Norwegian psychiatric hospitals, district psychiatric centers, and child and adolescent psychiatric units in 2004. A total of 67 (54%) psychiatric units responded, inclu...

The aims of the present study were to investigate clinically relevant patient and environment-related predictive factors for threats and violent incidents the first three days in a PICU population based on evaluations done at admittance. In 2000 and 2001 all 118 consecutive patients were assessed at admittance to a Psychiatric Intensive Care Unit (...

The aims of this study were to examine gender differences in symptoms, functioning, substance use problems and substance use correlates in patients with serious mental illness. The current study is cross-sectional, and data were collected using the Health of the Nation Outcome Scales for Severe Mental Illness (HoNOS-SMI) questionnaire. The question...

To investigate how the subjective burden of confidentiality can act as a stressor that affects physicians' psychological health and wellbeing. Cross-sectional survey data from a sample of university hospital physicians (N=1,956) in four European countries (Sweden, Norway, Iceland and Italy) who participated in the HOUPE (Health and Organization amo...

Instigation of proper measures in case of intellectual disability is often conditioned by a diagnosis. Our aim was to assess whether the Hayes Ability Screening Index (HASI) is a suitable screening instrument for intellectual disability among adults. The article is based on three former studies aimed at validating HASI for use among patients referr...

Depressive disorders are frequent in epilepsy and associated with reduced seizure control. Almost 50% of interictal depressive disorders have to be classified as atypical depressions according to DSM-4 criteria. Research has mainly focused on depressive symptoms in defined populations with epilepsy (e.g., patients admitted to tertiary epilepsy cent...

Background: The psychological, social, and physical aspects of the ward milieu affect treatment outcomes and patient satisfaction. The primary aim of the present study was to describe and explore patients’ perceptions of their stay at a Norwegian seclusion area. The patients’ experience of having received help and support from the staff, sense of r...

Intellectual disabilities (ID) among psychiatric patients have traditionally been neglected. A lack of convenient instruments and competency in ID may have worsened the conditions and treatment availability for these patients. Validation and adaptation of a screening instrument for ID (Hayes Ability Screening Index; HASI) in a psychiatric hospital...

The aims of this study were to examine evidence for the concurrent validity of two self-report measures and two staff-report measures measuring alcohol and drug problems in seriously mentally ill people and to examine if psychotic patients under-report their alcohol and drug problems in an early intervention clinic. This is a cross-sectional study...

Abstract A recent change in legislation in Norway redefined which persons with an intellectual disability (ID) are considered as “offenders” within the judicial system. After that change, the number of adults with ID convicted of a crime and subject to forensic services decreased from 27 in 2002 to 13 in 2006. Crimes considered under the statue inc...

In psychiatric acute departments some patients present with brief depressive periods accompanied with fluctuating arrays of other psychiatric symptoms like psychosis, panic or mania. For the purpose of the present study we call this condition Acute Unstable Depressive Syndrome (AUDS). The aims of the present study were to compare clinical signs of...

The aims of the study were twofold. First, the study examined the extent to which there are gender differences in the experience of caring in a sample of relatives of patients with serious mental illness. Secondly, the study examined the association of self-reports of health and functioning with the experience of burden among relatives of patients...

Patients with brief depressive episodes and concurrent rapidly fluctuating psychiatric symptoms do not fit current diagnostic criteria and they can be difficult to diagnose and treat in an acute psychiatric setting. We wanted to study whether these patients had signs of more epileptic or organic brain dysfunction than patients with depression witho...

Our aims were to examine the stability of self-rated anxiety and depression symptoms and the predictors for change in case-level status after 4 years in a general population sample. Prospective cohort study. Based on the total score on the Hospital Anxiety and Depression rating scale (HADS-T) in HUNT 2 (1995-1997), three groups were identified: Lev...

The aim of the study was to describe the pattern of injuries to various body parts in patient-staff incidents; 507 patient-staff incidents in a psychiatric acute ward during the period 1990-1997 were included. Staff members registered 193 injuries in the head, 112 in the trunk, 265 in the upper extremities and 69 in the lower extremities. No differ...

Excess mortality in anxiety and depression has mostly been studied for diagnostic categories of each condition separately. The aim of this article is to study the association between self-reported mixed anxiety and depression and mortality in the general population. A population survey of 2624 individuals was defined in three groups according to th...

The aim of the current study was to investigate feasibility, response, and consequences of mental health screening and intervention in a population study setting. In the Intervention study against Depression and Anxiety in Nord-Trøndelag (IDANT), all GPs and psychiatric nurses were invited to a psychiatric educational programme prior to the Health...

The purpose of this study is to compare the development in symptoms, behaviors, function and treatment between patients with or without a substance use (SU) diagnose in a Psychiatric Intensive Care Unit (PICU). A total of 118 admitted patients were assessed at admittance, day 3 and discharge from the PICU. Symptoms of psychopathology, therapeutic s...

The main objective of this study was to compare life skills between psychotic patients with substance abuse problems and psychotic patients without substance abuse problems. This is a cross-sectional study of 48 patients (26 inpatients and 22 outpatients) in a clinic for early intervention in psychosis. Patients were grouped into two categories bas...

Psychiatric acute units use different levels of segregation to satisfy needs for containment and decrease in sensory input for behaviourally disturbed patients. Controlled studies evaluating the effects of the procedure are lacking. The aim of the present study was to compare effects in acutely admitted patients with the use of a psychiatric intens...

Abstract  In Norway, certain adults with intellectual disabilities who were arrested were not held responsible for their crimes. Instead of receiving a conviction and a prison term, they were sentenced to preventive supervision. In January 2002, Norwegian law changed and these types of adults are now sentenced to “mandatory care” in their municipal...

Alpha-mannosidosis is characterized by mild to moderate intellectual disability (ID), moderate to severe neurosensory hearing loss, frequent infections, psychomotor disturbances and skeletal dysmorphism. For the first time, a panel of nine alpha-mannosidosis patients with psychiatric symptoms is presented. The clinical picture has several similarit...

Introduction: Preliminary observations indicate that patients with brief depressive periods and coexisting rapidly changing psychiatric symptoms may have increased frequency of epilepsy and other organic brain dysfunctions compared to patients with major depression. The hypothesis of the study was to find such difference in a PICU setting. Methods:...

Introduction: Preliminary observations suggest that patients with brief depressive periods and coexisting rapidly changing psychiatric symptoms may more frequently have organic brain dysfunction than patients with major depression. We wanted to investigate whether EEG and quantitative EEG recordings could shed light to the aetiology behind such sym...

We wanted to examine whether persons needing acute psychiatric admittance can give us reliable information about their functional status with the COOP/WONCA charts (Dartmouth Primary Care Cooperative Information Project-World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians), and if t...

The objective of the study was to compare development in symptoms, behaviours, treatment and patient satisfaction of a traditional interior and an interior furnished like an ordinary home in a seclusion area. A naturalistic sample of 56 consecutive patients admitted to an acute ward was allocated to two different seclusion areas, one with a traditi...

The objectives of the study were to describe monthly variations in issues in calls to a help-line for children and adolescents. All 80,983 calls to a Red Cross Help-Line for children in 1991-1997 were included. In 22,698 calls, information about age, sex or issue could be identified. A monthly variation in frequency of calls with peaks in April and...

Since the deinstitutionalisation reform in 1991, the general health services, including psychiatry, are expected to serve the needs of people with mental retardation. Studies have shown that users generally find the service provided by psychiatry unsatisfactory. One reason for this may be a lack of confidence on the part of psychiatrists to take on...

The main objective of this study was to compare symptom load and lifetime treatment experiences between psychotic patients with substance abuse problems and psychotic patients without substance abuse problems. This is a cross-sectional study of 48 patients (26 inpatients and 22 outpatients) in a clinic for early intervention in psychosis. Patients'...

The use of psychotropic medication among people with intellectual disability (ID) is widespread, and they are one of the most medicated groups in society. A substantial number of individuals with ID receive psychotropic medications that may be inappropriate for their diagnosis. One of the main reasons for the use of psychotropic medication is chall...

Background: The deinstitutionalization movement is presently spreading in Europe, but studies evaluating the effects of deinstitutionalization on behaviour disturbances among people with intellectual disability (ID) are inconclusive. The prevalence of aggressive behaviour among people with ID is high in both institutions and in community. Aggressi...

Objectives: To compare patient satisfaction with a traditional interior on a secluded area and with an interior and furniture like an ordinary Norwegian home in the same secluded area. Methods : 56 patients acutely admitted to a secluded area were randomized to either a traditional interior or an ordinary Norwegian home interior. After being discha...

Objective: To compare a traditional interior in a secluded area with an interior and furniture like an ordinary Norwegian home in the same secluded area. Method: 56 patients acutely admitted to a secluded area were randomized to traditional or an ordinary Norwegian home interior. Symptoms of psychopathology, therapeutic measures taken, violent epis...

To investigate seasonal variations in telephone calls to a help-line for children, and their correlation to changes in length of day, latitude and age. 691,787 calls to the Red Cross Help-Line in Norway for children in the three-year period 1996-1998 were included. Monthly frequencies of calls deviated significantly from an expected even distributi...

The influence of seasons on mood disorders is controversial. To examine monthly variations in admissions for mania and depressions including variations with sex and age and correlations with frequencies of suicides. All admissions for mania or depression (N=4341) in a population of 1,800,000 with 35,285 admissions in the years 1992-1996 were analys...

The deinstitutionalization movement is presently spreading in Europe. Studies evaluating the effects of deinstitutionalization on behaviour disturbances among people with intellectual disability (ID) have been inconclusive. The present paper focuses on people without self-injurious behaviour (SIB) who developed SIB after deinstitutionalization. The...

Clinical experience with patients taking neuroleptic drugs indicates major problems with compliance. The aim of this study was to determine if characteristics of the patient or the treatment are correlated to the patients' compliance. Forty-three patients, who had taken neuroleptics orally for at least one month, participated by completing a questi...

Mentally retarded persons have high prevalences of psychiatric disorders and often receive little professional help for them. From a total of 48 mentally retarded inhabitants in a local community, 28 were selected on the basis of possible psychiatric problems. A psychiatrist diagnosed the persons and gave advice based on personal observation, conta...

Seasonal variations of violence have been the subject of some controversy. Norway, situated between latitudes 58 degrees and 72 degrees N, has considerable seasonal variations of light and provides a good opportunity for studies of seasonality. The monthly numbers of police reports of violent incidents in 1991-1997 were obtained for the entire Norw...

Prison inmates have high frequencies of psychiatric disorders. Most prisons have little health-personnel resources, and methods to help focus resources towards those with serious health-care needs would be useful. The Global Symptom Index (GSI) of the Symptom Check List-90 (SCL-90) has performed well in other populations. Prisoners at Kristiansand...

We wanted to study the prevalence and characteristics of dangerousness among female psychiatric patients. A national survey was performed in Norway, covering all psychiatric in- and out-patient units. There were 329 persons reported to have a psychiatric disorder and to satisfy our criteria for dangerousness, giving a total prevalence of 9.9/100000...

Before total deinstitutionalization in Norway, many believed that the ordinary health care system could give people with intellectual disability the same or even better health care than that which they received in institutions. It was said that institutions created psychiatric problems, and that these would diminish or even disappear with the closi...

Before deinstitutionalization for the mentally retarded in Norway it was argued that the ordinary health care system could give the same or better health care than the institutions, and that institutions created psychiatric health problems that would diminish or disappear with their closing. The present study examines the psychiatric health problem...

Background: Both among psychiatric patients and in the general population, Seasonal variation of mood symptoms and aggression has been described, Aims: To investigate seasonal variations in violence among acutely admitted psychiatric patients and in the general population. Methods: The monthly frequency of 512 patient-staff incidents 1990-june 1997...

Reform of the health services in Norway for the mentally retarded led to a complete closure of all institutions for mentally retarded persons by the end of 1996. All 109 of the mentally retarded persons in the county of Sør-Trøndelag who were previously institutionalized were observed throughout this process, in 1987 and 1995. Both physical handica...

Reform of the health sévices in Norway for the mentally retarded led to a complete closure of all institutions for mentally retarded persons by the end of 1996. All 109 of the mentally retarded persons in the county of S0r-Tr0ndelag who were previously institutionalized were observed throughout this process, in 1987 and 1995. Both physical handicap...

Behavior and symptoms seen in 48 24-h periods preceding violent episodes and 93 control observations were studied. Six behaviors were more common before violence: confusion, irritability, boisterousness, physical threats, verbal threats and attacks on objects. A logistic regression equation based on these behaviors in a randomized half of the obser...

The Psychopathology Instrument for Mentally Retarded Adults (PIMRA) was designed to assess psychiatric disorders among mildly and moderately mentally retarded persons. In a psychiatric population without mental retardation (n = 53), the PIMRA schizophrenia scale had an internal consistency coefficient alpha = 0.52. By removing one outlier item this...

The authors briefly discuss past and present reasons for the psychiatric security unit system in Norway. They describe the patients in these units at the beginning of 1993 (N = 123). Of these patients, 16% were females, 78% had a main diagnosis of schizophrenia, and 12% were admitted because of personality disorders. Physical restraints had been us...

In an institution, 57 people with mental retardation who had shown assaultive behaviour during the last year were compared with a control group of 57 people in the same institution, matched by sex, level of retardation and age. The study group were younger and had more people with a moderate level of mental retardation than the total population of...

The Psychopathology Instrument for Mentally Retarded Adults (PIMRA) was used to diagnose 163 mentally retarded adults in an institution according to DSM-III axis 1 categories. The relevant 49 items of the PIMRA were subsequently factor analysed. The factors were compared with the diagnoses to examine similarities or differences. The nine factors ex...

The clients in an institution for the mentally retarded were screened for signs of psychopathology with the Psychopathology Instrument for Mentally Retarded Adults (PIMRA). Of the 168 clients, 146 satisfied criteria for DSM-III axis I disorders, and 153 satisfied criteria for at least one disorder on either axis I or II. Multiple diagnoses were com...

The frequency of psychotropic and anticonvulsant drug use in 168 institutionalised mentally retarded adults was studied. Use of neuroleptics and anticonvulsants was more frequent and use of hypnotics and antidepressants less frequent than in the general population. Neuroleptics were given to 49% of the population. Clients with no psychiatric diagno...

In an epidemiological study carried out in the town of Tromsö in northern Norway an extensive questionnaire was sent twice, in summer and winter, to 1000 subjects to investigate the degree of symptoms of mood variation (depression or hypomania) during the polar winter night and midnight sun seasons. The results suggest that the general population n...

The medical and psychiatric diagnoses of 168 clients aged 16 to 65 years in a Norwegian institution for the mentally retarded were registered together with medication, level of functioning, and types of problem behavior. Most of these clients (64.9%) were profoundly or deeply retarded, and only 6.5% were independent of continuous supervision or hel...