Inger Hilde Nordhus

University of Bergen, Bergen, Hordaland, Norway

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Publications (108)

  • Siri Kvam · Catrine Lykkedrang Kleppe · Inger Hilde Nordhus · Anders Hovland
    [Show abstract] [Hide abstract] ABSTRACT: Background: This meta-analysis of randomized controlled trials (RCTs) examines the efficacy of physical exercise as treatment for unipolar depression, both as an independent intervention and as an adjunct intervention to antidepressant medication. Methods: We searched PsycINFO, EMBASE, MEDLINE, CENTRAL, and Sports Discus for articles published until November 2014. Effect sizes were computed with random effects models. The main outcome was reduction in depressive symptoms or remission. Results: A total of 23 RCTs and 977 participants were included. Physical exercise had a moderate to large significant effect on depression compared to control conditions (g=-0.68), but the effect was small and not significant at follow-up (g=-0.22). Exercise compared to no intervention yielded a large and significant effect size (g=-1.24), and exercise had a moderate and significant effect compared to usual care (g=-0.48). The effects of exercise when compared to psychological treatments or antidepressant medication were small and not significant (g=-0.22 and g=-0.08, respectively). Exercise as an adjunct to antidepressant medication yielded a moderate effect (g=-0.50) that trended toward significance. Limitations: Use of the arms with the largest clinical effect instead of largest dose may have overestimated the effect of exercise. Conclusions: Physical exercise is an effective intervention for depression. It also could be a viable adjunct treatment in combination with antidepressants.
    Article · May 2016 · Journal of Affective Disorders
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    Ståle Pallesen · Inger Hilde Nordhus · Bjørn Bjorvatn · Kristoffer Rakner
    Full-text Article · Apr 2016
  • Tone Blågestad · Inger Hilde Nordhus · Janne Grønli · [...] · Ståle Pallesen
    [Show abstract] [Hide abstract] ABSTRACT: Total hip arthroplasty (THA) has been shown to reduce pain and improve function. In addition, it is suggested that THA improves sleep and alleviates symptoms of anxiety and depression. Patients with chronic pain are frequent users of analgesic and psychotropic drugs and thereby risk adverse drug events. The impact of THA on such drug use has not been thoroughly investigated. Based on merged data from the Norwegian Prescription Database and the Norwegian Arthroplasty Register, the present study sought to investigate redeemed medications in a complete population (N = 39 688) undergoing THA in 2005-2011. User rates and redeemed drug volume of analgesics (non-steroid anti-inflammatory drugs (NSAIDs), opioids and non-opioids) and psychotropics (hypnotics, anxiolytics and antidepressants) were calculated for four quarters before and four quarters after surgery. We analysed pre-operative prescription trends (Q1 vs. Q4), post-operative prescription (Q4 vs. Q5) and long-term effect of surgery (Q4 vs. Q8). Prior to surgery, use of all drug groups increased from Q1 to Q4. Use of opioids, non-opioids and hypnotics dramatically increased from Q4 to Q5. Long-term (Q4 vs. Q8), surgery reduced prescriptions of analgesics, hypnotics and anxiolytics, but not antidepressants. Overall, the present results extend the positive effects of THA to include reduced reliance on medication to alleviate symptoms.
    Article · Nov 2015 · Pain
  • Conference Paper · Aug 2015
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    Full-text Dataset · Jul 2015
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    [Show abstract] [Hide abstract] ABSTRACT: Internet-based cognitive behaviour therapy (ICBT) is a recommended, cost-effective and efficacious treatment for panic disorder (PD). However, treatment effects in psychiatric settings indicate that a substantial proportion fail to achieve remission. Physical exercise improves symptoms in patients with PD, and acts through mechanisms that can augment the effect of ICBT. The feasibility of combining these two interventions has not previously been investigated, and this was the aim of this study. The intervention comprised guided ICBT combined with one weekly session of supervised and two weekly sessions of unsupervised physical exercise for a total of 12 weeks. Treatment rationale, procedures and protocols are presented together with preliminary results for four patients with PD who have currently finished treatment. Quantitative and qualitative results are reported on the feasibility of adhering to the treatments, treatment outcome as assessed by clinician rating and estimation of reliable and clinically significant change for outcome measures, and participants' satisfactions with the combined treatment. The preliminary results indicate that the combined treatment is feasible to complete, and that the combination is perceived by the participants as beneficial.
    Full-text Article · Mar 2015 · Cognitive behaviour therapy
  • Article · Dec 2013 · Sleep Medicine
  • Minna J Hynninen · Ståle Pallesen · Jon Hardie · [...] · Inger Hilde Nordhus
    [Show abstract] [Hide abstract] ABSTRACT: Sleep disturbances are known to have a negative impact on a range of clinical outcomes in chronic obstructive pulmonary disease (COPD). We examined the associations of insomnia symptoms and objectively measured sleep parameters to a composite score for body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index (a multidimensional index of COPD severity), arterial blood gases, nocturnal respiratory disturbances, periodic limb movements (PLM), psychologic distress, pain, age, and sex. The sample comprised 73 COPD outpatients (mean age, 63.6years; standard deviation {SD}, 7.5; range 47-85years; 41.1% women). Insomnia symptoms were measured with the Bergen Insomnia Scale (BIS) and sleep efficiency (SE), slow-wave sleep (SWS), and total sleep time (TST) were assessed with clinical polysomnography (PSG). BODE index was positively associated with composite BIS score (P=.040). Patients with more severe COPD presented more complaints of nonrestorative sleep compared to patients with less severe COPD (P=.010). In multivariate analysis, the composite BIS score was independently associated with PLM (P<.001), nocturnal respiratory disturbances (P=.001), pain (P=.031), and psychologic distress (P=.044) but not with the BODE index. Objectively measured sleep variables were not associated with any of the health-related variables. Insomnia symptoms in COPD patients result from a wide range of health-related factors. More severe COPD may be associated with a subjective experience of nonrestorative sleep but not with objectively measured sleep variables.
    Article · Oct 2013 · Sleep Medicine
  • [Show abstract] [Hide abstract] ABSTRACT: To examine the associations between depressive/anxiety disorders (DAs), perceived health-related quality of life (HRQOL) and mortality in dialysis patients. Patients were assessed for depressive and DAs with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. The HRQOL was assessed with the Medical Outcome Short Form 36 (MOS SF-36), and the Beck Depression Inventory and Hospital Anxiety and Depression Scale were also applied. Sociodemographic, clinical and laboratory data were also collected. Patients with depressive disorders reported more impaired HRQOL on four of the eight subscales, while those with a depressive disorder comorbid with DA reported more impairment on all MOS SF-36 subscales compared to those without any psychiatric disorder. During the observation period, 50% of those with depression, 28% of those with anxiety and 33% of patients with DA disorder died. A survival analysis did not indicate that patients with depressive or DAs had a higher mortality than patients without such disorders. Dialysis patients with depressive disorders reported impaired HRQOL, whereas those with DAs did not. Patients with DA reported the most serious HRQOL impairment. No evidence was obtained to support the hypothesis that depressive and DAs contributed to compromised survival in dialysis patients. In patients with depression, DAs should also be assessed as they significantly contribute to impaired HRQOL.
    Article · Jul 2013 · General hospital psychiatry
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    [Show abstract] [Hide abstract] ABSTRACT: Objectives: Behavioral and psychological symptoms like depression and anxiety often coexist with dementia, and create an additional burden for patients and their caregivers. Anxiety symptoms have been related to poorer cognitive performance and decline in functional status. Whether anxiety is a cause or consequence of dementia-related impairment has received little attention so far. Most studies have focused on patients with Alzheimer´s disease (AD) and less is known about anxiety in Dementia with Lewy Bodies (DLB). The aims of the study were to investigate changes in the frequency and severity of anxiety in patients with AD or DLB over time and to assess the temporal relationship between anxiety symptoms and dementia-related impairment. Methods: In this observational longitudinal study, the sample comprised outpatients with first-time diagnosed mild dementia (n=196, 65% Alzheimer´s dementia, 20% DLB) recruited from clinics in geriatric medicine and old age psychiatry in Rogaland and Hordaland counties in Western Norway. Standardized clinical instruments and diagnostic criteria were employed. The participants are followed up at four years after the baseline assessments.
    Full-text Dataset · Mar 2013
  • [Show abstract] [Hide abstract] ABSTRACT: Delayed sleep phase disorder is characterized by a delay in the timing of the major sleep period relative to conventional norms. The sleep period itself has traditionally been described as normal. Nevertheless, it is possible that sleep regulatory mechanism disturbances associated with the disorder may affect sleep duration and/or architecture. Polysomnographic data that may shed light on the issue are scarce. Hence, the aim of this study was to examine polysomnographic measures of sleep in adolescents and young adults with delayed sleep phase disorder, and to compare findings to that of healthy controls. A second aim was to estimate dim light melatonin onset as a marker of circadian rhythm and to investigate the phase angle relationship (time interval) between dim light melatonin onset and the sleep period. Data from 54 adolescents and young adults were analysed, 35 diagnosed with delayed sleep phase disorder and 19 healthy controls. Results show delayed timing of sleep in participants with delayed sleep phase disorder, but once sleep was initiated no group differences in sleep parameters were observed. Dim light melatonin onset was delayed in participants with delayed sleep phase disorder, but no difference in phase angle was observed between the groups. In conclusion, both sleep and dim light melatonin onset were delayed in participants with delayed sleep phase disorder. The sleep period appeared to occur at the same circadian phase in both groups, and once sleep was initiated no differences in sleep parameters were observed.
    Article · Jan 2013 · Journal of Sleep Research
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    [Show abstract] [Hide abstract] ABSTRACT: Objectives: Shift-related sleep and sleepiness problems may be due to characteristics of both shifts (ie, day, evening and night shifts) and work schedules (ie, permanent vs rotational schedules). The Bergen Shift Work Sleep Questionnaire (BSWSQ) was used to investigate associations between shift-related sleep problems and work schedules. Methods: 1586 nurses completed the BSWSQ. Participants who, in relation to a shift, 'often' or 'always' experienced both a sleep problem and a tiredness/sleepiness problem were defined as having shift-related insomnia (separate for day, evening and night shifts and rest-days). Logistic regression analyses were conducted for day, evening, night, and rest-day insomnia with participants on both permanent and rotational schedules. Results: Shift-related insomnia differed between the work schedules. The evening shift insomnia was more prevalent in the two-shift rotation schedule than the three-shift rotation schedule (29.8% and 19.8%, respectively). Night shift insomnia showed higher frequencies among three-shift rotation workers compared with permanent night workers (67.7% and 41.7%, respectively). Rest-day insomnia was more prevalent among permanent night workers compared with two- and three-shift rotations (11.4% compared with 4.2% and 3.6%, respectively). Conclusions: The prevalences of shift-related insomnia differed between the work schedules with higher frequencies for three-shift rotations and night shifts. However, sleep problems were present in all shifts and schedules. This suggests that both shifts and work schedules should be considered in the study of shift work-related sleep problems.
    Full-text Article · Jan 2013 · Occupational and environmental medicine
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    Anders Hovland · Ståle Pallesen · Asa Hammar · [...] · Inger Hilde Nordhus
    [Show abstract] [Hide abstract] ABSTRACT: BACKGROUND: Patients with panic disorder (PD) are known to report impaired sleep quality and symptoms of insomnia. PD is an anxiety disorder characterised by deficient physiological regulation as measured by heart rate variability (HRV), and reduced HRV, PD and insomnia have all been related to impaired inhibitory ability. The present study aimed to investigate the interrelationships between subjectively reported sleep impairment, cognitive inhibition and vagally mediated HRV in a sample characterised by variability on measures of all these constructs. METHODS: Thirty-six patients with PD with or without agoraphobia were included. Cognitive inhibition was assessed with the Color-Word Interference Test from the Delis-Kaplan Executive Function System (D-KEFS), HRV was measured using high frequency (HF) power (ms(2)), and subjectively reported sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Cognitive inhibition was related to both Sleep latency and Sleep disturbances, whereas HRV was only related to Sleep disturbances. These relationships were significant also after controlling for depression. LIMITATIONS: Correlational design. CONCLUSION: Cognitive inhibition is related to key insomnia symptoms: sleep initiation and sleep maintenance. The data supports the psychobiological inhibition model of insomnia, and extends previous findings. Possible clinical implications of these findings are discussed.
    Full-text Article · Jan 2013 · Journal of Affective Disorders
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    A. Hovland · S. Pallesen · Å Hammar · [...] · I. H. Nordhus
    Full-text Article · Jan 2013
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    Ståle Pallesen · Børge Sivertsen · Inger Hilde Nordhus · Bjørn Bjorvatn
    [Show abstract] [Hide abstract] ABSTRACT: Objective We aimed to investigate the 10-year trend in the prevalence of insomnia symptoms, insomnia cases, and use of hypnotic agents in the adult Norwegian population. Methods Data from 2 representative surveys assessing identical insomnia symptoms in the adult population of Norway, one conducted in 1999 to 2000 (N=2001) and one conducted in 2009 to 2010 (N=2000), were compared. Results Controlling for basic demographic variables, significant increases were found over the 10-year study period in the prevalence of sleep-onset insomnia from 13.1% to 15.2%, dissatisfaction with sleep from 8.2% to 13.6%, daytime impairment from 14.8% to 18.8%, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) insomnia cases from 11.9% to 15.5%, and hypnotic agent use from 6.9% to 11.1%. No secular trend was found for maintenance insomnia or for early morning awakening insomnia. Across the 2 surveys, women reported a higher prevalence of insomnia than men. Age was positively associated with the prevalence of nocturnal sleep problems and use of hypnotic agents but was inversely associated with daytime impairment. Individuals with low socioeconomic status (SES) reported a higher prevalence of several insomnia symptoms. Conclusions Insomnia seems to be on the rise in the general adult population, which gives reason for concern. Prevention of insomnia and cost-effective interventions should receive higher priority in the future.
    Full-text Article · Jan 2013 · Sleep Medicine
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    Yngvild Sørebø Danielsen · Kjell Morten Stormark · Inger Hilde Nordhus · [...] · Ståle Pallesen
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Low self-esteem is one of the main psychosocial factors related to childhood overweight. Yet not all overweight children are affected. Little is known about what characterises the group of overweight children with the lowest self-esteem. Our aim was to identify factors related to low domain-specific self-esteem in children with overweight/obesity. Methods: Children (aged 10-13; N = 5,185) and parents from a large population-based sample completed the Eating Disturbance Scale, the Self-Perception Profile for Children, and questions about bullying and socio-economic status (SES). Parents reported the child's weight and height. 545 children with overweight/obesity were identified in the overall sample and selected for the current analyses. Self-esteem scores from this group were compared to scores from children with normal weight. Factors examined in relation to self-esteem in children with overweight/obesity were: age, gender, SES, disturbed eating, bullying, parents' evaluation of weight status and degree of overweight. Results: Children with overweight scored significantly lower than normal-weight children on all self-esteem domains. Athletic competence and physical appearance were most impaired. Disturbed eating and bullying were related to low physical appearance as well as scholastic, social and athletic self-esteem. Being female, a pre-teen, having a higher BMI and being evaluated as overweight by parents were associated with lower satisfaction with physical appearance. Conclusions: Disturbed eating and bullying are significantly related to low self-esteem in the overweight group.
    Full-text Article · Oct 2012 · Obesity Facts
  • Anders Hovland · Ståle Pallesen · Asa Hammar · [...] · Inger Hilde Nordhus
    [Show abstract] [Hide abstract] ABSTRACT: Heart rate variability (HRV) is reduced in patients who suffer from panic disorder (PD). Reduced HRV is related to hypoactivity in the prefrontal cortex (PFC), which negatively affects executive functioning. The present study assessed the relationships between vagally mediated HRV at baseline and measures of executive functioning in 36 patients with PD. Associations between these physiological and cognitive measures and panic-related variables were also investigated. HRV was measured using HF-power (ms(2)), and executive functions were assessed with the Wisconsin Card Sorting Test (WCST) and the Color-Word Interference Test (CWIT) from the Delis-Kaplan Executive Function System (D-KEFS). Panic-related variables comprised panic frequency, panic-related distress, and duration of PD. Performance on the neuropsychological measures correlated significantly with HRV. Both panic-related distress and duration of PD were inversely related with measures of HRV and cognitive inhibition. The current findings support the purported relationship between HRV and executive functions involving the PFC.
    Article · Oct 2012 · International journal of psychophysiology: official journal of the International Organization of Psychophysiology
  • [Show abstract] [Hide abstract] ABSTRACT: The prevalence of sexual abuse in a Norwegian representative population sample. The aim of the present study was to examine the prevalence of sexual abuse occurring before and after the age of sexual consent (16 years) in a representative Norwegian population sample. A random sample of 1450 men and women aged 18-80 years received a questionnaire about unwanted sexual experiences, which were categorized as unwanted sexual behaviours, unwanted sexual acts or unwanted intercourse. In total 703 people responded, giving a response rate of 48, 7%. The sample consisted of 387 women (55.3 %) and 316 men (44.9 %). Unwanted sexual behaviour before age 16 was reported by 24.3% of women and by 12.0 % of men, whereas 19.4 % of women and 7.6 % of men reported being 16 years or older the first time they had such experiences. Unwanted sexual acts before age 16 was reported by 18.3 % of women and 3.2 % of men, and by 9.0 % of women and 3.5 % of men above age 16. Unwanted intercourse occurring before the age of 16 was reported by 11.4 % of women and by 0.9 % of men, whereas 16.3 % of women and 1.6 % of men reported being 16 years or older the first time they had such experiences. The results show that unwanted sexual experiences were highly prevalent among these respondents, and more prevalent among women than men. Further, there was a relatively high prevalence of sexual abuse before the age of 16 years.
    Article · Oct 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Background: Type D personality may be a risk factor for poor outcome in patients with cardiovascular disease. The biological mechanisms underlying this association are poorly understood. The objective of the study was to test the hypotheses that Type D personality is associated with biological markers for sympathetic dysregulation.Design: Cross-sectional community-based study.Methods: Type D personality was evaluated by DS-14 in 450 persons (46% men), aged between 30 and 65 years. From a Holter-recording, (mean length 18.3 hours), long-term heart rate, ventricular arrhythmias, and heart rate variability (HRV) were registered as markers of sympathetic dysregulation. Traditional cardiovascular risk factors, apnoea-hypopnoea index, medication, and anxiety symptoms were adjusted for.Results: Type D persons had higher long-term averaged heart rate (74 vs. 71 beats/min, p = 0.003), but this difference was attenuated and not significant in the multivariate model (p = 0.078)). There was an increased prevalence of complex ventricular ectopy (bigeminy, trigeminy, or non-sustained ventricular tachycardia; 14 vs. 6%, p = 0.005 in multivariate model). HRV indices did not differ significantly between those with or without Type D personality. Anxiety symptoms did not confound these associations.Conclusions: Type D personality is independently associated with a higher likelihood of ventricular arrhythmias, which may be implicated in the increased cardiovascular risk observed in persons with Type D personality.
    Article · Sep 2012
  • Conference Paper · Sep 2012

Publication Stats

2k Citations


  • 1999-2015
    • University of Bergen
      • Department of Clinical Psychology
      Bergen, Hordaland, Norway
  • 2010
    • Haukeland University Hospital
      • Norwegian Competence Center for Sleep Disorders
      Bergen, Hordaland, Norway
  • 2007
    • Sisli Etfal Training and Research Hospital
      İstanbul, Istanbul, Turkey