Tone Tangen Haug

Bio: Tone Tangen Haug is an academic researcher from Haukeland University Hospital. The author has contributed to research in topics: Anxiety & Randomized controlled trial. The author has an hindex of 16, co-authored 20 publications receiving 8956 citations. Previous affiliations of Tone Tangen Haug include University of Bergen.

The association between anxiety, depression, and somatic symptoms in a large population: The HUNT-II study

Abstract: Objective Somatic symptoms are prevalent in the community, but at least one third of the symptoms lack organic explanation. Patients with such symptoms have a tendency to overuse the health care system with frequent consultations and have a high degree of disability and sickness compensation. Studies from clinical samples have shown that anxiety and depression are prevalent in such functional conditions. The aim of this study is to examine the connection between anxiety, depression, and functional somatic symptoms in a large community sample. Method The HUNT-II study invited all inhabitants aged 20 years and above in Nord-Trondelag County of Norway to have their health examined and sent a questionnaire asking about physical symptoms, demographic factors, lifestyle, and somatic diseases. Anxiety and depression were recorded by the Hospital Anxiety and Depression Scale. Of those invited, 62,651 participants (71.3%) filled in the questionnaire. A total of 10,492 people were excluded due to organic diseases, and 50,377 were taken into the analyses. Results Women reported more somatic symptoms than men (mean number of symptoms women/men: 3.8/2.9). There was a strong association between anxiety, depression, and functional somatic symptoms. The association was equally strong for anxiety and depression, and a somewhat stronger association was observed for comorbid anxiety and depression. The association of anxiety, depression, and functional somatic symptoms was equally strong in men and women (mean number of somatic symptoms men/women in anxiety: 4.5/5.9, in depression: 4.6/5.9, in comorbid anxiety and depression: 6.1/7.6, and in no anxiety or depression: 2.6/3.6) and in all age groups. The association between number of somatic symptoms and the total score on Hospital Anxiety and Depression Scale was linear. Conclusion There was a statistically significant relationship between anxiety, depression, and functional somatic symptoms, independent of age and gender.

Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia

Abstract: Background No controlled trial of treatment of generalised social phobia has been conducted in general practice. Aims To examine the efficacy of sertraline or exposure therapy, administered alone or in combination in this setting. Method Study was of a randomised, double-blind design. Patients ( n = 387) received sertraline 50-150 mg or placebo for 24 weeks. Patients were additionally randomised to exposure therapy or general medical care. Results Sertraline-treated patients were significantly more improved than non-sertraline-treated patients (χ2=12.53, P <0.001; odds ratio=0.534; 95% Cl 0.347-0.835). No significant difference was observed between exposure- and non-exposure-treated patients (χ2=2.18, P =0.140; odds ratio=0.732; 95% Cl 0.475-1.134). In the pairwise comparisons, combined sertraline and exposure (χ2=12.32; P <0.001) and sertraline (χ2=10.13; P =0.002) were significantly superior to placebo. Conclusions Sertraline is an effective treatment for generalised social phobia. Combined treatment with sertraline and exposure therapy, conducted by the general practitioner, may enhance the treatment efficacy in primary care.

Low vagal tone and antral dysmotility in patients with functional dyspepsia

Abstract: Effects of acute mental stress on gastric antral motility were investigated in 23 healthy persons and 25 patients with functional dyspepsia (FD). Real-time ultrasonography of gastric antrum was recorded, after ingestion of 500 ml meat soup, during a 4-min resting period, 2.5 min of mental stress, and a 4-min recovery period. Amplitude of antral contractions was scored as a fraction of relaxed area. Motility-index was calculated as the amplitude multiplied by frequency. Measurement of skin conductance reflected sympathetic tone, and respiratory sinus arrhythmia (RSA) was calculated to index vagal tone. Antral motility was reduced by mental stress in the healthy persons, but not in FD patients. Group differences were significant for amplitude (p < 0.002) and motility-index scores (p < 0.02). Sympathetic tone increased during stress in both groups. Vagal tone was lower in the FD patients than in the healthy controls (p < 0.001). The lack of stress-related reduction of motility among patients with FD may, therefore, be a consequence of poor vagal tone.

A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7

Abstract: Background Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. Methods A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. Results A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. Conclusion The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7

Abstract: Background Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. Methods A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. Results A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. Conclusion The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

Prospective Study of

Abstract: e thank Tuttolomondo et al. (1)fortheirinterestinourstudy(2).In response, we would like toclarify several points. First, coding ofstrokes has been ongoing in the Nurses’Health Study since 1976. We have nothad funding to implement coding byTOAST (Trial of Org 10172 in AcuteStroke Treatment) classification (3) buthope to do so in the future. In an internalcomparisonofcodingbyPerthcriteria(4)versus TOAST, the concordance rate forlacunar infarction was very high (91%);however, a percentage of large artery in-farctions as classified by Perth coding cri-teria was classified as “unknown type” byTOAST criteria due to inconclusive ca-rotid Doppler findings. Thus, it is possi-ble that differences in stroke classificationmay have lead to slightly higher risk esti-mates for large artery infarction in ourpopulation.Second, our results are consistentwithdiabetesbeingastrongriskfactorforlacunar infarction. As shown in Table 2 ofthe article, incidence rates for lacunar in-farction were higher than for large arteryinfarction among women with type 2 di-abetes (50 and 36 per 100,000 person-years, respectively), and risk estimateswere also slightly higher for lacunar thanlarge artery infarction (3.6 vs. 2.7 in age-adjusted analyses) compared with womenwithout diabetes.Third, both fatal and nonfatal infarc-tions were included, but only first eventswere considered. Thus, our methods dodifferfromsomehospital-basedstudiesinthat only first stroke events were in-cluded. As stated in the article, resultswere similar for confirmed (medicalrecords)andprobable(letterortelephonecorroboration) cases, thus the combinedresults were presented (see p. 1731, col-umn 2).Finally, as suggested by Tuttolomondoet al., it is possible that there are sex differ-ences in the strength of association be-tweendiabetesandlargearteryinfarction.Our results are limited to women, and weencourage further sex-specific evalua-tions of these associations.