In individuals with substance use disorders (SUDs), impairment of social, occupational, and/or recreational functioning is common. Social functioning encompasses social skills, social behavior, and cognitive skills, which are relevant for establishing meaningful relationships and effective functioning across different domains in life. The main aim of the study is to determine the effectiveness of tailored virtual reality (VR) social functioning training as an adjunct to in-patient SUD treatment in improving functionality, measured by World Health Organization Disability Assessment Scale 2.0 at 6 months post-intervention. The study is designed as a two-arm, statistician-blinded, pragmatic, multi-cite, randomized controlled trial. Eligible participants will be randomly assigned to either the intervention or control group using 1:1 allocation. The control group receives standard in-patient SUD treatment, and the intervention group receives additionally VR social functioning training (8 sessions). Both the intervention and control groups will be assessed for between-group differences in functioning change from before randomization (T0), to 6-week (T1), and to 6-month (T2). Both groups will also be assessed before (T0), at 6-month (T2), and at 12-month follow-up (T3) for a health economic evaluation. Evidence suggests that VR training can enhance patients’ social functioning and thereby improve relations and promote community participation in people with SUD. To the best of our knowledge, this is the first study that aim to explore the use of VR in improving social functioning in patients with SUD. Thus the results of this trial can provide valuable insights for clinicians and health authorities. ClinicalTrials.gov NCT06677515. Registered on November 11, 2024.

The purpose of this study is to analyse geographic variation in rates of patients and service utilisation for persons with substance use disorders (SUD) across Norwegian hospital catchment areas from 2017 to 2021, considering both outpatient and Inpatient care across substance use diagnosis. This registry-based study used data from the Norwegian Patient Registry and Statistics Norway, covering 58,889 unique patients and 121,495 patient-years. Adjusted for age and sex this material yields a national SUD treatment rate of 14.0 per 1,000 over five years, on average 5.8 per year with a declining annual rate from 6.1–5.5. Analyses included diagnoses related to alcohol, opioids, cannabis, and other substances, excluding tobacco and opioid maintenance treatment. Three variation measures—Extreme Quotient (EQ), Coefficient of Variation (CV), and Systematic Component of Variation (SCV)—were used to assess disparities. Geographic variation in SUD treatment rates ranged from 3.6 to 11.5 per 1,000 inhabitants reaching a threefold difference between areas (EQ = 3.1). We found that SCV values (8.7–23.5) and SCV 5–95 (5.7–14.5) for diagnose groups and service type consistently exceeded the threshold of high and extremely high variation. Procurement of private services increased capacity significantly but did not markedly reduce variation. Variation remained extremely high even when the highest and lowest rates were excluded (SCV 13.8, SCV5–95 11.3). Patient rates in SUD treatment fell every year between 2017–2021 and the geographic variation was high to extremely high. Treatment of substance use disorders in Norway may require stronger regional governance to reduce unwarranted variation and ensure equitable access to treatment. Substantial reductions in variation can be achieved by i) redistributing capacity among catchment areas, ii) purchasing fewer and shorter Inpatient stays and iii) increasing outpatient treatment. In addition, such means could dramatically increase patient rates. There is a need for more consistent clinical practices and adjusted capacity for treating specific substance diagnoses.

Objectives The mental health impacts of COVID-19 on frontline healthcare workers have been reported globally; however, there is limited evidence from low-income countries such as Ethiopia. We reviewed the literature to understand how COVID-19 impacted the mental health of frontline healthcare workers, including the associated risk and protective factors.Design A scoping review of peer-reviewed research was conducted between 2020-2025 to explore the mental health and well-being of frontline healthcare workers in Ethiopia during COVID-19. The process adhered to the guidelines for data extraction outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Our search identified 35 studies, of which 29 studies were included in the final synthesis.Data sources Three online databases, PubMed, Web of Science and PsycInfo, were systematically searched for data.Eligibility criteria Studies were considered for inclusion in the review if they focused on mental health conditions and psychosocial well-being among healthcare workers during COVID-19 in Ethiopia. Studies were only included if published in English and excluded if they were conference abstracts, case studies, reviews, commentaries, contained incomplete data or lacked variables of interest.Data extraction and synthesis Data extraction was conducted manually by two reviewers by using a data extraction sheet created in Excel.Results Most frontline healthcare workers experienced symptoms of insomnia, psychological distress, stress, anxiety, post-traumatic stress disorder and depression during COVID-19. Female frontline healthcare workers, nurses, midwives and laboratory technicians reported higher rates of adverse mental health outcomes. Our results found that being married, living together with a spouse and having a high educational level were risk factors for adverse mental health outcomes.Conclusion The mental health and well-being of frontline healthcare workers is at risk during a global health crisis; however, there is a limited understanding of how to protect the mental health of frontline healthcare workers in low-income countries, such as Ethiopia, at such a critical time. Additional research is needed to better inform mental health preparedness interventions for frontline healthcare workers in these contexts, particularly given predictions of another pandemic occurring within the next decade.

Despite the ongoing, brutal, and traumatic Russian war of aggression, Ukraine is successfully and persistently leveraging high-level political commitment and international partnerships to replace an antiquated, institutionalised mental health model with a modern, community-centred system focused on resilience and human rights. This report reflects the progress, changes, and transformation of Ukraine's mental health system since the publication of the 2024 Lancet Psychiatry Commission. The 2024 Commission has served as the official blueprint for reforming Ukrainian mental health services, gaining acceptance from both the Government and health-care practitioners. Consultations throughout 2025 focused on integrating international standards into the local systems and extracting lessons learned to benefit the global psychiatric community.

Suicide is a serious and global health problem, with important consequences for individuals and for society. Understanding health workers’ perspectives is important for understanding how clinicians think about this topic and their attitudes toward and adherence to current guidelines. These findings can also have implications for future directions in guideline development and suicide-prevention policy. The purpose of this study was to investigate health workers’ experiences with and perceptions of suicide risk assessments. We conducted an electronic survey in which we asked health workers (N = 183) 18 questions about their experiences with and opinions about suicide risk assessments, suicide prevention, risk factors for suicide, and questions relating to the Norwegian guidelines for suicide risk assessment. The health workers in this study consisted of psychologists, doctors, nurses, and social workers from three different Norwegian hospitals. We found that the professional groups differed significantly in their responses. We also found significant differences between staff at the different hospitals in how they perceived the risk factors and standardized questions. In general, the respondents were skeptical regarding the emphasis on standardized suicide risk assessments. Furthermore, respondents perceived suicide as at least partly preventable. There were some differences between professions and hospitals. This may be due to cultural and educational aspects. Suicide risk prevention is complex, involving a variety of factors. Methodological limitations should be taken into consideration. Future research should further explore health workers’ concerns about standardized suicide risk assessments.

Importance:Previous studies suggest that critically injured patients are at increased risk of suicide following discharge, but these have mainly been single-center studies or had limited data on comorbidities and socioeconomic factors. Objective:To examine the risk of suicide after hospitalization for traumatic injuries. Design, Setting, and Participants:This nationwide register-based cohort study used data from 5 Norwegian nationwide health registries and Statistics Norway between 2014 and 2020. Patients registered in the Norwegian Trauma Registry (NTR) for whom trauma team activation at hospital arrival was mandated by national guidelines between 2015 and 2018 were matched to general-population controls on gender and birth year in a 1:10 ratio according to a matched cohort design. Patients discharged alive were followed-up for a minimum of 2 years. All Norwegian hospitals treating patients with traumatic injuries provide data to the NTR. The final analysis was conducted in April 2025. Exposures:Traumatic injury, admitted to hospital, and registered in the NTR. Main Outcomes and Measures:The outcome of interest was suicide, as registered in the Norwegian Cause of Death Registry. Cumulative incidence ratios (CIR) of suicide with 95% CIs, taking nonsuicidal death as a competing event into account, were estimated. Adjustments for Charlson Comorbidity Index, previous psychiatric illness, and socioeconomic position (SEP) were conducted using inverse probability of treatment weights. Results:A total of 25 536 patients with traumatic injuries (165 897 [67%] male; mean [SD] age, 41 [23] years) were matched to 247 095 controls, with a mean (SD) age of 41 (23) years and 68% male. The cumulative incidences of suicide were 0.18% at 2 years and 0.34% and 5 years for patients with traumatic injuries and 0.02% at 2 years and 0.05% at 5 years for controls (2-year CIR, 9.3 [95% CI, 5.4-13.0]; 5-year CIR, 6.9 [95% CI, 4.4-9.1]). Patients with traumatic injury were older at the age of suicide compared with controls (mean [SD] age, 43 [19] years vs 36 [17] years; P = .03) and female patients with traumatic injury had higher incidence of suicide compared with female controls (36% vs 17%; P = .005). Conclusions and Relevance:In this cohort study of patients in Norway discharged alive after critical injury, a 9-fold increased risk of suicide after 2 years was observed. These findings suggest that follow-up is warranted for possible psychological distress in this patient group.

Substance use disorders (SUD) are associated with a high global burden of disease, with 5.4% of all disability-adjusted life years lost due to alcohol and illicit drugs. Highly prevalent multimorbidity includes polysubstance use, mental health conditions, and other non-communicable and infectious diseases. Where traditional treatments are insufficient alone, music therapy (MT) is highly engaging and improves motivation and reduces craving; however, its long-term effects are unknown. The present study aims to examine long-term effects of active music groups (AMG) and music listening groups (MLG) versus treatment as usual (TAU) on addiction severity, recovery, and other outcomes in people with SUD Immediate and short-term effects, as well as mechanisms of these interventions, will also be examined. In individuals with SUD across a wide range of age, gender, socioeconomic, and cultural backgrounds, a parallel 3-arm assessor-blinded pragmatic multinational randomised controlled trial (RCT) with embedded exploratory trials and mechanistic studies will determine long-term effects of AMG and MLG versus TAU on addiction severity (primary endpoint: 1 year), recovery, and other outcomes. Embedded trials will examine immediate effects of AMG or MLG combined with individual components of TAU combined to determine the best combinations of interventions. Experimental studies will examine mechanisms using cognitive testing and brain imaging. With 600 participants in 7 countries randomised, the trial will have 80% power on the primary outcome. Patient representatives, health technology assessment (HTA) bodies, and interventionists have been involved from conception and will ensure feasibility and applicability of the intervention across Europe. This document describes the FALCO RCT, the main part of the FALCO project, which aims to reduce disease burden through innovative, effective, and affordable treatment, and will strengthen research and innovation expertise. Recommendations from FALCO will inform intervention delivery across Europe and beyond, leading to increased safety, effectiveness, and cost-effectiveness, and improved quality of life for individuals with SUD. Stakeholders will be involved in communicating findings across all European countries and regions and ensuring that findings are effectively implemented. ClinicalTrials.gov , NCT07028983 , registered 11 th of June 2025. https://clinicaltrials.gov/study/NCT07028983

BACKGROUND: Alcohol use disorder (AUD) is often discovered very late or not at all, with a risk of undertreatment. High alcohol consumption may lead to hypertension. and hypertensive patients should be asked about their alcohol use. Our aim was to look at additional risk factors for receiving a diagnosis of AUD in patients with hypertension. METHODS: Using the Norwegian full coverage patient registry, we investigated all patients who received an ICD-10 diagnosis of hypertension and who were routinely registered in the specialized healthcare services in 2010. These were followed for six years and those who subsequently received an ICD-10 AUD diagnosis were identified. Age, sex and comorbidities found in the patient registry were used as covariates. RESULTS: Of the 103 623 patients diagnosed with hypertension in 2010, 1517 (1.46%) were later diagnosed with AUD. Male sex, young age, having several comorbidities, malnutrition and respiratory disease, anxiety, and especially a diagnosis of major depression increased the risk of being diagnosed with AUD in these hypertensive patients. CONCLUSION: Only a small proportion of the hypertensive patients were later diagnosed with AUD, reflecting that patient registries are poor indicators of true AUD prevalence, since AUD is heavily underdiagnosed. However, the current findings suggest that comorbid conditions such as depression, anxiety, malnutrition, and respiratory disease in hypertensive patients should prompt clinicians to assess alcohol use more proactively. This could in turn lead to better care for both those with hypertension and alcohol problems.

Comorbidity between mental disorders and somatic diseases exacerbates health outcomes and contributes to premature mortality. However, differences in this comorbidity among immigrant groups compared to the majority population are unclear. This study aims to examine disparities in the risk relationship between common mental disorders (CMDs) and somatic diseases among the majority population (Norwegians) and various immigrant groups. This national register study uses information from 3 142 925 residents aged 18+on diagnosed CMDs and selected somatic diseases for years 2008–2016. Poisson regression models were used to study the association between CMD and somatic diseases (i.e., cardiovascular diseases (CVDs), endocrine and metabolic diseases, cancer, and infectious diseases). Differences in risk between Norwegians and immigrant groups were investigated by introducing interaction terms between CMD and immigrant background. Individuals with CMDs had a higher risk for all somatic diseases compared to those without, regardless of immigrant status. Immigrant groups varied in comorbidity, with those without CMDs showing similar or lower risk compared to Norwegians. However, immigrants with CMDs from non-Western countries (i.e., Eastern Europe, sub-Saharan Africa, South Asia) had a significantly higher probability of developing CVD, hypertension, and diabetes mellitus than Norwegians with CMDs. Additionally, SSA immigrants with CMDs also had a higher risk for viral hepatitis. Findings suggest that immigrant groups experience varying degrees of comorbidity, which underscores the need for tailored healthcare interventions to address these disparities effectively.

The use of screens, especially mobile devices like tablets and smartphones has increased over the last years and have become an integral to daily life. Adolescents today spend a lot of time using screens both at school and outside school. Identifying possible associations between gaming, social media use and quality of life (QoL) may inform the development of public health guidelines targeting adolescent behaviour. The purpose of this study is to examine the association between gaming, social media use and quality of life (QoL) among adolescents, and whether sex, spending time with friends or psychological distress moderate these associations. This study was based on cross-sectional data from the Trøndelag Health study (Young-Hunt4), collected in 2017–2019. The target group comprised 8066 adolescents (13–19 years). QoL was measured with the Norwegian version of the Inventory of Life Quality (ILC). Electronic media use was measured using the two variables social media use and gaming. Multiple linear regression was used to analyse the association between social media use, gaming, and QoL. Results showed a negative association between gaming (> 3 h per day) after school and quality of life (b = -0.26) and social media use (> 3 h per day) after school and quality of life (b = -0.20). Similar negative associations were observed between more time spent on gaming (> 3 h per day) during weekends and quality of life (b = -0.33) and more time spent on social media (> 3 h per day) during weekends and quality of life (b = -0.16). An interaction effect was observed between sex and social media use (after school), between sex and gaming (after school and during weekends), and between psychological distress and gaming during weekends. More than three hours spent on gaming or social media per day, both during weekdays and weekends, was negatively associated with QoL. Sex moderated these associations; however, for social media use this was shown only after school. Additional research is needed to further explore these associations.

The pandemic worsened mental health conditions, especially for those with concurrent severe mental illness and substance use disorders (SMI/SUD). Studies have noted increased rates of psychotropic drugs prescription in the general population during the pandemic, serving as a proxy for worsened mental health. Investigating prescription trends among individuals with SMI/SUD would be of interest due to their high morbidity and high reliance of these drugs. This study aimed to examine the impact of the COVID-19 pandemic on the prescribing of psychotropic drugs in this group of patients. We conducted a retrospective cohort study using national register data from 2019 to 2021. A graphical approach and descriptive statistics were employed to analyse the prescribing of seven psychotropic drugs over time. Negative binominal regression analysis compared changes in prescriptions from pre-pandemic to pandemic periods. Prescription patterns among individuals with SMI/SUD remained generally stable during the pandemic, except for marginally increased prescription of antipsychotics (IRR 1.06, 95

Background:Skin diseases are symptomatic, visible, and stigmatizing and it is acknowledged that they can be associated with stress. However, large studies comparing disease-specific stress are scarce. Objectives:To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress. Methods:A cross-sectional, multicenter study was conducted in 22 dermatology clinics across 17 European countries (response rate 82.4%). The study included 5487 patients diagnosed with various dermatological conditions and 2808 skin-healthy controls. The Perceived Stress Scale, 10 items was used to measure stress. Results:Patients reported significantly higher stress levels, more stressful life events during the last 6 months, and more economic difficulties than controls. Patients with psychodermatological conditions, hyperhidrosis, hidradenitis suppurativa, atopic dermatitis, acne, and urticaria experienced the highest stress levels. 44% of the variance of perceived stress in patients with skin conditions could be predicted by sociodemographic data and disease-related and psychological variables (depression, anxiety, stigmatization, and body dysmorphic concerns). Limitations:As with all cross-sectional studies, causality and directionality cannot be inferred. Conclusion:Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.

BACKGROUND:We aimed to identify therapeutic approaches for managing schizophrenia in different phases and clinical situations - the prodromal phase, first-episode psychosis, cognitive and negative symptoms, pregnancy, treatment resistance, and antipsychotic-induced metabolic side effects - while assessing clinicians' adherence to guidelines. METHODS:A cross-sectional online survey was conducted in 2023 as part of the Ambassador project among psychiatrists and trainees from 35 European countries, based on a questionnaire that included six clinical vignettes (cases A-F). Additionally, a review of multiple guidelines/guidance papers was performed. RESULTS:The final analysis included 454 participants. Our findings revealed a moderate to high level of agreement among European psychiatrists regarding pharmacological treatment preferences for first-episode psychosis and cognitive and negative symptoms, prodromal symptoms and pregnancy, with moderate adherence to clinical guidelines. There was substantial similarity in treatment preferences for antipsychotic-induced metabolic side effects and treatment resistance; however, adherence to guidelines in these areas was only partial. Despite guideline recommendations, non-pharmacological treatments, including psychotherapy and recovery-oriented care, were generally underutilized, except for psychoeducation and lifestyle recommendations, and cognitive behavioural therapy for treatment of the prodromal phase. Contrary to guidelines, cognitive remediation and physical exercise for cognitive symptoms were significantly neglected. CONCLUSIONS:These discrepancies highlight the need for effective implementation strategies to bridge the gap between research evidence, clinical guidelines/guidance papers, and real-world clinical practice. Clinicians' unique combination of knowledge and experience positions them to shape future guidelines, especially where real-world practice diverges from recommendations, reinforcing the need to integrate both research evidence and clinical consensus.

08.05.2024: Debatt - Rapporten fra Statsforvalteren i Vestland etter at tvillingene Mina og Mille døde er sjokkerende lesning om et system som ikke er i stand til å ta vare på de mest utsatte menneskene i landet vårt.

BACKGROUND:Meaning in life is important to achieve quality of life, psychological well-being and good mental health. Existential issues such as meaning in life have limited attention in mental health care and treatment for children and young people in Norway. People in crisis often ponder existential questions. We find little research on this topic in relation to therapists who work with adolescents with developmental trauma. The purpose of this study was to examine how meaning in life is understood and addressed from the perspectives of therapists working with adolescents struggling with trauma.METHOD:The study has a qualitative design, based on focus groups with therapists in mental health care for children and adolescents. The interviews were transcribed and analyzed using systematic text condensation.RESULTS:Therapists had limited professional experience and competence to address and explore meaning as a topic in therapy. Yet there was interest in the topic and they thought that young people with trauma experience may benefit from the incorporation of meaning perspectives into therapy.CONCLUSION:Therapists at a mental health outpatient clinic for children and adolescents found the topic of meaning important but challenging to involve in the treatment of adolescents with developmental trauma. There is a need for more research to enhance understanding of what it means to include meaning as a topic in child and adolescent psychiatry, and what may be the specific benefit and challenges involved.