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ABSTRACTThe Indigenous Sámi have poorer mental health than the majority population and fairly equal access to professional mental healthcare. Despite this condition, certain studies indicate that this group is underrepresented among the users of such services. Religion or spirituality (R/S) often influences mental health-service utilisation and satisfaction among other Indigenous peoples and ethnic minorities. Thus, this study examines the situation in Sámi-Norwegian areas. We utilised cross-sectional data from the population-based SAMINOR 2 Questionnaire Survey (2012; subsample n = 2,364; 71% non-Sámi) in mixed Sámi-Norwegian regions of Northern and Central Norway. We analysed the associations between R/S factors and past-year mental health-service utilisation and satisfaction among individuals reporting mental health problems, substance use, or addictive behaviours. Multivariable-adjusted regression models considering sociodemographic factors, including Sámi ethnicity, were applied. Religious attendance was significantly associated with infrequent past-year use of mental health services (OR = 0.77) and fewer mental health problems, indicating that the R/S fellowship may buffer mental distress and represent an alternative psychological support to professional services. R/S was not significantly associated with lifetime mental health-service satisfaction. We found no ethnic differences in service utilisation or satisfaction.

Background: Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality. Methods: This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows follow-up of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60–99 (53% women). Primary outcome measures: Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. Predictor: Average weekly alcohol consumption (non-drinker, < 100 g/week, ≥100 g/week). We fitted two-level logistic random effects models to examine how alcohol consumption was related to SRH, and Cox proportional hazards models to examine its relation to all-cause mortality. Both models were stratified by sex and adjusted for sociodemographic factors, pathology, biometrics, smoking and physical activity. In addition, all the confounders were examined for whether they moderate the relationship between alcohol and the health-related outcomes through interaction analyses. Results: We found that women who consumed ≥100 g/week had better SRH than those who consumed < 100 g/week; OR 1.85 (1.46–2.34). This pattern was not found in men OR 1.18 (0.99–1.42). We identified an equal mortality risk in both women and men who exceeded 100 g/week compared with those who consumed less than 100 g/week; HR 0.95 (0.73–1.22) and HR 0.89 (0.77–1.03), respectively. Conclusions: There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100 g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specific risk factors in combination with the highest level of alcohol consumption led to adverse effects on self-rated health. In men it was the use of sleeping pills or tranquilisers and ≥ 20 years of smoking, in women it was physical illness and older age.

Medical advice does not necessarily concur with what the patient wants. Difference in opinion between the physician and the patient may be due to poor communication, but also different goals and views of health. This is a general problem. This article focuses on the basis for cooperation between doctor and patient with regard to use of anti-psychotic drugs. The question is whether the concept of compliance recognizes and takes in the complexity connected to use of anti-psychotic drugs. The concept of concordance, on the other hand, focuses consultation and cooperation. The question is whether this is feasible with regard to treatment of psychosis.Compliance depends on what the patients actually thinks or believes about the medication regardless the opinions are in fact true or not. We argue that patient opinions and experience will be crucial in understanding how patients choose to act. Consequently, we need a concept that emphasizes treatment goals and intentions of the patients. This also necessitates a need to investigate patient attitudes about anti-psychotic drugs.

ABSTRACTGiven the higher suicide rates among the adult population in the northernmost part of Norway and some unfavourable psychosocial outcomes associated with the Laestadian revival movement in this region, it is reasonable to investigate the relationship between religiosity/spirituality and suicidal behaviour in this context. This study used cross-sectional data from the population-based SAMINOR 2 questionnaire survey (2012; n= 11,222; 66% non-Sámi; 22% Laestadian-affiliated; 27% response rate) in mixed Sámi-Norwegian areas of Mid and North Norway. We analysed the associations between religious/spiritual factors and lifetime suicidal ideation and attempts, age at the first attempt, motives, and number of attempts. Multivariable-adjusted regression models considering sociodemographics, Sámi background and self-ascription, and health-related risk factors were applied. Sámi and Laestadian affiliations were significantly associated with religious self-ascription, regular attendance, and Established Church membership. In a fully adjusted model, Laestadian family background was negatively associated with lifetime suicide attempts (OR = 0.66, 95% CI: 0.47–0.93) compared with other family circumstances, whereas regular religious participation was inversely associated with suicide ideation (OR = 0.74, 95% CI: 0.61–0.91) compared with non- or rare attendance. The findings suggest that Laestadianism and religious attendance contribute to less suicidal behaviour among adults in Sámi-Norwegian areas.