title: The influence of long-term awareness of hyperlipidemia and of 3 years of dietary counseling on depression, anxiety, and quality of life.
abstract: OBJECTIVE
  The purpose of this study is to investigate the long-term effects of participation in a cardiovascular screening program and of dietary counseling on self-reported psychosocial outcomes and health concerns.
  
  
  METHODS
  High-risk subjects (n=563) with hyperlipidemia from the Oslo Diet and Antismoking Study (1972-1977) were reexamined after 25 years and randomly assigned to a new 3-year prospective 2x2 factorial placebo-controlled study in 1997 of n-3 polyunsaturated fatty acids and/or dietary counseling. Hospital Anxiety and Depression Scale (HADS), Life Satisfaction Index (LSI), and a new questionnaire on health concerns and behavior in response to risk information were collected at the 25-year follow-up. Hospital Anxiety and Depression Scale and LSI were evaluated at the end of the 3-year Diet and Omega-3 Intervention Trial on atherosclerosis (DOIT) in 505 subjects.
  
  
  RESULTS
  Twenty-five years after the screening program, HADS-anxiety was similar to the Norwegian norms (3.3 vs. 3.5), while HADS-depression was significantly lower (3.6 vs. 4.1, P<.01). Patients reported that 25 years of awareness of hyperlipidemia had influenced health concerns through a moderate change in diet habits, some restriction in life conduct, but an improvement of the total life situation. After a novel 3-year intervention in DOIT, there was no difference between the dietary counseling and control group with regard to anxiety, depression, or life satisfaction, but HADS-anxiety increased significantly (4.0 vs. 3.3, P<.001) in both groups.
  
  
  CONCLUSIONS
  Compared to the general population, screening-positive subjects did not have increased mental distress 25 years after screening, and beneficial health behavior persisted. Dietary counseling did not affect psychosocial outcomes.
authors.affiliation: Division of Medicine, Akershus University Hospital, Lorenskog, Norway; Department of Behavioural Science, University of Oslo, Oslo, Norway. gunnar.einvik@medisin.uio.no
authors.forename: Gunnar
authors.initials: G
authors.lastname: Einvik
authors.forename: Oivind
authors.initials: O
authors.lastname: Ekeberg
authors.forename: Jorgen Glatved
authors.initials: JG
authors.lastname: Lavik
authors.forename: Ingrid
authors.initials: I
authors.lastname: Ellingsen
authors.forename: Tor Ole
authors.initials: TO
authors.lastname: Klemsdal
authors.forename: Elsa M
authors.initials: EM
authors.lastname: Hjerkinn
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D050197:Atherosclerosis / Q000178:diet therapy / Q000523:psychology; D001294:Attitude to Health; D001364:Awareness; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D018752:Diet, Fat-Restricted / Q000523:psychology; D004038:Diet, Reducing / Q000523:psychology; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005247:Feeding Behavior / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy* / Q000523:psychology*; D008019:Life Style; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009664:Norway; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D016540:Smoking Cessation; D011795:Surveys and Questionnaires
chemical_list: D015525:Fatty Acids, Omega-3