Reidar Tyssen

• Bache-Mathiesen, Lena Kristin; Moum, Torbjørn; Tyssen, Reidar & Breivik, Jarle (2026). Medical students admitted solely by grade point average show a narrow but highly prosocial personality profile. BMC Medical Education. 26. doi: 10.1186/s12909-026-09929-7. Full text in Research Archive Show summary

  Background The distribution of students’ personality traits may indicate whether an admission system selects candidates suited to medical practice. While many countries use multi-step selection procedures, Norwegian medical schools admit students based solely on upper-secondary school grade point averages (GPA). We primarily aimed to characterise the personality profiles of medical students at the University of Oslo, and then compare them with previous studies of the Norwegian general population and medical students from systems in countries using alternative admission models. Methods We conducted an observational study of newly admitted medical students, 2022–2026 (mean age = 22.1 years, SD = 4.2; 68% female). Personality was assessed using the Big Five Inventory (BFI; five cohorts, n = 535, response rate (RR) = 89%) and the Myers–Briggs Type Indicator (MBTI; six cohorts, n = 632, RR = 95%). BFI scores were compared with available historical data: general Norwegian workers, German final-year, and French first‑ and third‑year medical students using one‑sample t‑tests. MBTI types were compared with previous studies on U.S. and South Korean medical students and the Norwegian general population using chi-squared tests. Results Norwegian medical students scored significantly higher than Norwegian workers on all BFI dimensions (p < 0.001). They also scored higher in Agreeableness than German final-year and French first- and third-year students (4.33 vs 4.17, 3.80 and 3.60, respectively) and lower in Neuroticism (2.50 vs. 2.85, 3.00 and 3.00; all p < 0.001). Norwegian students’ MBTI personality-type distribution differed significantly from the Norwegian general population and U.S. and South Korean medical students (p < 0.001). Most students were Judging (78%) and Extraverted (70%), with ENFJ the most frequent personality type among women (29%) and ENTJ among men (25%). Conclusions Medical students admitted through the Norwegian GPA-only admission system at UiO demonstrated high Agreeableness and Conscientiousness, with a marked overrepresentation of ENFJ women and ENTJ men. These findings indicate a consistently prosocial and structured, but relatively narrow, personality profile. While this profile includes interpersonal and organisational characteristics that may be relevant to clinical practice, the observed distribution also raises questions about limited diversity in personality type distribution and gender-related patterns in recruitment to medical education.

• Oftung, Bendik & Tyssen, Reidar (2024). Occupational stress among Norwegian physicians: A literature review of long-term prospective studies 2007–2019. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948241243164. Full text in Research Archive Show summary

  Aims: There are signs of increased stress at work among Norwegian physicians over the last decades, not least among general practitioners (GPs). In this review, we identify trends in both occupational stress and adverse work-related predictors of such stress and burnout in Norwegian physicians. Methods: We performed an extensive literature search using MEDLINE, Embase and PsycINFO. We included prospective and repeated cross-sectional studies of work stress among Norwegian physicians published in 2007–2019. Results: Nine studies with observation periods of 1–20 years were included. Occupational stress (global measure) among all doctors decreased gradually from medical school to 20 years later. The prevalence of an effort–reward imbalance increased fourfold among GPs during the period 2010–2019. Five studies reported higher levels of occupational stress among female physicians than among their male colleagues. Work–home conflict levels increased after graduation until 10 years after leaving medical school and plateaued thereafter. Physicians who graduated in a later cohort reported lower levels of work–home conflict and less workplace violence. Work–home conflict, low colleague support, number of work hours and workload/low autonomy were all independent predictors of occupational stress. Conclusions: The reduction in occupational stress during the years after leaving medical school may result from increased competency in clinical work and decreased on-call work. The Co-ordination Act implemented in 2012 may explain the increase in occupational stress among GPs. These findings suggest that both reducing work–home conflict and increasing colleague support are important for doctors’ well-being.

• Sandbu, Morten; Javo, Anne Cecilie; Thapa, Suraj Bahadur; Rø, Karin Elisabet Isaksson; Preljevic, Valjbona & Tyssen, Reidar (2024). Perceived clinical challenges when treating patients from different cultures: A study among psychiatry trainees in Norway. Transcultural Psychiatry. ISSN 1363-4615. p. 1–11. doi: 10.1177/13634615241296297. Full text in Research Archive Show summary

  The growing number of migrant patients in western countries calls for better cross-cultural competence among health providers. As workplaces, hospitals have become increasingly multicultural, and many doctors are themselves of foreign origin, including psychiatrists. The aims of this study were to explore what clinical challenges International Medical Graduates (IMGs) and native-born Norwegian doctors training in psychiatry perceived when treating patients from other cultures, and what factors might be associated with such cross-cultural challenges. We developed a six-item inventory of perceived cross-cultural clinical challenges (PCC), to assess what cross-cultural problems trainees in psychiatry found most challenging. The PCC was completed by 216 trainees who also reported on individual- and work-related background factors. Comparisons of PCC between the two groups were done by one-way analysis of variance, and associations between PCC and background factors were analyzed by linear multiple regression. The overall response rate was 93%. Native -born Norwegian doctors reported higher levels of PCC than did IMGs. Both native-born Norwegian doctors and IMGs rated “assessing psychosis,” “assessing suicide risk,” and “lacking tools in cross-cultural consultations” as the most demanding challenges in cross-cultural consultations. Independent factors associated with higher PCC included being a native-born Norwegian doctor and experiencing high levels of work–home conflict. The findings suggest that trainees in psychiatry may need more training and better tools in cross-cultural assessment of mental disorders. Possible differences in PCC between native-born doctors and IMGs should be taken into consideration when developing mentoring programs, as should the doctors’ work–home conflict level, which might impact the PCC.

• Dalum, Helene Seljenes; Tyssen, Reidar; Moum, Torbjørn; Thoresen, Magne & Hem, Erlend (2024). Euthanasia of animals – association with veterinarians’ suicidal thoughts and attitudes towards assisted dying in humans: a nationwide cross-sectional survey (the NORVET study). BMC Psychiatry. 24(2). doi: 10.1186/s12888-023-05402-7. Full text in Research Archive Show summary

  Background Veterinarians are an occupational group with an increased suicide risk. Euthanasing animals may influence both veterinarians’ views on assisted dying in humans and their suicide risk. We investigated (I) attitudes towards assisted dying, (II) whether the field of work and the frequency of euthanasing animals were associated with positive attitudes towards human euthanasia, and (III) whether frequently euthanasing animals was associated with serious suicidal thoughts. Methods We conducted a nationwide cross-sectional study among veterinarians in Norway (response rate: 75%). Logistic regression models were used to calculate the odds ratios for both positive attitudes towards human euthanasia and serious suicidal thoughts. The analyses were adjusted for socio-demographic and work-related factors. Results Fifty-five percent of the veterinarians agreed that euthanasia should be permitted for humans with a fatal disease and short life expectancy. Working with companion animals was independently associated with positive attitudes towards human euthanasia (OR = 1.66 (95% CI: 1.23–2.23)), while veterinarians’ frequency of euthanasing animals was not. Frequency of euthanasing animals was independently associated with serious suicidal thoughts, OR = 2.56 (95% CI: 1.35–4.87). Conclusions Veterinarians’ attitudes towards assisted dying in humans did not differ from those of the general population. Veterinarians’ frequency of euthanasing animals was not associated with positive attitudes towards euthanasia in humans. However, veterinarians working in companion animal practices were more likely to have positive attitudes towards euthanasia in humans. Moreover, euthanising animals five times or more a week was associated with serious suicidal thoughts. We need more research to infer about causality in these findings.

• Dalum, Helene Seljenes; Tyssen, Reidar; Moum, Torbjørn Åge; Thoresen, Magne & Hem, Erlend (2022). Professional help-seeking behaviour for mental health problems among veterinarians in Norway: a nationwide, cross-sectional study (The NORVET study). BMC Public Health. 22. doi: 10.1186/s12889-022-13710-y. Full text in Research Archive Show summary

  Background Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway. Method This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress). Results The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24–3.60), working with production animals, OR = 0.35 (0.13–0.98), public administration, OR = 2.27 (1.15–4.45), academia/research, OR = 4.78 (1.99–11.47) or ‘other’ fields, OR = 2.79 (1.23–6.32), and attitudes toward mental illness, OR = 1.32 (1.03–1.68). Conclusions Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and ‘other’ field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.

• Dalum, Helene Seljenes; Tyssen, Reidar & Hem, Erlend (2022). Prevalence and individual and work-related factors associated with suicidal thoughts and behaviours among veterinarians in Norway: a cross-sectional, nationwide survey-based study (the NORVET study). BMJ Open. 12(1). doi: 10.1136/bmjopen-2021-055827. Full text in Research Archive Show summary

  Objectives Several studies have shown increased suicide rates among veterinarians. We investigated the self-reported prevalence of suicidal thoughts and behaviours and contributing and independent factors associated with suicidal thoughts and behaviours among veterinarians in Norway. Design Cross-sectional, nationwide survey. Participants 2596 veterinarians in Norway (response rate: 75%). Main outcome measure Paykel’s five-item questionnaire. Results In total, 27% (n=682/2567) of veterinarians in Norway felt that life was not worth living during the last year, 5% (n=139/2562) had serious suicidal thoughts, and 0.2% (n=6/2537) had attempted suicide. Female veterinarians reported significantly higher prevalence of suicidal feelings and thoughts than males. For serious suicidal thoughts, women had nearly twice the prevalence as their male colleagues (6.2% (n=108/1754) vs 3.6% (n=28/766), χ2: 6.5, p=0.011). Independent factors associated with serious suicidal thoughts were being single (OR 1.76, 95% CI 1.13 to 2.72, p<0.05), negative life events (OR=1.43, 95% CI 1.22 to 1.68, p<0.001) and the presence of mental distress (OR 2.75, 95% CI 2.14 to 3.52, p<0.001). The veterinarians related their serious suicidal thoughts to work and personal problems, and a lesser degree to family, social and other problems. Nearly twice as many women (53%, n=57/108) as men (28%, n=7/25) reported work problems as the most important contributing factor to their serious suicidal thoughts (χ2: 4.99, p=0.03). 4% (n=6/139) reported work problems as the only factor of importance. Conclusions Veterinarians in Norway have relatively high prevalence of suicidal feelings and thoughts, including serious suicidal thoughts. In multivariable analyses, the individual factors were more important than work-related ones, while work problems were the most reported contributing factor to serious suicidal thoughts by the veterinarians themselves. The role of gender and specific work-related factors should be further investigated to better understand the complexity of suicidal behaviour among veterinarians. Data availability statement Data are available on reasonable request. http://creativecommons.org/licenses/by-nc/4.0/

• Mangory, Kashan Yasin; Ali, Lavin Yadgar; Rø, Karin Elisabet Isaksson & Tyssen, Reidar (2021). Effect of burnout among physicians on observed adverse patient outcomes: a literature review. BMC Health Services Research. 21. doi: 10.1186/s12913-021-06371-x. Full text in Research Archive Show summary

  Background Physician burnout has potentially harmful effects for both physicians and their patients. Despite relationships between physician burnout and lowered patient satisfaction and clinician-rated adverse patient outcomes, there is scarce literature regarding effects on objective patient outcomes. This study aimed to examine the relationship between physician burnout and observed adverse patient outcomes via a review of the literature. Methods A search was performed on the MEDLINE, EMBASE and PsychINFO databases, using keywords and Medical Subject Headings. The identified studies were in English, published from 2007 to 2019, measured burnout among physicians using the Maslach Burnout Inventory (MBI), and included observed adverse patient outcomes. In total, 360 eligible articles were identified, and 11 were included in the final review. All included studies measured patient outcomes by observed clinical measures (e.g. quality of care and medical errors). Results Four studies found a clear significant relationship between physician burnout and observed adverse patient outcomes, while 6 did not. One study found a significant relationship with one of the MBI subscales. Burnout was, in contrast to depression, only partly associated with observed patient outcomes. Conclusions This review illustrates the need for a validation of physician burnout measured by MBI with respect to observed patient outcomes. Further studies are required to investigate the effects of physician burnout on observed quality of their patient care.

• Rostad, Ingrid Steen; Tyssen, Reidar & Løvseth, Lise (2021). Symptoms of disturbed eating behavior risk: Gender and study factors in a cross-sectional study of two Norwegian medical schools. Eating Behaviors. ISSN 1471-0153. 43. doi: 10.1016/j.eatbeh.2021.101565. Full text in Research Archive Show summary

  Objectives: To study the explanatory role of curricular factors and distress in disturbed eating behavior among medical students and whether this varies according to gender, study stage, curriculum model, study stress and mental distress. Methods: The cross-sectional sample surveyed consisted of Norwegian medical students at two faculties with different curricular models (traditional and integrated). The total response rate was 64% (1044/1635). We tested differences in disturbed eating behavior symptoms (EDS) and their correlates using stepwise linear regression analysis. Results: In total, 18.3% were cases of disturbed eating behavior symptoms, including 23.5% of female and 5.6% of male participants. Disturbed eating behavior symptoms were independently associated with the medical school stress factors “medical school is cold and threatening” (β = 0.07, p = .041), “worries about work and competence” (β =0.15, p < .001) and “worries about finances and accommodation” (β = 0.07, p = .018), in addition to female gender (β = 0.30, p < .001), mental distress (β = 0.17, p < .001), and body mass index (β = 0.28, p < .001). The variables explained 28.9% of the variance in disturbed eating behavior symptoms, and medical school stress contributed 9%. “Worries about work and competence” was more important among the female students. Conclusions: Nearly one in five female medical students in the current sample reported symptoms of disturbed eating behavior. The symptoms were associated with medical school stress factors, mental distress, and body mass index.

• Nøland, Sara Julie Maria Tellefsen; Taipale, Hildegunn; Mahmood, Javed Iqbal & Tyssen, Reidar (2021). Analysis of Career Stage, Gender, and Personality and Workplace Violence in a 20-Year Nationwide Cohort of Physicians in Norway. JAMA Network Open. 4(6), p. 1–12. doi: 10.1001/jamanetworkopen.2021.14749. Full text in Research Archive Show summary

  Importance Workplace violence (WPV) is a worldwide problem in health services. Several studies have pointed to organizational factors, such as working in psychiatry and work stress. However, there is a lack of long-term longitudinal cohort studies with respect to trends during the career and individual factors among physicians. Objective To investigate WPV trends during Norwegian physicians’ careers and assess individual and work-related factors associated with WPV in a long-term longitudinal study. Design, Setting, and Participants This cohort study involved 2 nationwide medical student cohorts who graduated 6 years apart and were surveyed at graduation (T1: 1993-1994 and 1999) and 4 years later (T2), 10 years later (T3), 15 years later (T4), and 20 years after graduation (T5). Generalized estimated equations were used. Statistical analysis was performed from January to September 2020. Exposures Medical career during 20 years in Norway. Main Outcomes and Measures WPV was measured as threats or acts of violence from a patient or visitor experienced at least twice, at each of the stages after leaving medical school. Individual factors were obtained at T1 and work-related factors at T2 through T5. We analyzed WPV by repeated measures. Results At T1, a total of 893 participants (with a mean [SD] age of 28 (2.83) years; 499 [56%] women) responded to the questionnaire. The prevalence of multiple threats of violence was 20.3% (156 of 769) at T2, 17.1% (118 of 691) at T3, 11.2% (66 of 588) at T4, and 8.6% (46 of 536) at T5; and the prevalence of multiple acts of violence was 4.3% (33 of 763) at T2, 5.2% (36 of 687) at T3, 3.1% (18 of 584) at T4, and 2.2% (12 of 532) at T5. There was a decline from T2 to T5 of both multiple threats (β = −1.06; 95% CI, −1.31 to −0.09; P < .001) and acts of violence (β = −1.13; 95% CI, −1.73 to −0.53; P < .001). In adjusted analysis, factors associated with multiple threats of violence were male gender (odds ratio [OR], 2.76; 95% CI, 1.73 to 4.40; P < .001), vulnerability trait (neuroticism) (OR, 0.90; 95% CI, 0.82 to 0.99; P = .03), young physician cohort (OR, 1.63; 95% CI, 1.04 to 2.58; P = .04), and working in psychiatry (OR, 7.50; 95% CI, 4.42 to 12.71; P < .001). Factors associated with multiple acts of violence in adjusted analysis were male gender (OR, 3.37; 95% CI, 1.45 to 7.84; P = .005), young physician cohort (OR, 6.08; 95% CI, 1.68 to 21.97; P = .006), and working in psychiatry (OR, 12.34; 95% CI, 5.40 to 28.23; P < .001). There were no interactions with gender or cohort in the significant associated factors. Conclusions and Relevance Higher rates of multiple threats and acts of violence were observed during early medical careers, among male physicians, and in psychiatry. Low levels of the vulnerability trait (neuroticism) were associated with the experience of multiple threats. There was an association between the young physician cohort and WPV. Preventive efforts should include early-career and male physicians, with additional emphasis on personality.

• Rø, Karin Elisabet Isaksson; Rosta, Judith; Tyssen, Reidar & Bååthe, Fredrik (2021). Doctors' Well-being, Quality of Patient Care and Organizational Change. In Montgomery, Anthony; Doef, Margot vand der; Panagopoulou, Efharis & Leiter, Michael P. (Ed.), Connecting Healthcare worker Well-being, Patient Safety and Organizational Change. Springer Nature. ISSN 9783030609986. p. 91–114. doi: 10.1007/978-3-030-60998-6_7. Full text in Research Archive
• Ruud, Nora; Løvseth, Lise T; Rø, Karin Elisabet Isaksson & Tyssen, Reidar (2020). Comparing mental distress and help-seeking among first-year medical students in Norway: results of two cross-sectional surveys 20 years apart. BMJ Open. 10. doi: 10.1136/bmjopen-2020-036968. Full text in Research Archive Show summary

  Objective: To investigate any changes in mental distress levels over 20 years among medical students, as well as the clinical importance of these changes. Design: Two cross-sectional surveys 20 years apart. Setting: The surveys were performed at two Norwegian medical faculties in 1993 and 2015. Participants: One hundred and seventy-four first- year medical students in 1993 were compared with 169 students in 2015. Main outcome measures: Mental distress (Hopkins Symptom Checklist 5) and Mental Health Problems in Need of Treatment. Results: Mental distress increased from 1993 to 2015 (p<0.001) due to a larger increase among female students, which seemed to be of clinical importance (Cohen’s d=0.63). There was a significant gender difference in mental distress in 2015 (p=0.007), but not in 1993. Independent factors associated with mental distress in 2015 were female sex (p<0.001), low perceived social support from parents (p=0.023) and low perceived social support from other friends (p=0.048). Additional analyses showed that social support from friends was more important for female students than for their male peers. From 1993 to 2015, there was no significant increase in the proportion of female students reporting previous mental health problems in need of treatment (21.3% vs 27.8%), but we found a significant increase in help-seeking among those in need of treatment over these years from 30.0% (6/20) to 74.3% (26/35; p=0.003). Conclusions: We found a significant increase in mental distress among female medical students over the past 20 years, but also a promising increase in help-seeking among those in need of treatment. The strong and important association between low social support and mental distress should urge both universities and students to maintain students’ social life after entering medical school.

• Gude, Tore; Tyssen, Reidar; Anvik, Tor; Grimstad, Hilde; Holen, Are & Baerheim, Anders [Show all 8 contributors for this article] (2020). Have medical students’ attitudes towards clinical communication skills changed over a 12- year period? A comparative long-term study. BMC Medical Education. 20(11), p. 1–7. doi: 10.1186/s12909-019-1915-1. Full text in Research Archive Show summary

  Background Attitudes towards learning clinical communication skills at the end of medical school are likely to reflect the students’ training and motivation for the continued development of their skills as doctors. Students from two Norwegian medical schools, one with a traditional, and the other with an integrated curriculum, were approached in 2003 and 2015; with regard to changes in students’ attitudes towards acquiring communication skills in two diverse learning environments. This comparison might reveal the effects of the training programs from a long-term perspective, as neither of the medical schools made any major curriculum changes within the study period. Methods The samples comprised final-year medical students. Two separate cross-sectional surveys performed 12 years apart (2003 and 2015) used items from the Communication Skills Attitude Scale in addition to age and gender. The traditional curriculum included only theoretical teaching and no contact with patients was made during the first 2 to 2.5 years of medical school. However, the integrated curriculum combined training in theoretical and clinical communication skills with early patient contact from the beginning. Results Attitudes improved from the first to the second survey at both schools, however, students from the integrated school reported more positive attitudes than those from the traditional school. Female students from the integrated school contributed the most to the difference in attitudes in both surveys. Conclusions Students in both traditional and integrated curricula improved their attitudes from the first to the second assessment. However, compared with the traditional curriculum, the integrated one fostered even higher levels of positive attitudes towards acquiring communication skills, and a pronounced influence was observed on female students. These findings suggest that an educational program with greater emphasis on improving attitudes among male students may be required.

• Sletta, Christian; Tyssen, Reidar & Løvseth, Lise T (2019). Change in subjective well-being over 20 years at two Norwegian Medical Schools and factors linked to well-being today: a survey. BMC Medical Education. 19:45, p. 1–12. doi: 10.1186/s12909-019-1476-3. Full text in Research Archive Show summary

  Background There is a lack of studies on factors in the curriculum, study environment and individual differences that can promote well-being among medical students as a response to the frequent reports on the negative health effects of study demands among medical students worldwide. Objective This study investigates differences in well-being among today’s Norwegian medical students compared with students 20 years ago, the most important predictors of well-being today, and whether there have been any changes in the levels of some of these factors since the period analysed. Methods We analysed cross-sectional survey data among all medical students (63.9%, N = 1044/1635) at two medical faculties with different curriculums (traditional and integrated) in Norway in 2015 (STUDMED 2015). We used comparison data from a longitudinal survey among medical students from the same medical faculties in 1993 to 1999: the NORDOC project (T1 = 89%, T2 = 72% and T3 = 68%). Differences in subjective well-being and correlates by demographic, curriculum, and study environment factors among the present students were tested by t-tests and stepwise linear regression analysis. Results Students today scored lower on their levels of subjective well-being than students 20 years ago. The difference was found among female and males in different study stages. The final model showed that subjective well-being today was associated with self-esteem (β = .98, p < .001) and social support from medical school friends (β = .22, p < .001), a partner (β = .08, p = .020) or other family members (β = .04, p = .041), as well as perception of medical curriculum and environment (β = −.38, p < .001), personal competence (β = −.40, p < .001), finance/accommodation (β = −.22, p < .001) and perceived exam stress (β = −.26, p < .001). Conclusions The results show a decrease in subjective well-being among medical students and, in particular, among female students. The faculties should pay attention to the factors identified in the study environment and curriculum associated with subjective well-being in order to promote their student’s well-being and stimulate health and academic performance.

• Hertzberg, Tuva Kolstad; Tyssen, Reidar; Skirbekk, Helge & Rø, Karin Elisabet Isaksson (2019). Work-home balance in two cohorts of Norwegian doctors. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.18.0339. Full text in Research Archive
• Hertzberg, Tuva Kolstad; Tyssen, Reidar; Skirbekk, Helge & Rø, Karin Elisabet Isaksson (2019). Jobb-hjem-balanse i to kohorter av norske leger. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(10). doi: 10.4045/tidsskr.18.0339. Full text in Research Archive
• Mahmood, Javed Iqbal; Grotmol, Kjersti Støen; Tesli, Martin Steen; Moum, Torbjørn Åge; Andreassen, Ole Andreas & Tyssen, Reidar (2019). Life satisfaction in Norwegian medical doctors: a 15-year longitudinal study of work-related predictors. BMC Health Services Research. 19:729, p. 1–10. doi: 10.1186/s12913-019-4599-7. Full text in Research Archive Show summary

  Background Despite many recent studies on burn-out and dissatisfaction among American medical doctors, less is known about doctors in the Scandinavian public health service. The aims of this study were to analyse long-term work-related predictors of life satisfaction among established doctors in Norway and to identify predictors in a subgroup of doctors who reported a decline in life satisfaction. Methods Two nationwide cohorts of doctors (n = 1052), who graduated medical school 6 years apart, were surveyed at graduation from medical school (T1, 1993/94 and 1999), and 4 (T2), 10 (T3), and 15 (T4) years later. Work-related predictors of life satisfaction (three items) obtained at T2 to T4 were analysed. Individual and lifestyle confounders were controlled for using mixed-models repeated-measures analyses, and logistic regression analyses were applied to identify predictors of the decrease in life satisfaction. Results Ninety per cent (947/1052) responded at least once, and 42% (450/1052) responded at all four times. Work-related predictors of higher life satisfaction in the adjusted model were work–home stress (β = − 0.20, 95% confidence interval [CI] = − 0.25 to − 0.16, p < 0.001), perceived job demands (β = − 0.10, CI = − 0.15 to − 0.05, p < 0.001), and colleague support (β = 0.05, CI = 0.04 to 0.07, p < 0.001). The new adjusted individual predictors that we identified included female gender, reality weakness trait, and problematic drinking behaviour. Neuroticism trait and low colleague support predicted a decrease in life satisfaction. Conclusions Work–home stress, perceived job demands, and colleague support were the most important predictors of life satisfaction related to doctors’ work. When personality traits were controlled for, female doctors were more satisfied with their life than male doctors. These findings suggest that improving work-related factors with targeted interventions, including a supportive work environment, may increase life satisfaction among doctors.

• Solhaug, Ida; Vibe, Michael F. De; Friborg, Oddgeir; Sørlie, Tore; Tyssen, Reidar & Bjørndal, Arild [Show all 7 contributors for this article] (2019). Long-term mental health effects of mindfulness training: a 4-year follow-up study. Mindfulness. ISSN 1868-8527. 10(8), p. 1661–1672. doi: 10.1007/s12671-019-01100-2. Full text in Research Archive Show summary

  <i>Objectives</i> - Mindfulness-based stress reduction (MBSR) enhances short-term psychological health in clinical and non-clinical samples, whereas studies examining long-term effects are scarce. This study examined whether the effects of a 7-week MBSR programme on mental health persisted at 2- and 4-year follow-up and explored possible mechanisms of effect.<p> <p><i>Methods</i> - In a two-site randomised controlled trial, 288 medical and psychology students were allocated to an MBSR intervention (n = 144) or a no-treatment control group (n = 144). During the 4-year follow-up period, the MBSR group was offered 90-min booster sessions semi-annually. The primary outcome measures were mental distress (General Health Questionnaire (GHQ)) and subjective well-being (SWB); these were measured at baseline (T0) and post-intervention follow-up at 1 month (T1), 2 years (T1) and again at 4 years (T3). Secondary outcomes included coping, mindfulness and meditation practice.<p> <p><i>Results</i> - At 4-year follow-up, the MBSR group showed significantly better scores on mental distress, mindfulness, avoidance coping and problem-focused coping (Cohen’s d = 0.23–0.42). Meditation practice positively predicted long-term mindfulness scores. Short-term effects in mindfulness scores mediated long-term intervention effects in mental distress and coping. However, reversed mediation was also observed (i.e. changes in outcome mediating long-term mindfulness scores), and this indicates that initial changes in outcome and mindfulness are intrinsically intertwined and may both influence long-term effects. Small post-intervention effects on well-being and seeking social support did not persist at follow-up.<p> <p><i>Conclusions</i> - MBSR fostered enduring effects on mental distress and coping in medical and psychology students 4 years post-intervention.

• Tyssen, Reidar (2019). Work and mental health in doctors: A short review of Norwegian studies. Porto Biomedical Journal. ISSN 2444-8664. 4(5), p. 1–3. doi: 10.1097/j.pbj.0000000000000050. Full text in Research Archive
• Belfrage, Anna; Grotmol, Kjersti Støen; Tyssen, Reidar; Moum, Torbjørn Åge; Finset, Arnstein & Rø, Karin Isaksson [Show all 7 contributors for this article] (2018). Factors influencing doctors' counselling on patients' lifestyle habits: a cohort study. British Journal of General Practice Open. 2(3), p. 1–12. doi: 10.3399/bjgpopen18X101607. Full text in Research Archive Show summary

  Background Lifestyle changes are important for prevention and treatment of many common diseases, and doctors have an important role in the lifestyle counselling of patients. It is important to know more about factors influencing lifestyle counselling. Aim To investigate the frequency of counselling about physical activity compared to that about alcohol habits; the impact of doctors’ own physical activity and alcohol habits on patient counselling about these lifestyle dimensions; and whether perceived mastery of clinical work or vulnerable personality have a confounding or moderating effect on these associations. Design & setting In this nationwide cohort survey, a total of 978 doctors in Norway were surveyed by postal questionnaires in 1993/94 and 2014. The response rate was 562/978 (57%). Method The outcome variables were questions on frequency of asking about alcohol and exercise habits. Explanatory variables were questions on doctors’ own exercise habits, drinking habits (using Alcohol Use Disorders Identification Test [AUDIT]), perceived mastery of clinical work, vulnerable personality, and specialty. Associations were studied by linear regression analysis. Results Of the 526 responders, 307 (58%) reported asking usually/often about exercise habits, while n = 140/524 (27%) usually/often asked about alcohol habits. A doctor's own physical activity level was associated with frequency of asking about physical activity (unstandardised regression coefficient [B] = 0.07; 95% confidence intervals [CI] = 0.01 to 0.13). There were no significant associations between doctors' own lifestyle habits and counselling on alcohol habits. Doctors with low levels of vulnerability asked more frequently about physical activity, regardless of their own physical activity habits (F = 2.41, P = 0.048). Conclusion Doctors’ own lifestyles influenced their preventive counselling about physical activity, but not about alcohol. Vulnerability moderated these effects, indicating the importance of early interventions to help doctors with a vulnerable personality to handle negative criticism from patients

• Belfrage, Anna; Grotmol, Kjersti Støen; Tyssen, Reidar; Moum, Torbjørn Åge & Lien, Lars (2018). Factors associated with low vs increased perceived mastery of clinical work over ten years of practice: a prospective study of Norwegian doctors. BMC Medical Education. 18:116(116). doi: 10.1186/s12909-018-1236-9. Full text in Research Archive Show summary

  Background A higher sense of mastery of doctors’ clinical work could benefit not only their own mental health but also their work performance and patient care. However, we know little about factors associated with perceived mastery of clinical work among physicians. Our aim was therefore to study characteristics of those with stable low levels and of those with increased levels of mastery over a period of ten years of medical practice. Methods N = 631 doctors were surveyed in their final year of medical school in 1993/94 (T1) and 10 (T2), 15 (T3) and 20 (T4) years later. Low and increased perceived mastery of clinical work were measured between T2, T3 and T4. Response rates for all items measuring low and increased mastery were 238/522 (46%) and 256/522 (49%) respectively. The following explanatory variables were included: demographics, medical school factors, personality and contextual work-related and non-work-related factors. Results N = 73 (31%) of the doctors reported stable low mastery from T2 to T4. The following variables were significantly associated with low mastery in the adjusted analyses: vulnerability (OR: 1.30, P < .000, CI: 1.12 to 1.50), drinking alcohol to cope with stress during medical school (OR: 2.66, P = .04, CI: 1.03 to 6.85) and social support (OR: 0.78, P = .002, CI: 0.66 to 0.91). N = 39 (15%) reported increased mastery during the ten-year period from T2 to T4. Perceived job demands (OR: 0.66, P = .02, CI: 0.45 to 0.98) and taking up a leading position (OR: 3.04, P = .01, CI: 1.31 to 7.07) were associated with increased mastery after adjustment. Conclusions Stable low sense of mastery over time is associated with having a vulnerable personality, a history of having used alcohol to cope with stress during medical school and lack of contemporary social support. Conversely, increased sense of mastery is associated with taking up a leading position and having the perception that job demands are decreasing over time. These findings indicate that perceived mastery of clinical work may not be a trait, but a state modifiable over time

• Vibe, Michael F. De; Solhaug, Ida; Rosenvinge, Jan H; Tyssen, Reidar; Hanley, Adam & Garland, Eric (2018). Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; Results from a randomized controlled trial. PLOS ONE. 13(4). doi: 10.1371/journal.pone.0196053. Full text in Research Archive Show summary

  Longitudinal research investigating the enduring impact of mindfulness training is scarce. This study investigates the six-year effects of a seven-week mindfulness-based course, by studying intervention effects in the trajectory of dispositional mindfulness and coping skills, and the association between those change trajectories and subjective well-being at six-year follow-up. 288 Norwegian medical and psychology students participated in a randomized controlled trial. 144 received a 15-hour mindfulness course over seven weeks in the second or third semester with booster sessions twice yearly, while the rest continued their normal study curricula. Outcomes were subjective well-being, and dispositional mindfulness and coping assessed using the Five Facet Mindfulness Questionnaire and the Ways of Coping Checklist. Analyses were performed for the intention-to-treat sample, using latent growth curve models. At six-year follow-up, students receiving mindfulness training reported increased well-being. Furthermore, they reported greater increases in the trajectory of dispositional mindfulness and problem-focused coping along with greater decreases in the trajectory of avoidance-focused coping. Increases in problem-focused coping predicted increases in well-being. These effects were found despite relatively low levels of adherence to formal mindfulness practice. The findings demonstrate the viability of mindfulness training in the promotion of well-being and adaptive coping, which could contribute to the quality of care given, and to the resilience and persistence of health care professionals.

• Tyssen, Reidar (2017). Personality Traits. In Brower, Kirk J. & Riba, Michelle B. (Ed.), Physician Mental Health and Well-Being: Research and Practice (Integrating Psychiatry and Primary Care series). Springer. ISSN 9783319555829. p. 211–234. doi: 10.1007/978-3-319-55583-6. Full text in Research Archive
• Mahmood, Javed Iqbal; Grotmol, Kjersti Støen; Tesli, Martin Steen; Vaglum, Per Jørgen Wiggen & Tyssen, Reidar (2017). Contextual factors and mental distress as possible predictors of hazardous drinking in Norwegian medical doctors: a 15-year longitudinal nationwide study. European Addiction Research. ISSN 1022-6877. 23(1), p. 19–27. doi: 10.1159/000452442. Full text in Research Archive
• Belfrage, Anna; Grotmol, Kjersti Støen; Lien, Lars; Moum, Torbjørn Åge; Wiese, Ragna Veslemøy & Tyssen, Reidar (2017). Medical school predictors of later perceived mastery of clinical work among Norwegian doctors: a cohort study with 10-year and 20-year follow-up. BMJ Open. 7(9), p. 1–8. doi: 10.1136/bmjopen-2016-014462. Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Sullivan, Karen A.; Lyvers, Michael; Hurst, Cameron P & Tyssen, Reidar [Show all 10 contributors for this article] (2016). A Longitudinal Mediational Study on the Stability of Alexithymia among Alcohol-Dependent Outpatients in Cognitive-Behavioral Therapy. Psychology of Addictive Behaviors. ISSN 0893-164X. 30(1), p. 64–72. doi: 10.1037/adb0000135. Full text in Research Archive
• Hertzberg, Tuva Kolstad; Rø, Karin Elisabet Isaksson; Vaglum, Per Jørgen Wiggen; Moum, Torbjørn Åge; Røvik, Jan Ole & Gude, Tore [Show all 8 contributors for this article] (2016). Work-home interface stress: An important predictor of emotional exhaustion 15 years into a medical career. Industrial Health. ISSN 0019-8366. 54(2), p. 139–148. doi: 10.2486/indhealth.2015-0134. Full text in Research Archive
• Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw & Rø, Karin Elisabet Isaksson (2016). Dagens sykehuslege - fremdeles alltid på vakt. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 136(19), p. 1635–1638. doi: 10.4045/tidsskr.16.0067. Full text in Research Archive Show summary

  BAKGRUNN Norske sykehusleger fremholder verdien av å jobbe hardt og effektivt og ha stor grad av tilstedeværelse på jobb. Dette bidrar til å skape sosiale normer som virker styrende for atferd innen profesjonskulturen. Det er viktig å undersøke hvilke konsekvenser disse verdiene kan få, når legen også skal ivareta egne behov. MATERIALE OG METODE Vi gjennomførte åtte fokusgruppeintervjuer og tre individuelle intervjuer blant til sammen 48 overleger og leger under spesialisering, som jobbet innen kirurgi, psykiatri og indremedisin ved to ulike sykehus. Totalt N = 48, 56 % kvinner. Intervjuene ble analysert med systematisk tekstkondensering. RESULTATER Når norske sykehusleger ønsker å fremstå som gode leger, opplever de at det får konsekvenser for samspillet med legekollegiet, ledelsen og balansen mellom hjem og jobb. Interessekonflikter fremkom mellom overleger og leger i spesialisering. Ledelsesinitiativ for å håndtere fravær, livsfasetilpasning av legejobben og økt lederengasjement blant leger var tiltak som ble foreslått. FORTOLKNING Bedre gjensidig kunnskap mellom leger og ledelse om hverandres verdier og ansvarsområder vil være viktige premisser for å kunne gjøre strukturelle endringer, for eksempel bedre planlegging av fravær og mulighet for livsfasetilpasning i arbeidsplaner.

• Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw & Rø, Karin Elisabet Isaksson (2016). Den gode legen - sterk og utholdende. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 136(19), p. 1631–1634. doi: 10.4045/tidsskr.16.0066. Full text in Research Archive Show summary

  BAKGRUNN Legene i dagens samfunn møter mange kryssende interesser fra blant andre kolleger, pasienter og arbeidsgivere. Det er forsket mye på utvikling og regulering av den medisinske profesjonen. Imidlertid er det forsket mindre på legers egne opplevelser av hva det innebærer å være en god lege. MATERIALE OG METODE Vi gjennomførte åtte fokusgruppeintervjuer og tre individuelle intervjuer blant overleger og leger i spesialisering som jobbet innenfor kirurgi, psykiatri og indremedisin, ved to ulike sykehus. Totalt N = 48, 56 % kvinner. Intervjuene ble analysert med systematisk tekstkondensering. RESULTATER «Faglig dedikasjon» vist ved «høy grad av tilstedeværelse på jobb» og «stor arbeidskapasitet» var sentrale temaer for gode leger. Stor arbeidskapasitet ble definert som viljen til å strekke seg langt, jobbe overtid og jobbe effektivt. Overlegene opplevde det å være lege mer som en «livsstil», mens leger i spesialisering i større grad så på det som en «jobb». FORTOLKNING Norske sykehusleger ønsker å fremstå som faglig dedikerte. Dette kan de vise gjennom en sterk vilje til å jobbe hardt og effektivt med pasientarbeid og samtidig strekke seg langt for å være til stede utover regulær arbeidstid.

• Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw & Rø, Karin Elisabet Isaksson (2016). The good doctor–strong and persevering. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.16.0066. Full text in Research Archive
• Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw & Rø, Karin Elisabet Isaksson (2016). The hospital doctor of today – still continuously on duty. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.16.0067. Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Lyvers, Michael; Sullivan, Karen A.; Hasking, Penelope & London, Edyth D [Show all 9 contributors for this article] (2016). Alexithymia in relation to alcohol expectancies in alchol-dependent outpatients. Psychiatry Research. ISSN 0165-1781. 236, p. 186–188. doi: 10.1016/j.psychres.2016.01.016. Full text in Research Archive
• Aagestad, Cecilie; Tyssen, Reidar & Sterud, Tom (2016). Do work-related factors contribute to differences in doctor-certified sick leave? A prospective study comparing women in health and social occupations with women in the general working population. BMC Public Health. 16. doi: 10.1186/s12889-016-2908-1. Full text in Research Archive Show summary

  Background: Doctor –certified sick leave is prevalent in the health and social sector. We examined whether the higher risk of doctor-certified sick leave in women in health and social occupations compared to women in other occupations was explained by particular work-related psychosocial and mechanical risk factors. Methods: A randomly drawn cohort aged 18–69 years from the general population in Norway was surveyed in 2009 (n = 12,255, response at baseline = 60.9 %), and was followed up in the national registry of social transfer payments in 2010. Eligible respondents were women registered with an active employee relationship for ≥100 actual working days in 2009 and 2010 (n = 3032). Using this sample, we compared health and social workers (n = 661) with the general working population (n = 2371). The outcome of interest was long-term sick leave (LTSL) ≥21 working days during 2010. Eight psychosocial and eight mechanical factors were evaluated. Results: After adjusting for age, previous LTSL, education and working hours/week, women in health and social occupations had a higher risk for LTSL compared with women in the general working population (OR = 1.42, 95 % CI = 1.13–1.79; p = 0.003). After adjusting for psychosocial and mechanical factors, 70 % of the excess risk for LTSL was explained compared with the initial model. The main contributory factors to the increased risk were threats of violence and violence, emotional demands and awkward lifting. Conclusions: Psychosocial and mechanical factors explained much of the excess risk for LTSL in women in health and social occupations compared with working women in general. Psychosocial risk factors were the most important contributors.

• Vibe, Michael de; Solhaug, Ida; Tyssen, Reidar; Friborg, Oddgeir; Rosenvinge, Jan H & Sørlie, Tore [Show all 8 contributors for this article] (2015). Does Personality Moderate the Effects of Mindfulness Training for Medical and Psychology Students? Mindfulness. ISSN 1868-8527. 6(2), p. 281–289. doi: 10.1007/s12671-013-0258-y. Full text in Research Archive Show summary

  The majority of mindfulness research to date has reported only on the group-level effects of interventions. Therefore, there is a need to better understand who is most likely to benefit from mindfulness interventions. This study reports on moderation analyses from a two-centre randomised controlled trial of mindfulness-based stress reduction (MBSR) among 288 medical and psychology students. The study investigated whether baseline personality factors (neuroticism, conscientiousness and extroversion) and baseline mindfulness moderated effects on mental distress, study stress and subjective well-being measured after the intervention. An increased effect of the intervention on mental distress and subjective well-being was found in students with higher scores on neuroticism. Students with higher scores on conscientiousness showed an increased effect of mindfulness training on study stress. The training protected students against an increase in mental distress and study stress and a decrease in subjective well-being that was seen in the control group. Baseline mindfulness and extroversion did not moderate the effects of the intervention on the outcomes. The majority of the 288 medical and psychology students in the study sample were female. Female participants scored significantly higher on neuroticism and conscientiousness, and they may therefore be an important target group for mindfulness interventions among students.

• Thorberg, Fred Arne; Young, Ross; Sullivan, Karen; Lyvers, Michael; Connor, Jason & Noble, Ernest P [Show all 9 contributors for this article] (2015). A longitudinal mediational study of the stability of alexitymia among alcohol treatment seekers. Drug and Alcohol Dependence. ISSN 0376-8716. 156, p. e221–e221. doi: 10.1016/j.drugalcdep.2015.07.595. Full text in Research Archive
• Mahmood, Javed Iqbal; Grotmol, Kjersti Støen; Tesli, Martin Steen; Vaglum, Per Jørgen Wiggen & Tyssen, Reidar (2015). Risk factors measured during medical School for later hazardous drinking: a 10-year, longitudinal, nationwide study(NORDOC). Alcohol and Alcoholism. ISSN 0735-0414. 51(1), p. 71–76. doi: 10.1093/alcalc/agv059. Full text in Research Archive
• Halland, Even; Vibe, Michael de; Solhaug, Ida; Tyssen, Reidar; Friborg, Oddgeir & Rosenvinge, Jan H [Show all 8 contributors for this article] (2015). Mindfulness training improves problem-focused coping in psychology and medical students. College Student Journal. ISSN 0146-3934. 49(3), p. 387–398. Full text in Research Archive
• Berthelsen, Mona; Pallesen, Ståle; Magerøy, Nils; Tyssen, Reidar; Bjorvatn, Bjørn & Moen, Bente Elisabeth [Show all 7 contributors for this article] (2015). Effects of psychological and social factors in shiftwork on symptoms of anxiety and depression in nurses: A 1-year follow-up. Journal of Occupational and Environmental Medicine. ISSN 1076-2752. 57(10), p. 1127–1137. doi: 10.1097/JOM.0000000000000532. Full text in Research Archive Show summary

  Objectives: The aim of the current study was to elucidate prospective effects of both shift schedules and work environment on mental distress. Methods: A total of 2059 nurses participated at baseline (38.1%), and 1582 nurses completed wave 2 of the survey (76.8%). Psychosocial work factors were measured by the General Nordic Questionnaire for Psychological and Social factors at work and the Swedish Demand–Control–Support Questionnaire. Mental distress was measured by Hospital Anxiety and Depression Scale. Results: Shiftwork was not associated with ‘‘caseness’’ anxiety or depression. Effects of shiftwork on mental distress were not moderated by psychosocial work factors. Mental distress predicted role clarity, role conflict, fair leadership, and social support. Job demands predicted symptoms of depression. Conclusions: Whether psychosocial working conditions buffer mental health effects of shiftwork remains undecided. Prospective studies with multiple measurement points are needed to elucidate potential mutual relationships between work factors and mental distress.

• Aagestad, Cecilie; Tyssen, Reidar; Johannessen, Håkon Andre; Gravseth, Hans Magne Ulrik; Tynes, Tore & Sterud, Tom (2014). Psychosocial and organizational risk factors for doctor-certified sick leave: a prospective study of female health and social workers in Norway. BMC Public Health. 14. doi: 10.1186/1471-2458-14-1016. Full text in Research Archive Show summary

  Background: Doctor-certified sick leave differs substantially across sectors, and among health and social workers, in particular, there is an increased risk. Previous studies have shown that work environmental factors contribute to sick leave. Hence, the identification of specific organizational and psychosocial risk factors for long- term sick leave, taking into account potential confounding related to mechanical risk factors such as lifting and awkward body postures, will be of importance in the work of prevention. Methods: A randomly drawn population sample of Norwegian residents was interviewed about working conditions in 2009 (n = 12,255; response rate 60.9%). Female health and social care workers (n = 925) were followed in a national registry for subsequent sickness absence during 2010. The outcome of interest was doctor-certified sick leave of 21 days or more (long-term sick leave). Eleven work-related psychosocial and organizational factors were evaluated. Results: In total, 186 persons (20.1%) were classified with subsequent long-term sick leave. After thoroughly adjusting for competing explanatory variables, the most consistent predictors for long-term sick leave were violence and threats of violence (OR = 1.67; 95% CI 1.14–2.45). The estimated population attributable risk for violence and threats of violence was 13%. Conclusions: The present study among female health and social care workers revealed a substantial relationship between self-reported violence and threats of violence and subsequent long- term sick leave.

• Tyssen, Reidar (2014). Alkohol og leger – hvor mye er for mye? In Ronge, Kari; Rø, Karin Elisabet Isaksson & Bringedal, Berit (Ed.), Fra pidestall til skammel: Festskrift til Olaf Gjerløw Aasland 70 år. Den norske legeforening / Sykehjelps- og pensjonsordningen for leger (SOP). ISSN 9788280701060. p. 106–112. Full text in Research Archive
• Solberg, Ingunn Bjarnadottir; Tomasson, Kristinn; Aasland, Olaf Gjerløw & Tyssen, Reidar (2014). Cross-national comparison of job satisfaction in doctors during economic recession. Occupational Medicine. ISSN 0962-7480. doi: 10.1093/occmed/kqu114. Full text in Research Archive
• Tyssen, Reidar; Palmer, Karen S; Solberg, Ingunn Bjarnadottir; Voltmer, Edgar & Frank, Erica (2013). Physicians' perceptions of quality of care, professional autonomy, and job satisfaction in Canada, Norway, and the United States. BMC Health Services Research. 13. doi: 10.1186/1472-6963-13-516. Full text in Research Archive Show summary

  Background We lack national and cross-national studies of physicians’ perceptions of quality of patient care, professional autonomy, and job satisfaction to inform clinicians and policymakers. This study aims to compare such perceptions in Canada, the United States (U.S.), and Norway. Methods We analyzed data from large, nationwide, representative samples of physicians in Canada (n = 3,213), the U.S. (n = 6,628), and Norway (n = 657), examining demographics, job satisfaction, and professional autonomy. Results Among U.S. physicians, 79% strongly agreed/agreed they could provide high quality patient care vs. only 46% of Canadian and 59% of Norwegian physicians. U.S. physicians also perceived more clinical autonomy and time with their patients, with differences remaining significant even after controlling for age, gender, and clinical hours. Women reported less adequate time, clinical freedom, and ability to provide high-quality care. Country differences were the strongest predictors for the professional autonomy variables. In all three countries, physicians’ perceptions of quality of care, clinical freedom, and time with patients influenced their overall job satisfaction. Fewer U.S. physicians reported their overall job satisfaction to be at-least-somewhat satisfied than did Norwegian and Canadian physicians. Conclusions U.S. physicians perceived higher quality of patient care and greater professional autonomy, but somewhat lower job satisfaction than their colleagues in Norway and Canada. Differences in health care system financing and delivery might help explain this difference; Canada and Norway have more publicly-financed, not-for-profit health care delivery systems, vs. a more-privately-financed and profit-driven system in the U.S. None of these three highly-resourced countries, however, seem to have achieved an ideal health care system from the perspective of their physicians.

• Thorberg, Fred Arne; Young, Ross M.; Sullivan, Karen A.; Lyvers, Michael; Hurst, Cameron P & Tyssen, Reidar [Show all 8 contributors for this article] (2013). A confirmatory factor analysis of the Observer Alexithymia Scale in treatment seeking alcohol-dependent patients. Journal of Substance Use. ISSN 1465-9891. 18(6), p. 492–498. doi: 10.3109/14659891.2012.707281. Full text in Research Archive
• Solberg, Ingunn Bjarnadottir; Kristinn, Tómasson; Aasland, Olaf Gjerløw & Tyssen, Reidar (2013). The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study. BMC Health Services Research. 13. doi: 10.1186/1472-6963-13-524. Full text in Research Archive Show summary

  Background Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors’ migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors’ migration considerations. Methods In 2010, all doctors in Iceland registered with the Icelandic Medical Association were sent an electronic cross-sectional survey by email. The 467 specialists who participated in this study represent 55% of all specialist doctors working in Iceland. Information on doctors’ contemplation of migration was available from responses to the question: “Have you considered moving and working abroad?” The predictor variables in our logistic regression model are perceived cost-containment initiatives at work, stress related to personal finances, experience of working abroad during vacations, job dissatisfaction, job position, age, and gender. Results Sixty-three per cent of Iceland’s specialist doctors had considered relocation abroad, 4% were moving in the next year or two, and 33% had not considered relocating. Logistic regression analysis shows that, controlling for age, gender, job position, job satisfaction, and experience of working abroad during vacations, doctors’ migration considerations were significantly affected by their experiences of cost-containment initiatives at work (odds ratio (OR) = 2.0, p < 0.01) and being stressed about personal finances (OR = 1.6, p < 0.001). Age, job satisfaction, and working abroad during vacations also had an effect, whereas job position did not. Conclusions Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession on migration by doctors are needed.

• Grotmol, Kjersti Støen; Gude, Tore; Moum, Torbjørn Åge; Vaglum, Per Jørgen Wiggen & Tyssen, Reidar (2013). Risk factors at medical school for later severe depression: A 15-year longitudinal, nationwide study (NORDOC). Journal of Affective Disorders. ISSN 0165-0327. 146(1), p. 106–111. doi: 10.1016/j.jad.2012.08.047. Full text in Research Archive
• Ljoså, Cathrine Haugene; Tyssen, Reidar & Lau, Bjørn (2013). Perceived Mastery of Work among Shift Workers in the Norwegian Offshore Petroleum Industry. Industrial Health. ISSN 0019-8366. 51(2), p. 145–153. doi: 10.2486/indhealth.2012-0086. Full text in Research Archive Show summary

  This study investigated associations between individual and work-related factors and perceived mastery of work among offshore shift workers. 2,406 employees of a Norwegian petroleum company were invited to participate. A web-based survey was used and 1336 completed questionnaires were returned (56%). Mastery of work was assessed using QPS Nordic Mastery Scale and the results were compared with a sample from the QPS Nordic study. Individual factors adjusted for were age, gender, marital status and personality. The following work-related factors were included: demands, control, support, night work and shift work home interference. Female offshore shift workers reported higher levels of perceived mastery of work compared with women in the comparison sample. The following variables were independently associated with perceived mastery of work: female gender (β=0.10, p=0.008), decisional demands (β=0.13, p<0.001), control (β=0.05, p=0.009), social support (β=0.07, p<0.001), shift-work locus of control (β=0.04, p=0.005) and neuroticism (β=–0.29, p<0.001). Post hoc analyses showed no sex differences in perceived mastery in two separate work positions on the platforms. Work-related variables and personality explained 55% and 45% respectively of the total variance (R2=0.22) explained by the final model. Female petroleum offshore workers reported somewhat higher levels of mastery of work than their male colleagues, however, this may be due to different work positions. Work-related factors accounted for about half of the explained variance and decisional demands, control and support remained statistically significant after controlling for personality.

View all works in NVA

• Bache-Mathiesen, Lena Kristin; Moum, Torbjørn; Tyssen, Reidar & Breivik, Jarle (2026). Distinct and Narrow Personality Profile of Norwegian Medical Students: Implications of the National Admissions System. doi: https:/www.researchgate.net/publication/414086234_Distinct_and_Narrow_Personality_Profile_of_Norwegian_Medical_Students_Implications_of_the_National_Admissions_System. Full text in Research Archive Show summary

  Background --- Medical school admissions shape the physician workforce. Norway admits students exclusively by GPA. With no selection for suitability and professional attitude, combined with free education and low attrition, the admitted cohorts are largely shaped by who chooses to apply. To explore this effect, we characterised personality traits of medical students at the University of Oslo and compared them with the Norwegian population and published samples from medical schools in other countries. --- Summary of Work --- Newly admitted medical students (2022–2025; mean age 22.1, 67% female) completed the BFI-20S (four cohorts, n=436, 91% response) and the MBTI (five cohorts, n=532, 95% response) personality tests. BFI measured Agreeableness, Conscientiousness, Extraversion, Neuroticism, and Openness. One-sample t-tests compared mean scores with Norwegian workers (n=6,372). MBTI classified respondents on four dichotomies combined into 16 personality types. Chi-squared tests compared distributions between U.S. (n=83) and South Korean (n=171) medical students and the Norwegian general population (n=159,468). --- Summary of Results --- On the BFI, Norwegian medical students scored higher on Agreeableness, mean 23.9 (SD=3.0), Conscientiousness, 22.7 (3.6); Extraversion, 20.3 (5.9); Openness, 18.7 (4.7), and Neuroticism, 13.0 (4.8), than general Norwegian workers (22.2, SD=3.4; 20.5, SD=3.6; 19.0 SD=4.8; 17.8 SD=4.7; 12.0, SD=4.5, respectively, p<0.001). Female students reported higher Neuroticism (Pearson’s r=0.2, p<0.001) and Agreeableness (r=0.1, p=0.010) than male students. --- MBTI classified most medical students as Extraverted (69%), Intuitive (58%), Feeling (67%), and Judging (78%). The ENFJ type (Protagonist, 21%) was significantly overrepresented compared with U.S. (2%) and South Korean (3%) medical students, and the Norwegian population (6%) (p<0.001). The most common types among women were ENFJ/ESFJ (27%/14%); among men, ENTJ/INTJ (26%/13%). ---Discussion and Conclusion --- The Norwegian admission system is associated with elevated levels of Conscientiousness and Agreeableness and large overrepresentations of ENFJ/ENTJ. Although these traits and types can be well-suited for medical practice, limited diversity in perspective, leadership styles, and coping strategies might have implications for the composition of the physician workforce and patient care. --- Take-home Message(s) --- The Norwegian GPA-only admission model is associated with a distinct and narrow spectrum of personalities, with potential implications for physician well-being, leadership representation, and personality diversity.

• Tyssen, Reidar (2023). Unge leger forteller om en uholdbar arbeidssituasjon. Hva har skjedd? Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116. p. 31–31. Full text in Research Archive
• Tyssen, Reidar (2023). Helseplattformen: Hvorfor ikke høre på brukerne? Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116. p. 29–29. Full text in Research Archive
• Tyssen, Reidar (2023). Debatten: På helsa løs, mener legene. [TV]. Debatten NRK1. Full text in Research Archive
• Tyssen, Reidar (2023). 1.Er det personlighet eller arbeidsfaktorer som gjør meg sliten i jobben? 2.Hva kan gjøres for å bedre trivsel i jobben blant leger? (2 timers foredrag). Full text in Research Archive
• Tyssen, Reidar (2023). Er legelivet for krevende? Full text in Research Archive
• Tyssen, Reidar; Javo, Cecilie; Thapa, Suraj Bahadur; Rø, Karin Elisabet Isaksson; Preljevic, Valjbona & Sandbu, Morten (2023). Perceived clinical challenges when treating patients from another culture: a study among doctors training in psychiatry. Full text in Research Archive
• Tyssen, Reidar (2023). Unge leger melder om uholdbar arbeidssituasjon: Hva har skjedd med legeyrket? Full text in Research Archive
• Tyssen, Reidar (2022). Er det personlighet eller arbeidsfaktorer som gjør meg sliten i jobben? Kreftsykepleien. ISSN 0804-0567. 2, p. 64–67. Full text in Research Archive
• Tyssen, Reidar (2022). Er det jobb eller personlighet som gjør helsepersonell utbrent? Full text in Research Archive
• Montgomery, Anthony; Lainidi, Olga; Johnson, Judith; Creese, Jennifer; Baathe, Fredrik & Baban, Adriana [Show all 16 contributors for this article] (2022). Employee silence in health care: Charting new avenues for leadership and management. p. 1–9. doi: 10.1097/HMR.0000000000000349. Full text in Research Archive
• Tyssen, Reidar (2021). Spesialisten - psykiateren - intervju v/ Merete Lan Olsen. [Journal]. Æsculap. Full text in Research Archive
• Tyssen, Reidar (2021). Ny studie - hver syvende pasient har blitt angrepet av lege. [Radio]. NRK Nyhetsmorgen. Full text in Research Archive
• Tyssen, Reidar (2021). La oss ikke bli historieløse. Full text in Research Archive
• Tyssen, Reidar & Sebjørnsen, Anne Kathrine (2020). Humlesus og annen balansekunst. [Journal]. Tiddskriftet for den norske legeforening. Full text in Research Archive
• Hertzberg, Tuva Kolstad; Skirbekk, Helge; Rø, Karin Isaksson & Tyssen, Reidar (2019). T.K. Hertzberg og medarbeidere svarer. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.19.0524. Full text in Research Archive
• Tyssen, Reidar (2019). Vold forklarer sykefravær. Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116. Full text in Research Archive
• Tyssen, Reidar (2019). Å gi en dårlig beskjed. [Radio]. NRK P2. Full text in Research Archive
• Tyssen, Reidar (2019). Wellbeing for GPs and practice staff (Keynote). Full text in Research Archive
• Tyssen, Reidar (2019). Work and mental health in medical students and doctors: findings from longitudinal studies. Full text in Research Archive
• Tyssen, Reidar (2019). Trivsel blant praktiserende læger. Practicus. p. 16–17. Full text in Research Archive
• Tyssen, Reidar (2018). What is the level of burnout that impairs functioning? Journal of Internal Medicine. ISSN 0954-6820. 283(6), p. 594–596. doi: 10.1111/joim.12769. Full text in Research Archive
• Solhaug, Ida; Vibe, Michael F. De; Friborg, Oddgeir; Sørlie, Tore; Tyssen, Reidar & Bjørndal, Arild [Show all 7 contributors for this article] (2018). Long-term mental health effects of mindfulness training: A 4-year follow-up of an RCT in medical and psychology students. Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Lyvers, Michael; Connor, Jason P; Tyssen, Reidar & London, Edythe D [Show all 7 contributors for this article] (2017). Alexithymia in alcohol-dependent patients is mediated by stress, anxiety and loss of self-control over drinking. Drug and Alcohol Dependence. ISSN 0376-8716. 171, p. e201–e202. Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Lyvers, Michael; Connor, Jason P; Tyssen, Reidar & Danick, Edythe London [Show all 7 contributors for this article] (2016). Alexithymia in alcohol-dependent patients is mediated by stress, anxiety and loss of self-control over drinking. Full text in Research Archive
• Tyssen, Reidar (2016). Legeprofesjon, identitet og ledelse. Overlegen. ISSN 1503-2663. p. 20–21. Full text in Research Archive
• Gude, Tore; Hem, Erlend; Tyssen, Reidar; Mahmood, Javed Iqbal; Rø, Karin Isakson & Vaglum, Per Jørgen Wiggen (2016). To regret the choice of medicine as a student, how will it influence doctors’ later career? Full text in Research Archive
• Tyssen, Reidar (2015). Hva kan forskning om legers helse lære oss om forebygging i dag? Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Sullivan, Karen A.; Lyvers, Michael; Hurst, Cameron P & Tyssen, Reidar [Show all 10 contributors for this article] (2015). A Prospective Mediational Study on the Stability of Alexithymia among Alcohol-Dependent Outpatients in Cognitive-Behavioral Therapy. Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Lyvers, Michael; Connor, Jason P; Tyssen, Reidar & Landheim, Anne [Show all 8 contributors for this article] (2015). Loss of self-control over drinking and the relationship of alexithymia to quality of life in alcohol-dependent patients. Drug and Alcohol Dependence. ISSN 0376-8716. 146, p. e4–e4. doi: 10.1016/j.drugalcdep.2014.09.693. Full text in Research Archive
• Mahmood, Javed Iqbal; Grotmol, Kjersti Støen; Tesli, Martin Steen; Vaglum, Per Jørgen Wiggen & Tyssen, Reidar (2015). Risk factors at medical school for later hazardous drinking: a 10-year longitudinal, nationwide study. Full text in Research Archive
• Mahmood, Javed Iqbal; Grotmol, Kjersti Støen; Tesli, Martin Steen & Tyssen, Reidar (2015). Contextual stress and mental distress as predictors of hazardous drinking in Norwegian medical doctors: a 15-year longitudinal and Nationwide study. Full text in Research Archive
• Gude, Tore; Vaglum, Per Jørgen Wiggen; Mahmood, Javed Iqbal; Hem, Erlend & Tyssen, Reidar (2015). To regret or not to regret, does it matter for physicians’ later functioning? Full text in Research Archive
• Tyssen, Reidar (2015). Mental health and intervention studies in Norwegian medical students and doctors: a review and update of the NORDOC studies. Full text in Research Archive
• Tyssen, Reidar (2015). Reality weakness trait is linked to both mental health and performance-related issues among Medical students: a nationwide and cross-sectional study (NORDOC). Full text in Research Archive
• Tyssen, Reidar (2015). Tiden sårer alle leger - også psykiatere. Hva vet vi om psykisk helse blant psykiatere og andre leger, implikasjoner for forebygging og behandling? Full text in Research Archive
• Tyssen, Reidar (2014). Behandlingskvalitet: Amerikanske leger mer tilfredse enn norske. [Journal]. Dagens Medisin. Full text in Research Archive
• Tyssen, Reidar (2014). Verdens beste helsevesen? p. 26–27. Full text in Research Archive
• Thorberg, Fred Arne; Young, R; Lyvers, Michael; Connor, Jason; Tyssen, Reidar & Landheim, Anne [Show all 8 contributors for this article] (2014). A prospective study of alexithymia and craving among alcohol-dependent treatment seekers. Drug and Alcohol Dependence. ISSN 0376-8716. 140, p. e225–e225. Full text in Research Archive
• Tyssen, Reidar (2014). Medice cura te ipse – om medisineres selvmedisinering og sykdomsatferd. Full text in Research Archive
• Thorberg, Fred Arne; Young, Ross McD; Lyvers, Michael; Connor, Jason P; Tyssen, Reidar & Landheim, Anne [Show all 8 contributors for this article] (2014). Loss of self-control over drinking and the relationship of alexithymia to quality of life in alcohol-dependent patients. Full text in Research Archive
• Aagestad, Cecilie; Tyssen, Reidar; Johannessen, Håkon Andre; Gravseth, Hans Magne Ulrik; Tynes, Tore & Sterud, Tom (2014). Psychosocial and organizational risk factors for doctor-certified sick leave. A prospective study of female health and social workers in Norway: the role of violence. Full text in Research Archive
• Vibe, Michael de; Solhaug, Ida; Halland, Even; Tyssen, Reidar; Rosenvinge, Jan H & Sørlie, Tore [Show all 8 contributors for this article] (2014). Mindfulness Based Stress Reduction for Norwegian medical and psychology students: Pre-post results from a multisite, randomised controlled study. Full text in Research Archive
• Tyssen, Reidar (2014). Mental health and intervention studies in Norwegian medical students and doctors: a review. Full text in Research Archive
• Tyssen, Reidar (2014). Hva kan forskning om legers helse lære oss om forebygging? (2014). Full text in Research Archive
• Mahmood, Javed Iqbal; Grotmol, Kjersti Støen; Tesli, Martin Steen; Vaglum, Per Jørgen Wiggen & Tyssen, Reidar (2014). Risk Factors at Medical School for Later Hazardous Drinking: A 10-Year Longitudinal, Nationwide Study (NORDOC). Full text in Research Archive
• Tyssen, Reidar; Palmer, Karen S; Solberg, Ingunn Bjarnadottir; Voltmer, Edgar & Frank, Erica (2014). Physicians’ Perceptions of Quality of Care, Professional Autonomy, and Job Satisfaction in Canada, Norway, and the United States. Full text in Research Archive
• Hertzberg, Tuva Kolstad; Skirbekk, Helge; Aasland, Olaf G.; Tyssen, Reidar & Rø, Karin Elisabet Isaksson (2014). Is it possible to combine being 'a good doctor' with taking care of one's own health? A qualitative study of the importance of professionalism among hospital doctors. Full text in Research Archive
• DeVibe, Michael; Solhaug, Ida; Halland, Even; Tyssen, Reidar; Friborg, Oddgeir & Rosenvinge, Jan H [Show all 8 contributors for this article] (2014). Mindfulness training for Norwegian medical and psychology students: Pre-post results from a multisite, randomised controlled study. Full text in Research Archive
• Rø, Karin Elisabet Isaksson & Tyssen, Reidar (2013). Work-home stress in Norwegian doctors (NORDOC): the role of year-cohort and gender. Full text in Research Archive
• Tyssen, Reidar (2013). Legers psykiske helse og utbrenthet, implikasjoner for forebygging og behandling. Full text in Research Archive
• Tyssen, Reidar (2013). Om medisinstudenter og legers mentale helse. Full text in Research Archive
• Solhaug, Ida; Vibe, Michael de; Tyssen, Reidar; Friborg, Oddgeir; Rosenvinge, Jan H & Sørlie, Tore [Show all 7 contributors for this article] (2013). Mindfulness training for medical and psychology students: Initial effects from a multisite, randomised controlled study. Full text in Research Archive
• Tyssen, Reidar (2013). Work-home stress in Norwegian doctors (NORDOC): the role of year-cohort and gender. Full text in Research Archive
• Tyssen, Reidar (2013). Farer i faget - utbrenthet? Full text in Research Archive

View all works in NVA