Suraj Thapa

• Ojha, Sneha; Thapa, Suraj Bahadur; Haag, Katharina; Straiton, Melanie Lindsay; Nickerson, Angela & Nissen, Alexander (2026). Comparison of Specialized Mental Healthcare Utilization Among Syrian Refugees and the General Norwegian Population: A Longitudinal, Registry-Based Cohort Study on PTSD, Mood Disorders, and Anxiety and Fear-Related Disorders. Psychiatry Research. ISSN 0165-1781. doi: 10.1016/j.psychres.2026.117488. Fulltekst i vitenarkiv
• Sivanesan, Shivanthe; Ramberg, Håkon; Kristiansen, Thomas; Thapa, Suraj; Bjøre, Marthe & Berge, Viktor [Vis alle 15 forfattere av denne artikkelen] (2026). Perioperative propranolol during robotic-assisted radical prostatectomy: A randomised, double-blind, placebo-controlled, pilot trial (PeP-RALP). BJUI Compass. 7(9). doi: 10.1002/bco2.70267.
• Haune, Monica Christine; Nissen, Alexander; Thapa, Suraj Bahadur; Myrvold, Trine; Christiansen, Øivin & Heiervang, Einar Røshol (2025). From health assessment to service use: Do children in out-of-home care receive recommended services? Developmental Child Welfare (DCW). ISSN 2516-1032. 7(1), s. 3–21. doi: 10.1177/25161032251324861. Fulltekst i vitenarkiv Vis sammendrag

  As a response to the substantial health problems and unmet needs among children in out-of-home care, a comprehensive health assessment was piloted in a Norwegian region, as the first of its kind in Norway. The current study is a follow-up of service use among children who received the assessment, designed to investigate the relationship between service recommendations and service contact with six services within the following year. Participants included children (ages 1–17 years) living in out-of-home care, who had received the health assessment (N = 103, M age = 7.5 years). Baseline data on service recommendations were extracted from assessment reports, while data on service contact was collected through a survey to carers 12 months after the assessment. Bivariate analyses and logistic regression models tested associations between service recommendations and service contact. Results show that for low-threshold services within municipal primary health care, recommendations were associated with service contact (OR 5.0, [1.65–15.19] p = .001). For specialized mental and somatic health care and educational services, no associations between service recommendation and service contact were found. Around 40% of the children had been in contact with recommended specialized mental or physical healthcare services, and educational services at follow-up. The findings illustrate the failure of the existing service systems in meeting the severe health challenges of this high-risk child population. This has implications for assessment practices, child welfare services referral routines and interagency collaboration, and may indicate a need for specialized organizational solutions to provide necessary services to children in out-of-home care.

• 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. s. 1–11. doi: 10.1177/13634615241296297. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Edwards, Maria G. P.; Furuholmen-Jenssen, Tobias; Søegaard, Erik Ganesh Iyer; Thapa, Suraj Bahadur & Andersen, Jens R. (2024). Exploring diet-induced ketosis with exogenous ketone supplementation as a potential intervention in post-traumatic stress disorder: a feasibility study. Frontiers in Nutrition. 11. doi: 10.3389/fnut.2024.1406366. Fulltekst i vitenarkiv Vis sammendrag

  Background: Post-Traumatic Stress Disorder (PTSD) is a severe and pervasive mental disorder, and patients experience numerous distressing symptoms and impairments that significantly impact their lives. In addition to being a mental disorder, PTSD is strongly associated with a wide range of metabolic abnormalities that affect the entire body. Existing treatment options of psychotherapy and medications are often ineffective. Exploring other potential treatments is necessitated. The ketogenic diet has shown potential as a metabolic therapy in certain neurological and mental disorders and is a promising intervention in the treatment of PTSD. Aim: This study aimed to examine if a 4-week ketogenic diet intervention supplemented with exogenous ketones (KD-KS) was feasible in adult patients with PTSD, to what extent it was possible to recruit patients, attain and maintain ketosis (plasma concentration of β-hydroxybutyrate (BHB) ≥ 0.5 mmol/L), the occurrence of serious adverse reactions and adverse reactions to KD-KS, and acceptance of treatment. Our exploratory aims were changes in PTSD symptoms and health-related quality of life (QoL) from baseline to 4 weeks. Methods: Patients 18 ≤ 65 years old, diagnosed with PTSD, and receiving outpatient treatment for PTSD at Southern Oslo District Psychiatric Centre (DPC), Oslo University Hospital, Oslo, Norway, were included. The intervention consisted of a ketogenic diet supplemented with β-hydroxybutyrate salt to obtain ketosis. PTSD symptoms were measured with the PTSD Checklist for DSM-5 (PCL-5) and QoL was measured with the RAND 36-Item Health Survey 1.0. Results: During a 21-week inclusion period, three of four eligible patients (75% [95% CI: 30 to 95%]) were included. Two patients (67% [95% CI: 21 to 94%]) completed the 4-week intervention and one patient (33% [95% CI: 6 to 79%]) completed 2 weeks of intervention before discontinuing. Ketosis was achieved on day 1 in one patient, and on day 2 in two patients, and was maintained in 87% of the intervention. There were no serious adverse reactions. Adverse reactions were reported in a total of 70% of intervention days, the most frequent being headache followed by fatigue. The participant-perceived degree of adverse reactions was low to moderate. The treatment was accepted by patients on all intervention days. PCL-5 decreased by 20 points (70 to 50) in patient 1 and by 10 points (50 to 40) in patient 2, from baseline to 4 weeks, which is a reliable and clinically meaningful improvement. QoL improved in six of eight RAND-36 subscales in patient 1 and three of eight in patient 2. Patient 3 did not complete assessments after week 2. Conclusion: To the best of our knowledge, this feasibility study is the first study examining a ketogenic diet intervention in patients with PTSD. Three of four predefined feasibility criteria were achieved. Ketosis was attained fast and maintained, patients were compliant and there were clinically meaningful improvements in PTSD symptoms and QoL. Despite the small sample size, the knowledge obtained in this study is important for the planning of future studies with ketogenic diet interventions in this patient group. It is a first step for potential dietary and metabolic therapies in PTSD. Further feasibility and pilot studies with larger sample sizes are needed to determine feasibility and safety before planning future randomised controlled trials investigating an effect.

• Ojha, Sneha; Thapa, Sahara & Thapa, Suraj Bahadur (2024). Mental health problems among Syrian refugees in Nordic countries: a systematic review. Nordic Journal of Psychiatry. ISSN 0803-9488. 78(7), s. 561–569. doi: 10.1080/08039488.2024.2403600. Fulltekst i vitenarkiv Vis sammendrag

  Introduction The Syrian refugee crisis has led to significant population displacement, with many seeking refuge and asylum in Nordic countries. While these countries offer safety and stability, the resettlement process combined with the refugees’ own traumatic experiences can exacerbate existing or precipitate new mental health issues. Aim This systematic review aims to comprehensively analyse the literature on mental health problems among Syrian refugees resettled in Nordic countries, exploring their prevalence and associated factors. Methods A comprehensive literature search was conducted following PRISMA guidelines, utilizing databases including Web of Science, PubMed, MEDLINE, and Cochrane. The included studies focused on adult Syrian refugees or asylum seekers aged 18 and above, residing within Nordic countries, and investigated various mental health problems between March 2011 and January 2024, conducted in various Nordic countries. Results Studies revealed high prevalence rates of PTSD (26%–45%), depression (40%–45%), and anxiety (30%–32%). Factors contributing to mental health problems included pre- and post-migration trauma, perceived discrimination, and socio-demographic variables. Pre-migration trauma exposure, such as witnessing violent events, was linked to trauma centrality and emotional suppression. Post-migration stressors like discrimination and financial strain, along with socio-demographic factors like gender and age, were associated with mental health issues. Specifically, female and older refugees reported higher levels of anxiety, depression, and low future expectations. Conclusion The findings underscore the urgent need for comprehensive mental health assessment and services for Syrian refugees in Nordic countries. Addressing trauma, discrimination, and socio-economic challenges is crucial for improving their well-being and facilitating successful integration into host countries.

• Mainali, Anustha; Søegaard, Erik Ganesh Iyer; Hauff, Edvard & Thapa, Suraj Bahadur (2024). A comparative study of comorbidities, symptom profiles, and childhood trauma in PTSD and non-PTSD trauma patients at Oslo University Hospital. Nordic Journal of Psychiatry. ISSN 0803-9488. s. 1–8. doi: 10.1080/08039488.2024.2415306. Fulltekst i vitenarkiv Vis sammendrag

  Purpose To explore the differences in mental health symptom profiles, trauma profiles, childhood trauma and comorbidities in patients with PTSD and those without PTSD. Materials and methods A cross-sectional study was carried out on 110 adult patients with trauma backgrounds attending a mental health outpatient clinic in Southern Oslo, Norway. In addition to self- report questionnaires, several standardized validated diagnostic tools were used to assess mental disorders. Multiple linear regression models were used to assess the association between trauma history, the mental health symptom profile of the patients, and PTSD diagnosis. Bivariate logistic regression was used to examine if childhood trauma/adversities were associated with PTSD. Results Patients diagnosed with PTSD had significantly higher rates of comorbid major depressive disorder, panic disorder, agoraphobia disorder, and social phobia compared to those without PTSD. We also found a positive association between PTSD diagnosis and all the different mental health symptoms domains of the Symptom Checklist-90-Revised instrument. When adjusted for age, gender, education, smoking habits, immigration, relationship, and employment status, these associations persisted with varying effects. We did not find any association between PTSD and childhood trauma/adversities, however, sexual abuse trended towards an association. Conclusion Adult trauma patients with PTSD may have more comorbid disorders and mental health symptoms. Childhood trauma may be less critical for the PTSD diagnosis in this group. In clinical practice, personalized treatment plans addressing both the symptom burden and its comorbidities may be beneficial.

• Pant, Sagun Ballav; Thapa, Suraj Bahadur; Howard, John; Ojha, Saroj Prasad & Lien, Lars (2023). Internalized Stigma and its Correlates Among Opioid Agonist Treatment Service Users in Nepal. Journal of Psychosocial Rehabilitation and Mental Health. ISSN 2198-9834. doi: 10.1007/s40737-023-00353-4. Fulltekst i vitenarkiv Vis sammendrag

  Opioid use disorder is associated with high levels of stigma and discrimination, which impact treatment seeking and compliance. Despite extensive evidence as an optimal intervention for opioid use disorder, enrollment in Opioid Agonist Treatment (OAT) in settings like Nepal, is accompanied by moral judgements and stigma with a broad narrative of it being merely a replacement of ‘one addiction with another’. Stigma is eventually internalized by many service users impacting enrollment and maintenance in OAT, and quality of life. This study aimed to assess internalized stigma among OAT service users in Nepal and to explore its association with sociodemographic characteristics, lifetime mental disorders and quality of life. A cross-sectional study was conducted among 231 OAT service users, the survey instrument included the Mini-International Neuropsychiatric Interview for DSM-5, Internalized Stigma of Mental Illness Inventory (ISMI) and the World Health Organization Quality of Life –BREF. Factors associated with quality of life and internalized stigma were investigated using bivariate and multivariate analyses. More than half (56.28%) of respondents reported having high internalized stigma with a mean ISMI score of 2.71 ± 0.64. All 29 ISMI items were found to have a mean score greater than 2.5 indicating a high burden of internalized stigma. Service users reporting higher internalized stigma had significantly lower quality of life across all domains, greater medical co-morbidity, lifetime anxiety and depressive disorder and alcohol use disorder. To lessen stigma and its impacts, our findings recommend a national initiative targeting stigma reduction interventions for existing OAT services and beneficiaries.

• Trinh, Nhung; Semark, Birgitte Dige; Munk-Olsen, Trine; Liu, Xiaoqin; Thapa, Suraj Bahadur & Yilmaz, Zeynep [Vis alle 8 forfattere av denne artikkelen] (2023). Antidepressant treatment in pregnancy: a Danish registry linkage study in pregnant women with pre-existing obsessive‐compulsive disorder. Translational Psychiatry. 13(1). doi: 10.1038/s41398-023-02516-0. Fulltekst i vitenarkiv Vis sammendrag

  Abstract The association between antidepressant continuation during pregnancy and postpartum mental health in women with obsessive-compulsive disorder (OCD) is uncertain. We identified 1317 women with live-birth singleton pregnancies and having outpatient/inpatient visits for OCD in the 4 years pre-pregnancy from the Danish registries. We defined three groups based on antidepressant prescriptions filled in the 2 years before pregnancy to delivery: (i) unexposed ( n  = 449); (ii) discontinuers ( n  = 346), i.e., with pre-pregnancy antidepressant fills only; (iii) continuers ( n  = 522), i.e., with antidepressant fills before and during pregnancy. We estimated crude and propensity score weighted hazard ratio (HRs) of postpartum visit for OCD and mood/anxiety disorders using Cox proportional hazard models. In weighted analyses, we found no difference in the probability of a postpartum visit for OCD or MADs with antidepressant continuation compared to unexposed and discontinuers. The likelihood of a postpartum OCD visit was higher in pregnancies having only one prescription fill during pregnancy compared to unexposed (HR = 3.44, 95% CI: 1.24, 9.54) or discontinuers (HR = 2.49, 95% CI: 0.91, 6.83). Continuers in pregnancy without antidepressant fill in the first three months postpartum had higher probability for postpartum visit for mood/anxiety disorders compared to discontinuers (HR = 3.84, 95% CI: 1.49, 9.92). Among pregnant women with pre-existing OCD, we found similar probabilities of a postpartum visit for OCD or mood/anxiety disorders in antidepressant continuers compared to unexposed and discontinuers. Continuers with a single prescription fill during pregnancy or no fill postpartum may have higher risks for these outcomes. Our findings highlight the importance of continuity of treatment throughout the perinatal period.

• Mainali, Anustha; Infanti, Jennifer Jean; Thapa, Suraj Bahadur; Jacobsen, Geir Wenberg & Larose, Tricia Lynn Lois (2023). Anxiety and depression in pregnant women who have experienced a previous perinatal loss: a case‑cohort study from Scandinavia. BMC Pregnancy and Childbirth. 23(1). doi: 10.1186/s12884-022-05318-2. Fulltekst i vitenarkiv Vis sammendrag

  Background: Perinatal loss can have long-lasting adverse effects on a woman’s psychosocial health, including during subsequent pregnancies. However, maternal mental health status after perinatal loss during subsequent pregnancy is understudied with very little data available for Scandinavian populations. Aims: The primary aim of the study was to explore the association between previous perinatal loss and anxiety/ depression symptoms of expectant mothers during the subsequent pregnancy. The secondary aim of this study was to explore possible determinants of maternal mental health during the subsequent pregnancy, independent of previous perinatal loss. Method: This case-cohort study is based on primary data from Scandinavian Successive Small-for-Gestational Age Births Study (SGA Study) in Norway and Sweden. The total case-cohort sample in the current study includes 1458 women. Cases include 401 women who had reported a previous perinatal loss (spontaneous abortion, stillbirth, or neonatal death) and who responded to two mental health assessment instruments, the State-Trait Anxiety Inventory (STAI), and the Centre for Epidemiological Studies Depression (CES-D) scale. Multiple linear regression models were used to assess the association between previous perinatal loss and maternal mental health in subsequent pregnancy. Results: Scandinavian pregnant women with previous perinatal loss reported higher symptoms for both anxiety and depression during their subsequent pregnancy compared to mothers in the same cohort reported no previous perinatal loss. Multiple linear regression analyses showed a positive association between previous perinatal loss and per unit increase in both total anxiety score (β: 1.22, 95% CI: 0.49–1.95) and total depression score (β: 0.90, 95% CI: 0.06–1.74). We identified several factors associated with maternal mental health during pregnancy independent of perinatal loss, including unintended pregnancy despite 97% of our population being married/cohabitating. Conclusion: Women who have experienced previous perinatal loss face a significantly higher risk of anxiety and depression symptoms in their subsequent pregnancy.

• Pant, Sagun Ballav; Thapa, Suraj Bahadur; Howard, John; Ojha, Saroj Prasad & Lien, Lars (2023). Psychological distress and quality of life among Opioid Agonist Treatment service users with a history of injecting and non-injecting drug use: A cross-sectional study in Kathmandu, Nepal. PLOS ONE. 18(2). doi: 10.1371/journal.pone.0281437. Fulltekst i vitenarkiv Vis sammendrag

  Background: Opioid use disorder is a serious public health problem in Nepal. People who use opioids often experience psychological distress and poor quality of life. Opioid agonist Treatment (OAT) is central in managing opioid dependence. This study aimed to examine factors associated with quality of life and serious psychological distress among OAT service users in the Kathmandu Valley, Nepal and compare those who had injected opioids prior to OAT and those who had not. Methods: A cross-sectional study with 231 was conducted using a semi-structured questionnaire, the Nepalese versions of the Kessler 6 psychological distress scale and World Health Organization Quality of Life scale (WHOQOL-BREF). Bivariate and multivariate analyses were undertaken to examine factors associated with quality of life and serious psychological distress. Results: Most participants were males (92%) and about half had injected opioids before initiating OAT. Serious psychological distress in the past four weeks was significantly more prevalent among participants with a history of injecting (32.2%) than those who did not inject (15.9%). In the adjusted linear regression model, those who had history of injecting were likely to have lower physical quality of life compared to non-injectors. Those self-reporting a past history of mental illness were more than seven times and those with medical comorbidity twice more likely to have serious psychological distress over last four weeks. Lower socioeconomic status and a history of self-reported mental illness in the past were found to be significantly associated with lower quality of life on all four domains. Conclusion: Those who had history of injecting were younger, had frequent quit attempts, higher medical comorbidity, lower socioeconomic status and remained longer in OAT services. Alongside OAT, the complex and entangled needs of service users, especially those with a history of injecting drugs, need to be addressed to improve quality of life and lessen psychological distress. Copyright: © 2023 Pant et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

• Ojha, Sneha & Thapa, Suraj Bahadur (2023). Psychological distress and suicidality in psychiatric patients during the COVID-19 pandemic in Norway: A repeated cross-sectional study. SSM - Mental Health (SSM-MH). 4. doi: 10.1016/j.ssmmh.2023.100286. Fulltekst i vitenarkiv Vis sammendrag

  Background Psychiatric patients are vulnerable to disruptions caused by the Corona Virus Disease 2019 (COVID-19) pandemic. This study aimed to investigate the effects of the pandemic on mental health symptoms and suicidality among these patients during lockdowns. Methods This repeated cross-sectional study utilized data from “Psychological distress and Coping in Patients in Community Mental Health Centers during COVID-19 pandemic (PsyCo-COVID-19) " study, conducted in two phases between June–July 2020 and March–April 2021. It included 261 participants from six Community Mental Health Centers (CMHCs) who completed a digital questionnaire, including Norwegian version of Mini International Neuropsychiatric Interview Plus (M.I.N.I. Plus), Hopkins Symptoms Checklist (HSCL-25), Post-traumatic Stress Disorder Checklist (PCL-5). Results A higher percentage of patients reported PTSD during the second phase of lockdown (47.4%) compared to the first phase of lockdown (33.7%). A third of participants (33.7%) reported high levels of suicidality. Moderate to severe effects of pandemic on mental health were associated with a significantly higher risk of suicide (AOR = 3.12; 95% CI: 1.50, 6.48; p = 0.0001), while having children (AOR = 0.35; 95% CI: 0.16, 0.76; p = 0.008) and being employed (AOR = 0.44; 95% CI: 0.23, 0.84; p = 0.013) were protective factors. Non-Norwegian background was associated with a higher risk of suicide (AOR = 2.59; 95% CI: 1.08, 6.19; p = 0.032). Conclusion High prevalence of suicidality was found among patients in CMHCs in Norway, with a significant association with self-reported worsening of mental health. PTSD and suicidality increased significantly during the second phase of lockdown, emphasizing the lasting impact of the pandemic on mental health. Targeted interventions and support services are needed for psychiatric patients during times of increased stress and uncertainty. Healthcare providers should be aware of the increased risk of suicide and provide appropriate support and interventions to prevent adverse outcomes.

• Koirala, Rishav; Aass, Hans Christian; Søegaard, Erik Ganesh Iyer; Dhakal, Hari Prasad; Ojha, Saroj Prasad & Hauff, Edvard [Vis alle 7 forfattere av denne artikkelen] (2023). Association of pro-inflammatory cytokines with trauma and post-traumatic stress disorder visiting a tertiary care hospital in Kathmandu. PLOS ONE. 18(2). doi: 10.1371/journal.pone.0281125. Fulltekst i vitenarkiv Vis sammendrag

  Post-traumatic stress disorder (PTSD) is a mental disorder that can occur after trauma. Although inflammatory markers such as cytokines are found altered in trauma and PTSD, there is no consensus regarding which can be considered as biomarkers. Studies from South Asia region is also rare. We studied cytokines among trauma affected patients and matched healthy controls. Fifty patients (cases) with trauma, visiting the University hospital in Kathmandu and thirty-nine healthy controls were selected, and the levels of cytokines were determined using a Luminex IS 200. We compared the levels of the cytokines in thirty-four age and gender matched pairs of case and control among three groups: healthy volunteers, cases diagnosed as PTSD, and cases without PTSD. Among the 34 pair-matched cases and controls, IL-6 was significantly higher in both PTSD positive cases [2.43 (0.00–14.54) pg/ml; p = 0.004] and PTSD negative cases [3.00 (0.92–3.86) pg/ml; p = 0.005], than in controls [0.39 (0.00–11.38) pg/ml]. IL-1β was significantly higher in PTSD positive cases [0.17 (0.00–5.27) pg/ml; p = 0.011] than in controls 0.00 (0.00–0.12) pg/ml. Other cytokines did not show significant differences. IL-6 was higher in both the trauma affected groups and IL-1β was higher in the trauma affected group with PTSD when compared to healthy controls. This supports the immune system activation hypothesis after trauma.

• Stensland, Synne; Glad, Kristin Alve; Andersen, Arnfinn J.; Brodersen, Dorte; Bækkelund, Harald & Daae, Cecilie [Vis alle 17 forfattere av denne artikkelen] (2023). Oppfølging av mennesker rammet av krig og katastrofer. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(18), s. 1–5. doi: 10.4045/tidsskr.23.0791. Fulltekst i vitenarkiv
• Kan, Zhanna; Søegaard, Erik Ganesh Iyer; Siqveland, Johan; Hussain, Ajmal; Hanssen-Bauer, Ketil & Jensen, Pia [Vis alle 12 forfattere av denne artikkelen] (2022). Coping, Social Support and Loneliness during the COVID-19 Pandemic and Their Effect on Depression and Anxiety: Patients’ Experiences in Community Mental Health Centers in Norway. Healthcare. 10(5). doi: 10.3390/healthcare10050875. Fulltekst i vitenarkiv Vis sammendrag

  Background: Little is known about psychiatric patients’ experiences during the COVID-19 pandemic. The purpose of this study was to investigate associations of coping strategies, social support and loneliness with mental health symptoms among these patients. Methods: We recruited 164 patients from Community Mental Health Centers in June–July 2020. Participants responded to an online questionnaire on corona-related questions, Brief Coping Orientation to Problems Experience, Crisis Support Scale, a 3-item Loneliness Scale, and Hopkins Symptom Checklist-25. We used linear regression models to investigate associations between these and symptoms of depression and anxiety. Results: Almost 51% were aged 31–50 years and 77% were females. Forty-six (28%) participants reported worsened overall mental health due to the pandemic. The reported rates of clinical depression and anxiety were 84% and 76%, respectively. Maladaptive coping was independently associated with both depression and anxiety symptoms. Loneliness was independently associated with depression symptoms. Conclusions: Patients in Community Mental Health Centers in Norway reported high rates of depression and anxiety symptoms. Many of them reported worsening of their mental health due to the pandemic, even at a time when COVID-19 infections and restrictive measures were relatively low. Maladaptive coping strategies and loneliness may be possible explanations for more distress. Keywords: anxiety; depression; COVID-19; coping; Community Mental Health Centers; loneliness; social support

• Pant, Sagun Ballav; Thapa, Suraj Bahadur; Howard, J.; Ojha, SP & Lien, Lars (2022). Mental disorders and Suicidality among Opioid Agonist Treatment service users in Nepal: a cross sectional study. SSM - Mental Health (SSM-MH). 2. doi: 10.1016/j.ssmmh.2022.100165. Fulltekst i vitenarkiv Vis sammendrag

  Background High lifetime prevalence of major mental disorders and suicidality are common among Opioid Agonist Treatment (OAT) service users and impact on the outcomes of OAT programs. Despite the known detrimental effects across personal, social and economic aspects of life these associations and implications remain under-studied in resource poor settings. The aim of this study was to identify common mental disorders among OAT service users in Kathmandu valley and to explore factors associated with lifetime suicidality and major depressive disorder. Methods A cross-sectional study was conducted among 231 participants from five OAT centers in the Kathmandu valley. Participants were administered a semi-structured questionnaire, the Nepalese version of the Kessler 6 Psychological Distress Scale (K6), and the Mini International Neuropsychiatric Interview (M.I.N.I.) 7.0.2. Bivariate and multivariate analyses were employed to identify associations between lifetime suicidality and lifetime major depressive disorder with socio-demographic variables, other mental disorders, and substance use related variables. Results Among OAT service users, 16.5% reported a history of mental disorder and one in four had a Kessler-6 psychological distress score ≥13 within the last four weeks. Using M.I.N.I lifetime suicidality was observed in 26.0% and lifetime major depressive disorder in 24.2%. Lifetime suicidality were significantly higher among participants with lifetime psychotic disorder (AOR ​= ​5.94; 95% CI:1.66, 21.34, p ​= ​0.006), lifetime antisocial personality disorder (AOR ​= ​2.60; 95% CI:1.0, 6.71, p ​= ​0.049) and having a Kessler-6 score ≥13 (AOR ​= ​2.45; 95% CI:1.13, 5.29, p ​= ​0.023). Lifetime major depressive disorder was independently associated with a Kessler-6 score ≥13 (AOR ​= ​5.38; 95% CI:2.49, 11.62, p ​< ​0.001). Conclusion This study revealed a high prevalence of mental disorders and lifetime suicidality among OAT service users. Reviewing initial screening and assessment protocols for OAT, and routine use of brief screening tools to ensure better identification of those at risk is warranted, including suicidality risk assessment.

• Dhungana, Saraswati; Koirala, Rishav; Ojha, Saroj Prasad & Thapa, Suraj (2022). Resilience and its association with post-traumatic stress disorder, anxiety, and depression symptoms in the aftermath of trauma: A cross-sectional study from Nepal. SSM - Mental Health (SSM-MH). 2. doi: 10.1016/j.ssmmh.2022.100135. Fulltekst i vitenarkiv Vis sammendrag

  Background Resilience is a multidimensional construct. Despite its importance as protective against psychiatric disorders, it remains largely unexplored in context of Nepal. We investigated the role of resilience in the development of various psychiatric symptoms as post-traumatic stress disorder, anxiety and depression following trauma in clinical population in a psychiatry outpatient. Methods We interviewed one hundred patients who sought treatment in psychiatry outpatient of Tribhuvan University Teaching Hospital in Kathmandu, Nepal. The sampling strategy was purposive and inclusion criteria were 18–60 years and trauma history. We used the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization, the Post-Traumatic Stress Disorder Checklist-Civilian version to measure the post-traumatic stress disorder symptoms, and the 25-item Hopkins Symptom Checklist-25 to assess the level of anxiety and depression symptoms. We used Nepali adapted resilience scale derived from the original Wagnild and Young Resilience scale to measure resilience. We investigated the associations between resilience scores and the scores on depression, anxiety and post-traumatic stress disorder using bivariate and multivariate analysis. We adjusted for trauma type, socioeconomic status, employment, marital status and gender in the final models. Results Resilience was found to have negative relation with post-traumatic stress disorder, anxiety, and depression symptoms even after adjusting for other important factors in patients with trauma in the final multivariate analysis. Conclusion Resilience was independently and negatively related with symptoms of post-traumatic stress disorder, anxiety, and depression in patients with history of trauma presenting to the hospital. Interventions aiming to promote resilience in trauma patients might be effective in reducing psychiatric symptoms such as stress disorder, anxiety and depression. Prospective studies using more robust measures of resilience combining personal attributes to social support systems, across different settings in trauma population should be the focus of future research.

• Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Aass, Hans Christian Dalsbotten; Koirala, Rishav; Hauff, Edvard & Thapa, Suraj (2022). Abnormal Cytokines in Trauma Patients Explained by Obesity, Musculoskeletal Disease, Smoking, and Lung Disease. Neuropsychobiology. ISSN 0302-282X. 81(6), s. 516–530. doi: 10.1159/000526806. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Low-grade inflammation observed through abnormal plasma cytokine levels has been associated with post-traumatic stress disorder (PTSD). It is not clear whether PTSD independently causes the inflammation or if it is mainly through co-occurring somatic factors such as smoking and obesity. We wanted to explore the effects of biopsychosocial factors on cytokine levels in a clinical setting. Methods: The sample consisted of 51 patients with PTSD, 58 trauma patients without PTSD, and 40 matched controls. We selected cytokines and relevant risk factors for systemic inflammation through pairwise correlations. Then, we used linear regression to analyze the individual and combined effects of these on the (Log10) cytokines, particularly estimating the effect of PTSD adjusted for other factors. Results: Higher age, female gender, cigarette smoking, presence of lung and musculoskeletal disease, use of antipsychotic medication, and higher BMI were correlated with higher levels of interleukins IL-1RA, IL-2RA, and IL-6. In the adjusted regression analysis, higher BMI was associated with increased IL-1RA (B = 0.06, p < 0.01), IL-2RA (B = 0.01, p < 0.01), and IL-6 (B = 0.01, p = 0.03). Presence of musculoskeletal disease was associated with increased IL-1RA (B = 0.72, p < 0.01) and IL-6 (B = 0.16, p = 0.01), and decreased IL-2RA (B = −0.09, p < 0.01). Cigarette smoking (B = 0.16, p = 0.01) and presence of lung disease (B = 0.14, p = 0.02) were associated with increased IL-6. PTSD diagnosis was associated with decreased IL-2RA (B = −0.06, p = 0.04). Discussion/Conclusion: Altered cytokine levels in distressed trauma-affected individuals are probably mostly through co-occurring risk factors and not PTSD diagnosis. Increased BMI and musculoskeletal (pain) disease may be particularly strong risk factors and should be addressed.

• Dhungana, Saraswati; Koirala, Rishav; Ojha, Saroj Prasad & Thapa, Suraj (2022). Association of childhood trauma, and resilience, with quality of life in patients seeking treatment at a psychiatry outpatient: A cross-sectional study from Nepal. PLOS ONE. 17(10), s. 1–13. doi: 10.1371/journal.pone.0275637. Fulltekst i vitenarkiv Vis sammendrag

  Quality of life is defined by the World Health Organization as "Individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". It is a comprehensive measure of health outcome after trauma. Childhood maltreatment is a determinant of poor mental health and quality of life. Resilience, however, is supposed to be protective. Our aim is to examine childhood trauma and resilience in patients visiting psychiatry outpatient and investigate their relations with quality of life. A descriptive cross-sectional study was conducted with a hundred patients with trauma and visiting psychiatry outpatient. Standardized tools were applied to explore childhood trauma, resilience, quality of life and clinical diagnoses and trauma categorization. Sociodemographic and relevant clinical information were obtained with a structured proforma. Bivariate followed by multivariate logistic regressions were conducted to explore the relation between childhood trauma, resilience, and quality of life. Poor quality of life was reported in almost one third of the patients. Upper socioeconomic status, emotional neglect during childhood, current depression and low resilience were the determinants of poor quality of life in bivariate analysis. Final models revealed that emotional neglect during childhood and low resilience had independent associations with poor quality of life. Efforts should be made to minimize childhood maltreatment in general; and explore strategies to build resilience suited to the cultural context to improve quality of life.

• Abraham, Ruth; Leonhardt, Marja; Lien, Lars; Hanssen, Ingrid; Hauff, Edvard & Thapa, Suraj Bahadur (2021). The relationship between religiosity/spirituality and quality of life among female Eritrean refugees living in Norwegian asylum centres. International Journal of Social Psychiatry. ISSN 0020-7640. doi: 10.1177/00207640211010207. Fulltekst i vitenarkiv Vis sammendrag

  Background: Women are more vulnerable to mental health problems than men after migration, but little is known about the influence of religiosity/spirituality on their quality of life. The purpose of this study was to explore religiosity/spirituality, in relationships with various domains of quality of life, among female Eritrean refugees staying in Norwegian asylum centres. Method: A questionnaire assessing sociodemographic characteristics was used together with the World Health OrganizationQuality of Life – Spirituality, Religiosity and Personal Beliefs (WHOQOL-SRPB) questionnaire, which assesses religiosity/spirituality and domains of quality of life. A total of 63 adult female Eritrean refugees who had been granted asylum but were still living in asylum reception centres located in southern and central Norway participated. Results: Religiosity/spirituality was independently associated with psychological quality of life (B = 0.367, p < .001), level of independence (B = 0.184, p = .028), social quality of life (B = 0.500, p = .003), environmental quality of life (B = 0.323, p < .001) and overall quality of life (B = 0.213, p < .001), but not with physical quality of life (B = 0.056, p = .679). There were no significant differences between religious affiliations on religiosity/spirituality or quality of life measures. Conclusion: Consistent with previous research, this study highlights the correlation between religiosity/spirituality and overall quality of life. We recommend a longitudinal follow-up study of similar populations, after they are resettled and integrated into their host countries, to understand the associations between quality of life and religiosity/spirituality over time. Keywords Eritrea, refugees, religiosity, spirituality, quality of life, well-being

• Koirala, Rishav; Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Ojha, Saroj Prasad; Hauff, Edvard & Thapa, Suraj (2021). Exploring complex PTSD in patients visiting a psychiatric outpatient clinic in Kathmandu, Nepal. Journal of Psychiatric Research. ISSN 0022-3956. 143, s. 23–29. doi: 10.1016/j.jpsychires.2021.08.030. Fulltekst i vitenarkiv Vis sammendrag

  Decades of research on trauma patients have shown that a post-traumatic stress disorder (PTSD) diagnosis does not always cover the full spectrum of symptoms after severe trauma. Complex PTSD (CPTSD) was recently introduced in the International Classification of Diseases 11th Revision. There have been no published studies on CPTSD in the South Asian region to date. The objective of this study was to evaluate CPTSD in a sample of trauma patients in Nepal. We also examined quality of life (QOL) and mental health comorbidities and their association with CPTSD caseness. One hundred patients with a history of trauma who visited the outpatient psychiatry clinic at a hospital in Kathmandu from 2017 to 2018 were assessed. The Composite International Diagnostic Interview Version 2.1 was used to evaluate PTSD, major depressive disorder, and generalized anxiety disorder (GAD). Disturbance of self-organization symptoms from the Structured Interview for Disorders of Extreme Stress (SIDES) together with the PTSD diagnosis was used to confirm CPTSD caseness. The World Health Organization (WHO) QOL Scale Brief Version (WHOQOL-BREF) was used to assess QOL in four domains. Among the 83 patients who had PTSD, 42 also had CPTSD. CPTSD was significantly associated with major depressive disorder, GAD, female gender, and lower QOL in all four domains. CPTSD was prevalent among these patients. Having CPTSD was significantly associated with worse outcomes in terms of QOL and comorbid mental disorders, even with similar trauma. There is a need to explore CPTSD symptoms and to address trauma patients with CPTSD in this region.

• Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Koirala, Rishav; Hauff, Edvard & Thapa, Suraj Bahadur (2021). Gender differences in a wide range of trauma symptoms after victimization and accidental traumas: a cross-sectional study in a clinical setting. European Journal of Psychotraumatology. 12(1), s. 1–13. doi: 10.1080/20008198.2021.1975952. Fulltekst i vitenarkiv Vis sammendrag

  Background There are large gender differences in PTSD prevalence. Gender differences in a wide range of trauma symptoms including disturbances in self-organization have not been extensively researched. Objective To explore gender differences in a wide range of trauma symptoms by comparing victimization trauma (VT) with accidental trauma (AT). Method A cross-sectional study of 110 traumatized patients attending a mental health outpatient clinic in Oslo, Norway (38.2% men, Mage = 40.4, 40% ethnic Norwegians). The trauma was categorized as VT or AT based on the Life Events Checklist. The Structured Clinical Interview for DSM-IV-PTSD-module and Structured Interview for Disorders of Extreme Stress Not-Otherwise-Specified (DESNOS) assessed a wide range of trauma symptoms. First, we examined gender differences within the trauma categories, then MANCOVA for an adjusted two-by-two between-groups analysis. Results Among VT patients, men reported more symptoms of alteration of negative self-perception (p = .02, ES = 0.50) and alteration in systems of meaning (p < .01, ES = 1.04). Within the AT group, women reported more symptoms of affect and impulses (p = .01, ES = 0.94). The VT-AT difference was significantly higher in men in intrusion (p < .01, η2 = 0.04), affect and impulses (p < .01, η2 = 0.12), negative self-perception (p < .01, η2 = 0.11), difficulty in relations (p = .01, η2 = 0.10) and alterations in systems of meaning (p = .01, η2 = 0.14). Conclusion: Comparing the VT-AT differences between the genders, men with VT had relatively more symptoms of intrusion, self-organization, identity, ideology/meaning, cognition, and relations difficulties. Effect sizes were moderate to large. Men may be relatively more vulnerable to VT than AT, while women may be more equally affected by VT and AT. Acknowledging possible gender differences in a wider range of trauma symptoms depending on trauma category may have clinical benefits

• Dhungana, Saraswati; Koirala, Rishav; Ojha, Saroj Prasad & Thapa, Suraj Bahadur (2021). Quality of life and its association with psychiatric disorders in outpatients with trauma history in a tertiary hospital in Kathmandu, Nepal: a cross-sectional study. BMC Psychiatry. 21:98, s. 1–11. doi: 10.1186/s12888-021-03104-6. Fulltekst i vitenarkiv Vis sammendrag

  Background Quality of life is an important indicator of health and has multiple dimensions. It is adversely affected in patients with trauma history, and psychiatric disorders play an important role therein. Studies in trauma-affected populations focus mainly on the development of psychiatric disorders. Our study explored various aspects of quality of life in trauma patients in a clinical setting, mainly focusing on the association of psychiatric disorders on various domains of quality of life. Methods One hundred patients seeking help at the psychiatry outpatient of a tertiary hospital in Kathmandu, Nepal, and with history of trauma were interviewed using the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization. Post-traumatic stress disorder symptoms were assessed using the Post-Traumatic Stress Disorder Checklist-Civilian Version; while the level of anxiety and depression symptoms was assessed using the 25-item Hopkins Symptom Checklist-25. Quality of life was assessed using the World Health Organization Quality Of Life-Brief Version measure. Information on sociodemographic and trauma-related variables was collected using a semi-structured interview schedule. The associations between psychiatric disorders and quality of life domains were explored using bivariate analyses followed by multiple regressions. Results The mean scores (standard deviations) for overall quality of life and health status perception were 2.79 (.87) and 2.35 (1.11), respectively. The mean scores for the physical, psychological, social and environmental domains were 12.31 (2.96), 11.46 (2.84), 12.79 (2.89), and 13.36 (1.79), respectively. Natural disaster was the only trauma variable significantly associated with overall quality of life, but not with other domains. Anxiety, depression and post-traumatic stress disorder were all significantly associated with various quality of life domains, where anxiety had the greatest number of associations. Conclusion Quality of life, overall and across domains, was affected in various ways based on the presence of psychiatric disorders such as anxiety, depression and post-traumatic stress disorder in patients with trauma. Our findings therefore emphasize the need to address these disorders in a systematic way to improve the patients’ quality of life.

• Koirala, Rishav; Søegaard, Erik Ganesh Iyer; Ojha, Saroj Prasad; Hauff, Edvard & Thapa, Suraj B. (2020). Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal. PLOS ONE. 15(6), s. e0234203–e0234203. doi: 10.1371/journal.pone.0234203. Fulltekst i vitenarkiv Vis sammendrag

  Background Nepal, like many other low-income countries, has a great burden of mental health issues but few resources to meet them. In addition, Nepal has endured several traumatic events in recent decades but the impact on mental health has not been studied in clinical settings. This study explores trauma-related psychiatric disorders and their correlates. Methods 100 patients with a history of trauma who visited the outpatient psychiatry clinic at a University hospital in Kathmandu were assessed. The Composite International Diagnostic Interview 2.1 (CIDI) was used to evaluate lifetime and current depressive disorder, generalized anxiety disorder (GAD) and lifetime post-traumatic stress disorder (PTSD). Current PTSD was evaluated using PSTD Checklist—Civilian Version (PCL-C). Results The median number of lifetime traumatic events was two. Natural disaster was the most common trauma type (84%) compared to other types of trauma. Rape was reported as the most traumatizing. Current PTSD was found in 15%, depression in 33% and GAD in 38% of the patients. The lifetime rates were PTSD 83%, depression 45% and GAD 40%. There was high comorbidity between the disorders. The 31 to 45 years age group, above high school education level and trauma types other than earthquake were independently associated with current PTSD. Marital status and upper socioeconomic status (SES) compared to upper-middle SES were independently associated with lifetime PTSD. Both lifetime and current depression rates were independently associated with the upper SES compared to upper-middle SES. Place of living, education above high school and lower-middle SES were significantly associated with lifetime and current GAD. Conclusion PTSD, depression and GAD were prevalent in a trauma exposed patient population visiting a psychiatric clinic in Nepal. High rates of comorbidities and several risk factors were identified. Our findings highlight the need for addressing trauma related disorders in clinical settings in developing countries.

• Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Koirala, Rishav; Hauff, Edvard & Thapa, Suraj Bahadur (2020). Variations in psychiatric morbidity between traumatized Norwegian, refugees and other immigrant patients in Oslo. Nordic Journal of Psychiatry. ISSN 0803-9488. 74(6), s. 390–399. doi: 10.1080/08039488.2020.1714724. Fulltekst i vitenarkiv Vis sammendrag

  Background: There is a lack of clinical studies that focus on different psychiatric disorders after trauma and the relationship with migration status. Purpose: To examine differences in psychiatric morbidity in traumatized patients referred to psychiatric treatment in Southern Oslo. Materials and methods: Hundred and ten patients with trauma background attending an outpatient clinic in Southern Oslo were studied. Forty-four of the participants (40%) were ethnic Norwegians, 25 (22.7%) had refugee background and 41 (37.3%) were first- or second-generation immigrants without refugee background. Thorough diagnostic assessment was done by experienced psychiatrists through several structured clinical interviews and self-report questionnaires. Results: Ninety-eight patients (89%) were diagnosed with at least one Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) disorder. There was a clear difference in the presentation of certain psychiatric disorders between the groups. Ethnic Norwegian patients were more likely to have anxiety disorders: agoraphobia, social phobia and panic disorder than non-refugee immigrant patients. They also had higher rates of alcohol abuse/dependence. Somatoform pain disorder was more common in both the refugee and other-immigrant groups than among the ethnic Norwegian patients. The refugee patients had significantly more major depressive disorder, post-traumatic stress disorder (PTSD) and both co-occurring. Conclusion: Trauma is frequently associated with depression, anxiety disorders, somatoform pain disorder and PTSD in a clinical population. The clinical presentation and comorbidity of these disorders seem to vary significantly between traumatized patients with Norwegian, refugee and non-refugee immigrant backgrounds. After a major trauma, refugees may be at greater risk for both PTSD and depression than other immigrants and the native population.

• Koirala, Rishav; Søegaard, Erik Ganesh Iyer & Thapa, Suraj Bahadur (2017). Updates on pharmacological treatment of post-traumatic stress disorder. Journal of Nepal Medical Association. ISSN 0028-2715. 56(206), s. 274–280. doi: 10.31729/jnma.3108. Fulltekst i vitenarkiv Vis sammendrag

  Post-Traumatic Stress Disorder affects a significant proportion of those who have been exposed to exceptionally threatening or catastrophic events or situations such as earthquakes, rape and civil war. The condition can often become chronic and disabling. Medical intervention can therefore be of paramount importance. There are no national guidelines for trauma disorders in Nepal and there is a lack of adequate knowledge regarding drug treatment of PTSD among doctors and other service providers. Though psychotherapy is internationally regarded as the first line treatment for PTSD, it is often not feasible in Nepal due to lack of resources and skilled health workers in this field. The use of right psycho-pharmacotherapy is therefore important to reduce the burden of disease. A wide range of pharmacotherapy has been tested in the treatment of PTSD. This article is based on a selected sample of relevant articles from PubMed, PsycINFO, national guidelines from other countries and our own clinical experience. We have tried to give a concise and practical review regarding the use of drugs, their side effects and available evidence in the treatment of PTSD. The main findings point to use of Selective Serotonin Reuptake Inhibitors as the first line pharmacotherapy, and they can have effect on the full range of symptoms in PTSD. SNRIs show similar efficacy. Adjuvant drugs like Alpha-blockers and atypical antipsychotics have shown strong evidence in treating partially remitted cases and resolving ancillary symptoms.

• Thapa, Suraj Bahadur; Martinez, Priscilla & Clausen, Thomas (2014). Depression and its correlates in South Africa and Ghana among people aged 50 and above: Findings from the WHO Study on global AGEing and adult health. African Journal of Psychiatry. ISSN 1994-8220. 17(6). doi: 10.4172/Psychiatry.1000167. Fulltekst i vitenarkiv
• Luitel, Nagendra P.; Jordans, Mark J.D.; Sapkota, Ram P.; Tol, Wietse A.; Kohrt, Brandon A. & Thapa, Suraj Bahadur [Vis alle 8 forfattere av denne artikkelen] (2013). Conflict and mental health: a cross-sectional epidemiological study in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 48(2), s. 183–193. doi: 10.1007/s00127-012-0539-0. Fulltekst i vitenarkiv
• Thapa, Suraj Bahadur & Hauff, Edvard (2012). Perceived needs, self-reported health and disability among displaced persons during an armed conflict in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 47(4), s. 589–595. doi: 10.1007/s00127-011-0359-7. Fulltekst i vitenarkiv
• Kohrt, Brandon A.; Hruschka, Daniel J.; Worthman, Carol M.; Kunz, Richard D.; Baldwin, Jennifer L. & Upadhaya, Nawaraj [Vis alle 14 forfattere av denne artikkelen] (2012). Political violence and mental health in Nepal: prospective study. British Journal of Psychiatry. ISSN 0007-1250. 201(4), s. 268–275. doi: 10.1192/bjp.bp.111.096222. Fulltekst i vitenarkiv
• Thapa, Suraj Bahadur & Hauff, Edvard (2011). Perceived needs, self-reported health and disibility among displaced persons during an armed conflict in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. s. 359–359. doi: 10.1007/s00127-011-0359-7. Fulltekst i vitenarkiv
• Lien, Lars; Thapa, Suraj Bahadur; Rove, Jon Andreas; Kumar, Bernadette. N & Hauff, Edvard (2010). Premigration Traumatic Events and Psychological Distress Among Five Immigrant Groups. International Journal of Mental Health. ISSN 0020-7411. 39(3), s. 3–19. doi: 10.2753/IMH0020-7411390301. Fulltekst i vitenarkiv
• Tol, Wietse A.; Kohrt, Brandon A.; Jordans, Mark J.D.; Thapa, Suraj Bahadur; Pettigrew, Judith & Upadhaya, Nawaraj [Vis alle 7 forfattere av denne artikkelen] (2010). Political violence and mental health: A multi-disciplinary review of the literature on Nepal. Social Science and Medicine. ISSN 0277-9536. 70(1), s. 35–44. doi: 10.1016/j.socscimed.2009.09.037. Fulltekst i vitenarkiv
• Tol, WA; Komproe, IH; Jordans, MJD; Thapa, Suraj Bahadur; Sharma, B & Jong, JTVM De (2009). BRIEF MULTI-DISCIPLINARY TREATMENT FOR TORTURE SURVIVORS IN NEPAL: A NATURALISTIC COMPARATIVE STUDY. International Journal of Social Psychiatry. ISSN 0020-7640. 55(1), s. 39–56. doi: 10.1177/0020764008091525. Fulltekst i vitenarkiv
• Tol, WA; Komproe, IH; Thapa, Suraj Bahadur; Jordans, MJD; Sharma, B & Jong, JTVM De (2007). Disability associated with psychiatric symptoms among torture survivors in rural Nepal. Journal of Nervous and Mental Disease. ISSN 0022-3018. 195. doi: 10.1097/NMD.0b013e31802f5dac. Fulltekst i vitenarkiv
• Dalgard, Odd Steffen; Suraj, Bahadur Thapa; Hauff, Edvard; McCubbin, Michael & Syed, Hammad Raza Zaidi (2006). Immigration, lack of control and psychological distress: Findings from the Oslo Health Study. Scandinavian Journal of Psychology. ISSN 0036-5564. 47, s. 551–558. Fulltekst i vitenarkiv
• Suraj, Bahadur Thapa & Hauff, Edvard (2005). Gender differences in factors associated with psychological distress among immigrants from low- and middle-income countries - Findings from the Oslo Health Study. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 40. Fulltekst i vitenarkiv
• Suraj, Bahadur Thapa & Hauff, Edvard (2005). Psychological distress among displaced persons during an armed conflict in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 40(6). Fulltekst i vitenarkiv
• Thapa, Suraj Bahadur; Ommeren, Mark Van; Sharma, Bhogendra; Jong, JTVM de & Hauff, Edvard (2003). Psychiatric disability among Bhutanese refugees. American Journal of Psychiatry. ISSN 0002-953X. 160, s. 2032–2037. Fulltekst i vitenarkiv
• Ommeren, Mark Van; Jong, JTVM de; Sharma, B; Komproe, I; Thapa, Suraj Bahadur & Carden, E (2001). Psychiatric disorders among tortured refugees in Nepal. 2001. Archives of General Psychiatry. ISSN 0003-990X. s. 475–482. Fulltekst i vitenarkiv
• Thapa, Suraj Bahadur; Ommeren, Mark Van; Sharma, B; Makaju, R & Jong, JTVM de (2000). Limited cultural validity of Composite International Diagnostic Interview's proble flow chart. Transcultural Psychiatry. ISSN 1363-4615. 37, s. 123–134. Fulltekst i vitenarkiv
• Ommeren, M Van; Sharma, B; Thapa, Suraj Bahadur; Makaju, R; Prasain, D & Bhattarai, R [Vis alle 7 forfattere av denne artikkelen] (1999). Preparing instruments for transcultural research: use of the translation monitoring form with Nepali speaking Bhutanese refugees. Transcultural Psychiatry. ISSN 1363-4615. 36, s. 285–301. Fulltekst i vitenarkiv

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• 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. Fulltekst i vitenarkiv
• Sapkota, Dipak; Thapa, Suraj Bahadur; Hasseus, Bengt & Jensen, Janicke Liaaen (2020). Saliva testing for COVID-19? British Dental Journal. ISSN 0007-0610. doi: 10.1038/s41415-020-1594-7. Fulltekst i vitenarkiv
• Thapa, Suraj; Mainali, Anustha; Schwank, Simone E. & Acharya, Ganesh (2020). Maternal mental health in the time of the COVID-19 pandemic. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 99(7), s. 817–818. doi: 10.1111/aogs.13894. Fulltekst i vitenarkiv
• Thapa, Suraj Bahadur & Acharya, Ganesh (2017). Women's health is not in focus in disaster zones: lessons from the Nepal earthquake. Journal of family planning and reproductive health care. ISSN 1471-1893. 43(2), s. 92–93. doi: 10.1136/jfprhc-2016-101605. Fulltekst i vitenarkiv
• Preljevic, Valjbona T. & Thapa, Suraj Bahadur (2014). Tverkulturelle forhold, Psykiske reaksjoner ved somatisk sykdom. Cappelen Damm Akademisk. ISSN 9788202418786. s. 89–106. Fulltekst i vitenarkiv
• Patel, Vikram; Sumathipala, Athula; Khan, MM & Thapa, Suraj Bahadur (2007). South Asia. I Bhui, Kamaldeep & Bhugra, Dinesh (Red.), Culture and mental health: a comprehensive textbook. CRC Press. ISSN 9780340810460. s. 212–224. Fulltekst i vitenarkiv
• Haune, Monica Christine; Heiervang, Einar Røshol; Thapa, Suraj Bahadur; Christiansen, Øivin & Haavind, Hanne (2026). A Call to Care: An Evaluation of a Multi-Disciplinary Health Assessment for Children in Out-of-Home Care, Exploring Needs, Service Utilization and Experiences. Universitetet i Oslo. ISSN 9788234807770. Fulltekst i vitenarkiv Vis sammendrag

  Children in out-of-home care often have complex physical and mental health needs, many of which remain undetected upon entering care. This PhD thesis, conducted at the Unit for Child and Adolescent Psychiatry, evaluated a multi-disciplinary health assessment in Norway. examining needs, subsequent service use, and user experiences. The assessment included 196 children aged 0-17 years. The thesis combines quantitative data on mental health and service needs, a 12-month follow-up survey of 103 children, and qualitative interviews with 9 adolescents and 12 foster carers. Findings revealed extensive and multifaceted needs. Mental disorders were highly prevalent (50% of children 0-6 years; 70% of children 7-17 years). Overall, 92% were recommended support from services beyond child welfare, and 39% of younger and 71% of older children required help from three or more services. Yet, follow-up data showed substantial gaps in service provision. Only one third of children needing specialized somatic or mental health services had been in contact with these services one year later. User experience indicated high trust in the assessment team. The children emphasized the importance of being seen and heard in a safe environment, while foster carers valued being involved and having the opportunity to provide and receive information. Both groups expressed concern that recommendations might not be followed – a concern largely confirmed by follow-up findings. The discrepancy between identified needs and actual service provision highlights challenges in referral practices and interagency collaboration. Without systematic follow-up of recommendations, the potential benefits of health assessments may be lost. Strengthening referral routines and monitoring adherence to recommendations is essential to ensure that identifying needs translate into support. The findings are important for enhancing health assessment practices and informing service development for children in out-of-home care.

• Suraj, Bahadur Thapa (2006). Population based studies of mental health among migrants in Nepal and Norway: migration and adversity in different contexts. Universitetet i Oslo. ISSN 9788280801852. Fulltekst i vitenarkiv

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